{ "schema": "openbill.drugs/3", "sources": { "nadac": { "name": "CMS NADAC", "title": "NADAC (National Average Drug Acquisition Cost) 2026", "publisher": "data.medicaid.gov", "license": "https://www.usa.gov/publicdomain/label/1.0/", "source_url": "https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704", "download_url": "https://download.medicaid.gov/data/nadac-national-average-drug-acquisition-cost-20261014.csv", "source_file": "nadac-national-average-drug-acquisition-cost-20261014.csv", "sha256": "15335686bbc0ab0d1d0e9392ff7c0b8341b64674741589dbed27aed61fb634ff", "bytes": 107347500, "period": null, "as_of_date": "2026-10-14", "retrieved_date": "2026-10-17", "weeks_in_file": 41 }, "fda_ndc": { "name": "FDA NDC Directory", "title": "National Drug Code Directory (NDC database file, text version)", "publisher": "U.S. Food and Drug Administration (FDA), Center for Drug Evaluation and Research", "license": "https://www.fda.gov/about-fda/about-website/website-policies", "source_url": "https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory", "download_url": "https://www.accessdata.fda.gov/cder/ndctext.zip", "source_file": "ndctext.zip", "sha256": "ee609cef6e4e4393959fc0f5a46a6f7a1c62f2a025a3721100b6653479a5a778", "bytes": 10865102, "period": null, "as_of_date": "2026-10-16", "retrieved_date": "2026-10-17", "products": 116607, "packages": 219166 }, "partd": { "name": "Medicare Part D", "title": "Medicare Part D Spending by Drug, data year 2024", "publisher": "Centers for Medicare & Medicaid Services (CMS), Office of Enterprise Data and Analytics (OEDA)", "license": "https://www.usa.gov/government-works", "source_url": "https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug", "download_url": "https://data.cms.gov/sites/default/files/2026-06/98218f98-166c-4723-8438-c344a4ef96a6/DSD_PTD_RY26_P04_V10_DY24_BGM.csv", "source_file": "DSD_PTD_RY26_P04_V10_DY24_BGM.csv", "sha256": "5dcc9d7bd7d7f88d9f6b24485c06d961ed6d70f9aa6deffa50dd47a6854c2a55", "bytes": 5326806, "period": "2024-01-01/2024-12-31", "as_of_date": "2026-06-25", "retrieved_date": "2026-10-18", "data_year": 2024, "data_dictionary_url": "https://data.cms.gov/sites/default/files/2026-06/Medicare%20Part%20D%20Spending%20by%20Drug%20Data%20Dictionary%2020260603_508.pdf", "methodology_url": "https://data.cms.gov/sites/default/files/2026-06/d7e0a571-9d08-40ec-8278-1b2300f59424/DSD_PTD_RY26_20260603_Methodology_WDDSE_508.pdf" }, "asp_limits": { "name": "Medicare Part B", "title": "October 2026 Medicare Part B Payment Limit Files", "publisher": "Centers for Medicare & Medicaid Services (CMS)", "license": "https://www.usa.gov/government-copyright", "source_url": "https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files", "download_url": "https://www.cms.gov/files/zip/october-2026-medicare-part-b-payment-limit-files-final.zip", "source_file": "october-2026-medicare-part-b-payment-limit-files-final.zip", "sha256": "a9b7afa80aae96c43cf84bf0b18648f1974429de2913e2e29d8342747174c417", "bytes": 85594, "period": "2026-10-01/2026-12-31", "as_of_date": "2026-09-17", "retrieved_date": "2026-10-18", "member": "section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csv" }, "asp_crosswalk": { "name": "Medicare Part B crosswalk", "title": "October 2026 NDC-HCPCS Crosswalk", "publisher": "Centers for Medicare & Medicaid Services (CMS)", "license": "https://www.usa.gov/government-copyright", "source_url": "https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files", "download_url": "https://www.cms.gov/files/zip/october-2026-ndc-hcpcs-crosswalk-final.zip", "source_file": "october-2026-ndc-hcpcs-crosswalk-final.zip", "sha256": "e6bbf7c61e6d8bbbe83cac1272772ef7e5ff2ff2dc7029a75eede77201ef5ab1", "bytes": 426375, "period": "2026-10-01/2026-12-31", "as_of_date": "2026-09-17", "retrieved_date": "2026-10-18", "member": "section 508 version of October 2026 ASP NDC-HCPCS Crosswalk 091126.csv" } }, "counts": { "rows": 30031, "rows_by_state": { "filed": 30031 }, "records_by_state": { "filed": 38503 }, "distinct_names": 5936, "identity_matched": 27083, "identity_ambiguous": 0, "identity_with_pharm_classes": 24902, "identity_pharm_classes_ambiguous": 0, "epc_classes": 329, "part_d_matched": 19277, "part_d_by_basis": { "brand": 2166, "generic": 17111 }, "part_d_by_join": { "generic_name": 1299, "name": 17978 }, "part_d_by_rate_class": { "B": { "rows": 2240, "matched": 1599 }, "B-ANDA": { "rows": 89, "matched": 54 }, "B-BIO": { "rows": 33, "matched": 15 }, "G": { "rows": 27669, "matched": 17609 } }, "part_d_otc": { "rows": 2611, "matched": 10 }, "part_d_outliers": 742, "part_d_outlier_flag_blank": 1, "part_d_multiple_routes": 2154, "part_d_fda_by_product_code": { "rows": 2035, "matched": 1385 }, "part_d_route_from_product_code": { "rows": 263, "joined": 146, "not_joined": { "mixed_units": 58, "multi_route_minority": 55, "multi_route_tie": 4 } }, "part_d_unmatched": { "mixed_units": 2739, "no_generic_name": 2040, "ambiguous_name": 1625, "otc_monograph": 1320, "otc_no_exact_name": 1019, "multi_route_minority": 501, "generic_name_disagrees": 323, "no_brand_name": 303, "release_form_conflict": 296, "ambiguous_salt": 175, "otc_generic_name": 152, "ambiguous_generic": 108, "multi_route_no_identity": 108, "multi_route_tie": 44, "ambiguous_presentation": 1 }, "part_b_matched": 1427, "part_b_unit_reconciled": 1338, "part_b_unit_reconciled_by": { "fda_amount": 1289, "kit": 32, "strength_check": 17 }, "part_b_unmatched": { "not_in_crosswalk": 28587, "ambiguous_crosswalk": 17 }, "part_d_names": 1458, "part_b_codes": 138, "part_b_single_labeler_codes": 36, "carried_forward": 955, "with_generic_nadac": 999, "rejected": 0, "duplicate_ndcs": 0 }, "part_d_names": { "Abacavir-Lamivudine|Abacavir Sulfate/Lamivudine":{"brand_name":"Abacavir-Lamivudine","generic_name":"Abacavir Sulfate/Lamivudine","avg_per_unit":{"value":7.9588223844,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Abacavir-Lamivudine / Abacavir Sulfate/Lamivudine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":17348,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Abacavir-Lamivudine / Abacavir Sulfate/Lamivudine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Abacavir|Abacavir Sulfate":{"brand_name":"Abacavir","generic_name":"Abacavir Sulfate","avg_per_unit":{"value":2.4243778651,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Abacavir / Abacavir Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16306,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Abacavir / Abacavir Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Abilify Asimtufii|Aripiprazole":{"brand_name":"Abilify Asimtufii","generic_name":"Aripiprazole","avg_per_unit":{"value":1764.2364197,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Abilify Asimtufii / Aripiprazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":11621,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Abilify Asimtufii / Aripiprazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Abilify|Aripiprazole":{"brand_name":"Abilify","generic_name":"Aripiprazole","avg_per_unit":{"value":22.526569107,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Abilify / Aripiprazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7139,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Abilify / Aripiprazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Abiraterone Acetate|Abiraterone Acetate":{"brand_name":"Abiraterone Acetate","generic_name":"Abiraterone Acetate","avg_per_unit":{"value":22.109611142,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Abiraterone Acetate / Abiraterone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":389368,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Abiraterone Acetate / Abiraterone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Absorica Ld|Isotretinoin, Micronized":{"brand_name":"Absorica Ld","generic_name":"Isotretinoin, Micronized","avg_per_unit":{"value":42.312592262,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Absorica Ld / Isotretinoin, Micronized: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Absorica Ld / Isotretinoin, Micronized, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Absorica|Isotretinoin":{"brand_name":"Absorica","generic_name":"Isotretinoin","avg_per_unit":{"value":36.413263889,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Absorica / Isotretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":24,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Absorica / Isotretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Acamprosate Calcium|Acamprosate Calcium":{"brand_name":"Acamprosate Calcium","generic_name":"Acamprosate Calcium","avg_per_unit":{"value":0.7578741915,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acamprosate Calcium / Acamprosate Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":51736,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acamprosate Calcium / Acamprosate Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acarbose|Acarbose":{"brand_name":"Acarbose","generic_name":"Acarbose","avg_per_unit":{"value":0.2246814797,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acarbose / Acarbose: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":174820,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acarbose / Acarbose, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acebutolol HCl|Acebutolol HCl":{"brand_name":"Acebutolol HCl","generic_name":"Acebutolol HCl","avg_per_unit":{"value":0.5166833907,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acebutolol HCl / Acebutolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":75741,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acebutolol HCl / Acebutolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acetazolamide ER|Acetazolamide":{"brand_name":"Acetazolamide ER","generic_name":"Acetazolamide","avg_per_unit":{"value":0.772808764,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acetazolamide ER / Acetazolamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":87073,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acetazolamide ER / Acetazolamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acetazolamide|Acetazolamide":{"brand_name":"Acetazolamide","generic_name":"Acetazolamide","avg_per_unit":{"value":0.6079037446,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acetazolamide / Acetazolamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":246007,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acetazolamide / Acetazolamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acetic Acid*|Acetic Acid":{"brand_name":"Acetic Acid*","generic_name":"Acetic Acid","avg_per_unit":{"value":0.7486241463,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acetic Acid* / Acetic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 2 NADAC NDCs the name join matched to it have an FDA route including AURICULAR (OTIC).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":85824,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acetic Acid* / Acetic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acetylcysteine*|Acetylcysteine":{"brand_name":"Acetylcysteine*","generic_name":"Acetylcysteine","avg_per_unit":{"value":0.9435981404,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acetylcysteine* / Acetylcysteine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 18 NADAC NDCs the name join matched to it have an FDA route including RESPIRATORY (INHALATION). 2 of the 18 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":20730,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acetylcysteine* / Acetylcysteine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acitretin|Acitretin":{"brand_name":"Acitretin","generic_name":"Acitretin","avg_per_unit":{"value":7.4634127782,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acitretin / Acitretin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":45250,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acitretin / Acitretin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Actemra Actpen|Tocilizumab":{"brand_name":"Actemra Actpen","generic_name":"Tocilizumab","avg_per_unit":{"value":1291.6012379,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Actemra Actpen / Tocilizumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":56900,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Actemra Actpen / Tocilizumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Actonel|Risedronate Sodium":{"brand_name":"Actonel","generic_name":"Risedronate Sodium","avg_per_unit":{"value":171.24788259,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Actonel / Risedronate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1426,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Actonel / Risedronate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Acular Ls|Ketorolac Tromethamine":{"brand_name":"Acular Ls","generic_name":"Ketorolac Tromethamine","avg_per_unit":{"value":45.978304348,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Acular Ls / Ketorolac Tromethamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":74,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Acular Ls / Ketorolac Tromethamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Adalimumab-Aaty(Cf) Autoinj(2)|Adalimumab-Aaty":{"brand_name":"Adalimumab-Aaty(Cf) Autoinj(2)","generic_name":"Adalimumab-Aaty","avg_per_unit":{"value":987.6202381,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adalimumab-Aaty(Cf) Autoinj(2) / Adalimumab-Aaty: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adalimumab-Aaty(Cf) Autoinj(2) / Adalimumab-Aaty, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide":{"brand_name":"Adapalene-Benzoyl Peroxide","generic_name":"Adapalene/Benzoyl Peroxide","avg_per_unit":{"value":1.8486632524,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adapalene-Benzoyl Peroxide / Adapalene/Benzoyl Peroxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":2006,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adapalene-Benzoyl Peroxide / Adapalene/Benzoyl Peroxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Adapalene|Adapalene":{"brand_name":"Adapalene","generic_name":"Adapalene","avg_per_unit":{"value":2.9795046255,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adapalene / Adapalene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":9624,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adapalene / Adapalene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Adderall XR|Dextroamphetamine/Amphetamine":{"brand_name":"Adderall XR","generic_name":"Dextroamphetamine/Amphetamine","avg_per_unit":{"value":6.936622779,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adderall XR / Dextroamphetamine/Amphetamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39181,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adderall XR / Dextroamphetamine/Amphetamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Adderall|Dextroamphetamine/Amphetamine":{"brand_name":"Adderall","generic_name":"Dextroamphetamine/Amphetamine","avg_per_unit":{"value":10.426741136,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adderall / Dextroamphetamine/Amphetamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13734,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adderall / Dextroamphetamine/Amphetamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Adefovir Dipivoxil|Adefovir Dipivoxil":{"brand_name":"Adefovir Dipivoxil","generic_name":"Adefovir Dipivoxil","avg_per_unit":{"value":21.420971061,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adefovir Dipivoxil / Adefovir Dipivoxil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2545,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adefovir Dipivoxil / Adefovir Dipivoxil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Admelog|Insulin Lispro":{"brand_name":"Admelog","generic_name":"Insulin Lispro","avg_per_unit":{"value":9.77619697,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Admelog / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":46508,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Admelog / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Adrenalin|Epinephrine":{"brand_name":"Adrenalin","generic_name":"Epinephrine","avg_per_unit":{"value":13.744945388,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adrenalin / Epinephrine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2931,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adrenalin / Epinephrine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Advair Diskus|Fluticasone Propion/Salmeterol":{"brand_name":"Advair Diskus","generic_name":"Fluticasone Propion/Salmeterol","avg_per_unit":{"value":3.261556082,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Advair Diskus / Fluticasone Propion/Salmeterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":268262,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Advair Diskus / Fluticasone Propion/Salmeterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Advair HFA|Fluticasone Propion/Salmeterol":{"brand_name":"Advair HFA","generic_name":"Fluticasone Propion/Salmeterol","avg_per_unit":{"value":28.713283272,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Advair HFA / Fluticasone Propion/Salmeterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":715505,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Advair HFA / Fluticasone Propion/Salmeterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Adzenys XR-ODT|Amphetamine":{"brand_name":"Adzenys XR-ODT","generic_name":"Amphetamine","avg_per_unit":{"value":16.147754706,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Adzenys XR-ODT / Amphetamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2030,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Adzenys XR-ODT / Amphetamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Afrezza|Insulin Regular, Human":{"brand_name":"Afrezza","generic_name":"Insulin Regular, Human","avg_per_unit":{"value":8.9819693392,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Afrezza / Insulin Regular, Human: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13165,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Afrezza / Insulin Regular, Human, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Airsupra|Albuterol Sulfate/Budesonide":{"brand_name":"Airsupra","generic_name":"Albuterol Sulfate/Budesonide","avg_per_unit":{"value":43.555756709,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Airsupra / Albuterol Sulfate/Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":46082,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Airsupra / Albuterol Sulfate/Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ajovy Autoinjector|Fremanezumab-Vfrm":{"brand_name":"Ajovy Autoinjector","generic_name":"Fremanezumab-Vfrm","avg_per_unit":{"value":454.6061768,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ajovy Autoinjector / Fremanezumab-Vfrm: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":89892,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ajovy Autoinjector / Fremanezumab-Vfrm, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ajovy Syringe|Fremanezumab-Vfrm":{"brand_name":"Ajovy Syringe","generic_name":"Fremanezumab-Vfrm","avg_per_unit":{"value":471.62941082,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ajovy Syringe / Fremanezumab-Vfrm: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":26083,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ajovy Syringe / Fremanezumab-Vfrm, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aklief|Trifarotene":{"brand_name":"Aklief","generic_name":"Trifarotene","avg_per_unit":{"value":15.178716374,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aklief / Trifarotene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":373,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aklief / Trifarotene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Albendazole|Albendazole":{"brand_name":"Albendazole","generic_name":"Albendazole","avg_per_unit":{"value":31.873216839,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Albendazole / Albendazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12458,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Albendazole / Albendazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Albuterol Sulfate HFA|Albuterol Sulfate":{"brand_name":"Albuterol Sulfate HFA","generic_name":"Albuterol Sulfate","avg_per_unit":{"value":2.3873380481,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Albuterol Sulfate HFA / Albuterol Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":18591605,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Albuterol Sulfate HFA / Albuterol Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alclometasone Dipropionate|Alclometasone Dipropionate":{"brand_name":"Alclometasone Dipropionate","generic_name":"Alclometasone Dipropionate","avg_per_unit":{"value":0.9332774818,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alclometasone Dipropionate / Alclometasone Dipropionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":45637,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alclometasone Dipropionate / Alclometasone Dipropionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alendronate Sodium|Alendronate Sodium":{"brand_name":"Alendronate Sodium","generic_name":"Alendronate Sodium","avg_per_unit":{"value":0.8521784802,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alendronate Sodium / Alendronate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 19 of 21 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8814023,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alendronate Sodium / Alendronate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alfuzosin HCl ER|Alfuzosin HCl":{"brand_name":"Alfuzosin HCl ER","generic_name":"Alfuzosin HCl","avg_per_unit":{"value":0.298574906,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alfuzosin HCl ER / Alfuzosin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1095800,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alfuzosin HCl ER / Alfuzosin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aliskiren|Aliskiren Hemifumarate":{"brand_name":"Aliskiren","generic_name":"Aliskiren Hemifumarate","avg_per_unit":{"value":4.3561777491,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aliskiren / Aliskiren Hemifumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":29887,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aliskiren / Aliskiren Hemifumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Allopurinol|Allopurinol":{"brand_name":"Allopurinol","generic_name":"Allopurinol","avg_per_unit":{"value":0.1286295063,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Allopurinol / Allopurinol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9710041,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Allopurinol / Allopurinol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Almotriptan Malate|Almotriptan Malate":{"brand_name":"Almotriptan Malate","generic_name":"Almotriptan Malate","avg_per_unit":{"value":18.592667301,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Almotriptan Malate / Almotriptan Malate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5489,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Almotriptan Malate / Almotriptan Malate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alogliptin-Metformin|Alogliptin Benz/Metformin HCl":{"brand_name":"Alogliptin-Metformin","generic_name":"Alogliptin Benz/Metformin HCl","avg_per_unit":{"value":2.6115531276,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alogliptin-Metformin / Alogliptin Benz/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6563,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alogliptin-Metformin / Alogliptin Benz/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alogliptin-Pioglitazone|Alogliptin Benz/Pioglitazone":{"brand_name":"Alogliptin-Pioglitazone","generic_name":"Alogliptin Benz/Pioglitazone","avg_per_unit":{"value":5.1448953036,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alogliptin-Pioglitazone / Alogliptin Benz/Pioglitazone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1377,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alogliptin-Pioglitazone / Alogliptin Benz/Pioglitazone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alogliptin|Alogliptin Benzoate":{"brand_name":"Alogliptin","generic_name":"Alogliptin Benzoate","avg_per_unit":{"value":5.3179214688,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alogliptin / Alogliptin Benzoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":76792,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alogliptin / Alogliptin Benzoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alosetron HCl|Alosetron HCl":{"brand_name":"Alosetron HCl","generic_name":"Alosetron HCl","avg_per_unit":{"value":10.994679114,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alosetron HCl / Alosetron HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12900,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alosetron HCl / Alosetron HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alphagan P|Brimonidine Tartrate":{"brand_name":"Alphagan P","generic_name":"Brimonidine Tartrate","avg_per_unit":{"value":37.441910116,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alphagan P / Brimonidine Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":256839,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alphagan P / Brimonidine Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alprazolam ER|Alprazolam":{"brand_name":"Alprazolam ER","generic_name":"Alprazolam","avg_per_unit":{"value":0.7041234107,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alprazolam ER / Alprazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":55629,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alprazolam ER / Alprazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alprazolam ODT|Alprazolam":{"brand_name":"Alprazolam ODT","generic_name":"Alprazolam","avg_per_unit":{"value":1.2082521154,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alprazolam ODT / Alprazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8884,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alprazolam ODT / Alprazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alprazolam XR|Alprazolam":{"brand_name":"Alprazolam XR","generic_name":"Alprazolam","avg_per_unit":{"value":0.6270029864,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alprazolam XR / Alprazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16776,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alprazolam XR / Alprazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alprazolam|Alprazolam":{"brand_name":"Alprazolam","generic_name":"Alprazolam","avg_per_unit":{"value":0.0914609179,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alprazolam / Alprazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11609703,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alprazolam / Alprazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alrex|Loteprednol Etabonate":{"brand_name":"Alrex","generic_name":"Loteprednol Etabonate","avg_per_unit":{"value":55.825276921,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alrex / Loteprednol Etabonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":16908,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alrex / Loteprednol Etabonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Altavera|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Altavera","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.350779524,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Altavera / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2999,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Altavera / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alvesco|Ciclesonide":{"brand_name":"Alvesco","generic_name":"Ciclesonide","avg_per_unit":{"value":12.837658575,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alvesco / Ciclesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":217395,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alvesco / Ciclesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Alyacen|Norethindrone-Ethin. Estradiol":{"brand_name":"Alyacen","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.4889113647,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alyacen / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3963,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alyacen / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Alyq|Tadalafil":{"brand_name":"Alyq","generic_name":"Tadalafil","avg_per_unit":{"value":17.341980928,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Alyq / Tadalafil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":618,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Alyq / Tadalafil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ambien Cr|Zolpidem Tartrate":{"brand_name":"Ambien Cr","generic_name":"Zolpidem Tartrate","avg_per_unit":{"value":20.495141325,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ambien Cr / Zolpidem Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7083,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ambien Cr / Zolpidem Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ambien|Zolpidem Tartrate":{"brand_name":"Ambien","generic_name":"Zolpidem Tartrate","avg_per_unit":{"value":20.682170697,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ambien / Zolpidem Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13186,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ambien / Zolpidem Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ambrisentan|Ambrisentan":{"brand_name":"Ambrisentan","generic_name":"Ambrisentan","avg_per_unit":{"value":99.237420337,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ambrisentan / Ambrisentan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":58711,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ambrisentan / Ambrisentan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amcinonide|Amcinonide":{"brand_name":"Amcinonide","generic_name":"Amcinonide","avg_per_unit":{"value":23.404663756,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amcinonide / Amcinonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":2328,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amcinonide / Amcinonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amethyst|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Amethyst","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":1.3064759127,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amethyst / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":499,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amethyst / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amikacin Sulfate|Amikacin Sulfate":{"brand_name":"Amikacin Sulfate","generic_name":"Amikacin Sulfate","avg_per_unit":{"value":1.358849621,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amikacin Sulfate / Amikacin Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":12540,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amikacin Sulfate / Amikacin Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amiloride HCl|Amiloride HCl":{"brand_name":"Amiloride HCl","generic_name":"Amiloride HCl","avg_per_unit":{"value":0.1960979956,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amiloride HCl / Amiloride HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":112602,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amiloride HCl / Amiloride HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amiloride-Hydrochlorothiazide|Amiloride/Hydrochlorothiazide":{"brand_name":"Amiloride-Hydrochlorothiazide","generic_name":"Amiloride/Hydrochlorothiazide","avg_per_unit":{"value":0.4676954842,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amiloride-Hydrochlorothiazide / Amiloride/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":34882,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amiloride-Hydrochlorothiazide / Amiloride/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amiodarone HCl*|Amiodarone HCl":{"brand_name":"Amiodarone HCl*","generic_name":"Amiodarone HCl","avg_per_unit":{"value":0.416368256,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amiodarone HCl* / Amiodarone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (27 of the 29 the name join matched); NDCs of another route or with no known FDA route do not. 2 of the 27 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 27 of 29 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3102724,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amiodarone HCl* / Amiodarone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amitiza|Lubiprostone":{"brand_name":"Amitiza","generic_name":"Lubiprostone","avg_per_unit":{"value":5.6500560316,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amitiza / Lubiprostone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6887,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amitiza / Lubiprostone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amitriptyline HCl|Amitriptyline HCl":{"brand_name":"Amitriptyline HCl","generic_name":"Amitriptyline HCl","avg_per_unit":{"value":0.2186446807,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amitriptyline HCl / Amitriptyline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3704512,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amitriptyline HCl / Amitriptyline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril":{"brand_name":"Amlodipine Besylate-Benazepril","generic_name":"Amlodipine Besylate/Benazepril","avg_per_unit":{"value":0.2276703319,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amlodipine Besylate-Benazepril / Amlodipine Besylate/Benazepril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1701710,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amlodipine Besylate-Benazepril / Amlodipine Besylate/Benazepril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amlodipine Besylate|Amlodipine Besylate":{"brand_name":"Amlodipine Besylate","generic_name":"Amlodipine Besylate","avg_per_unit":{"value":0.084782714,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amlodipine Besylate / Amlodipine Besylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":50204110,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amlodipine Besylate / Amlodipine Besylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amlodipine-Atorvastatin|Amlodipine/Atorvastatin":{"brand_name":"Amlodipine-Atorvastatin","generic_name":"Amlodipine/Atorvastatin","avg_per_unit":{"value":2.3600487108,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amlodipine-Atorvastatin / Amlodipine/Atorvastatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":104801,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amlodipine-Atorvastatin / Amlodipine/Atorvastatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med":{"brand_name":"Amlodipine-Olmesartan","generic_name":"Amlodipine Bes/Olmesartan Med","avg_per_unit":{"value":0.6694525699,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amlodipine-Olmesartan / Amlodipine Bes/Olmesartan Med: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":347238,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amlodipine-Olmesartan / Amlodipine Bes/Olmesartan Med, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amlodipine-Valsartan|Amlodipine Besylate/Valsartan":{"brand_name":"Amlodipine-Valsartan","generic_name":"Amlodipine Besylate/Valsartan","avg_per_unit":{"value":0.6985832108,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amlodipine-Valsartan / Amlodipine Besylate/Valsartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":437348,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amlodipine-Valsartan / Amlodipine Besylate/Valsartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ammonium Lactate|Ammonium Lactate":{"brand_name":"Ammonium Lactate","generic_name":"Ammonium Lactate","avg_per_unit":{"value":0.0662486021,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ammonium Lactate / Ammonium Lactate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1270511,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ammonium Lactate / Ammonium Lactate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amnesteem|Isotretinoin":{"brand_name":"Amnesteem","generic_name":"Isotretinoin","avg_per_unit":{"value":3.2392225269,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amnesteem / Isotretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1519,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amnesteem / Isotretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Amphetamine Sulfate|Amphetamine Sulfate":{"brand_name":"Amphetamine Sulfate","generic_name":"Amphetamine Sulfate","avg_per_unit":{"value":1.5840437199,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Amphetamine Sulfate / Amphetamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":990,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Amphetamine Sulfate / Amphetamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Anagrelide HCl|Anagrelide HCl":{"brand_name":"Anagrelide HCl","generic_name":"Anagrelide HCl","avg_per_unit":{"value":1.4184126306,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Anagrelide HCl / Anagrelide HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":29521,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Anagrelide HCl / Anagrelide HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Analpram HC*|Hydrocortisone/Pramoxine":{"brand_name":"Analpram HC*","generic_name":"Hydrocortisone/Pramoxine","avg_per_unit":{"value":6.2705400249,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Analpram HC* / Hydrocortisone/Pramoxine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. CMS outlier flag 1: the average is substantially affected by outlier records. All 2 NADAC NDCs the name join matched to it have an FDA route including TOPICAL. 1 of the 2 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":33,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Analpram HC* / Hydrocortisone/Pramoxine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Anastrozole|Anastrozole":{"brand_name":"Anastrozole","generic_name":"Anastrozole","avg_per_unit":{"value":0.2918159329,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Anastrozole / Anastrozole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1702914,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Anastrozole / Anastrozole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Angeliq|Drospirenone/Estradiol":{"brand_name":"Angeliq","generic_name":"Drospirenone/Estradiol","avg_per_unit":{"value":6.5132656266,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Angeliq / Drospirenone/Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1117,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Angeliq / Drospirenone/Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Annovera|Segesterone Ac/Ethin Estradiol":{"brand_name":"Annovera","generic_name":"Segesterone Ac/Ethin Estradiol","avg_per_unit":{"value":2250.627,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Annovera / Segesterone Ac/Ethin Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":40,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Annovera / Segesterone Ac/Ethin Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Anoro Ellipta|Umeclidinium Brm/Vilanterol Tr":{"brand_name":"Anoro Ellipta","generic_name":"Umeclidinium Brm/Vilanterol Tr","avg_per_unit":{"value":7.5812799513,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Anoro Ellipta / Umeclidinium Brm/Vilanterol Tr: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1383988,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Anoro Ellipta / Umeclidinium Brm/Vilanterol Tr, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Apidra Solostar|Insulin Glulisine":{"brand_name":"Apidra Solostar","generic_name":"Insulin Glulisine","avg_per_unit":{"value":10.328581547,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Apidra Solostar / Insulin Glulisine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":8018,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Apidra Solostar / Insulin Glulisine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Apidra|Insulin Glulisine":{"brand_name":"Apidra","generic_name":"Insulin Glulisine","avg_per_unit":{"value":7.9991083669,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Apidra / Insulin Glulisine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2245,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Apidra / Insulin Glulisine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Apraclonidine HCl|Apraclonidine HCl":{"brand_name":"Apraclonidine HCl","generic_name":"Apraclonidine HCl","avg_per_unit":{"value":10.174965278,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Apraclonidine HCl / Apraclonidine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3990,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Apraclonidine HCl / Apraclonidine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aprepitant|Aprepitant":{"brand_name":"Aprepitant","generic_name":"Aprepitant","avg_per_unit":{"value":96.141770837,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aprepitant / Aprepitant: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12502,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aprepitant / Aprepitant, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Apri|Desogestrel-Ethinyl Estradiol":{"brand_name":"Apri","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.3706986914,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Apri / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6043,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Apri / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aptiom|Eslicarbazepine Acetate":{"brand_name":"Aptiom","generic_name":"Eslicarbazepine Acetate","avg_per_unit":{"value":42.927547529,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aptiom / Eslicarbazepine Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":83810,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aptiom / Eslicarbazepine Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aranelle|Norethindrone-Ethin. Estradiol":{"brand_name":"Aranelle","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.8061505914,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aranelle / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":428,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aranelle / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aranesp|Darbepoetin Alfa In Polysorbat":{"brand_name":"Aranesp","generic_name":"Darbepoetin Alfa In Polysorbat","avg_per_unit":{"value":2556.447447,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aranesp / Darbepoetin Alfa In Polysorbat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":27006,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aranesp / Darbepoetin Alfa In Polysorbat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Arformoterol Tartrate|Arformoterol Tartrate":{"brand_name":"Arformoterol Tartrate","generic_name":"Arformoterol Tartrate","avg_per_unit":{"value":3.2165794426,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Arformoterol Tartrate / Arformoterol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":20162,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Arformoterol Tartrate / Arformoterol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Arimidex|Anastrozole":{"brand_name":"Arimidex","generic_name":"Anastrozole","avg_per_unit":{"value":50.351841222,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Arimidex / Anastrozole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1348,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Arimidex / Anastrozole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aripiprazole ODT|Aripiprazole":{"brand_name":"Aripiprazole ODT","generic_name":"Aripiprazole","avg_per_unit":{"value":15.551425783,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aripiprazole ODT / Aripiprazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12808,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aripiprazole ODT / Aripiprazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aripiprazole|Aripiprazole":{"brand_name":"Aripiprazole","generic_name":"Aripiprazole","avg_per_unit":{"value":1.5499353611,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aripiprazole / Aripiprazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 177 of 184 NADAC NDCs joined to this name are priced per EA (7 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3844727,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aripiprazole / Aripiprazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Armodafinil|Armodafinil":{"brand_name":"Armodafinil","generic_name":"Armodafinil","avg_per_unit":{"value":1.7370034794,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Armodafinil / Armodafinil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":122371,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Armodafinil / Armodafinil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Armour Thyroid|Thyroid,Pork":{"brand_name":"Armour Thyroid","generic_name":"Thyroid,Pork","avg_per_unit":{"value":1.1825662712,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Armour Thyroid / Thyroid,Pork: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":308847,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Armour Thyroid / Thyroid,Pork, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Arnuity Ellipta|Fluticasone Furoate":{"brand_name":"Arnuity Ellipta","generic_name":"Fluticasone Furoate","avg_per_unit":{"value":7.3685530321,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Arnuity Ellipta / Fluticasone Furoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":659581,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Arnuity Ellipta / Fluticasone Furoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aromasin|Exemestane":{"brand_name":"Aromasin","generic_name":"Exemestane","avg_per_unit":{"value":36.850085392,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aromasin / Exemestane: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":646,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aromasin / Exemestane, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ascomp With Codeine|Codeine/Butalbital/Asa/Caffein":{"brand_name":"Ascomp With Codeine","generic_name":"Codeine/Butalbital/Asa/Caffein","avg_per_unit":{"value":1.1508750121,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ascomp With Codeine / Codeine/Butalbital/Asa/Caffein: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5500,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ascomp With Codeine / Codeine/Butalbital/Asa/Caffein, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Asenapine Maleate|Asenapine Maleate":{"brand_name":"Asenapine Maleate","generic_name":"Asenapine Maleate","avg_per_unit":{"value":4.8497322263,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Asenapine Maleate / Asenapine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":66185,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Asenapine Maleate / Asenapine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ashlyna|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Ashlyna","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":0.5958627049,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ashlyna / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1115,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ashlyna / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Asmanex HFA|Mometasone Furoate":{"brand_name":"Asmanex HFA","generic_name":"Mometasone Furoate","avg_per_unit":{"value":8.1142360534,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Asmanex HFA / Mometasone Furoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":29556,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Asmanex HFA / Mometasone Furoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Asmanex|Mometasone Furoate":{"brand_name":"Asmanex","generic_name":"Mometasone Furoate","avg_per_unit":{"value":117.78322885,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Asmanex / Mometasone Furoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":35699,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Asmanex / Mometasone Furoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aspirin-Dipyridamole ER|Aspirin/Dipyridamole":{"brand_name":"Aspirin-Dipyridamole ER","generic_name":"Aspirin/Dipyridamole","avg_per_unit":{"value":1.6155111132,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aspirin-Dipyridamole ER / Aspirin/Dipyridamole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":93409,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aspirin-Dipyridamole ER / Aspirin/Dipyridamole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Astagraf XL|Tacrolimus":{"brand_name":"Astagraf XL","generic_name":"Tacrolimus","avg_per_unit":{"value":9.0531243492,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Astagraf XL / Tacrolimus: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":703,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Astagraf XL / Tacrolimus, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atacand|Candesartan Cilexetil":{"brand_name":"Atacand","generic_name":"Candesartan Cilexetil","avg_per_unit":{"value":8.6554159277,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atacand / Candesartan Cilexetil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2894,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atacand / Candesartan Cilexetil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atazanavir Sulfate|Atazanavir Sulfate":{"brand_name":"Atazanavir Sulfate","generic_name":"Atazanavir Sulfate","avg_per_unit":{"value":8.6145637928,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atazanavir Sulfate / Atazanavir Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10596,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atazanavir Sulfate / Atazanavir Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Atenolol-Chlorthalidone|Atenolol/Chlorthalidone":{"brand_name":"Atenolol-Chlorthalidone","generic_name":"Atenolol/Chlorthalidone","avg_per_unit":{"value":0.3452120516,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atenolol-Chlorthalidone / Atenolol/Chlorthalidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":350207,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atenolol-Chlorthalidone / Atenolol/Chlorthalidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atenolol|Atenolol":{"brand_name":"Atenolol","generic_name":"Atenolol","avg_per_unit":{"value":0.0879940262,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atenolol / Atenolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6459376,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atenolol / Atenolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atomoxetine HCl|Atomoxetine HCl":{"brand_name":"Atomoxetine HCl","generic_name":"Atomoxetine HCl","avg_per_unit":{"value":2.2730397467,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atomoxetine HCl / Atomoxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":325761,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atomoxetine HCl / Atomoxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atorvastatin Calcium|Atorvastatin Calcium":{"brand_name":"Atorvastatin Calcium","generic_name":"Atorvastatin Calcium","avg_per_unit":{"value":0.1451833479,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atorvastatin Calcium / Atorvastatin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":73349032,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atorvastatin Calcium / Atorvastatin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl":{"brand_name":"Atovaquone-Proguanil HCl","generic_name":"Atovaquone/Proguanil HCl","avg_per_unit":{"value":2.6422974937,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atovaquone-Proguanil HCl / Atovaquone/Proguanil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":87360,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atovaquone-Proguanil HCl / Atovaquone/Proguanil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atovaquone|Atovaquone":{"brand_name":"Atovaquone","generic_name":"Atovaquone","avg_per_unit":{"value":1.6408587376,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atovaquone / Atovaquone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":87458,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atovaquone / Atovaquone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atropine Sulfate*|Atropine Sulfate":{"brand_name":"Atropine Sulfate*","generic_name":"Atropine Sulfate","avg_per_unit":{"value":7.7643747315,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atropine Sulfate* / Atropine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 6 NADAC NDCs the name join matched to it have an FDA route including OPHTHALMIC.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":214955,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atropine Sulfate* / Atropine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Atrovent HFA|Ipratropium Bromide":{"brand_name":"Atrovent HFA","generic_name":"Ipratropium Bromide","avg_per_unit":{"value":36.193510186,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Atrovent HFA / Ipratropium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":200254,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Atrovent HFA / Ipratropium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aubra Eq|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Aubra Eq","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.4057224646,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aubra Eq / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":177,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aubra Eq / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aurovela Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Aurovela Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.3599168777,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aurovela Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3655,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aurovela Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Auryxia|Ferric Citrate":{"brand_name":"Auryxia","generic_name":"Ferric Citrate","avg_per_unit":{"value":7.2355899066,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Auryxia / Ferric Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":72567,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Auryxia / Ferric Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Austedo XR|Deutetrabenazine":{"brand_name":"Austedo XR","generic_name":"Deutetrabenazine","avg_per_unit":{"value":224.91879879,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Austedo XR / Deutetrabenazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":81595,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Austedo XR / Deutetrabenazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Austedo|Deutetrabenazine":{"brand_name":"Austedo","generic_name":"Deutetrabenazine","avg_per_unit":{"value":103.13655426,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Austedo / Deutetrabenazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":162212,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Austedo / Deutetrabenazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Auvi-Q|Epinephrine":{"brand_name":"Auvi-Q","generic_name":"Epinephrine","avg_per_unit":{"value":300.57204383,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Auvi-Q / Epinephrine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1035,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Auvi-Q / Epinephrine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Avalide|Irbesartan/Hydrochlorothiazide":{"brand_name":"Avalide","generic_name":"Irbesartan/Hydrochlorothiazide","avg_per_unit":{"value":9.214736554,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Avalide / Irbesartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1141,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Avalide / Irbesartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Avapro|Irbesartan":{"brand_name":"Avapro","generic_name":"Irbesartan","avg_per_unit":{"value":8.1667190512,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Avapro / Irbesartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3829,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Avapro / Irbesartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Aviane|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Aviane","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3872060576,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Aviane / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4989,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Aviane / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ayuna|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Ayuna","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.2633176692,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ayuna / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":17,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ayuna / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Azasite|Azithromycin":{"brand_name":"Azasite","generic_name":"Azithromycin","avg_per_unit":{"value":99.612987506,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azasite / Azithromycin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5084,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azasite / Azithromycin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azathioprine|Azathioprine":{"brand_name":"Azathioprine","generic_name":"Azathioprine","avg_per_unit":{"value":0.4767395263,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azathioprine / Azathioprine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":397033,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azathioprine / Azathioprine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azelaic Acid|Azelaic Acid":{"brand_name":"Azelaic Acid","generic_name":"Azelaic Acid","avg_per_unit":{"value":1.912419783,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azelaic Acid / Azelaic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":81342,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azelaic Acid / Azelaic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azelastine HCl*|Azelastine HCl":{"brand_name":"Azelastine HCl*","generic_name":"Azelastine HCl","avg_per_unit":{"value":1.0715163944,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azelastine HCl* / Azelastine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes NASAL point at this name (5 of the 10 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3263509,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azelastine HCl* / Azelastine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azilect|Rasagiline Mesylate":{"brand_name":"Azilect","generic_name":"Rasagiline Mesylate","avg_per_unit":{"value":36.269966314,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azilect / Rasagiline Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":725,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azilect / Rasagiline Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azopt|Brinzolamide":{"brand_name":"Azopt","generic_name":"Brinzolamide","avg_per_unit":{"value":35.400135201,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azopt / Brinzolamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":30493,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azopt / Brinzolamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azor|Amlodipine Bes/Olmesartan Med":{"brand_name":"Azor","generic_name":"Amlodipine Bes/Olmesartan Med","avg_per_unit":{"value":13.837156853,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azor / Amlodipine Bes/Olmesartan Med: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3507,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azor / Amlodipine Bes/Olmesartan Med, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Azurette|Desog-E.Estradiol/E.Estradiol":{"brand_name":"Azurette","generic_name":"Desog-E.Estradiol/E.Estradiol","avg_per_unit":{"value":0.7025510033,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Azurette / Desog-E.Estradiol/E.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":634,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Azurette / Desog-E.Estradiol/E.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Baclofen*|Baclofen":{"brand_name":"Baclofen*","generic_name":"Baclofen","avg_per_unit":{"value":0.1865385009,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Baclofen* / Baclofen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (113 of the 127 the name join matched); NDCs of another route or with no known FDA route do not. 9 of the 113 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 119 of 127 NADAC NDCs joined to this name are priced per EA (8 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5180407,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Baclofen* / Baclofen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Balcoltra|Levonorgest/Eth.Estradiol/Iron":{"brand_name":"Balcoltra","generic_name":"Levonorgest/Eth.Estradiol/Iron","avg_per_unit":{"value":9.4579864532,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Balcoltra / Levonorgest/Eth.Estradiol/Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Balcoltra / Levonorgest/Eth.Estradiol/Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Balsalazide Disodium|Balsalazide Disodium":{"brand_name":"Balsalazide Disodium","generic_name":"Balsalazide Disodium","avg_per_unit":{"value":0.4774822612,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Balsalazide Disodium / Balsalazide Disodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":106888,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Balsalazide Disodium / Balsalazide Disodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Balziva|Norethindrone-Ethin. Estradiol":{"brand_name":"Balziva","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.7357421804,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Balziva / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":908,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Balziva / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Baqsimi|Glucagon":{"brand_name":"Baqsimi","generic_name":"Glucagon","avg_per_unit":{"value":282.92518216,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Baqsimi / Glucagon: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43157,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Baqsimi / Glucagon, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Baraclude|Entecavir":{"brand_name":"Baraclude","generic_name":"Entecavir","avg_per_unit":{"value":31.282987674,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Baraclude / Entecavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1512,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Baraclude / Entecavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Belbuca|Buprenorphine HCl":{"brand_name":"Belbuca","generic_name":"Buprenorphine HCl","avg_per_unit":{"value":12.762774232,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Belbuca / Buprenorphine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":217647,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Belbuca / Buprenorphine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Belsomra|Suvorexant":{"brand_name":"Belsomra","generic_name":"Suvorexant","avg_per_unit":{"value":14.507700111,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Belsomra / Suvorexant: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":315401,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Belsomra / Suvorexant, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Benazepril HCl|Benazepril HCl":{"brand_name":"Benazepril HCl","generic_name":"Benazepril HCl","avg_per_unit":{"value":0.1215158008,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Benazepril HCl / Benazepril HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2142239,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Benazepril HCl / Benazepril HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide":{"brand_name":"Benazepril-Hydrochlorothiazide","generic_name":"Benazepril/Hydrochlorothiazide","avg_per_unit":{"value":0.3836142586,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Benazepril-Hydrochlorothiazide / Benazepril/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":260649,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Benazepril-Hydrochlorothiazide / Benazepril/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Benicar HCT|Olmesartan/Hydrochlorothiazide":{"brand_name":"Benicar HCT","generic_name":"Olmesartan/Hydrochlorothiazide","avg_per_unit":{"value":12.087476595,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Benicar HCT / Olmesartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8866,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Benicar HCT / Olmesartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Benicar|Olmesartan Medoxomil":{"brand_name":"Benicar","generic_name":"Olmesartan Medoxomil","avg_per_unit":{"value":11.297346279,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Benicar / Olmesartan Medoxomil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19325,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Benicar / Olmesartan Medoxomil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Benzonatate|Benzonatate":{"brand_name":"Benzonatate","generic_name":"Benzonatate","avg_per_unit":{"value":0.3718860489,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Benzonatate / Benzonatate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":169630,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Benzonatate / Benzonatate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Benztropine Mesylate*|Benztropine Mesylate":{"brand_name":"Benztropine Mesylate*","generic_name":"Benztropine Mesylate","avg_per_unit":{"value":0.2330810748,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Benztropine Mesylate* / Benztropine Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 52 NADAC NDCs the name join matched to it have an FDA route including ORAL. 3 of the 52 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1944678,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Benztropine Mesylate* / Benztropine Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bepotastine Besilate|Bepotastine Besilate":{"brand_name":"Bepotastine Besilate","generic_name":"Bepotastine Besilate","avg_per_unit":{"value":21.695841238,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bepotastine Besilate / Bepotastine Besilate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":59528,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bepotastine Besilate / Bepotastine Besilate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bepreve|Bepotastine Besilate":{"brand_name":"Bepreve","generic_name":"Bepotastine Besilate","avg_per_unit":{"value":54.521481535,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bepreve / Bepotastine Besilate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3553,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bepreve / Bepotastine Besilate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Besivance|Besifloxacin HCl":{"brand_name":"Besivance","generic_name":"Besifloxacin HCl","avg_per_unit":{"value":44.016215485,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Besivance / Besifloxacin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":30315,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Besivance / Besifloxacin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Betadine|Povidone-Iodine":{"brand_name":"Betadine","generic_name":"Povidone-Iodine","avg_per_unit":{"value":0.6202083333,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Betadine / Povidone-Iodine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":49,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Betadine / Povidone-Iodine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Betamethasone Valerate|Betamethasone Valerate":{"brand_name":"Betamethasone Valerate","generic_name":"Betamethasone Valerate","avg_per_unit":{"value":0.6690314758,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Betamethasone Valerate / Betamethasone Valerate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. 16 of 17 NADAC NDCs joined to this name are priced per GM (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":279579,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Betamethasone Valerate / Betamethasone Valerate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Betaseron|Interferon Beta-1b":{"brand_name":"Betaseron","generic_name":"Interferon Beta-1b","avg_per_unit":{"value":689.47669649,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Betaseron / Interferon Beta-1b: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9136,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Betaseron / Interferon Beta-1b, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bethanechol Chloride|Bethanechol Chloride":{"brand_name":"Bethanechol Chloride","generic_name":"Bethanechol Chloride","avg_per_unit":{"value":0.5148778066,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bethanechol Chloride / Bethanechol Chloride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":194589,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bethanechol Chloride / Bethanechol Chloride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Betimol|Timolol":{"brand_name":"Betimol","generic_name":"Timolol","avg_per_unit":{"value":31.576436369,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Betimol / Timolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":14344,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Betimol / Timolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Betoptic S|Betaxolol HCl":{"brand_name":"Betoptic S","generic_name":"Betaxolol HCl","avg_per_unit":{"value":35.609674669,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Betoptic S / Betaxolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":7033,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Betoptic S / Betaxolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bevespi Aerosphere|Glycopyrrolate/Formoterol Fum":{"brand_name":"Bevespi Aerosphere","generic_name":"Glycopyrrolate/Formoterol Fum","avg_per_unit":{"value":38.537211528,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bevespi Aerosphere / Glycopyrrolate/Formoterol Fum: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":125109,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bevespi Aerosphere / Glycopyrrolate/Formoterol Fum, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bicalutamide|Bicalutamide":{"brand_name":"Bicalutamide","generic_name":"Bicalutamide","avg_per_unit":{"value":0.6289930668,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bicalutamide / Bicalutamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":209938,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bicalutamide / Bicalutamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bidil|Isosorbide Dinit/Hydralazine":{"brand_name":"Bidil","generic_name":"Isosorbide Dinit/Hydralazine","avg_per_unit":{"value":4.1712389416,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bidil / Isosorbide Dinit/Hydralazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":923,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bidil / Isosorbide Dinit/Hydralazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bijuva|Estradiol/Progesterone":{"brand_name":"Bijuva","generic_name":"Estradiol/Progesterone","avg_per_unit":{"value":8.1088398071,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bijuva / Estradiol/Progesterone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1694,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bijuva / Estradiol/Progesterone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bimatoprost*|Bimatoprost":{"brand_name":"Bimatoprost*","generic_name":"Bimatoprost","avg_per_unit":{"value":19.737117101,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bimatoprost* / Bimatoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 26 NADAC NDCs the name join matched to it have an FDA route including OPHTHALMIC.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":67911,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bimatoprost* / Bimatoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bimzelx Autoinjector|Bimekizumab-Bkzx":{"brand_name":"Bimzelx Autoinjector","generic_name":"Bimekizumab-Bkzx","avg_per_unit":{"value":7257.9409464,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bimzelx Autoinjector / Bimekizumab-Bkzx: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5294,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bimzelx Autoinjector / Bimekizumab-Bkzx, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Binosto|Alendronate Sodium":{"brand_name":"Binosto","generic_name":"Alendronate Sodium","avg_per_unit":{"value":73.808713199,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Binosto / Alendronate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1123,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Binosto / Alendronate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bisoprolol Fumarate|Bisoprolol Fumarate":{"brand_name":"Bisoprolol Fumarate","generic_name":"Bisoprolol Fumarate","avg_per_unit":{"value":0.3640853754,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bisoprolol Fumarate / Bisoprolol Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1091996,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bisoprolol Fumarate / Bisoprolol Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide":{"brand_name":"Bisoprolol-Hydrochlorothiazide","generic_name":"Bisoprolol/Hydrochlorothiazide","avg_per_unit":{"value":0.3429356448,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bisoprolol-Hydrochlorothiazide / Bisoprolol/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":568266,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bisoprolol-Hydrochlorothiazide / Bisoprolol/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bleomycin Sulfate|Bleomycin Sulfate":{"brand_name":"Bleomycin Sulfate","generic_name":"Bleomycin Sulfate","avg_per_unit":{"value":36.175576923,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bleomycin Sulfate / Bleomycin Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bleomycin Sulfate / Bleomycin Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Blisovi 24 Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Blisovi 24 Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.7190883085,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Blisovi 24 Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":791,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Blisovi 24 Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Blisovi Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Blisovi Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.3143806729,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Blisovi Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8673,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Blisovi Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Breo Ellipta|Fluticasone/Vilanterol":{"brand_name":"Breo Ellipta","generic_name":"Fluticasone/Vilanterol","avg_per_unit":{"value":6.4996345906,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Breo Ellipta / Fluticasone/Vilanterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2617269,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Breo Ellipta / Fluticasone/Vilanterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Breyna|Budesonide/Formoterol Fumarate":{"brand_name":"Breyna","generic_name":"Budesonide/Formoterol Fumarate","avg_per_unit":{"value":14.133343965,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Breyna / Budesonide/Formoterol Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":554739,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Breyna / Budesonide/Formoterol Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Breztri Aerosphere|Budesonide/Glycopyr/Formoterol":{"brand_name":"Breztri Aerosphere","generic_name":"Budesonide/Glycopyr/Formoterol","avg_per_unit":{"value":58.028676748,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Breztri Aerosphere / Budesonide/Glycopyr/Formoterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1431108,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Breztri Aerosphere / Budesonide/Glycopyr/Formoterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Briellyn|Norethindrone-Ethin. Estradiol":{"brand_name":"Briellyn","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.7727504355,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Briellyn / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":459,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Briellyn / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Brilinta|Ticagrelor":{"brand_name":"Brilinta","generic_name":"Ticagrelor","avg_per_unit":{"value":7.2601195099,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Brilinta / Ticagrelor: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1029007,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Brilinta / Ticagrelor, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Brimonidine Tartrate*|Brimonidine Tartrate":{"brand_name":"Brimonidine Tartrate*","generic_name":"Brimonidine Tartrate","avg_per_unit":{"value":3.9036910166,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Brimonidine Tartrate* / Brimonidine Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes OPHTHALMIC point at this name (43 of the 44 the name join matched); NDCs of another route or with no known FDA route do not. 43 of 44 NADAC NDCs joined to this name are priced per ML (1 per GM): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2435341,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Brimonidine Tartrate* / Brimonidine Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol":{"brand_name":"Brimonidine Tartrate-Timolol","generic_name":"Brimonidine Tartrate/Timolol","avg_per_unit":{"value":16.984041366,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Brimonidine Tartrate-Timolol / Brimonidine Tartrate/Timolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":530348,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Brimonidine Tartrate-Timolol / Brimonidine Tartrate/Timolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Brinzolamide|Brinzolamide":{"brand_name":"Brinzolamide","generic_name":"Brinzolamide","avg_per_unit":{"value":14.607862216,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Brinzolamide / Brinzolamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":193228,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Brinzolamide / Brinzolamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bromfenac Sodium|Bromfenac Sodium":{"brand_name":"Bromfenac Sodium","generic_name":"Bromfenac Sodium","avg_per_unit":{"value":61.386882619,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bromfenac Sodium / Bromfenac Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":133996,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bromfenac Sodium / Bromfenac Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bromocriptine Mesylate|Bromocriptine Mesylate":{"brand_name":"Bromocriptine Mesylate","generic_name":"Bromocriptine Mesylate","avg_per_unit":{"value":2.3072100852,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bromocriptine Mesylate / Bromocriptine Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":35798,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bromocriptine Mesylate / Bromocriptine Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bromsite|Bromfenac Sodium":{"brand_name":"Bromsite","generic_name":"Bromfenac Sodium","avg_per_unit":{"value":51.671413479,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bromsite / Bromfenac Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5089,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bromsite / Bromfenac Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Brovana|Arformoterol Tartrate":{"brand_name":"Brovana","generic_name":"Arformoterol Tartrate","avg_per_unit":{"value":4.5439727908,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Brovana / Arformoterol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":333,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Brovana / Arformoterol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Budesonide Dr|Budesonide":{"brand_name":"Budesonide Dr","generic_name":"Budesonide","avg_per_unit":{"value":1.2835439463,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Budesonide Dr / Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":207194,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Budesonide Dr / Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Budesonide EC|Budesonide":{"brand_name":"Budesonide EC","generic_name":"Budesonide","avg_per_unit":{"value":1.9511368027,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Budesonide EC / Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":106512,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Budesonide EC / Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Budesonide ER|Budesonide":{"brand_name":"Budesonide ER","generic_name":"Budesonide","avg_per_unit":{"value":12.693151611,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Budesonide ER / Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":27485,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Budesonide ER / Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Budesonide*|Budesonide":{"brand_name":"Budesonide*","generic_name":"Budesonide","avg_per_unit":{"value":2.2930285073,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Budesonide* / Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes RESPIRATORY (INHALATION) point at this name (22 of the 32 the name join matched); NDCs of another route or with no known FDA route do not. 31 of 32 NADAC NDCs joined to this name are priced per ML (1 per GM): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":173739,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Budesonide* / Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Budesonide-Formoterol Fumarate|Budesonide/Formoterol Fumarate":{"brand_name":"Budesonide-Formoterol Fumarate","generic_name":"Budesonide/Formoterol Fumarate","avg_per_unit":{"value":16.52082444,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Budesonide-Formoterol Fumarate / Budesonide/Formoterol Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1147488,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Budesonide-Formoterol Fumarate / Budesonide/Formoterol Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bumetanide*|Bumetanide":{"brand_name":"Bumetanide*","generic_name":"Bumetanide","avg_per_unit":{"value":0.4343578874,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bumetanide* / Bumetanide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (61 of the 67 the name join matched); NDCs of another route or with no known FDA route do not. 5 of the 61 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2403773,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bumetanide* / Bumetanide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl":{"brand_name":"Buprenorphine-Naloxone","generic_name":"Buprenorphine HCl/Naloxone HCl","avg_per_unit":{"value":2.625282102,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Buprenorphine-Naloxone / Buprenorphine HCl/Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1625314,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Buprenorphine-Naloxone / Buprenorphine HCl/Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Buprenorphine|Buprenorphine":{"brand_name":"Buprenorphine","generic_name":"Buprenorphine","avg_per_unit":{"value":61.653243547,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Buprenorphine / Buprenorphine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":455308,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Buprenorphine / Buprenorphine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bupropion HCl SR|Bupropion HCl":{"brand_name":"Bupropion HCl SR","generic_name":"Bupropion HCl","avg_per_unit":{"value":0.2323915968,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bupropion HCl SR / Bupropion HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2256886,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bupropion HCl SR / Bupropion HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bupropion HCl|Bupropion HCl":{"brand_name":"Bupropion HCl","generic_name":"Bupropion HCl","avg_per_unit":{"value":0.2891818134,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bupropion HCl / Bupropion HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":702514,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bupropion HCl / Bupropion HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bupropion XL|Bupropion HCl":{"brand_name":"Bupropion XL","generic_name":"Bupropion HCl","avg_per_unit":{"value":0.4038309599,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bupropion XL / Bupropion HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6831216,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bupropion XL / Bupropion HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Buspirone HCl|Buspirone HCl":{"brand_name":"Buspirone HCl","generic_name":"Buspirone HCl","avg_per_unit":{"value":0.1464716937,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Buspirone HCl / Buspirone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7847445,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Buspirone HCl / Buspirone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Butalbital-Acetaminophen|Butalbital/Acetaminophen":{"brand_name":"Butalbital-Acetaminophen","generic_name":"Butalbital/Acetaminophen","avg_per_unit":{"value":1.9316068802,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Butalbital-Acetaminophen / Butalbital/Acetaminophen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13597,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Butalbital-Acetaminophen / Butalbital/Acetaminophen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Butalbital-Aspirin-Caffeine|Butalbital/Aspirin/Caffeine":{"brand_name":"Butalbital-Aspirin-Caffeine","generic_name":"Butalbital/Aspirin/Caffeine","avg_per_unit":{"value":0.8623720072,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Butalbital-Aspirin-Caffeine / Butalbital/Aspirin/Caffeine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":44947,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Butalbital-Aspirin-Caffeine / Butalbital/Aspirin/Caffeine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Butorphanol Tartrate*|Butorphanol Tartrate":{"brand_name":"Butorphanol Tartrate*","generic_name":"Butorphanol Tartrate","avg_per_unit":{"value":15.10755404,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Butorphanol Tartrate* / Butorphanol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 2 NADAC NDCs the name join matched to it have an FDA route including NASAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":24382,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Butorphanol Tartrate* / Butorphanol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Butrans|Buprenorphine":{"brand_name":"Butrans","generic_name":"Buprenorphine","avg_per_unit":{"value":102.43317331,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Butrans / Buprenorphine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25786,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Butrans / Buprenorphine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Bystolic|Nebivolol HCl":{"brand_name":"Bystolic","generic_name":"Nebivolol HCl","avg_per_unit":{"value":5.7420331429,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Bystolic / Nebivolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":41207,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Bystolic / Nebivolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cabergoline|Cabergoline":{"brand_name":"Cabergoline","generic_name":"Cabergoline","avg_per_unit":{"value":4.904429914,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cabergoline / Cabergoline: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":90444,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cabergoline / Cabergoline, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Calcipotriene|Calcipotriene":{"brand_name":"Calcipotriene","generic_name":"Calcipotriene","avg_per_unit":{"value":1.9343521796,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Calcipotriene / Calcipotriene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. 10 of 11 NADAC NDCs joined to this name are priced per GM (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":150149,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Calcipotriene / Calcipotriene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Calcium Acetate|Calcium Acetate":{"brand_name":"Calcium Acetate","generic_name":"Calcium Acetate","avg_per_unit":{"value":0.3038761748,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Calcium Acetate / Calcium Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":384757,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Calcium Acetate / Calcium Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Camila|Norethindrone":{"brand_name":"Camila","generic_name":"Norethindrone","avg_per_unit":{"value":0.3611854619,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Camila / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":638,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Camila / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Camrese Lo|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Camrese Lo","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":1.0895556973,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Camrese Lo / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":517,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Camrese Lo / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Camrese|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Camrese","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":0.6151594307,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Camrese / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":364,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Camrese / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Canasa|Mesalamine":{"brand_name":"Canasa","generic_name":"Mesalamine","avg_per_unit":{"value":36.056080939,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Canasa / Mesalamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":842,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Canasa / Mesalamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Candesartan Cilexetil|Candesartan Cilexetil":{"brand_name":"Candesartan Cilexetil","generic_name":"Candesartan Cilexetil","avg_per_unit":{"value":1.0769883562,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Candesartan Cilexetil / Candesartan Cilexetil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":493798,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Candesartan Cilexetil / Candesartan Cilexetil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Capecitabine|Capecitabine":{"brand_name":"Capecitabine","generic_name":"Capecitabine","avg_per_unit":{"value":2.9884784496,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Capecitabine / Capecitabine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":162,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Capecitabine / Capecitabine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Caplyta|Lumateperone Tosylate":{"brand_name":"Caplyta","generic_name":"Lumateperone Tosylate","avg_per_unit":{"value":56.09831882,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Caplyta / Lumateperone Tosylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":159224,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Caplyta / Lumateperone Tosylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Captopril|Captopril":{"brand_name":"Captopril","generic_name":"Captopril","avg_per_unit":{"value":0.5710972154,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Captopril / Captopril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":70928,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Captopril / Captopril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carafate|Sucralfate":{"brand_name":"Carafate","generic_name":"Sucralfate","avg_per_unit":{"value":1.2380005078,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carafate / Sucralfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2941,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carafate / Sucralfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carbamazepine ER|Carbamazepine":{"brand_name":"Carbamazepine ER","generic_name":"Carbamazepine","avg_per_unit":{"value":0.9786069575,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carbamazepine ER / Carbamazepine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":503816,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carbamazepine ER / Carbamazepine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carbidopa-Levodopa ER|Carbidopa/Levodopa":{"brand_name":"Carbidopa-Levodopa ER","generic_name":"Carbidopa/Levodopa","avg_per_unit":{"value":0.3565849732,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carbidopa-Levodopa ER / Carbidopa/Levodopa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":604966,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carbidopa-Levodopa ER / Carbidopa/Levodopa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone":{"brand_name":"Carbidopa-Levodopa-Entacapone","generic_name":"Carbidopa/Levodopa/Entacapone","avg_per_unit":{"value":1.3434262576,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carbidopa-Levodopa-Entacapone / Carbidopa/Levodopa/Entacapone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":50738,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carbidopa-Levodopa-Entacapone / Carbidopa/Levodopa/Entacapone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carbidopa-Levodopa|Carbidopa/Levodopa":{"brand_name":"Carbidopa-Levodopa","generic_name":"Carbidopa/Levodopa","avg_per_unit":{"value":0.1380003781,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carbidopa-Levodopa / Carbidopa/Levodopa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2964396,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carbidopa-Levodopa / Carbidopa/Levodopa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carbidopa|Carbidopa":{"brand_name":"Carbidopa","generic_name":"Carbidopa","avg_per_unit":{"value":1.8554484513,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carbidopa / Carbidopa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22022,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carbidopa / Carbidopa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carbinoxamine Maleate|Carbinoxamine Maleate":{"brand_name":"Carbinoxamine Maleate","generic_name":"Carbinoxamine Maleate","avg_per_unit":{"value":2.3886651695,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carbinoxamine Maleate / Carbinoxamine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4508,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carbinoxamine Maleate / Carbinoxamine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cardura XL|Doxazosin Mesylate":{"brand_name":"Cardura XL","generic_name":"Doxazosin Mesylate","avg_per_unit":{"value":6.7144323239,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cardura XL / Doxazosin Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2157,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cardura XL / Doxazosin Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carisoprodol|Carisoprodol":{"brand_name":"Carisoprodol","generic_name":"Carisoprodol","avg_per_unit":{"value":0.1590198419,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carisoprodol / Carisoprodol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":346870,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carisoprodol / Carisoprodol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carteolol HCl|Carteolol HCl":{"brand_name":"Carteolol HCl","generic_name":"Carteolol HCl","avg_per_unit":{"value":2.2390216179,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carteolol HCl / Carteolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":19459,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carteolol HCl / Carteolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cartia Xt|Diltiazem HCl":{"brand_name":"Cartia Xt","generic_name":"Diltiazem HCl","avg_per_unit":{"value":0.3650829729,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cartia Xt / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":258636,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cartia Xt / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carvedilol ER|Carvedilol Phosphate":{"brand_name":"Carvedilol ER","generic_name":"Carvedilol Phosphate","avg_per_unit":{"value":5.3173293361,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carvedilol ER / Carvedilol Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":85750,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carvedilol ER / Carvedilol Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Carvedilol|Carvedilol":{"brand_name":"Carvedilol","generic_name":"Carvedilol","avg_per_unit":{"value":0.0649548466,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Carvedilol / Carvedilol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15794645,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Carvedilol / Carvedilol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cefaclor|Cefaclor":{"brand_name":"Cefaclor","generic_name":"Cefaclor","avg_per_unit":{"value":1.7362630941,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cefaclor / Cefaclor: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9351,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cefaclor / Cefaclor, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cefazolin Sodium*|Cefazolin Sodium":{"brand_name":"Cefazolin Sodium*","generic_name":"Cefazolin Sodium","avg_per_unit":{"value":2.0712130772,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cefazolin Sodium* / Cefazolin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. CMS outlier flag 1: the average is substantially affected by outlier records. Only NADAC NDCs whose FDA route includes INTRAMUSCULAR and INTRAVENOUS point at this name (9 of the 10 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":82069,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cefazolin Sodium* / Cefazolin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Ceftazidime|Ceftazidime":{"brand_name":"Ceftazidime","generic_name":"Ceftazidime","avg_per_unit":{"value":2.1510726963,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ceftazidime / Ceftazidime: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15704,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ceftazidime / Ceftazidime, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Cefuroxime|Cefuroxime Axetil":{"brand_name":"Cefuroxime","generic_name":"Cefuroxime Axetil","avg_per_unit":{"value":0.918717824,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cefuroxime / Cefuroxime Axetil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1149804,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cefuroxime / Cefuroxime Axetil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Celebrex|Celecoxib":{"brand_name":"Celebrex","generic_name":"Celecoxib","avg_per_unit":{"value":14.388181573,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Celebrex / Celecoxib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11915,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Celebrex / Celecoxib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Celecoxib|Celecoxib":{"brand_name":"Celecoxib","generic_name":"Celecoxib","avg_per_unit":{"value":0.4441089086,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Celecoxib / Celecoxib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5701064,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Celecoxib / Celecoxib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Celexa|Citalopram Hydrobromide":{"brand_name":"Celexa","generic_name":"Citalopram Hydrobromide","avg_per_unit":{"value":9.1778939575,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Celexa / Citalopram Hydrobromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4196,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Celexa / Citalopram Hydrobromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Celontin|Methsuximide":{"brand_name":"Celontin","generic_name":"Methsuximide","avg_per_unit":{"value":4.5018516305,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Celontin / Methsuximide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":587,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Celontin / Methsuximide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cequa|Cyclosporine":{"brand_name":"Cequa","generic_name":"Cyclosporine","avg_per_unit":{"value":9.3351721378,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cequa / Cyclosporine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":90056,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cequa / Cyclosporine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cetirizine HCl|Cetirizine HCl":{"brand_name":"Cetirizine HCl","generic_name":"Cetirizine HCl","avg_per_unit":{"value":0.0472029505,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cetirizine HCl / Cetirizine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":16308,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cetirizine HCl / Cetirizine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cevimeline HCl|Cevimeline HCl":{"brand_name":"Cevimeline HCl","generic_name":"Cevimeline HCl","avg_per_unit":{"value":1.1406704541,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cevimeline HCl / Cevimeline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":113139,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cevimeline HCl / Cevimeline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chantix|Varenicline Tartrate":{"brand_name":"Chantix","generic_name":"Varenicline Tartrate","avg_per_unit":{"value":8.1281232481,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chantix / Varenicline Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chantix / Varenicline Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Charlotte 24 Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Charlotte 24 Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":1.2695447942,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Charlotte 24 Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":239,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Charlotte 24 Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chateal Eq|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Chateal Eq","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.4374036918,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chateal Eq / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":75,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chateal Eq / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chlordiazepoxide HCl|Chlordiazepoxide HCl":{"brand_name":"Chlordiazepoxide HCl","generic_name":"Chlordiazepoxide HCl","avg_per_unit":{"value":0.2034162697,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chlordiazepoxide HCl / Chlordiazepoxide HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":96694,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chlordiazepoxide HCl / Chlordiazepoxide HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chlordiazepoxide-Amitriptyline|Amitriptyline/Chlordiazepoxide":{"brand_name":"Chlordiazepoxide-Amitriptyline","generic_name":"Amitriptyline/Chlordiazepoxide","avg_per_unit":{"value":1.1813487647,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chlordiazepoxide-Amitriptyline / Amitriptyline/Chlordiazepoxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3122,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chlordiazepoxide-Amitriptyline / Amitriptyline/Chlordiazepoxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chlorhexidine Gluconate|Chlorhexidine Gluconate":{"brand_name":"Chlorhexidine Gluconate","generic_name":"Chlorhexidine Gluconate","avg_per_unit":{"value":0.0103958406,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chlorhexidine Gluconate / Chlorhexidine Gluconate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2600933,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chlorhexidine Gluconate / Chlorhexidine Gluconate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chloroquine Phosphate|Chloroquine Phosphate":{"brand_name":"Chloroquine Phosphate","generic_name":"Chloroquine Phosphate","avg_per_unit":{"value":4.1156876506,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chloroquine Phosphate / Chloroquine Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3472,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chloroquine Phosphate / Chloroquine Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chlorpromazine HCl*|Chlorpromazine HCl":{"brand_name":"Chlorpromazine HCl*","generic_name":"Chlorpromazine HCl","avg_per_unit":{"value":3.3226421898,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chlorpromazine HCl* / Chlorpromazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (81 of the 86 the name join matched); NDCs of another route or with no known FDA route do not. 17 of the 81 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":248177,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chlorpromazine HCl* / Chlorpromazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chlorthalidone|Chlorthalidone":{"brand_name":"Chlorthalidone","generic_name":"Chlorthalidone","avg_per_unit":{"value":0.2418557496,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chlorthalidone / Chlorthalidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2941224,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chlorthalidone / Chlorthalidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Chlorzoxazone|Chlorzoxazone":{"brand_name":"Chlorzoxazone","generic_name":"Chlorzoxazone","avg_per_unit":{"value":2.1674691179,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Chlorzoxazone / Chlorzoxazone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":63482,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Chlorzoxazone / Chlorzoxazone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cholestyramine Light|Cholestyramine":{"brand_name":"Cholestyramine Light","generic_name":"Cholestyramine","avg_per_unit":{"value":1.1059350786,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cholestyramine Light / Cholestyramine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":155684,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cholestyramine Light / Cholestyramine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cialis|Tadalafil":{"brand_name":"Cialis","generic_name":"Tadalafil","avg_per_unit":{"value":9.682610164,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cialis / Tadalafil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7402,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cialis / Tadalafil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cibinqo|Abrocitinib":{"brand_name":"Cibinqo","generic_name":"Abrocitinib","avg_per_unit":{"value":183.57254743,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cibinqo / Abrocitinib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2728,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cibinqo / Abrocitinib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cilostazol|Cilostazol":{"brand_name":"Cilostazol","generic_name":"Cilostazol","avg_per_unit":{"value":0.1957981809,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cilostazol / Cilostazol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":795710,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cilostazol / Cilostazol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ciloxan|Ciprofloxacin HCl":{"brand_name":"Ciloxan","generic_name":"Ciprofloxacin HCl","avg_per_unit":{"value":75.760012481,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ciloxan / Ciprofloxacin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":5419,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ciloxan / Ciprofloxacin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cimetidine|Cimetidine":{"brand_name":"Cimetidine","generic_name":"Cimetidine","avg_per_unit":{"value":0.7207017399,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cimetidine / Cimetidine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 21 of 23 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":103616,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cimetidine / Cimetidine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cinacalcet HCl|Cinacalcet HCl":{"brand_name":"Cinacalcet HCl","generic_name":"Cinacalcet HCl","avg_per_unit":{"value":5.5625286742,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cinacalcet HCl / Cinacalcet HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":287865,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cinacalcet HCl / Cinacalcet HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Cipro HC|Ciprofloxacin/Hydrocortisone":{"brand_name":"Cipro HC","generic_name":"Ciprofloxacin/Hydrocortisone","avg_per_unit":{"value":36.556089137,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cipro HC / Ciprofloxacin/Hydrocortisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10023,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cipro HC / Ciprofloxacin/Hydrocortisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ciprofloxacin HCl*|Ciprofloxacin HCl":{"brand_name":"Ciprofloxacin HCl*","generic_name":"Ciprofloxacin HCl","avg_per_unit":{"value":0.5535208279,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ciprofloxacin HCl* / Ciprofloxacin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (4 of the 5 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4856922,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ciprofloxacin HCl* / Ciprofloxacin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ciprofloxacin|Ciprofloxacin":{"brand_name":"Ciprofloxacin","generic_name":"Ciprofloxacin","avg_per_unit":{"value":2.522624269,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ciprofloxacin / Ciprofloxacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ciprofloxacin / Ciprofloxacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Citalopram HBr|Citalopram Hydrobromide":{"brand_name":"Citalopram HBr","generic_name":"Citalopram Hydrobromide","avg_per_unit":{"value":0.1178313531,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Citalopram HBr / Citalopram Hydrobromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 41 of 43 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6741609,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Citalopram HBr / Citalopram Hydrobromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Claravis|Isotretinoin":{"brand_name":"Claravis","generic_name":"Isotretinoin","avg_per_unit":{"value":3.3474803717,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Claravis / Isotretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4013,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Claravis / Isotretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clarinex-D 12 Hour|Desloratadine/Pseudoephedrine":{"brand_name":"Clarinex-D 12 Hour","generic_name":"Desloratadine/Pseudoephedrine","avg_per_unit":{"value":5.4290223213,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clarinex-D 12 Hour / Desloratadine/Pseudoephedrine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1225,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clarinex-D 12 Hour / Desloratadine/Pseudoephedrine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clarinex|Desloratadine":{"brand_name":"Clarinex","generic_name":"Desloratadine","avg_per_unit":{"value":7.9874249185,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clarinex / Desloratadine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":457,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clarinex / Desloratadine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clarithromycin ER|Clarithromycin":{"brand_name":"Clarithromycin ER","generic_name":"Clarithromycin","avg_per_unit":{"value":3.9562437244,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clarithromycin ER / Clarithromycin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4553,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clarithromycin ER / Clarithromycin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clenpiq|Sod Picosulf/Mag Ox/Citric Ac":{"brand_name":"Clenpiq","generic_name":"Sod Picosulf/Mag Ox/Citric Ac","avg_per_unit":{"value":0.4871876835,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clenpiq / Sod Picosulf/Mag Ox/Citric Ac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":154263,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clenpiq / Sod Picosulf/Mag Ox/Citric Ac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Climara Pro|Estradiol/Levonorgestrel":{"brand_name":"Climara Pro","generic_name":"Estradiol/Levonorgestrel","avg_per_unit":{"value":61.161408746,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Climara Pro / Estradiol/Levonorgestrel: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8334,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Climara Pro / Estradiol/Levonorgestrel, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Climara|Estradiol":{"brand_name":"Climara","generic_name":"Estradiol","avg_per_unit":{"value":13.213676695,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Climara / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22120,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Climara / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clindacin|Clindamycin Phosphate":{"brand_name":"Clindacin","generic_name":"Clindamycin Phosphate","avg_per_unit":{"value":3.230580163,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clindacin / Clindamycin Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":74,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clindacin / Clindamycin Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clindamycin (Pediatric)|Clindamycin Palmitate HCl":{"brand_name":"Clindamycin (Pediatric)","generic_name":"Clindamycin Palmitate HCl","avg_per_unit":{"value":0.2461998214,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clindamycin (Pediatric) / Clindamycin Palmitate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":4953,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clindamycin (Pediatric) / Clindamycin Palmitate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clindamycin HCl|Clindamycin HCl":{"brand_name":"Clindamycin HCl","generic_name":"Clindamycin HCl","avg_per_unit":{"value":0.3221745,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clindamycin HCl / Clindamycin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2147011,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clindamycin HCl / Clindamycin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clindamycin Phos-Tretinoin|Clindamycin/Tretinoin":{"brand_name":"Clindamycin Phos-Tretinoin","generic_name":"Clindamycin/Tretinoin","avg_per_unit":{"value":7.2400879152,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clindamycin Phos-Tretinoin / Clindamycin/Tretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":428,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clindamycin Phos-Tretinoin / Clindamycin/Tretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clindesse|Clindamycin Phosphate":{"brand_name":"Clindesse","generic_name":"Clindamycin Phosphate","avg_per_unit":{"value":27.163718656,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clindesse / Clindamycin Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":251,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clindesse / Clindamycin Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clodan|Clobetasol Propionate":{"brand_name":"Clodan","generic_name":"Clobetasol Propionate","avg_per_unit":{"value":0.5734957627,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clodan / Clobetasol Propionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":34,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clodan / Clobetasol Propionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clomid|Clomiphene Citrate":{"brand_name":"Clomid","generic_name":"Clomiphene Citrate","avg_per_unit":{"value":6.3950995666,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clomid / Clomiphene Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4273,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clomid / Clomiphene Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clomiphene Citrate|Clomiphene Citrate":{"brand_name":"Clomiphene Citrate","generic_name":"Clomiphene Citrate","avg_per_unit":{"value":4.0164150943,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clomiphene Citrate / Clomiphene Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clomiphene Citrate / Clomiphene Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Clomipramine HCl|Clomipramine HCl":{"brand_name":"Clomipramine HCl","generic_name":"Clomipramine HCl","avg_per_unit":{"value":1.5104184088,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clomipramine HCl / Clomipramine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":124494,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clomipramine HCl / Clomipramine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clonazepam|Clonazepam":{"brand_name":"Clonazepam","generic_name":"Clonazepam","avg_per_unit":{"value":0.1476088429,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clonazepam / Clonazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8844831,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clonazepam / Clonazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clonidine HCl ER|Clonidine HCl":{"brand_name":"Clonidine HCl ER","generic_name":"Clonidine HCl","avg_per_unit":{"value":1.1369011544,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clonidine HCl ER / Clonidine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14907,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clonidine HCl ER / Clonidine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clonidine HCl|Clonidine HCl":{"brand_name":"Clonidine HCl","generic_name":"Clonidine HCl","avg_per_unit":{"value":0.0625655455,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clonidine HCl / Clonidine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3484806,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clonidine HCl / Clonidine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clonidine|Clonidine":{"brand_name":"Clonidine","generic_name":"Clonidine","avg_per_unit":{"value":18.682451781,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clonidine / Clonidine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":473634,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clonidine / Clonidine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clopidogrel|Clopidogrel Bisulfate":{"brand_name":"Clopidogrel","generic_name":"Clopidogrel Bisulfate","avg_per_unit":{"value":0.1765963306,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clopidogrel / Clopidogrel Bisulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13582037,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clopidogrel / Clopidogrel Bisulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clorazepate Dipotassium|Clorazepate Dipotassium":{"brand_name":"Clorazepate Dipotassium","generic_name":"Clorazepate Dipotassium","avg_per_unit":{"value":1.3971212334,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clorazepate Dipotassium / Clorazepate Dipotassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":130507,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clorazepate Dipotassium / Clorazepate Dipotassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip":{"brand_name":"Clotrimazole-Betamethasone","generic_name":"Clotrimazole/Betamethasone Dip","avg_per_unit":{"value":0.5466583855,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clotrimazole-Betamethasone / Clotrimazole/Betamethasone Dip: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1764999,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clotrimazole-Betamethasone / Clotrimazole/Betamethasone Dip, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clozapine ODT|Clozapine":{"brand_name":"Clozapine ODT","generic_name":"Clozapine","avg_per_unit":{"value":9.2460666752,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clozapine ODT / Clozapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36574,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clozapine ODT / Clozapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clozapine|Clozapine":{"brand_name":"Clozapine","generic_name":"Clozapine","avg_per_unit":{"value":1.2397390552,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clozapine / Clozapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1135283,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clozapine / Clozapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Clozaril|Clozapine":{"brand_name":"Clozaril","generic_name":"Clozapine","avg_per_unit":{"value":13.668434103,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Clozaril / Clozapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8193,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Clozaril / Clozapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Coartem|Artemether/Lumefantrine":{"brand_name":"Coartem","generic_name":"Artemether/Lumefantrine","avg_per_unit":{"value":5.5859252537,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Coartem / Artemether/Lumefantrine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":324,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Coartem / Artemether/Lumefantrine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cobenfy|Xanomeline Tart/Trospium Chlor":{"brand_name":"Cobenfy","generic_name":"Xanomeline Tart/Trospium Chlor","avg_per_unit":{"value":31.093824653,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cobenfy / Xanomeline Tart/Trospium Chlor: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1539,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cobenfy / Xanomeline Tart/Trospium Chlor, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Codeine Sulfate|Codeine Sulfate":{"brand_name":"Codeine Sulfate","generic_name":"Codeine Sulfate","avg_per_unit":{"value":0.6986579572,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Codeine Sulfate / Codeine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14814,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Codeine Sulfate / Codeine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Colchicine|Colchicine":{"brand_name":"Colchicine","generic_name":"Colchicine","avg_per_unit":{"value":1.134926982,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Colchicine / Colchicine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1495868,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Colchicine / Colchicine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Colesevelam HCl|Colesevelam HCl":{"brand_name":"Colesevelam HCl","generic_name":"Colesevelam HCl","avg_per_unit":{"value":1.0407925974,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Colesevelam HCl / Colesevelam HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":262604,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Colesevelam HCl / Colesevelam HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Combigan|Brimonidine Tartrate/Timolol":{"brand_name":"Combigan","generic_name":"Brimonidine Tartrate/Timolol","avg_per_unit":{"value":38.746688453,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Combigan / Brimonidine Tartrate/Timolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":465280,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Combigan / Brimonidine Tartrate/Timolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Combipatch|Estradiol/Norethindrone Acet":{"brand_name":"Combipatch","generic_name":"Estradiol/Norethindrone Acet","avg_per_unit":{"value":29.88512687,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Combipatch / Estradiol/Norethindrone Acet: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13387,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Combipatch / Estradiol/Norethindrone Acet, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Combivent Respimat|Ipratropium/Albuterol Sulfate":{"brand_name":"Combivent Respimat","generic_name":"Ipratropium/Albuterol Sulfate","avg_per_unit":{"value":121.10767172,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Combivent Respimat / Ipratropium/Albuterol Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":602035,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Combivent Respimat / Ipratropium/Albuterol Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Complera|Emtricita/Rilpivirine/Tenof Df":{"brand_name":"Complera","generic_name":"Emtricita/Rilpivirine/Tenof Df","avg_per_unit":{"value":119.72716267,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Complera / Emtricita/Rilpivirine/Tenof Df: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5950,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Complera / Emtricita/Rilpivirine/Tenof Df, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Complete Natal DHA|PNV Cmb 52/Iron/FA/Omega-3/DHA":{"brand_name":"Complete Natal DHA","generic_name":"PNV Cmb 52/Iron/FA/Omega-3/DHA","avg_per_unit":{"value":0.3781503445,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Complete Natal DHA / PNV Cmb 52/Iron/FA/Omega-3/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":203,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Complete Natal DHA / PNV Cmb 52/Iron/FA/Omega-3/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Compro|Prochlorperazine":{"brand_name":"Compro","generic_name":"Prochlorperazine","avg_per_unit":{"value":6.5836555637,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Compro / Prochlorperazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10507,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Compro / Prochlorperazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Constulose|Lactulose":{"brand_name":"Constulose","generic_name":"Lactulose","avg_per_unit":{"value":0.0198677814,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Constulose / Lactulose: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":228452,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Constulose / Lactulose, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Copaxone|Glatiramer Acetate":{"brand_name":"Copaxone","generic_name":"Glatiramer Acetate","avg_per_unit":{"value":428.54400381,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Copaxone / Glatiramer Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":40460,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Copaxone / Glatiramer Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Corlanor|IVabradine HCl":{"brand_name":"Corlanor","generic_name":"IVabradine HCl","avg_per_unit":{"value":9.6726895299,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Corlanor / IVabradine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":50208,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Corlanor / IVabradine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cortef|Hydrocortisone":{"brand_name":"Cortef","generic_name":"Hydrocortisone","avg_per_unit":{"value":1.3044915657,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cortef / Hydrocortisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2648,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cortef / Hydrocortisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cortifoam|Hydrocortisone Acetate":{"brand_name":"Cortifoam","generic_name":"Hydrocortisone Acetate","avg_per_unit":{"value":28.016471271,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cortifoam / Hydrocortisone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":821,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cortifoam / Hydrocortisone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cosopt PF|Dorzolamide/Timolol/PF":{"brand_name":"Cosopt PF","generic_name":"Dorzolamide/Timolol/PF","avg_per_unit":{"value":3.2067997546,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cosopt PF / Dorzolamide/Timolol/PF: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12769,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cosopt PF / Dorzolamide/Timolol/PF, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cosopt|Dorzolamide HCl/Timolol Maleat":{"brand_name":"Cosopt","generic_name":"Dorzolamide HCl/Timolol Maleat","avg_per_unit":{"value":22.374666996,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cosopt / Dorzolamide HCl/Timolol Maleat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1932,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cosopt / Dorzolamide HCl/Timolol Maleat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cotempla XR-ODT|Methylphenidate":{"brand_name":"Cotempla XR-ODT","generic_name":"Methylphenidate","avg_per_unit":{"value":16.649735125,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cotempla XR-ODT / Methylphenidate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":238,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cotempla XR-ODT / Methylphenidate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cozaar|Losartan Potassium":{"brand_name":"Cozaar","generic_name":"Losartan Potassium","avg_per_unit":{"value":4.5279600213,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cozaar / Losartan Potassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12050,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cozaar / Losartan Potassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cresemba*|Isavuconazonium Sulfate":{"brand_name":"Cresemba*","generic_name":"Isavuconazonium Sulfate","avg_per_unit":{"value":107.61746726,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cresemba* / Isavuconazonium Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 2 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 2 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19216,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cresemba* / Isavuconazonium Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Crestor|Rosuvastatin Calcium":{"brand_name":"Crestor","generic_name":"Rosuvastatin Calcium","avg_per_unit":{"value":8.7928395675,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Crestor / Rosuvastatin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":54565,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Crestor / Rosuvastatin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Crinone|Progesterone, Micronized":{"brand_name":"Crinone","generic_name":"Progesterone, Micronized","avg_per_unit":{"value":20.307357407,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Crinone / Progesterone, Micronized: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":124,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Crinone / Progesterone, Micronized, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cromolyn Sodium*|Cromolyn Sodium":{"brand_name":"Cromolyn Sodium*","generic_name":"Cromolyn Sodium","avg_per_unit":{"value":1.2319202647,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cromolyn Sodium* / Cromolyn Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (3 of the 8 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":92422,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cromolyn Sodium* / Cromolyn Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Crotan|Crotamiton":{"brand_name":"Crotan","generic_name":"Crotamiton","avg_per_unit":{"value":4.7638330097,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Crotan / Crotamiton: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":2170,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Crotan / Crotamiton, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cryselle|Norgestrel-Ethinyl Estradiol":{"brand_name":"Cryselle","generic_name":"Norgestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.5676286347,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cryselle / Norgestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7915,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cryselle / Norgestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cuvposa|Glycopyrrolate":{"brand_name":"Cuvposa","generic_name":"Glycopyrrolate","avg_per_unit":{"value":0.9614666531,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cuvposa / Glycopyrrolate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":246,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cuvposa / Glycopyrrolate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cyclobenzaprine HCl ER|Cyclobenzaprine HCl":{"brand_name":"Cyclobenzaprine HCl ER","generic_name":"Cyclobenzaprine HCl","avg_per_unit":{"value":8.2152012752,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyclobenzaprine HCl ER / Cyclobenzaprine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5267,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyclobenzaprine HCl ER / Cyclobenzaprine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Cyclobenzaprine HCl|Cyclobenzaprine HCl":{"brand_name":"Cyclobenzaprine HCl","generic_name":"Cyclobenzaprine HCl","avg_per_unit":{"value":0.1420662544,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyclobenzaprine HCl / Cyclobenzaprine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7401986,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyclobenzaprine HCl / Cyclobenzaprine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cyclogyl|Cyclopentolate HCl":{"brand_name":"Cyclogyl","generic_name":"Cyclopentolate HCl","avg_per_unit":{"value":11.853661567,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyclogyl / Cyclopentolate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":298,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyclogyl / Cyclopentolate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cyclopentolate HCl|Cyclopentolate HCl":{"brand_name":"Cyclopentolate HCl","generic_name":"Cyclopentolate HCl","avg_per_unit":{"value":2.4766268521,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyclopentolate HCl / Cyclopentolate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":17761,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyclopentolate HCl / Cyclopentolate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cyclophosphamide*|Cyclophosphamide":{"brand_name":"Cyclophosphamide*","generic_name":"Cyclophosphamide","avg_per_unit":{"value":74.340410269,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyclophosphamide* / Cyclophosphamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 6 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5947,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyclophosphamide* / Cyclophosphamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cycloset|Bromocriptine Mesylate":{"brand_name":"Cycloset","generic_name":"Bromocriptine Mesylate","avg_per_unit":{"value":5.4130306634,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cycloset / Bromocriptine Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2635,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cycloset / Bromocriptine Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cyclosporine*|Cyclosporine":{"brand_name":"Cyclosporine*","generic_name":"Cyclosporine","avg_per_unit":{"value":4.3292659551,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyclosporine* / Cyclosporine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes OPHTHALMIC point at this name (16 of the 22 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":744577,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyclosporine* / Cyclosporine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cyred Eq|Desogestrel-Ethinyl Estradiol":{"brand_name":"Cyred Eq","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.3133969156,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cyred Eq / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cyred Eq / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Cytomel|Liothyronine Sodium":{"brand_name":"Cytomel","generic_name":"Liothyronine Sodium","avg_per_unit":{"value":0.4000606888,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Cytomel / Liothyronine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8950,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Cytomel / Liothyronine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dabigatran Etexilate|Dabigatran Etexilate Mesylate":{"brand_name":"Dabigatran Etexilate","generic_name":"Dabigatran Etexilate Mesylate","avg_per_unit":{"value":2.2466749073,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dabigatran Etexilate / Dabigatran Etexilate Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":299692,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dabigatran Etexilate / Dabigatran Etexilate Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dalfampridine ER|Dalfampridine":{"brand_name":"Dalfampridine ER","generic_name":"Dalfampridine","avg_per_unit":{"value":5.5537533053,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dalfampridine ER / Dalfampridine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":109971,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dalfampridine ER / Dalfampridine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Daliresp|Roflumilast":{"brand_name":"Daliresp","generic_name":"Roflumilast","avg_per_unit":{"value":13.547634686,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Daliresp / Roflumilast: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9113,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Daliresp / Roflumilast, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Danazol|Danazol":{"brand_name":"Danazol","generic_name":"Danazol","avg_per_unit":{"value":3.4142640748,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Danazol / Danazol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6670,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Danazol / Danazol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dantrolene Sodium|Dantrolene Sodium":{"brand_name":"Dantrolene Sodium","generic_name":"Dantrolene Sodium","avg_per_unit":{"value":0.7739139477,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dantrolene Sodium / Dantrolene Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43159,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dantrolene Sodium / Dantrolene Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin":{"brand_name":"Dapagliflozin-Metformin ER","generic_name":"Dapaglifloz Propaned/Metformin","avg_per_unit":{"value":10.478784283,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dapagliflozin-Metformin ER / Dapaglifloz Propaned/Metformin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12164,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dapagliflozin-Metformin ER / Dapaglifloz Propaned/Metformin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dapagliflozin|Dapagliflozin Propanediol":{"brand_name":"Dapagliflozin","generic_name":"Dapagliflozin Propanediol","avg_per_unit":{"value":16.243324338,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dapagliflozin / Dapagliflozin Propanediol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":391756,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dapagliflozin / Dapagliflozin Propanediol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Daptomycin|Daptomycin":{"brand_name":"Daptomycin","generic_name":"Daptomycin","avg_per_unit":{"value":50.130073785,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Daptomycin / Daptomycin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":152673,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Daptomycin / Daptomycin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Darifenacin ER|Darifenacin Hydrobromide":{"brand_name":"Darifenacin ER","generic_name":"Darifenacin Hydrobromide","avg_per_unit":{"value":2.9753397631,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Darifenacin ER / Darifenacin Hydrobromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":37954,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Darifenacin ER / Darifenacin Hydrobromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Darunavir|Darunavir":{"brand_name":"Darunavir","generic_name":"Darunavir","avg_per_unit":{"value":24.095791214,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Darunavir / Darunavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":51231,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Darunavir / Darunavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dasatinib|Dasatinib":{"brand_name":"Dasatinib","generic_name":"Dasatinib","avg_per_unit":{"value":298.94157842,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dasatinib / Dasatinib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5485,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dasatinib / Dasatinib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dasetta|Norethindrone-Ethin. Estradiol":{"brand_name":"Dasetta","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.4675157356,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dasetta / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3226,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dasetta / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Daysee|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Daysee","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":0.582712254,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Daysee / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1838,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Daysee / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dayvigo|Lemborexant":{"brand_name":"Dayvigo","generic_name":"Lemborexant","avg_per_unit":{"value":11.031804179,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dayvigo / Lemborexant: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":57890,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dayvigo / Lemborexant, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Deblitane|Norethindrone":{"brand_name":"Deblitane","generic_name":"Norethindrone","avg_per_unit":{"value":0.3798746302,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Deblitane / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2106,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Deblitane / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Deferasirox|Deferasirox":{"brand_name":"Deferasirox","generic_name":"Deferasirox","avg_per_unit":{"value":19.067034913,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Deferasirox / Deferasirox: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19514,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Deferasirox / Deferasirox, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Delestrogen|Estradiol Valerate":{"brand_name":"Delestrogen","generic_name":"Estradiol Valerate","avg_per_unit":{"value":30.525349448,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Delestrogen / Estradiol Valerate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":475,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Delestrogen / Estradiol Valerate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Delstrigo|Doravirine/Lamivu/Tenofov Diso":{"brand_name":"Delstrigo","generic_name":"Doravirine/Lamivu/Tenofov Diso","avg_per_unit":{"value":88.391127658,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Delstrigo / Doravirine/Lamivu/Tenofov Diso: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6688,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Delstrigo / Doravirine/Lamivu/Tenofov Diso, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Demeclocycline HCl|Demeclocycline HCl":{"brand_name":"Demeclocycline HCl","generic_name":"Demeclocycline HCl","avg_per_unit":{"value":7.1674451107,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Demeclocycline HCl / Demeclocycline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9438,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Demeclocycline HCl / Demeclocycline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Denavir|Penciclovir":{"brand_name":"Denavir","generic_name":"Penciclovir","avg_per_unit":{"value":155.22093667,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Denavir / Penciclovir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":518,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Denavir / Penciclovir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dentagel|Fluoride (Sodium)":{"brand_name":"Dentagel","generic_name":"Fluoride (Sodium)","avg_per_unit":{"value":0.1173901023,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dentagel / Fluoride (Sodium): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":19961,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dentagel / Fluoride (Sodium), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Depakote ER|Divalproex Sodium":{"brand_name":"Depakote ER","generic_name":"Divalproex Sodium","avg_per_unit":{"value":3.6692584461,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Depakote ER / Divalproex Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12774,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Depakote ER / Divalproex Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Depo-Estradiol|Estradiol Cypionate":{"brand_name":"Depo-Estradiol","generic_name":"Estradiol Cypionate","avg_per_unit":{"value":37.395141047,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Depo-Estradiol / Estradiol Cypionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3076,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Depo-Estradiol / Estradiol Cypionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Depo-Medrol|Methylprednisolone Acetate":{"brand_name":"Depo-Medrol","generic_name":"Methylprednisolone Acetate","avg_per_unit":{"value":15.576323487,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Depo-Medrol / Methylprednisolone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":914,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Depo-Medrol / Methylprednisolone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Depo-Provera|Medroxyprogesterone Acetate":{"brand_name":"Depo-Provera","generic_name":"Medroxyprogesterone Acetate","avg_per_unit":{"value":56.809438202,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Depo-Provera / Medroxyprogesterone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":178,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Depo-Provera / Medroxyprogesterone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Depo-Subq Provera 104|Medroxyprogesterone Acetate":{"brand_name":"Depo-Subq Provera 104","generic_name":"Medroxyprogesterone Acetate","avg_per_unit":{"value":83.048217371,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Depo-Subq Provera 104 / Medroxyprogesterone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":927,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Depo-Subq Provera 104 / Medroxyprogesterone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Depo-Testosterone|Testosterone Cypionate":{"brand_name":"Depo-Testosterone","generic_name":"Testosterone Cypionate","avg_per_unit":{"value":10.09719057,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Depo-Testosterone / Testosterone Cypionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2818,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Depo-Testosterone / Testosterone Cypionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dermacinrx Lidocan|Lidocaine":{"brand_name":"Dermacinrx Lidocan","generic_name":"Lidocaine","avg_per_unit":{"value":52.447995205,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dermacinrx Lidocan / Lidocaine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1567,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dermacinrx Lidocan / Lidocaine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dermotic|Fluocinolone Acetonide Oil":{"brand_name":"Dermotic","generic_name":"Fluocinolone Acetonide Oil","avg_per_unit":{"value":1.3471228464,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dermotic / Fluocinolone Acetonide Oil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1316,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dermotic / Fluocinolone Acetonide Oil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Descovy|Emtricitabine/Tenofov Alafenam":{"brand_name":"Descovy","generic_name":"Emtricitabine/Tenofov Alafenam","avg_per_unit":{"value":72.192166535,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Descovy / Emtricitabine/Tenofov Alafenam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":238782,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Descovy / Emtricitabine/Tenofov Alafenam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Desipramine HCl|Desipramine HCl":{"brand_name":"Desipramine HCl","generic_name":"Desipramine HCl","avg_per_unit":{"value":0.7836705862,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Desipramine HCl / Desipramine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":54189,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Desipramine HCl / Desipramine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Desloratadine|Desloratadine":{"brand_name":"Desloratadine","generic_name":"Desloratadine","avg_per_unit":{"value":0.7217990039,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Desloratadine / Desloratadine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":152884,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Desloratadine / Desloratadine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Desoximetasone|Desoximetasone":{"brand_name":"Desoximetasone","generic_name":"Desoximetasone","avg_per_unit":{"value":1.1109477024,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Desoximetasone / Desoximetasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. 26 of 27 NADAC NDCs joined to this name are priced per GM (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":46030,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Desoximetasone / Desoximetasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Desvenlafaxine Succinate ER|Desvenlafaxine Succinate":{"brand_name":"Desvenlafaxine Succinate ER","generic_name":"Desvenlafaxine Succinate","avg_per_unit":{"value":1.1974586321,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Desvenlafaxine Succinate ER / Desvenlafaxine Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":958249,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Desvenlafaxine Succinate ER / Desvenlafaxine Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dexamethasone|Dexamethasone":{"brand_name":"Dexamethasone","generic_name":"Dexamethasone","avg_per_unit":{"value":0.5323151891,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dexamethasone / Dexamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 65 of 71 NADAC NDCs joined to this name are priced per EA (6 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1472228,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dexamethasone / Dexamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dexlansoprazole Dr|Dexlansoprazole":{"brand_name":"Dexlansoprazole Dr","generic_name":"Dexlansoprazole","avg_per_unit":{"value":5.0625514239,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dexlansoprazole Dr / Dexlansoprazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":796724,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dexlansoprazole Dr / Dexlansoprazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dexmethylphenidate HCl ER|Dexmethylphenidate HCl":{"brand_name":"Dexmethylphenidate HCl ER","generic_name":"Dexmethylphenidate HCl","avg_per_unit":{"value":2.7414890132,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dexmethylphenidate HCl ER / Dexmethylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":44752,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dexmethylphenidate HCl ER / Dexmethylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dexmethylphenidate HCl|Dexmethylphenidate HCl":{"brand_name":"Dexmethylphenidate HCl","generic_name":"Dexmethylphenidate HCl","avg_per_unit":{"value":0.5045315424,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dexmethylphenidate HCl / Dexmethylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":28862,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dexmethylphenidate HCl / Dexmethylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate":{"brand_name":"Dextroamphetamine Sulfate ER","generic_name":"Dextroamphetamine Sulfate","avg_per_unit":{"value":1.6301251581,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dextroamphetamine Sulfate ER / Dextroamphetamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38715,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dextroamphetamine Sulfate ER / Dextroamphetamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dextroamphetamine Sulfate|Dextroamphetamine Sulfate":{"brand_name":"Dextroamphetamine Sulfate","generic_name":"Dextroamphetamine Sulfate","avg_per_unit":{"value":0.9721167067,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dextroamphetamine Sulfate / Dextroamphetamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 28 of 30 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":57362,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dextroamphetamine Sulfate / Dextroamphetamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dhivy|Carbidopa/Levodopa":{"brand_name":"Dhivy","generic_name":"Carbidopa/Levodopa","avg_per_unit":{"value":3.0412469031,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dhivy / Carbidopa/Levodopa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1703,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dhivy / Carbidopa/Levodopa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diazepam*|Diazepam":{"brand_name":"Diazepam*","generic_name":"Diazepam","avg_per_unit":{"value":0.9408481898,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diazepam* / Diazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (31 of the 42 the name join matched); NDCs of another route or with no known FDA route do not. 3 of the 31 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 40 of 42 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2984541,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diazepam* / Diazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diazoxide|Diazoxide":{"brand_name":"Diazoxide","generic_name":"Diazoxide","avg_per_unit":{"value":6.8006752403,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diazoxide / Diazoxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2613,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diazoxide / Diazoxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diclofenac Epolamine|Diclofenac Epolamine":{"brand_name":"Diclofenac Epolamine","generic_name":"Diclofenac Epolamine","avg_per_unit":{"value":10.750209488,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diclofenac Epolamine / Diclofenac Epolamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":170571,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diclofenac Epolamine / Diclofenac Epolamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diclofenac Potassium|Diclofenac Potassium":{"brand_name":"Diclofenac Potassium","generic_name":"Diclofenac Potassium","avg_per_unit":{"value":2.0664259192,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diclofenac Potassium / Diclofenac Potassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":369447,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diclofenac Potassium / Diclofenac Potassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diclofenac Sodium ER|Diclofenac Sodium":{"brand_name":"Diclofenac Sodium ER","generic_name":"Diclofenac Sodium","avg_per_unit":{"value":0.8857732426,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diclofenac Sodium ER / Diclofenac Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":208582,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diclofenac Sodium ER / Diclofenac Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dicloxacillin Sodium|Dicloxacillin Sodium":{"brand_name":"Dicloxacillin Sodium","generic_name":"Dicloxacillin Sodium","avg_per_unit":{"value":0.7793927031,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dicloxacillin Sodium / Dicloxacillin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25502,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dicloxacillin Sodium / Dicloxacillin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dicyclomine HCl*|Dicyclomine HCl":{"brand_name":"Dicyclomine HCl*","generic_name":"Dicyclomine HCl","avg_per_unit":{"value":0.1660028673,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dicyclomine HCl* / Dicyclomine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 51 NADAC NDCs the name join matched to it have an FDA route including ORAL. 3 of the 48 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 48 of 51 NADAC NDCs joined to this name are priced per EA (3 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2350747,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dicyclomine HCl* / Dicyclomine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dificid|Fidaxomicin":{"brand_name":"Dificid","generic_name":"Fidaxomicin","avg_per_unit":{"value":245.74831742,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dificid / Fidaxomicin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":34589,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dificid / Fidaxomicin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diflorasone Diacetate|Diflorasone Diacetate":{"brand_name":"Diflorasone Diacetate","generic_name":"Diflorasone Diacetate","avg_per_unit":{"value":7.9944107359,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diflorasone Diacetate / Diflorasone Diacetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":28642,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diflorasone Diacetate / Diflorasone Diacetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diflunisal|Diflunisal":{"brand_name":"Diflunisal","generic_name":"Diflunisal","avg_per_unit":{"value":0.871873048,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diflunisal / Diflunisal: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9163,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diflunisal / Diflunisal, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Difluprednate|Difluprednate":{"brand_name":"Difluprednate","generic_name":"Difluprednate","avg_per_unit":{"value":19.002317709,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Difluprednate / Difluprednate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":131416,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Difluprednate / Difluprednate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Digoxin*|Digoxin":{"brand_name":"Digoxin*","generic_name":"Digoxin","avg_per_unit":{"value":0.4330038025,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Digoxin* / Digoxin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 33 NADAC NDCs the name join matched to it have an FDA route including ORAL. 3 of the 30 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 30 of 33 NADAC NDCs joined to this name are priced per EA (3 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1579920,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Digoxin* / Digoxin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate":{"brand_name":"Dihydroergotamine Mesylate*","generic_name":"Dihydroergotamine Mesylate","avg_per_unit":{"value":149.45629394,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dihydroergotamine Mesylate* / Dihydroergotamine Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes NASAL point at this name (8 of the 10 the name join matched); NDCs of another route or with no known FDA route do not. 3 of the 8 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":17794,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dihydroergotamine Mesylate* / Dihydroergotamine Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diltiazem 12hr ER|Diltiazem HCl":{"brand_name":"Diltiazem 12hr ER","generic_name":"Diltiazem HCl","avg_per_unit":{"value":1.7737026119,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diltiazem 12hr ER / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":189166,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diltiazem 12hr ER / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diltiazem 24hr ER (Cd)|Diltiazem HCl":{"brand_name":"Diltiazem 24hr ER (Cd)","generic_name":"Diltiazem HCl","avg_per_unit":{"value":0.3883347573,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diltiazem 24hr ER (Cd) / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3662791,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diltiazem 24hr ER (Cd) / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diltiazem 24hr ER (La)|Diltiazem HCl":{"brand_name":"Diltiazem 24hr ER (La)","generic_name":"Diltiazem HCl","avg_per_unit":{"value":1.5064575251,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diltiazem 24hr ER (La) / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":189131,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diltiazem 24hr ER (La) / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diltiazem 24hr ER (XR)|Diltiazem HCl":{"brand_name":"Diltiazem 24hr ER (XR)","generic_name":"Diltiazem HCl","avg_per_unit":{"value":0.4713398132,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diltiazem 24hr ER (XR) / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":209383,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diltiazem 24hr ER (XR) / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diltiazem HCl*|Diltiazem HCl":{"brand_name":"Diltiazem HCl*","generic_name":"Diltiazem HCl","avg_per_unit":{"value":0.2169211028,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diltiazem HCl* / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (25 of the 31 the name join matched); NDCs of another route or with no known FDA route do not. 2 of the 25 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":707541,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diltiazem HCl* / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diovan HCT|Valsartan/Hydrochlorothiazide":{"brand_name":"Diovan HCT","generic_name":"Valsartan/Hydrochlorothiazide","avg_per_unit":{"value":11.924995924,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diovan HCT / Valsartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7543,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diovan HCT / Valsartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diovan|Valsartan":{"brand_name":"Diovan","generic_name":"Valsartan","avg_per_unit":{"value":9.7220973527,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diovan / Valsartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25913,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diovan / Valsartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dipentum|Olsalazine Sodium":{"brand_name":"Dipentum","generic_name":"Olsalazine Sodium","avg_per_unit":{"value":14.54719448,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dipentum / Olsalazine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1345,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dipentum / Olsalazine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diphenhydramine HCl*|Diphenhydramine HCl":{"brand_name":"Diphenhydramine HCl*","generic_name":"Diphenhydramine HCl","avg_per_unit":{"value":1.2368779186,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diphenhydramine HCl* / Diphenhydramine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 10 NADAC NDCs the name join matched to it have an FDA route including INTRAMUSCULAR and INTRAVENOUS.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":61123,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diphenhydramine HCl* / Diphenhydramine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine":{"brand_name":"Diphenoxylate-Atropine","generic_name":"Diphenoxylate HCl/Atropine","avg_per_unit":{"value":0.2615448703,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Diphenoxylate-Atropine / Diphenoxylate HCl/Atropine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":741208,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Diphenoxylate-Atropine / Diphenoxylate HCl/Atropine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dipyridamole|Dipyridamole":{"brand_name":"Dipyridamole","generic_name":"Dipyridamole","avg_per_unit":{"value":0.7925802589,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dipyridamole / Dipyridamole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12019,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dipyridamole / Dipyridamole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Disopyramide Phosphate|Disopyramide Phosphate":{"brand_name":"Disopyramide Phosphate","generic_name":"Disopyramide Phosphate","avg_per_unit":{"value":1.4056644384,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Disopyramide Phosphate / Disopyramide Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10341,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Disopyramide Phosphate / Disopyramide Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Disulfiram|Disulfiram":{"brand_name":"Disulfiram","generic_name":"Disulfiram","avg_per_unit":{"value":2.4375284412,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Disulfiram / Disulfiram: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22761,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Disulfiram / Disulfiram, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Divalproex Sodium ER|Divalproex Sodium":{"brand_name":"Divalproex Sodium ER","generic_name":"Divalproex Sodium","avg_per_unit":{"value":0.6568529232,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Divalproex Sodium ER / Divalproex Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1619238,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Divalproex Sodium ER / Divalproex Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dofetilide|Dofetilide":{"brand_name":"Dofetilide","generic_name":"Dofetilide","avg_per_unit":{"value":1.5408492053,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dofetilide / Dofetilide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":335349,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dofetilide / Dofetilide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dolishale|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Dolishale","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":1.1421021803,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dolishale / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":219,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dolishale / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Donepezil HCl ODT|Donepezil HCl":{"brand_name":"Donepezil HCl ODT","generic_name":"Donepezil HCl","avg_per_unit":{"value":0.5452080256,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Donepezil HCl ODT / Donepezil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48849,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Donepezil HCl ODT / Donepezil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Donepezil HCl|Donepezil HCl":{"brand_name":"Donepezil HCl","generic_name":"Donepezil HCl","avg_per_unit":{"value":0.2467048326,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Donepezil HCl / Donepezil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8063081,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Donepezil HCl / Donepezil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dorzolamide HCl|Dorzolamide HCl":{"brand_name":"Dorzolamide HCl","generic_name":"Dorzolamide HCl","avg_per_unit":{"value":1.559880242,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dorzolamide HCl / Dorzolamide HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1050631,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dorzolamide HCl / Dorzolamide HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat":{"brand_name":"Dorzolamide-Timolol","generic_name":"Dorzolamide HCl/Timolol Maleat","avg_per_unit":{"value":1.4327907751,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dorzolamide-Timolol / Dorzolamide HCl/Timolol Maleat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2955061,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dorzolamide-Timolol / Dorzolamide HCl/Timolol Maleat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dotti|Estradiol":{"brand_name":"Dotti","generic_name":"Estradiol","avg_per_unit":{"value":7.0405350212,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dotti / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":122816,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dotti / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dovato|Dolutegravir Sodium/Lamivudine":{"brand_name":"Dovato","generic_name":"Dolutegravir Sodium/Lamivudine","avg_per_unit":{"value":98.499174617,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dovato / Dolutegravir Sodium/Lamivudine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":176933,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dovato / Dolutegravir Sodium/Lamivudine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Doxazosin Mesylate|Doxazosin Mesylate":{"brand_name":"Doxazosin Mesylate","generic_name":"Doxazosin Mesylate","avg_per_unit":{"value":0.2034860575,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Doxazosin Mesylate / Doxazosin Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2210014,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Doxazosin Mesylate / Doxazosin Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Doxepin HCl*|Doxepin HCl":{"brand_name":"Doxepin HCl*","generic_name":"Doxepin HCl","avg_per_unit":{"value":0.9224502682,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Doxepin HCl* / Doxepin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (106 of the 116 the name join matched); NDCs of another route or with no known FDA route do not. 4 of the 106 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 112 of 116 NADAC NDCs joined to this name are priced per EA (3 per GM, 1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1270415,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Doxepin HCl* / Doxepin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Doxycycline Hyclate*|Doxycycline Hyclate":{"brand_name":"Doxycycline Hyclate*","generic_name":"Doxycycline Hyclate","avg_per_unit":{"value":0.4852084924,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Doxycycline Hyclate* / Doxycycline Hyclate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (76 of the 83 the name join matched); NDCs of another route or with no known FDA route do not. 5 of the 76 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6667052,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Doxycycline Hyclate* / Doxycycline Hyclate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Doxycycline Ir-Dr|Doxycycline Monohydrate":{"brand_name":"Doxycycline Ir-Dr","generic_name":"Doxycycline Monohydrate","avg_per_unit":{"value":17.487109399,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Doxycycline Ir-Dr / Doxycycline Monohydrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14645,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Doxycycline Ir-Dr / Doxycycline Monohydrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Doxycycline Monohydrate|Doxycycline Monohydrate":{"brand_name":"Doxycycline Monohydrate","generic_name":"Doxycycline Monohydrate","avg_per_unit":{"value":0.6034079612,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Doxycycline Monohydrate / Doxycycline Monohydrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1931472,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Doxycycline Monohydrate / Doxycycline Monohydrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dronabinol|Dronabinol":{"brand_name":"Dronabinol","generic_name":"Dronabinol","avg_per_unit":{"value":3.0961985889,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dronabinol / Dronabinol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39997,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dronabinol / Dronabinol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone":{"brand_name":"Drospirenone-Ethinyl Estradiol","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.6604841067,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Drospirenone-Ethinyl Estradiol / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14519,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Drospirenone-Ethinyl Estradiol / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Droxidopa|Droxidopa":{"brand_name":"Droxidopa","generic_name":"Droxidopa","avg_per_unit":{"value":8.7158703006,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Droxidopa / Droxidopa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39170,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Droxidopa / Droxidopa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Duavee|Estrogens,Conj/Bazedoxifene":{"brand_name":"Duavee","generic_name":"Estrogens,Conj/Bazedoxifene","avg_per_unit":{"value":6.3725855534,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Duavee / Estrogens,Conj/Bazedoxifene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2844,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Duavee / Estrogens,Conj/Bazedoxifene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dulera|Mometasone/Formoterol":{"brand_name":"Dulera","generic_name":"Mometasone/Formoterol","avg_per_unit":{"value":26.102326062,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dulera / Mometasone/Formoterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":369910,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dulera / Mometasone/Formoterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Duloxetine HCl|Duloxetine HCl":{"brand_name":"Duloxetine HCl","generic_name":"Duloxetine HCl","avg_per_unit":{"value":0.3506240754,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Duloxetine HCl / Duloxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13094360,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Duloxetine HCl / Duloxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Durezol|Difluprednate":{"brand_name":"Durezol","generic_name":"Difluprednate","avg_per_unit":{"value":42.003717641,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Durezol / Difluprednate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2990,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Durezol / Difluprednate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl":{"brand_name":"Dutasteride-Tamsulosin","generic_name":"Dutasteride/Tamsulosin HCl","avg_per_unit":{"value":2.7002083675,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dutasteride-Tamsulosin / Dutasteride/Tamsulosin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":50272,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dutasteride-Tamsulosin / Dutasteride/Tamsulosin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dutasteride|Dutasteride":{"brand_name":"Dutasteride","generic_name":"Dutasteride","avg_per_unit":{"value":0.4638618995,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dutasteride / Dutasteride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":955565,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dutasteride / Dutasteride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Dymista|Azelastine/Fluticasone":{"brand_name":"Dymista","generic_name":"Azelastine/Fluticasone","avg_per_unit":{"value":8.6287006497,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Dymista / Azelastine/Fluticasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":2117,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Dymista / Azelastine/Fluticasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ebglyss Pen|Lebrikizumab-Lbkz":{"brand_name":"Ebglyss Pen","generic_name":"Lebrikizumab-Lbkz","avg_per_unit":{"value":1717.2578136,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ebglyss Pen / Lebrikizumab-Lbkz: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":292,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ebglyss Pen / Lebrikizumab-Lbkz, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Econazole Nitrate|Econazole Nitrate":{"brand_name":"Econazole Nitrate","generic_name":"Econazole Nitrate","avg_per_unit":{"value":0.5160109222,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Econazole Nitrate / Econazole Nitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":158122,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Econazole Nitrate / Econazole Nitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Edarbi|Azilsartan Medoxomil":{"brand_name":"Edarbi","generic_name":"Azilsartan Medoxomil","avg_per_unit":{"value":8.0149969413,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Edarbi / Azilsartan Medoxomil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":80628,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Edarbi / Azilsartan Medoxomil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Edarbyclor|Azilsartan Med/Chlorthalidone":{"brand_name":"Edarbyclor","generic_name":"Azilsartan Med/Chlorthalidone","avg_per_unit":{"value":7.8541252955,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Edarbyclor / Azilsartan Med/Chlorthalidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":60706,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Edarbyclor / Azilsartan Med/Chlorthalidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Edluar|Zolpidem Tartrate":{"brand_name":"Edluar","generic_name":"Zolpidem Tartrate","avg_per_unit":{"value":14.126079882,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Edluar / Zolpidem Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1219,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Edluar / Zolpidem Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Edurant|Rilpivirine HCl":{"brand_name":"Edurant","generic_name":"Rilpivirine HCl","avg_per_unit":{"value":48.469680889,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Edurant / Rilpivirine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15435,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Edurant / Rilpivirine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Efavirenz|Efavirenz":{"brand_name":"Efavirenz","generic_name":"Efavirenz","avg_per_unit":{"value":8.8944419493,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Efavirenz / Efavirenz: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10906,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Efavirenz / Efavirenz, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Effer-K|Potassium Bicarbonate/Cit Ac":{"brand_name":"Effer-K","generic_name":"Potassium Bicarbonate/Cit Ac","avg_per_unit":{"value":0.4913876502,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Effer-K / Potassium Bicarbonate/Cit Ac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10059,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Effer-K / Potassium Bicarbonate/Cit Ac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Effexor XR|Venlafaxine HCl":{"brand_name":"Effexor XR","generic_name":"Venlafaxine HCl","avg_per_unit":{"value":18.83672653,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Effexor XR / Venlafaxine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16997,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Effexor XR / Venlafaxine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Elestrin|Estradiol":{"brand_name":"Elestrin","generic_name":"Estradiol","avg_per_unit":{"value":4.6929034471,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Elestrin / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":975,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Elestrin / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eletriptan HBr|Eletriptan Hydrobromide":{"brand_name":"Eletriptan HBr","generic_name":"Eletriptan Hydrobromide","avg_per_unit":{"value":7.2963225297,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eletriptan HBr / Eletriptan Hydrobromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":67842,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eletriptan HBr / Eletriptan Hydrobromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Elinest|Norgestrel-Ethinyl Estradiol":{"brand_name":"Elinest","generic_name":"Norgestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.5489456666,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Elinest / Norgestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3265,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Elinest / Norgestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eliquis|Apixaban":{"brand_name":"Eliquis","generic_name":"Apixaban","avg_per_unit":{"value":9.6370356894,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eliquis / Apixaban: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":24061332,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eliquis / Apixaban, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Elmiron|Pentosan Polysulfate Sodium":{"brand_name":"Elmiron","generic_name":"Pentosan Polysulfate Sodium","avg_per_unit":{"value":11.012472282,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Elmiron / Pentosan Polysulfate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":42953,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Elmiron / Pentosan Polysulfate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eluryng|Etonogestrel/Ethinyl Estradiol":{"brand_name":"Eluryng","generic_name":"Etonogestrel/Ethinyl Estradiol","avg_per_unit":{"value":75.729800304,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eluryng / Etonogestrel/Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2065,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eluryng / Etonogestrel/Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Elyxyb|Celecoxib":{"brand_name":"Elyxyb","generic_name":"Celecoxib","avg_per_unit":{"value":29.541148605,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Elyxyb / Celecoxib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1462,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Elyxyb / Celecoxib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Emsam|Selegiline":{"brand_name":"Emsam","generic_name":"Selegiline","avg_per_unit":{"value":71.428007221,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Emsam / Selegiline: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5355,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Emsam / Selegiline, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Emtricitabine|Emtricitabine":{"brand_name":"Emtricitabine","generic_name":"Emtricitabine","avg_per_unit":{"value":11.797791205,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Emtricitabine / Emtricitabine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5093,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Emtricitabine / Emtricitabine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Emtriva|Emtricitabine":{"brand_name":"Emtriva","generic_name":"Emtricitabine","avg_per_unit":{"value":14.263868333,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Emtriva / Emtricitabine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":439,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Emtriva / Emtricitabine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Emverm|Mebendazole":{"brand_name":"Emverm","generic_name":"Mebendazole","avg_per_unit":{"value":667.07892139,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Emverm / Mebendazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1734,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Emverm / Mebendazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enalapril Maleate|Enalapril Maleate":{"brand_name":"Enalapril Maleate","generic_name":"Enalapril Maleate","avg_per_unit":{"value":0.1811309867,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enalapril Maleate / Enalapril Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 66 of 73 NADAC NDCs joined to this name are priced per EA (7 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2000801,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enalapril Maleate / Enalapril Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enalapril-Hydrochlorothiazide|Enalapril/Hydrochlorothiazide":{"brand_name":"Enalapril-Hydrochlorothiazide","generic_name":"Enalapril/Hydrochlorothiazide","avg_per_unit":{"value":0.2870307784,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enalapril-Hydrochlorothiazide / Enalapril/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":61579,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enalapril-Hydrochlorothiazide / Enalapril/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enbrel Mini|Etanercept":{"brand_name":"Enbrel Mini","generic_name":"Etanercept","avg_per_unit":{"value":1839.7729712,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enbrel Mini / Etanercept: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":32410,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enbrel Mini / Etanercept, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enbrel Sureclick|Etanercept":{"brand_name":"Enbrel Sureclick","generic_name":"Etanercept","avg_per_unit":{"value":1821.2306452,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enbrel Sureclick / Etanercept: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":296022,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enbrel Sureclick / Etanercept, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enbrel|Etanercept":{"brand_name":"Enbrel","generic_name":"Etanercept","avg_per_unit":{"value":1804.192229,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enbrel / Etanercept: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":80845,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enbrel / Etanercept, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Endocet|Oxycodone HCl/Acetaminophen":{"brand_name":"Endocet","generic_name":"Oxycodone HCl/Acetaminophen","avg_per_unit":{"value":0.3389698303,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Endocet / Oxycodone HCl/Acetaminophen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":44724,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Endocet / Oxycodone HCl/Acetaminophen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Endometrin|Progesterone, Micronized":{"brand_name":"Endometrin","generic_name":"Progesterone, Micronized","avg_per_unit":{"value":13.126723647,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Endometrin / Progesterone, Micronized: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Endometrin / Progesterone, Micronized, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Enilloring|Etonogestrel/Ethinyl Estradiol":{"brand_name":"Enilloring","generic_name":"Etonogestrel/Ethinyl Estradiol","avg_per_unit":{"value":84.628163533,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enilloring / Etonogestrel/Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1126,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enilloring / Etonogestrel/Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enoxaparin Sodium|Enoxaparin Sodium":{"brand_name":"Enoxaparin Sodium","generic_name":"Enoxaparin Sodium","avg_per_unit":{"value":12.251449805,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enoxaparin Sodium / Enoxaparin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":532949,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enoxaparin Sodium / Enoxaparin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enskyce|Desogestrel-Ethinyl Estradiol":{"brand_name":"Enskyce","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.3779510859,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enskyce / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3492,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enskyce / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enstilar|Calcipotriene/Betamethasone":{"brand_name":"Enstilar","generic_name":"Calcipotriene/Betamethasone","avg_per_unit":{"value":21.564559378,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enstilar / Calcipotriene/Betamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":4017,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enstilar / Calcipotriene/Betamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Entacapone|Entacapone":{"brand_name":"Entacapone","generic_name":"Entacapone","avg_per_unit":{"value":0.9670266984,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Entacapone / Entacapone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":128596,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Entacapone / Entacapone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Entecavir|Entecavir":{"brand_name":"Entecavir","generic_name":"Entecavir","avg_per_unit":{"value":4.1504543828,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Entecavir / Entecavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":131142,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Entecavir / Entecavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Entresto|Sacubitril/Valsartan":{"brand_name":"Entresto","generic_name":"Sacubitril/Valsartan","avg_per_unit":{"value":11.039950084,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Entresto / Sacubitril/Valsartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3898804,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Entresto / Sacubitril/Valsartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Enulose|Lactulose":{"brand_name":"Enulose","generic_name":"Lactulose","avg_per_unit":{"value":0.0267387862,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Enulose / Lactulose: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":236911,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Enulose / Lactulose, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eohilia|Budesonide":{"brand_name":"Eohilia","generic_name":"Budesonide","avg_per_unit":{"value":3.0340079881,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eohilia / Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":776,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eohilia / Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epaned|Enalapril Maleate":{"brand_name":"Epaned","generic_name":"Enalapril Maleate","avg_per_unit":{"value":3.972383692,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epaned / Enalapril Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":63,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epaned / Enalapril Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epclusa|Sofosbuvir/Velpatasvir":{"brand_name":"Epclusa","generic_name":"Sofosbuvir/Velpatasvir","avg_per_unit":{"value":848.71572212,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epclusa / Sofosbuvir/Velpatasvir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":31431,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epclusa / Sofosbuvir/Velpatasvir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epiduo Forte|Adapalene/Benzoyl Peroxide":{"brand_name":"Epiduo Forte","generic_name":"Adapalene/Benzoyl Peroxide","avg_per_unit":{"value":14.970487085,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epiduo Forte / Adapalene/Benzoyl Peroxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":87,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epiduo Forte / Adapalene/Benzoyl Peroxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epifoam|Hydrocortisone/Pramoxine":{"brand_name":"Epifoam","generic_name":"Hydrocortisone/Pramoxine","avg_per_unit":{"value":9.285259555,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epifoam / Hydrocortisone/Pramoxine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":160,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epifoam / Hydrocortisone/Pramoxine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epinastine HCl|Epinastine HCl":{"brand_name":"Epinastine HCl","generic_name":"Epinastine HCl","avg_per_unit":{"value":9.7439677585,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epinastine HCl / Epinastine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":21821,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epinastine HCl / Epinastine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epinephrine|Epinephrine":{"brand_name":"Epinephrine","generic_name":"Epinephrine","avg_per_unit":{"value":99.629479652,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epinephrine / Epinephrine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 12 of 13 NADAC NDCs joined to this name are priced per EA (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":578447,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epinephrine / Epinephrine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eplerenone|Eplerenone":{"brand_name":"Eplerenone","generic_name":"Eplerenone","avg_per_unit":{"value":1.0771569226,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eplerenone / Eplerenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":320900,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eplerenone / Eplerenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Epogen|Epoetin Alfa":{"brand_name":"Epogen","generic_name":"Epoetin Alfa","avg_per_unit":{"value":179.43422628,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Epogen / Epoetin Alfa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":16346,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Epogen / Epoetin Alfa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eprontia|Topiramate":{"brand_name":"Eprontia","generic_name":"Topiramate","avg_per_unit":{"value":1.8856102542,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eprontia / Topiramate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1364,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eprontia / Topiramate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Equetro|Carbamazepine":{"brand_name":"Equetro","generic_name":"Carbamazepine","avg_per_unit":{"value":4.3945528363,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Equetro / Carbamazepine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2532,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Equetro / Carbamazepine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ergomar|Ergotamine Tartrate":{"brand_name":"Ergomar","generic_name":"Ergotamine Tartrate","avg_per_unit":{"value":67.057663219,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ergomar / Ergotamine Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":138,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ergomar / Ergotamine Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Errin|Norethindrone":{"brand_name":"Errin","generic_name":"Norethindrone","avg_per_unit":{"value":0.393407493,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Errin / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4727,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Errin / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ertapenem|Ertapenem Sodium":{"brand_name":"Ertapenem","generic_name":"Ertapenem Sodium","avg_per_unit":{"value":27.034491995,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ertapenem / Ertapenem Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":173446,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ertapenem / Ertapenem Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Erythromycin-Benzoyl Peroxide|Erythromycin/Benzoyl Peroxide":{"brand_name":"Erythromycin-Benzoyl Peroxide","generic_name":"Erythromycin/Benzoyl Peroxide","avg_per_unit":{"value":2.0462652929,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Erythromycin-Benzoyl Peroxide / Erythromycin/Benzoyl Peroxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":8102,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Erythromycin-Benzoyl Peroxide / Erythromycin/Benzoyl Peroxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ery|Erythromycin Base In Ethanol":{"brand_name":"Ery","generic_name":"Erythromycin Base In Ethanol","avg_per_unit":{"value":1.0281678564,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ery / Erythromycin Base In Ethanol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1345,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ery / Erythromycin Base In Ethanol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Escitalopram Oxalate|Escitalopram Oxalate":{"brand_name":"Escitalopram Oxalate","generic_name":"Escitalopram Oxalate","avg_per_unit":{"value":0.1902531661,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Escitalopram Oxalate / Escitalopram Oxalate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 65 of 70 NADAC NDCs joined to this name are priced per EA (5 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12685003,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Escitalopram Oxalate / Escitalopram Oxalate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Estarylla|Norgestimate-Ethinyl Estradiol":{"brand_name":"Estarylla","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.3516475817,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Estarylla / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11845,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Estarylla / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Estazolam|Estazolam":{"brand_name":"Estazolam","generic_name":"Estazolam","avg_per_unit":{"value":1.8838604555,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Estazolam / Estazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":64766,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Estazolam / Estazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Estrace*|Estradiol":{"brand_name":"Estrace*","generic_name":"Estradiol","avg_per_unit":{"value":6.0083444795,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Estrace* / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 1 NADAC NDCs the name join matched to it have an FDA route including VAGINAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":6218,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Estrace* / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Estradiol Valerate|Estradiol Valerate":{"brand_name":"Estradiol Valerate","generic_name":"Estradiol Valerate","avg_per_unit":{"value":22.316679055,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Estradiol Valerate / Estradiol Valerate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":14281,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Estradiol Valerate / Estradiol Valerate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet":{"brand_name":"Estradiol-Norethindrone Acetat","generic_name":"Estradiol/Norethindrone Acet","avg_per_unit":{"value":1.4607127341,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Estradiol-Norethindrone Acetat / Estradiol/Norethindrone Acet: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":53207,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Estradiol-Norethindrone Acetat / Estradiol/Norethindrone Acet, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Estring|Estradiol":{"brand_name":"Estring","generic_name":"Estradiol","avg_per_unit":{"value":539.53308091,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Estring / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":90750,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Estring / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eszopiclone|Eszopiclone":{"brand_name":"Eszopiclone","generic_name":"Eszopiclone","avg_per_unit":{"value":0.5923625377,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eszopiclone / Eszopiclone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":838132,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eszopiclone / Eszopiclone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ethacrynic Acid|Ethacrynic Acid":{"brand_name":"Ethacrynic Acid","generic_name":"Ethacrynic Acid","avg_per_unit":{"value":4.2231100235,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ethacrynic Acid / Ethacrynic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14655,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ethacrynic Acid / Ethacrynic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ethambutol HCl|Ethambutol HCl":{"brand_name":"Ethambutol HCl","generic_name":"Ethambutol HCl","avg_per_unit":{"value":0.6561656321,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ethambutol HCl / Ethambutol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":73812,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ethambutol HCl / Ethambutol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Etodolac ER|Etodolac":{"brand_name":"Etodolac ER","generic_name":"Etodolac","avg_per_unit":{"value":1.4511134195,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Etodolac ER / Etodolac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22778,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Etodolac ER / Etodolac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Etodolac|Etodolac":{"brand_name":"Etodolac","generic_name":"Etodolac","avg_per_unit":{"value":0.4882523207,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Etodolac / Etodolac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":243587,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Etodolac / Etodolac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Etravirine|Etravirine":{"brand_name":"Etravirine","generic_name":"Etravirine","avg_per_unit":{"value":15.662523251,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Etravirine / Etravirine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":21251,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Etravirine / Etravirine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eucrisa|Crisaborole":{"brand_name":"Eucrisa","generic_name":"Crisaborole","avg_per_unit":{"value":11.902270282,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eucrisa / Crisaborole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":10592,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eucrisa / Crisaborole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Evamist|Estradiol":{"brand_name":"Evamist","generic_name":"Estradiol","avg_per_unit":{"value":16.832104578,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Evamist / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1700,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Evamist / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Everolimus|Everolimus":{"brand_name":"Everolimus","generic_name":"Everolimus","avg_per_unit":{"value":103.83052456,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Everolimus / Everolimus: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":40638,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Everolimus / Everolimus, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Evista|Raloxifene HCl":{"brand_name":"Evista","generic_name":"Raloxifene HCl","avg_per_unit":{"value":6.2365999852,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Evista / Raloxifene HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2355,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Evista / Raloxifene HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Evotaz|Atazanavir Sulfate/Cobicistat":{"brand_name":"Evotaz","generic_name":"Atazanavir Sulfate/Cobicistat","avg_per_unit":{"value":53.114963962,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Evotaz / Atazanavir Sulfate/Cobicistat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6152,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Evotaz / Atazanavir Sulfate/Cobicistat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Evoxac|Cevimeline HCl":{"brand_name":"Evoxac","generic_name":"Cevimeline HCl","avg_per_unit":{"value":7.6876109363,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Evoxac / Cevimeline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":797,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Evoxac / Cevimeline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Exelon|Rivastigmine":{"brand_name":"Exelon","generic_name":"Rivastigmine","avg_per_unit":{"value":22.66382217,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Exelon / Rivastigmine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12602,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Exelon / Rivastigmine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Exemestane|Exemestane":{"brand_name":"Exemestane","generic_name":"Exemestane","avg_per_unit":{"value":2.4452077594,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Exemestane / Exemestane: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":212206,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Exemestane / Exemestane, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Exforge HCT|Amlodipine/Valsartan/HCThiazid":{"brand_name":"Exforge HCT","generic_name":"Amlodipine/Valsartan/HCThiazid","avg_per_unit":{"value":12.15583812,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Exforge HCT / Amlodipine/Valsartan/HCThiazid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":993,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Exforge HCT / Amlodipine/Valsartan/HCThiazid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Exforge|Amlodipine Besylate/Valsartan":{"brand_name":"Exforge","generic_name":"Amlodipine Besylate/Valsartan","avg_per_unit":{"value":11.965846954,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Exforge / Amlodipine Besylate/Valsartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2644,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Exforge / Amlodipine Besylate/Valsartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Eysuvis|Loteprednol Etabonate":{"brand_name":"Eysuvis","generic_name":"Loteprednol Etabonate","avg_per_unit":{"value":58.777595643,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Eysuvis / Loteprednol Etabonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":25219,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Eysuvis / Loteprednol Etabonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ezetimibe-Simvastatin|Ezetimibe/Simvastatin":{"brand_name":"Ezetimibe-Simvastatin","generic_name":"Ezetimibe/Simvastatin","avg_per_unit":{"value":1.153353495,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ezetimibe-Simvastatin / Ezetimibe/Simvastatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":265265,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ezetimibe-Simvastatin / Ezetimibe/Simvastatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ezetimibe|Ezetimibe":{"brand_name":"Ezetimibe","generic_name":"Ezetimibe","avg_per_unit":{"value":0.3191986617,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ezetimibe / Ezetimibe: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8748229,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ezetimibe / Ezetimibe, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fabior|Tazarotene":{"brand_name":"Fabior","generic_name":"Tazarotene","avg_per_unit":{"value":12.285083636,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fabior / Tazarotene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":28,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fabior / Tazarotene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Falmina|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Falmina","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3986530268,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Falmina / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2346,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Falmina / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Famciclovir|Famciclovir":{"brand_name":"Famciclovir","generic_name":"Famciclovir","avg_per_unit":{"value":1.0957786643,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Famciclovir / Famciclovir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":120444,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Famciclovir / Famciclovir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fanapt|Iloperidone":{"brand_name":"Fanapt","generic_name":"Iloperidone","avg_per_unit":{"value":42.457531574,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fanapt / Iloperidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":41979,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fanapt / Iloperidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Farxiga|Dapagliflozin Propanediol":{"brand_name":"Farxiga","generic_name":"Dapagliflozin Propanediol","avg_per_unit":{"value":18.314120983,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Farxiga / Dapagliflozin Propanediol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5634650,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Farxiga / Dapagliflozin Propanediol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Febuxostat|Febuxostat":{"brand_name":"Febuxostat","generic_name":"Febuxostat","avg_per_unit":{"value":1.8649808396,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Febuxostat / Febuxostat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":333303,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Febuxostat / Febuxostat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Felbatol|Felbamate":{"brand_name":"Felbatol","generic_name":"Felbamate","avg_per_unit":{"value":15.520456885,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Felbatol / Felbamate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1837,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Felbatol / Felbamate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Felodipine ER|Felodipine":{"brand_name":"Felodipine ER","generic_name":"Felodipine","avg_per_unit":{"value":0.3632472478,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Felodipine ER / Felodipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":326120,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Felodipine ER / Felodipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Femara|Letrozole":{"brand_name":"Femara","generic_name":"Letrozole","avg_per_unit":{"value":25.026166228,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Femara / Letrozole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":905,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Femara / Letrozole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Femring|Estradiol Acetate":{"brand_name":"Femring","generic_name":"Estradiol Acetate","avg_per_unit":{"value":753.53960206,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Femring / Estradiol Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9145,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Femring / Estradiol Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fentanyl|Fentanyl":{"brand_name":"Fentanyl","generic_name":"Fentanyl","avg_per_unit":{"value":11.103795,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fentanyl / Fentanyl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":821141,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fentanyl / Fentanyl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fesoterodine Fumarate ER|Fesoterodine Fumarate":{"brand_name":"Fesoterodine Fumarate ER","generic_name":"Fesoterodine Fumarate","avg_per_unit":{"value":2.1617668632,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fesoterodine Fumarate ER / Fesoterodine Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":163060,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fesoterodine Fumarate ER / Fesoterodine Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fetzima|Levomilnacipran HCl":{"brand_name":"Fetzima","generic_name":"Levomilnacipran HCl","avg_per_unit":{"value":16.456402126,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fetzima / Levomilnacipran HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39287,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fetzima / Levomilnacipran HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fiasp Flextouch|Insulin Aspart (Niacinamide)":{"brand_name":"Fiasp Flextouch","generic_name":"Insulin Aspart (Niacinamide)","avg_per_unit":{"value":35.443676198,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fiasp Flextouch / Insulin Aspart (Niacinamide): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":398663,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fiasp Flextouch / Insulin Aspart (Niacinamide), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fiasp|Insulin Aspart (Niacinamide)":{"brand_name":"Fiasp","generic_name":"Insulin Aspart (Niacinamide)","avg_per_unit":{"value":27.788550354,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fiasp / Insulin Aspart (Niacinamide): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":83323,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fiasp / Insulin Aspart (Niacinamide), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Finacea|Azelaic Acid":{"brand_name":"Finacea","generic_name":"Azelaic Acid","avg_per_unit":{"value":8.4903395316,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Finacea / Azelaic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":6032,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Finacea / Azelaic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Finasteride|Finasteride":{"brand_name":"Finasteride","generic_name":"Finasteride","avg_per_unit":{"value":0.185577711,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Finasteride / Finasteride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7380163,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Finasteride / Finasteride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fingolimod|Fingolimod HCl":{"brand_name":"Fingolimod","generic_name":"Fingolimod HCl","avg_per_unit":{"value":62.625438295,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fingolimod / Fingolimod HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":26583,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fingolimod / Fingolimod HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Finzala|Norethindrone-E.Estradiol-Iron":{"brand_name":"Finzala","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":1.1958314732,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Finzala / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":76,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Finzala / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fioricet|Butalb/Acetaminophen/Caffeine":{"brand_name":"Fioricet","generic_name":"Butalb/Acetaminophen/Caffeine","avg_per_unit":{"value":7.0255289723,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fioricet / Butalb/Acetaminophen/Caffeine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1556,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fioricet / Butalb/Acetaminophen/Caffeine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Firvanq|Vancomycin HCl":{"brand_name":"Firvanq","generic_name":"Vancomycin HCl","avg_per_unit":{"value":0.9238168545,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Firvanq / Vancomycin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2932,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Firvanq / Vancomycin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flarex|Fluorometholone Acetate":{"brand_name":"Flarex","generic_name":"Fluorometholone Acetate","avg_per_unit":{"value":24.712889364,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flarex / Fluorometholone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":19312,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flarex / Fluorometholone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flavoxate HCl|Flavoxate HCl":{"brand_name":"Flavoxate HCl","generic_name":"Flavoxate HCl","avg_per_unit":{"value":0.8764506679,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flavoxate HCl / Flavoxate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5199,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flavoxate HCl / Flavoxate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flecainide Acetate|Flecainide Acetate":{"brand_name":"Flecainide Acetate","generic_name":"Flecainide Acetate","avg_per_unit":{"value":0.3042005936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flecainide Acetate / Flecainide Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1287139,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flecainide Acetate / Flecainide Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fleqsuvy|Baclofen":{"brand_name":"Fleqsuvy","generic_name":"Baclofen","avg_per_unit":{"value":5.2579831806,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fleqsuvy / Baclofen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":176,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fleqsuvy / Baclofen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fludrocortisone Acetate|Fludrocortisone Acetate":{"brand_name":"Fludrocortisone Acetate","generic_name":"Fludrocortisone Acetate","avg_per_unit":{"value":0.3873915546,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fludrocortisone Acetate / Fludrocortisone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":497178,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fludrocortisone Acetate / Fludrocortisone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flumazenil|Flumazenil":{"brand_name":"Flumazenil","generic_name":"Flumazenil","avg_per_unit":{"value":1.6535749561,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flumazenil / Flumazenil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":6025,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flumazenil / Flumazenil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flunisolide|Flunisolide":{"brand_name":"Flunisolide","generic_name":"Flunisolide","avg_per_unit":{"value":1.5702366731,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flunisolide / Flunisolide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":47550,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flunisolide / Flunisolide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluocinolone Acetonide|Fluocinolone Acetonide":{"brand_name":"Fluocinolone Acetonide","generic_name":"Fluocinolone Acetonide","avg_per_unit":{"value":0.724331648,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluocinolone Acetonide / Fluocinolone Acetonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":140225,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluocinolone Acetonide / Fluocinolone Acetonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluoride|Fluoride (Sodium)":{"brand_name":"Fluoride","generic_name":"Fluoride (Sodium)","avg_per_unit":{"value":0.1035585863,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluoride / Fluoride (Sodium): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":446,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluoride / Fluoride (Sodium), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluorometholone|Fluorometholone":{"brand_name":"Fluorometholone","generic_name":"Fluorometholone","avg_per_unit":{"value":12.142175424,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluorometholone / Fluorometholone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":393837,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluorometholone / Fluorometholone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluoxetine Dr|Fluoxetine HCl":{"brand_name":"Fluoxetine Dr","generic_name":"Fluoxetine HCl","avg_per_unit":{"value":26.333883507,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluoxetine Dr / Fluoxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6347,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluoxetine Dr / Fluoxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluoxetine HCl|Fluoxetine HCl":{"brand_name":"Fluoxetine HCl","generic_name":"Fluoxetine HCl","avg_per_unit":{"value":0.1628862147,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluoxetine HCl / Fluoxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 144 of 150 NADAC NDCs joined to this name are priced per EA (6 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7481805,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluoxetine HCl / Fluoxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluphenazine Decanoate|Fluphenazine Decanoate":{"brand_name":"Fluphenazine Decanoate","generic_name":"Fluphenazine Decanoate","avg_per_unit":{"value":19.703898251,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluphenazine Decanoate / Fluphenazine Decanoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":79338,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluphenazine Decanoate / Fluphenazine Decanoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluphenazine HCl*|Fluphenazine HCl":{"brand_name":"Fluphenazine HCl*","generic_name":"Fluphenazine HCl","avg_per_unit":{"value":2.1999261406,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluphenazine HCl* / Fluphenazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 77 NADAC NDCs the name join matched to it have an FDA route including ORAL. 7 of the 77 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":220188,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluphenazine HCl* / Fluphenazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flurandrenolide|Flurandrenolide":{"brand_name":"Flurandrenolide","generic_name":"Flurandrenolide","avg_per_unit":{"value":1.5435900727,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flurandrenolide / Flurandrenolide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":340,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flurandrenolide / Flurandrenolide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Flurbiprofen|Flurbiprofen":{"brand_name":"Flurbiprofen","generic_name":"Flurbiprofen","avg_per_unit":{"value":0.5327021275,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Flurbiprofen / Flurbiprofen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16235,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Flurbiprofen / Flurbiprofen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluticasone Propionate HFA|Fluticasone Propionate":{"brand_name":"Fluticasone Propionate HFA","generic_name":"Fluticasone Propionate","avg_per_unit":{"value":20.698677265,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluticasone Propionate HFA / Fluticasone Propionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":312596,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluticasone Propionate HFA / Fluticasone Propionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol":{"brand_name":"Fluticasone-Salmeterol","generic_name":"Fluticasone Propion/Salmeterol","avg_per_unit":{"value":8.7029494148,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluticasone-Salmeterol / Fluticasone Propion/Salmeterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2594479,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluticasone-Salmeterol / Fluticasone Propion/Salmeterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluvastatin ER|Fluvastatin Sodium":{"brand_name":"Fluvastatin ER","generic_name":"Fluvastatin Sodium","avg_per_unit":{"value":2.9110505121,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluvastatin ER / Fluvastatin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16248,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluvastatin ER / Fluvastatin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluvastatin Sodium|Fluvastatin Sodium":{"brand_name":"Fluvastatin Sodium","generic_name":"Fluvastatin Sodium","avg_per_unit":{"value":1.9295059981,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluvastatin Sodium / Fluvastatin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22406,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluvastatin Sodium / Fluvastatin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluvoxamine Maleate ER|Fluvoxamine Maleate":{"brand_name":"Fluvoxamine Maleate ER","generic_name":"Fluvoxamine Maleate","avg_per_unit":{"value":5.9754064372,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluvoxamine Maleate ER / Fluvoxamine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":17787,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluvoxamine Maleate ER / Fluvoxamine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fluvoxamine Maleate|Fluvoxamine Maleate":{"brand_name":"Fluvoxamine Maleate","generic_name":"Fluvoxamine Maleate","avg_per_unit":{"value":0.6576292901,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fluvoxamine Maleate / Fluvoxamine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":409767,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fluvoxamine Maleate / Fluvoxamine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fml Forte|Fluorometholone":{"brand_name":"Fml Forte","generic_name":"Fluorometholone","avg_per_unit":{"value":33.583847564,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fml Forte / Fluorometholone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3778,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fml Forte / Fluorometholone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fml|Fluorometholone":{"brand_name":"Fml","generic_name":"Fluorometholone","avg_per_unit":{"value":25.220836689,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fml / Fluorometholone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":673,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fml / Fluorometholone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Focalin XR|Dexmethylphenidate HCl":{"brand_name":"Focalin XR","generic_name":"Dexmethylphenidate HCl","avg_per_unit":{"value":7.6441821459,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Focalin XR / Dexmethylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3848,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Focalin XR / Dexmethylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Focalin|Dexmethylphenidate HCl":{"brand_name":"Focalin","generic_name":"Dexmethylphenidate HCl","avg_per_unit":{"value":1.2410262672,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Focalin / Dexmethylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":995,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Focalin / Dexmethylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Folic Acid*|Folic Acid":{"brand_name":"Folic Acid*","generic_name":"Folic Acid","avg_per_unit":{"value":0.0925037659,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Folic Acid* / Folic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 24 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 24 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1075231,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Folic Acid* / Folic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fondaparinux Sodium|Fondaparinux Sodium":{"brand_name":"Fondaparinux Sodium","generic_name":"Fondaparinux Sodium","avg_per_unit":{"value":67.44546297,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fondaparinux Sodium / Fondaparinux Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":13143,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fondaparinux Sodium / Fondaparinux Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Formoterol Fumarate|Formoterol Fumarate":{"brand_name":"Formoterol Fumarate","generic_name":"Formoterol Fumarate","avg_per_unit":{"value":6.0470444618,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Formoterol Fumarate / Formoterol Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":13928,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Formoterol Fumarate / Formoterol Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Forteo|Teriparatide":{"brand_name":"Forteo","generic_name":"Teriparatide","avg_per_unit":{"value":1571.0678928,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Forteo / Teriparatide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":67653,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Forteo / Teriparatide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Fosamax Plus D|Alendronate Sodium/Vitamin D3":{"brand_name":"Fosamax Plus D","generic_name":"Alendronate Sodium/Vitamin D3","avg_per_unit":{"value":49.642930232,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fosamax Plus D / Alendronate Sodium/Vitamin D3: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1838,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fosamax Plus D / Alendronate Sodium/Vitamin D3, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fosamax|Alendronate Sodium":{"brand_name":"Fosamax","generic_name":"Alendronate Sodium","avg_per_unit":{"value":34.220119797,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fosamax / Alendronate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1437,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fosamax / Alendronate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fosfomycin Tromethamine|Fosfomycin Tromethamine":{"brand_name":"Fosfomycin Tromethamine","generic_name":"Fosfomycin Tromethamine","avg_per_unit":{"value":56.966518402,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fosfomycin Tromethamine / Fosfomycin Tromethamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":129002,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fosfomycin Tromethamine / Fosfomycin Tromethamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fosinopril Sodium|Fosinopril Sodium":{"brand_name":"Fosinopril Sodium","generic_name":"Fosinopril Sodium","avg_per_unit":{"value":0.2181280331,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fosinopril Sodium / Fosinopril Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":201962,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fosinopril Sodium / Fosinopril Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fosinopril-Hydrochlorothiazide|Fosinopril/Hydrochlorothiazide":{"brand_name":"Fosinopril-Hydrochlorothiazide","generic_name":"Fosinopril/Hydrochlorothiazide","avg_per_unit":{"value":0.5177523458,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fosinopril-Hydrochlorothiazide / Fosinopril/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12564,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fosinopril-Hydrochlorothiazide / Fosinopril/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Frovatriptan Succinate|Frovatriptan Succinate":{"brand_name":"Frovatriptan Succinate","generic_name":"Frovatriptan Succinate","avg_per_unit":{"value":18.111932111,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Frovatriptan Succinate / Frovatriptan Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8156,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Frovatriptan Succinate / Frovatriptan Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fulphila|PEGfilgrastim-Jmdb":{"brand_name":"Fulphila","generic_name":"PEGfilgrastim-Jmdb","avg_per_unit":{"value":3316.6365511,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fulphila / PEGfilgrastim-Jmdb: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3443,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fulphila / PEGfilgrastim-Jmdb, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fyavolv|Norethindrone Ac/Eth Estradiol":{"brand_name":"Fyavolv","generic_name":"Norethindrone Ac/Eth Estradiol","avg_per_unit":{"value":1.3480903236,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fyavolv / Norethindrone Ac/Eth Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7968,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fyavolv / Norethindrone Ac/Eth Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Fycompa|Perampanel":{"brand_name":"Fycompa","generic_name":"Perampanel","avg_per_unit":{"value":37.611785044,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Fycompa / Perampanel: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. 12 of 13 NADAC NDCs joined to this name are priced per EA (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":59762,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Fycompa / Perampanel, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gabapentin ER|Gabapentin":{"brand_name":"Gabapentin ER","generic_name":"Gabapentin","avg_per_unit":{"value":5.01379795,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gabapentin ER / Gabapentin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8073,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gabapentin ER / Gabapentin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gabapentin|Gabapentin":{"brand_name":"Gabapentin","generic_name":"Gabapentin","avg_per_unit":{"value":0.1192028839,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gabapentin / Gabapentin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 254 of 262 NADAC NDCs joined to this name are priced per EA (8 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36804628,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gabapentin / Gabapentin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Galantamine ER|Galantamine HBr":{"brand_name":"Galantamine ER","generic_name":"Galantamine HBr","avg_per_unit":{"value":1.9237719497,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Galantamine ER / Galantamine HBr: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":134745,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Galantamine ER / Galantamine HBr, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gallifrey|Norethindrone Acetate":{"brand_name":"Gallifrey","generic_name":"Norethindrone Acetate","avg_per_unit":{"value":0.4554704658,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gallifrey / Norethindrone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":880,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gallifrey / Norethindrone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gastrocrom|Cromolyn Sodium":{"brand_name":"Gastrocrom","generic_name":"Cromolyn Sodium","avg_per_unit":{"value":2.2101809869,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gastrocrom / Cromolyn Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":291,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gastrocrom / Cromolyn Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gatifloxacin|Gatifloxacin":{"brand_name":"Gatifloxacin","generic_name":"Gatifloxacin","avg_per_unit":{"value":15.500439628,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gatifloxacin / Gatifloxacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":29232,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gatifloxacin / Gatifloxacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gavilyte-N|Sodium Chloride/NaHCO3/KCl/PEG":{"brand_name":"Gavilyte-N","generic_name":"Sodium Chloride/NaHCO3/KCl/PEG","avg_per_unit":{"value":0.0039734151,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gavilyte-N / Sodium Chloride/NaHCO3/KCl/PEG: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":16333,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gavilyte-N / Sodium Chloride/NaHCO3/KCl/PEG, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gemfibrozil|Gemfibrozil":{"brand_name":"Gemfibrozil","generic_name":"Gemfibrozil","avg_per_unit":{"value":0.1592381432,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gemfibrozil / Gemfibrozil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":754028,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gemfibrozil / Gemfibrozil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gemmily|Norethindrone-E.Estradiol-Iron":{"brand_name":"Gemmily","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":2.2778871129,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gemmily / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":79,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gemmily / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gemtesa|Vibegron":{"brand_name":"Gemtesa","generic_name":"Vibegron","avg_per_unit":{"value":15.878614646,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gemtesa / Vibegron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1361795,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gemtesa / Vibegron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Generlac|Lactulose":{"brand_name":"Generlac","generic_name":"Lactulose","avg_per_unit":{"value":0.0223915057,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Generlac / Lactulose: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2053,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Generlac / Lactulose, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gengraf|Cyclosporine, Modified":{"brand_name":"Gengraf","generic_name":"Cyclosporine, Modified","avg_per_unit":{"value":1.1425701142,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gengraf / Cyclosporine, Modified: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4222,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gengraf / Cyclosporine, Modified, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Genotropin|Somatropin":{"brand_name":"Genotropin","generic_name":"Somatropin","avg_per_unit":{"value":625.6172,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Genotropin / Somatropin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11033,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Genotropin / Somatropin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gentamicin Sulfate*|Gentamicin Sulfate":{"brand_name":"Gentamicin Sulfate*","generic_name":"Gentamicin Sulfate","avg_per_unit":{"value":1.3993869307,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gentamicin Sulfate* / Gentamicin Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 4 NADAC NDCs the name join matched to it have an FDA route including INTRAMUSCULAR and INTRAVENOUS.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":403490,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gentamicin Sulfate* / Gentamicin Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glatiramer Acetate|Glatiramer Acetate":{"brand_name":"Glatiramer Acetate","generic_name":"Glatiramer Acetate","avg_per_unit":{"value":167.77960494,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glatiramer Acetate / Glatiramer Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":35563,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glatiramer Acetate / Glatiramer Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Glatopa|Glatiramer Acetate":{"brand_name":"Glatopa","generic_name":"Glatiramer Acetate","avg_per_unit":{"value":163.07768876,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glatopa / Glatiramer Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":30739,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glatopa / Glatiramer Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Glimepiride|Glimepiride":{"brand_name":"Glimepiride","generic_name":"Glimepiride","avg_per_unit":{"value":0.0862599589,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glimepiride / Glimepiride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4597334,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glimepiride / Glimepiride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glipizide ER|Glipizide":{"brand_name":"Glipizide ER","generic_name":"Glipizide","avg_per_unit":{"value":0.1508920137,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glipizide ER / Glipizide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3267396,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glipizide ER / Glipizide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glipizide-Metformin|Glipizide/Metformin HCl":{"brand_name":"Glipizide-Metformin","generic_name":"Glipizide/Metformin HCl","avg_per_unit":{"value":0.2778982822,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glipizide-Metformin / Glipizide/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":224327,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glipizide-Metformin / Glipizide/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glipizide|Glipizide":{"brand_name":"Glipizide","generic_name":"Glipizide","avg_per_unit":{"value":0.0782623323,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glipizide / Glipizide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4523542,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glipizide / Glipizide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glyburide Micronized|Glyburide,Micronized":{"brand_name":"Glyburide Micronized","generic_name":"Glyburide,Micronized","avg_per_unit":{"value":0.2377126106,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glyburide Micronized / Glyburide,Micronized: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6476,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glyburide Micronized / Glyburide,Micronized, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glyburide-Metformin HCl|Glyburide/Metformin HCl":{"brand_name":"Glyburide-Metformin HCl","generic_name":"Glyburide/Metformin HCl","avg_per_unit":{"value":0.1053045335,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glyburide-Metformin HCl / Glyburide/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":51949,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glyburide-Metformin HCl / Glyburide/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glyburide|Glyburide":{"brand_name":"Glyburide","generic_name":"Glyburide","avg_per_unit":{"value":0.1101055356,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glyburide / Glyburide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":196466,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glyburide / Glyburide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glydo|Lidocaine HCl":{"brand_name":"Glydo","generic_name":"Lidocaine HCl","avg_per_unit":{"value":0.611033141,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glydo / Lidocaine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":8472,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glydo / Lidocaine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Glyxambi|Empagliflozin/Linagliptin":{"brand_name":"Glyxambi","generic_name":"Empagliflozin/Linagliptin","avg_per_unit":{"value":19.459118639,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Glyxambi / Empagliflozin/Linagliptin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":136734,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Glyxambi / Empagliflozin/Linagliptin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Golytely|PEG3350/Sod Sulf,Bicarb,Cl/KCl":{"brand_name":"Golytely","generic_name":"PEG3350/Sod Sulf,Bicarb,Cl/KCl","avg_per_unit":{"value":0.0056521292,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Golytely / PEG3350/Sod Sulf,Bicarb,Cl/KCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":8171,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Golytely / PEG3350/Sod Sulf,Bicarb,Cl/KCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Grastek|Grass Pollen-Timothy, Standard":{"brand_name":"Grastek","generic_name":"Grass Pollen-Timothy, Standard","avg_per_unit":{"value":11.204975699,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Grastek / Grass Pollen-Timothy, Standard: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":759,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Grastek / Grass Pollen-Timothy, Standard, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Guanfacine HCl ER|Guanfacine HCl":{"brand_name":"Guanfacine HCl ER","generic_name":"Guanfacine HCl","avg_per_unit":{"value":0.839908056,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Guanfacine HCl ER / Guanfacine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":134577,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Guanfacine HCl ER / Guanfacine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Guanfacine HCl|Guanfacine HCl":{"brand_name":"Guanfacine HCl","generic_name":"Guanfacine HCl","avg_per_unit":{"value":0.56698271,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Guanfacine HCl / Guanfacine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":117298,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Guanfacine HCl / Guanfacine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gvoke|Glucagon":{"brand_name":"Gvoke","generic_name":"Glucagon","avg_per_unit":{"value":1525.1287025,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gvoke / Glucagon: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2163,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gvoke / Glucagon, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Gynazole 1|Butoconazole Nitrate":{"brand_name":"Gynazole 1","generic_name":"Butoconazole Nitrate","avg_per_unit":{"value":24.241804176,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Gynazole 1 / Butoconazole Nitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":249,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Gynazole 1 / Butoconazole Nitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hadlima|Adalimumab-Bwwd":{"brand_name":"Hadlima","generic_name":"Adalimumab-Bwwd","avg_per_unit":{"value":626.9605017,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hadlima / Adalimumab-Bwwd: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":278,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hadlima / Adalimumab-Bwwd, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hailey Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Hailey Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.3408706962,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hailey Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5076,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hailey Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Halcinonide|Halcinonide":{"brand_name":"Halcinonide","generic_name":"Halcinonide","avg_per_unit":{"value":8.0374974271,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Halcinonide / Halcinonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1418,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Halcinonide / Halcinonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Halobetasol Propionate|Halobetasol Propionate":{"brand_name":"Halobetasol Propionate","generic_name":"Halobetasol Propionate","avg_per_unit":{"value":1.2578142506,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Halobetasol Propionate / Halobetasol Propionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":187352,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Halobetasol Propionate / Halobetasol Propionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Haloperidol Lactate*|Haloperidol Lactate":{"brand_name":"Haloperidol Lactate*","generic_name":"Haloperidol Lactate","avg_per_unit":{"value":1.0620809071,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Haloperidol Lactate* / Haloperidol Lactate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 1 NADAC NDCs the name join matched to it have an FDA route including INTRAMUSCULAR.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":72963,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Haloperidol Lactate* / Haloperidol Lactate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Haloperidol|Haloperidol":{"brand_name":"Haloperidol","generic_name":"Haloperidol","avg_per_unit":{"value":0.5584768212,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Haloperidol / Haloperidol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":939570,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Haloperidol / Haloperidol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Heather|Norethindrone":{"brand_name":"Heather","generic_name":"Norethindrone","avg_per_unit":{"value":0.4019052229,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Heather / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5775,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Heather / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humalog Junior Kwikpen|Insulin Lispro":{"brand_name":"Humalog Junior Kwikpen","generic_name":"Insulin Lispro","avg_per_unit":{"value":9.9833041475,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humalog Junior Kwikpen / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":17083,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humalog Junior Kwikpen / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humalog Kwikpen U-100|Insulin Lispro":{"brand_name":"Humalog Kwikpen U-100","generic_name":"Insulin Lispro","avg_per_unit":{"value":9.9120085462,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humalog Kwikpen U-100 / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1392033,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humalog Kwikpen U-100 / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humalog Kwikpen U-200|Insulin Lispro":{"brand_name":"Humalog Kwikpen U-200","generic_name":"Insulin Lispro","avg_per_unit":{"value":65.662372758,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humalog Kwikpen U-200 / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":159898,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humalog Kwikpen U-200 / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humalog|Insulin Lispro":{"brand_name":"Humalog","generic_name":"Insulin Lispro","avg_per_unit":{"value":6.1845409229,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humalog / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":511120,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humalog / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humulin N Kwikpen|Insulin NPh Human Isophane":{"brand_name":"Humulin N Kwikpen","generic_name":"Insulin NPh Human Isophane","avg_per_unit":{"value":6.744145497,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humulin N Kwikpen / Insulin NPh Human Isophane: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":162921,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humulin N Kwikpen / Insulin NPh Human Isophane, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humulin N|Insulin NPh Human Isophane":{"brand_name":"Humulin N","generic_name":"Insulin NPh Human Isophane","avg_per_unit":{"value":3.7916631538,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humulin N / Insulin NPh Human Isophane: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":286710,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humulin N / Insulin NPh Human Isophane, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Humulin R|Insulin Regular, Human":{"brand_name":"Humulin R","generic_name":"Insulin Regular, Human","avg_per_unit":{"value":4.0095283157,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Humulin R / Insulin Regular, Human: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":207421,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Humulin R / Insulin Regular, Human, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydralazine HCl*|Hydralazine HCl":{"brand_name":"Hydralazine HCl*","generic_name":"Hydralazine HCl","avg_per_unit":{"value":0.0887032619,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydralazine HCl* / Hydralazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (63 of the 70 the name join matched); NDCs of another route or with no known FDA route do not. 6 of the 63 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6074425,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydralazine HCl* / Hydralazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydrochlorothiazide|Hydrochlorothiazide":{"brand_name":"Hydrochlorothiazide","generic_name":"Hydrochlorothiazide","avg_per_unit":{"value":0.0584332318,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydrochlorothiazide / Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18462765,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydrochlorothiazide / Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydrocodone Bitartrate ER|Hydrocodone Bitartrate":{"brand_name":"Hydrocodone Bitartrate ER","generic_name":"Hydrocodone Bitartrate","avg_per_unit":{"value":9.2277158976,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydrocodone Bitartrate ER / Hydrocodone Bitartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9895,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydrocodone Bitartrate ER / Hydrocodone Bitartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen":{"brand_name":"Hydrocodone-Acetaminophen","generic_name":"Hydrocodone/Acetaminophen","avg_per_unit":{"value":0.2754156967,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydrocodone-Acetaminophen / Hydrocodone/Acetaminophen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 113 of 116 NADAC NDCs joined to this name are priced per EA (3 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20107206,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydrocodone-Acetaminophen / Hydrocodone/Acetaminophen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydrocodone-Ibuprofen|Hydrocodone/Ibuprofen":{"brand_name":"Hydrocodone-Ibuprofen","generic_name":"Hydrocodone/Ibuprofen","avg_per_unit":{"value":0.9709826594,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydrocodone-Ibuprofen / Hydrocodone/Ibuprofen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":21734,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydrocodone-Ibuprofen / Hydrocodone/Ibuprofen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydrocortisone Sod Succinate|Hydrocortisone Sod Succinate":{"brand_name":"Hydrocortisone Sod Succinate","generic_name":"Hydrocortisone Sod Succinate","avg_per_unit":{"value":13.617886905,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydrocortisone Sod Succinate / Hydrocortisone Sod Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":110,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydrocortisone Sod Succinate / Hydrocortisone Sod Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydrocortisone Valerate|Hydrocortisone Valerate":{"brand_name":"Hydrocortisone Valerate","generic_name":"Hydrocortisone Valerate","avg_per_unit":{"value":1.1096546805,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydrocortisone Valerate / Hydrocortisone Valerate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":24734,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydrocortisone Valerate / Hydrocortisone Valerate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydromorphone ER|Hydromorphone HCl":{"brand_name":"Hydromorphone ER","generic_name":"Hydromorphone HCl","avg_per_unit":{"value":8.0250084568,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydromorphone ER / Hydromorphone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14879,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydromorphone ER / Hydromorphone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate":{"brand_name":"Hydroxychloroquine Sulfate","generic_name":"Hydroxychloroquine Sulfate","avg_per_unit":{"value":0.3853032205,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydroxychloroquine Sulfate / Hydroxychloroquine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2542283,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydroxychloroquine Sulfate / Hydroxychloroquine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydroxyurea|Hydroxyurea":{"brand_name":"Hydroxyurea","generic_name":"Hydroxyurea","avg_per_unit":{"value":0.2853268389,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydroxyurea / Hydroxyurea: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":521514,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydroxyurea / Hydroxyurea, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydroxyzine HCl*|Hydroxyzine HCl":{"brand_name":"Hydroxyzine HCl*","generic_name":"Hydroxyzine HCl","avg_per_unit":{"value":0.2122686973,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydroxyzine HCl* / Hydroxyzine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 70 NADAC NDCs the name join matched to it have an FDA route including ORAL. 3 of the 63 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 63 of 70 NADAC NDCs joined to this name are priced per EA (7 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4702557,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydroxyzine HCl* / Hydroxyzine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hydroxyzine Pamoate|Hydroxyzine Pamoate":{"brand_name":"Hydroxyzine Pamoate","generic_name":"Hydroxyzine Pamoate","avg_per_unit":{"value":0.1603497543,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hydroxyzine Pamoate / Hydroxyzine Pamoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1578610,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hydroxyzine Pamoate / Hydroxyzine Pamoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hyoscyamine Sulfate ER|Hyoscyamine Sulfate":{"brand_name":"Hyoscyamine Sulfate ER","generic_name":"Hyoscyamine Sulfate","avg_per_unit":{"value":0.5479432855,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hyoscyamine Sulfate ER / Hyoscyamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":53,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hyoscyamine Sulfate ER / Hyoscyamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hyoscyamine Sulfate*|Hyoscyamine Sulfate":{"brand_name":"Hyoscyamine Sulfate*","generic_name":"Hyoscyamine Sulfate","avg_per_unit":{"value":0.3810986446,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hyoscyamine Sulfate* / Hyoscyamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (5 of the 7 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":24235,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hyoscyamine Sulfate* / Hyoscyamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hysingla ER|Hydrocodone Bitartrate":{"brand_name":"Hysingla ER","generic_name":"Hydrocodone Bitartrate","avg_per_unit":{"value":19.896836426,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hysingla ER / Hydrocodone Bitartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":29893,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hysingla ER / Hydrocodone Bitartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Hyzaar|Losartan/Hydrochlorothiazide":{"brand_name":"Hyzaar","generic_name":"Losartan/Hydrochlorothiazide","avg_per_unit":{"value":5.4997617704,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Hyzaar / Losartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3947,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Hyzaar / Losartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "IVabradine HCl|IVabradine HCl":{"brand_name":"IVabradine HCl","generic_name":"IVabradine HCl","avg_per_unit":{"value":4.6098570866,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for IVabradine HCl / IVabradine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12904,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for IVabradine HCl / IVabradine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ibsrela|Tenapanor HCl":{"brand_name":"Ibsrela","generic_name":"Tenapanor HCl","avg_per_unit":{"value":29.045294248,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ibsrela / Tenapanor HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":32759,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ibsrela / Tenapanor HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ibuprofen-Famotidine|Ibuprofen/FAmotidine":{"brand_name":"Ibuprofen-Famotidine","generic_name":"Ibuprofen/FAmotidine","avg_per_unit":{"value":2.8079338217,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ibuprofen-Famotidine / Ibuprofen/FAmotidine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9913,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ibuprofen-Famotidine / Ibuprofen/FAmotidine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ibuprofen|Ibuprofen":{"brand_name":"Ibuprofen","generic_name":"Ibuprofen","avg_per_unit":{"value":0.1169286929,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ibuprofen / Ibuprofen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 97 of 107 NADAC NDCs joined to this name are priced per EA (10 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7174958,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ibuprofen / Ibuprofen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ibu|Ibuprofen":{"brand_name":"Ibu","generic_name":"Ibuprofen","avg_per_unit":{"value":0.0537572879,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ibu / Ibuprofen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":399096,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ibu / Ibuprofen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Icosapent Ethyl|Icosapent Ethyl":{"brand_name":"Icosapent Ethyl","generic_name":"Icosapent Ethyl","avg_per_unit":{"value":1.4370307026,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Icosapent Ethyl / Icosapent Ethyl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":555547,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Icosapent Ethyl / Icosapent Ethyl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ilevro|Nepafenac":{"brand_name":"Ilevro","generic_name":"Nepafenac","avg_per_unit":{"value":122.66830217,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ilevro / Nepafenac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":37389,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ilevro / Nepafenac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Imatinib Mesylate|Imatinib Mesylate":{"brand_name":"Imatinib Mesylate","generic_name":"Imatinib Mesylate","avg_per_unit":{"value":33.390683137,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Imatinib Mesylate / Imatinib Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":123463,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Imatinib Mesylate / Imatinib Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Imipramine HCl|Imipramine HCl":{"brand_name":"Imipramine HCl","generic_name":"Imipramine HCl","avg_per_unit":{"value":0.2302984887,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Imipramine HCl / Imipramine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":198793,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Imipramine HCl / Imipramine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Imipramine Pamoate|Imipramine Pamoate":{"brand_name":"Imipramine Pamoate","generic_name":"Imipramine Pamoate","avg_per_unit":{"value":5.4464415367,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Imipramine Pamoate / Imipramine Pamoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5829,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Imipramine Pamoate / Imipramine Pamoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Imvexxy|Estradiol":{"brand_name":"Imvexxy","generic_name":"Estradiol","avg_per_unit":{"value":25.694280965,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Imvexxy / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":34317,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Imvexxy / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Incassia|Norethindrone":{"brand_name":"Incassia","generic_name":"Norethindrone","avg_per_unit":{"value":0.3761125421,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Incassia / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3887,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Incassia / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Incruse Ellipta|Umeclidinium Bromide":{"brand_name":"Incruse Ellipta","generic_name":"Umeclidinium Bromide","avg_per_unit":{"value":11.357731294,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Incruse Ellipta / Umeclidinium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":852329,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Incruse Ellipta / Umeclidinium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Indapamide|Indapamide":{"brand_name":"Indapamide","generic_name":"Indapamide","avg_per_unit":{"value":0.1865193342,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Indapamide / Indapamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":370726,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Indapamide / Indapamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Inderal XL|Propranolol HCl":{"brand_name":"Inderal XL","generic_name":"Propranolol HCl","avg_per_unit":{"value":70.977247065,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Inderal XL / Propranolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":254,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Inderal XL / Propranolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Indomethacin ER|Indomethacin":{"brand_name":"Indomethacin ER","generic_name":"Indomethacin","avg_per_unit":{"value":0.5587726776,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Indomethacin ER / Indomethacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18751,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Indomethacin ER / Indomethacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Indomethacin*|Indomethacin":{"brand_name":"Indomethacin*","generic_name":"Indomethacin","avg_per_unit":{"value":0.2609225879,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Indomethacin* / Indomethacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 14 NADAC NDCs the name join matched to it have an FDA route including ORAL. 2 of the 14 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":247264,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Indomethacin* / Indomethacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ingrezza|Valbenazine Tosylate":{"brand_name":"Ingrezza","generic_name":"Valbenazine Tosylate","avg_per_unit":{"value":272.77478764,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ingrezza / Valbenazine Tosylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":254899,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ingrezza / Valbenazine Tosylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Innopran XL|Propranolol HCl":{"brand_name":"Innopran XL","generic_name":"Propranolol HCl","avg_per_unit":{"value":70.909368527,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Innopran XL / Propranolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":584,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Innopran XL / Propranolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Inpefa|Sotagliflozin":{"brand_name":"Inpefa","generic_name":"Sotagliflozin","avg_per_unit":{"value":19.325308608,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Inpefa / Sotagliflozin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7368,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Inpefa / Sotagliflozin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Aspart|Insulin Aspart":{"brand_name":"Insulin Aspart","generic_name":"Insulin Aspart","avg_per_unit":{"value":7.141454115,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Aspart / Insulin Aspart: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":71602,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Aspart / Insulin Aspart, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Degludec Pen (U-100)|Insulin Degludec":{"brand_name":"Insulin Degludec Pen (U-100)","generic_name":"Insulin Degludec","avg_per_unit":{"value":11.403676869,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Degludec Pen (U-100) / Insulin Degludec: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":54277,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Degludec Pen (U-100) / Insulin Degludec, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Degludec Pen (U-200)|Insulin Degludec":{"brand_name":"Insulin Degludec Pen (U-200)","generic_name":"Insulin Degludec","avg_per_unit":{"value":22.44944325,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Degludec Pen (U-200) / Insulin Degludec: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":34823,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Degludec Pen (U-200) / Insulin Degludec, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Degludec|Insulin Degludec":{"brand_name":"Insulin Degludec","generic_name":"Insulin Degludec","avg_per_unit":{"value":12.262457109,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Degludec / Insulin Degludec: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":4826,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Degludec / Insulin Degludec, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Lispro Junior Kwikpen|Insulin Lispro":{"brand_name":"Insulin Lispro Junior Kwikpen","generic_name":"Insulin Lispro","avg_per_unit":{"value":10.080619217,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Lispro Junior Kwikpen / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10234,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Lispro Junior Kwikpen / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Lispro Kwikpen U-100|Insulin Lispro":{"brand_name":"Insulin Lispro Kwikpen U-100","generic_name":"Insulin Lispro","avg_per_unit":{"value":10.201026473,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Lispro Kwikpen U-100 / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":847641,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Lispro Kwikpen U-100 / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Insulin Lispro|Insulin Lispro":{"brand_name":"Insulin Lispro","generic_name":"Insulin Lispro","avg_per_unit":{"value":2.4922814411,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Insulin Lispro / Insulin Lispro: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":300584,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Insulin Lispro / Insulin Lispro, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Intelence|Etravirine":{"brand_name":"Intelence","generic_name":"Etravirine","avg_per_unit":{"value":22.628305691,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Intelence / Etravirine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1596,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Intelence / Etravirine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Intrarosa|Prasterone (Dhea)":{"brand_name":"Intrarosa","generic_name":"Prasterone (Dhea)","avg_per_unit":{"value":9.2699974354,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Intrarosa / Prasterone (Dhea): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11112,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Intrarosa / Prasterone (Dhea), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Invega Hafyera|Paliperidone Palmitate":{"brand_name":"Invega Hafyera","generic_name":"Paliperidone Palmitate","avg_per_unit":{"value":4143.6108128,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Invega Hafyera / Paliperidone Palmitate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5856,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Invega Hafyera / Paliperidone Palmitate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Invega Sustenna|Paliperidone Palmitate":{"brand_name":"Invega Sustenna","generic_name":"Paliperidone Palmitate","avg_per_unit":{"value":2352.6637965,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Invega Sustenna / Paliperidone Palmitate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":624867,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Invega Sustenna / Paliperidone Palmitate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Invega Trinza|Paliperidone Palmitate":{"brand_name":"Invega Trinza","generic_name":"Paliperidone Palmitate","avg_per_unit":{"value":3985.206008,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Invega Trinza / Paliperidone Palmitate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":63911,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Invega Trinza / Paliperidone Palmitate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Inveltys|Loteprednol Etabonate":{"brand_name":"Inveltys","generic_name":"Loteprednol Etabonate","avg_per_unit":{"value":103.32689117,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Inveltys / Loteprednol Etabonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":4610,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Inveltys / Loteprednol Etabonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Invokamet XR|Canagliflozin/Metformin HCl":{"brand_name":"Invokamet XR","generic_name":"Canagliflozin/Metformin HCl","avg_per_unit":{"value":9.2881103461,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Invokamet XR / Canagliflozin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10648,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Invokamet XR / Canagliflozin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Invokamet|Canagliflozin/Metformin HCl":{"brand_name":"Invokamet","generic_name":"Canagliflozin/Metformin HCl","avg_per_unit":{"value":9.3112842182,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Invokamet / Canagliflozin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15740,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Invokamet / Canagliflozin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Invokana|Canagliflozin":{"brand_name":"Invokana","generic_name":"Canagliflozin","avg_per_unit":{"value":18.579610786,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Invokana / Canagliflozin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":255843,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Invokana / Canagliflozin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ipratropium Bromide*|Ipratropium Bromide":{"brand_name":"Ipratropium Bromide*","generic_name":"Ipratropium Bromide","avg_per_unit":{"value":1.0657880482,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ipratropium Bromide* / Ipratropium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes RESPIRATORY (INHALATION) point at this name (16 of the 29 the name join matched); NDCs of another route or with no known FDA route do not. 28 of 29 NADAC NDCs joined to this name are priced per ML (1 per GM): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2093538,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ipratropium Bromide* / Ipratropium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate":{"brand_name":"Ipratropium-Albuterol","generic_name":"Ipratropium/Albuterol Sulfate","avg_per_unit":{"value":0.2507988261,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ipratropium-Albuterol / Ipratropium/Albuterol Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":641618,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ipratropium-Albuterol / Ipratropium/Albuterol Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide":{"brand_name":"Irbesartan-Hydrochlorothiazide","generic_name":"Irbesartan/Hydrochlorothiazide","avg_per_unit":{"value":0.312409443,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Irbesartan-Hydrochlorothiazide / Irbesartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":568754,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Irbesartan-Hydrochlorothiazide / Irbesartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Irbesartan|Irbesartan":{"brand_name":"Irbesartan","generic_name":"Irbesartan","avg_per_unit":{"value":0.2761674095,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Irbesartan / Irbesartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2562169,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Irbesartan / Irbesartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isentress|Raltegravir Potassium":{"brand_name":"Isentress","generic_name":"Raltegravir Potassium","avg_per_unit":{"value":33.143559012,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isentress / Raltegravir Potassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":53765,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isentress / Raltegravir Potassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isibloom|Desogestrel-Ethinyl Estradiol":{"brand_name":"Isibloom","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.3843612082,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isibloom / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5283,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isibloom / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isoniazid|Isoniazid":{"brand_name":"Isoniazid","generic_name":"Isoniazid","avg_per_unit":{"value":0.2186227206,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isoniazid / Isoniazid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36423,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isoniazid / Isoniazid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isosorbide Dinitrate|Isosorbide Dinitrate":{"brand_name":"Isosorbide Dinitrate","generic_name":"Isosorbide Dinitrate","avg_per_unit":{"value":0.4779807958,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isosorbide Dinitrate / Isosorbide Dinitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":539423,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isosorbide Dinitrate / Isosorbide Dinitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isosorbide Mononitrate ER|Isosorbide Mononitrate":{"brand_name":"Isosorbide Mononitrate ER","generic_name":"Isosorbide Mononitrate","avg_per_unit":{"value":0.1825457059,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isosorbide Mononitrate ER / Isosorbide Mononitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4766057,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isosorbide Mononitrate ER / Isosorbide Mononitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isosorbide Mononitrate|Isosorbide Mononitrate":{"brand_name":"Isosorbide Mononitrate","generic_name":"Isosorbide Mononitrate","avg_per_unit":{"value":0.350354789,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isosorbide Mononitrate / Isosorbide Mononitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":96539,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isosorbide Mononitrate / Isosorbide Mononitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isotretinoin|Isotretinoin":{"brand_name":"Isotretinoin","generic_name":"Isotretinoin","avg_per_unit":{"value":4.4048957667,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isotretinoin / Isotretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7711,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isotretinoin / Isotretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Isradipine|Isradipine":{"brand_name":"Isradipine","generic_name":"Isradipine","avg_per_unit":{"value":1.4000776783,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Isradipine / Isradipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6306,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Isradipine / Isradipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Istalol|Timolol Maleate":{"brand_name":"Istalol","generic_name":"Timolol Maleate","avg_per_unit":{"value":78.539353207,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Istalol / Timolol Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1279,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Istalol / Timolol Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Iyuzeh|Latanoprost/PF":{"brand_name":"Iyuzeh","generic_name":"Latanoprost/PF","avg_per_unit":{"value":9.6330371375,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Iyuzeh / Latanoprost/PF: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15866,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Iyuzeh / Latanoprost/PF, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jaimiess|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Jaimiess","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":0.6184272852,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jaimiess / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":902,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jaimiess / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jantoven|Warfarin Sodium":{"brand_name":"Jantoven","generic_name":"Warfarin Sodium","avg_per_unit":{"value":0.1200619444,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jantoven / Warfarin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":368987,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jantoven / Warfarin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Janumet XR|Sitagliptin Phos/Metformin HCl":{"brand_name":"Janumet XR","generic_name":"Sitagliptin Phos/Metformin HCl","avg_per_unit":{"value":12.173024811,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Janumet XR / Sitagliptin Phos/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":382969,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Janumet XR / Sitagliptin Phos/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Janumet|Sitagliptin Phos/Metformin HCl":{"brand_name":"Janumet","generic_name":"Sitagliptin Phos/Metformin HCl","avg_per_unit":{"value":8.9671480602,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Janumet / Sitagliptin Phos/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":743903,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Janumet / Sitagliptin Phos/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Januvia|Sitagliptin Phosphate":{"brand_name":"Januvia","generic_name":"Sitagliptin Phosphate","avg_per_unit":{"value":17.965092237,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Januvia / Sitagliptin Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4027317,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Januvia / Sitagliptin Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jardiance|Empagliflozin":{"brand_name":"Jardiance","generic_name":"Empagliflozin","avg_per_unit":{"value":18.937748413,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jardiance / Empagliflozin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11368280,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jardiance / Empagliflozin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jasmiel|Ethinyl Estradiol/Drospirenone":{"brand_name":"Jasmiel","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.6170238095,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jasmiel / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":180,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jasmiel / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jatenzo|Testosterone Undecanoate":{"brand_name":"Jatenzo","generic_name":"Testosterone Undecanoate","avg_per_unit":{"value":13.201034263,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jatenzo / Testosterone Undecanoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7521,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jatenzo / Testosterone Undecanoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jencycla|Norethindrone":{"brand_name":"Jencycla","generic_name":"Norethindrone","avg_per_unit":{"value":0.3303282181,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jencycla / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6733,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jencycla / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jentadueto XR|Linagliptin/Metformin HCl":{"brand_name":"Jentadueto XR","generic_name":"Linagliptin/Metformin HCl","avg_per_unit":{"value":12.508759316,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jentadueto XR / Linagliptin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38263,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jentadueto XR / Linagliptin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jentadueto|Linagliptin/Metformin HCl":{"brand_name":"Jentadueto","generic_name":"Linagliptin/Metformin HCl","avg_per_unit":{"value":8.3617760962,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jentadueto / Linagliptin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":106443,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jentadueto / Linagliptin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jinteli|Norethindrone Ac/Eth Estradiol":{"brand_name":"Jinteli","generic_name":"Norethindrone Ac/Eth Estradiol","avg_per_unit":{"value":1.443731472,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jinteli / Norethindrone Ac/Eth Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1655,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jinteli / Norethindrone Ac/Eth Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jolessa|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Jolessa","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.5574127869,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jolessa / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1426,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jolessa / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Jornay PM|Methylphenidate HCl":{"brand_name":"Jornay PM","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":15.064162808,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Jornay PM / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2964,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Jornay PM / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Joyeaux|Levonorgest/Eth.Estradiol/Iron":{"brand_name":"Joyeaux","generic_name":"Levonorgest/Eth.Estradiol/Iron","avg_per_unit":{"value":5.984773166,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Joyeaux / Levonorgest/Eth.Estradiol/Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":56,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Joyeaux / Levonorgest/Eth.Estradiol/Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Juleber|Desogestrel-Ethinyl Estradiol":{"brand_name":"Juleber","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.4239782886,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Juleber / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":466,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Juleber / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Juluca|Dolutegravir/Rilpivirine":{"brand_name":"Juluca","generic_name":"Dolutegravir/Rilpivirine","avg_per_unit":{"value":116.11442329,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Juluca / Dolutegravir/Rilpivirine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":112878,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Juluca / Dolutegravir/Rilpivirine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Junel|Norethindrone Ac/Eth Estradiol":{"brand_name":"Junel","generic_name":"Norethindrone Ac/Eth Estradiol","avg_per_unit":{"value":0.5904781199,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Junel / Norethindrone Ac/Eth Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8038,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Junel / Norethindrone Ac/Eth Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "K-Phos No.2|Sod Phos,M-B/K Phos,Monob":{"brand_name":"K-Phos No.2","generic_name":"Sod Phos,M-B/K Phos,Monob","avg_per_unit":{"value":0.9641927036,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for K-Phos No.2 / Sod Phos,M-B/K Phos,Monob: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":265,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for K-Phos No.2 / Sod Phos,M-B/K Phos,Monob, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "K-Phos Original|Potassium Phosphate,Monobasic":{"brand_name":"K-Phos Original","generic_name":"Potassium Phosphate,Monobasic","avg_per_unit":{"value":0.5162373538,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for K-Phos Original / Potassium Phosphate,Monobasic: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2851,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for K-Phos Original / Potassium Phosphate,Monobasic, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kaitlib Fe|Noreth-Ethinyl Estradiol/Iron":{"brand_name":"Kaitlib Fe","generic_name":"Noreth-Ethinyl Estradiol/Iron","avg_per_unit":{"value":1.8279257988,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kaitlib Fe / Noreth-Ethinyl Estradiol/Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":243,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kaitlib Fe / Noreth-Ethinyl Estradiol/Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kariva|Desog-E.Estradiol/E.Estradiol":{"brand_name":"Kariva","generic_name":"Desog-E.Estradiol/E.Estradiol","avg_per_unit":{"value":0.570513135,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kariva / Desog-E.Estradiol/E.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1296,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kariva / Desog-E.Estradiol/E.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Katerzia|Amlodipine Benzoate":{"brand_name":"Katerzia","generic_name":"Amlodipine Benzoate","avg_per_unit":{"value":3.8747120317,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Katerzia / Amlodipine Benzoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1715,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Katerzia / Amlodipine Benzoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kenalog-10|Triamcinolone Acetonide":{"brand_name":"Kenalog-10","generic_name":"Triamcinolone Acetonide","avg_per_unit":{"value":2.7135029535,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kenalog-10 / Triamcinolone Acetonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":284,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kenalog-10 / Triamcinolone Acetonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kenalog-40|Triamcinolone Acetonide":{"brand_name":"Kenalog-40","generic_name":"Triamcinolone Acetonide","avg_per_unit":{"value":1.8710603038,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kenalog-40 / Triamcinolone Acetonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":867,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kenalog-40 / Triamcinolone Acetonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kenalog-80|Triamcinolone Acetonide":{"brand_name":"Kenalog-80","generic_name":"Triamcinolone Acetonide","avg_per_unit":{"value":20.625006418,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kenalog-80 / Triamcinolone Acetonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":492,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kenalog-80 / Triamcinolone Acetonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Keppra XR|Levetiracetam":{"brand_name":"Keppra XR","generic_name":"Levetiracetam","avg_per_unit":{"value":10.375053605,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Keppra XR / Levetiracetam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13615,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Keppra XR / Levetiracetam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kerendia|Finerenone":{"brand_name":"Kerendia","generic_name":"Finerenone","avg_per_unit":{"value":21.064286484,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kerendia / Finerenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":403577,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kerendia / Finerenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kesimpta Pen|Ofatumumab":{"brand_name":"Kesimpta Pen","generic_name":"Ofatumumab","avg_per_unit":{"value":21690.379815,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kesimpta Pen / Ofatumumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":59976,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kesimpta Pen / Ofatumumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ketodan|Ketoconazole":{"brand_name":"Ketodan","generic_name":"Ketoconazole","avg_per_unit":{"value":4.2647561914,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ketodan / Ketoconazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":66,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ketodan / Ketoconazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kevzara|Sarilumab":{"brand_name":"Kevzara","generic_name":"Sarilumab","avg_per_unit":{"value":1858.0017656,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kevzara / Sarilumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":37496,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kevzara / Sarilumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kionex|Sodium Polystyrene Sulfon/Sorb":{"brand_name":"Kionex","generic_name":"Sodium Polystyrene Sulfon/Sorb","avg_per_unit":{"value":0.3657015492,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kionex / Sodium Polystyrene Sulfon/Sorb: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3135,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kionex / Sodium Polystyrene Sulfon/Sorb, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kisqali|Ribociclib Succinate":{"brand_name":"Kisqali","generic_name":"Ribociclib Succinate","avg_per_unit":{"value":296.84033748,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kisqali / Ribociclib Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":52578,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kisqali / Ribociclib Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Klayesta|Nystatin":{"brand_name":"Klayesta","generic_name":"Nystatin","avg_per_unit":{"value":0.4656630867,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Klayesta / Nystatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":129701,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Klayesta / Nystatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Klonopin|Clonazepam":{"brand_name":"Klonopin","generic_name":"Clonazepam","avg_per_unit":{"value":2.7799603775,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Klonopin / Clonazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14868,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Klonopin / Clonazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Klor-Con-Ef|Potassium Bicarbonate/Cit Ac":{"brand_name":"Klor-Con-Ef","generic_name":"Potassium Bicarbonate/Cit Ac","avg_per_unit":{"value":0.9201363026,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Klor-Con-Ef / Potassium Bicarbonate/Cit Ac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4308,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Klor-Con-Ef / Potassium Bicarbonate/Cit Ac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kloxxado|Naloxone HCl":{"brand_name":"Kloxxado","generic_name":"Naloxone HCl","avg_per_unit":{"value":59.59804882,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kloxxado / Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2886,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kloxxado / Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Konvomep|Omeprazole/Sodium Bicarbonate":{"brand_name":"Konvomep","generic_name":"Omeprazole/Sodium Bicarbonate","avg_per_unit":{"value":1.4067702671,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Konvomep / Omeprazole/Sodium Bicarbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10159,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Konvomep / Omeprazole/Sodium Bicarbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kristalose|Lactulose":{"brand_name":"Kristalose","generic_name":"Lactulose","avg_per_unit":{"value":9.7175365093,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kristalose / Lactulose: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6944,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kristalose / Lactulose, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Kurvelo|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Kurvelo","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3866578347,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Kurvelo / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4326,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Kurvelo / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamictal ODT|Lamotrigine":{"brand_name":"Lamictal ODT","generic_name":"Lamotrigine","avg_per_unit":{"value":15.990018709,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamictal ODT / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1808,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamictal ODT / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamictal XR|Lamotrigine":{"brand_name":"Lamictal XR","generic_name":"Lamotrigine","avg_per_unit":{"value":34.142629746,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamictal XR / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15467,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamictal XR / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamictal|Lamotrigine":{"brand_name":"Lamictal","generic_name":"Lamotrigine","avg_per_unit":{"value":11.425671583,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamictal / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43491,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamictal / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamivudine-Zidovudine|Lamivudine/Zidovudine":{"brand_name":"Lamivudine-Zidovudine","generic_name":"Lamivudine/Zidovudine","avg_per_unit":{"value":2.9159085231,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamivudine-Zidovudine / Lamivudine/Zidovudine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6265,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamivudine-Zidovudine / Lamivudine/Zidovudine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamotrigine ER|Lamotrigine":{"brand_name":"Lamotrigine ER","generic_name":"Lamotrigine","avg_per_unit":{"value":3.6468071101,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamotrigine ER / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":157313,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamotrigine ER / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamotrigine ODT (Orange)|Lamotrigine":{"brand_name":"Lamotrigine ODT (Orange)","generic_name":"Lamotrigine","avg_per_unit":{"value":9.2028713826,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamotrigine ODT (Orange) / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":86,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamotrigine ODT (Orange) / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamotrigine ODT|Lamotrigine":{"brand_name":"Lamotrigine ODT","generic_name":"Lamotrigine","avg_per_unit":{"value":4.4589975503,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamotrigine ODT / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":23561,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamotrigine ODT / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lamotrigine|Lamotrigine":{"brand_name":"Lamotrigine","generic_name":"Lamotrigine","avg_per_unit":{"value":0.1665614914,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lamotrigine / Lamotrigine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4154338,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lamotrigine / Lamotrigine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lansoprazol-Amoxicil-Clarithro|Lansoprazole/Amoxiciln/Clarith":{"brand_name":"Lansoprazol-Amoxicil-Clarithro","generic_name":"Lansoprazole/Amoxiciln/Clarith","avg_per_unit":{"value":5.4479371138,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lansoprazol-Amoxicil-Clarithro / Lansoprazole/Amoxiciln/Clarith: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":641,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lansoprazol-Amoxicil-Clarithro / Lansoprazole/Amoxiciln/Clarith, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lanthanum Carbonate|Lanthanum Carbonate":{"brand_name":"Lanthanum Carbonate","generic_name":"Lanthanum Carbonate","avg_per_unit":{"value":5.5926643167,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lanthanum Carbonate / Lanthanum Carbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48746,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lanthanum Carbonate / Lanthanum Carbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lantus Solostar|Insulin Glargine,Hum.Rec.Anlog":{"brand_name":"Lantus Solostar","generic_name":"Insulin Glargine,Hum.Rec.Anlog","avg_per_unit":{"value":6.1119548718,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lantus Solostar / Insulin Glargine,Hum.Rec.Anlog: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5570732,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lantus Solostar / Insulin Glargine,Hum.Rec.Anlog, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lantus|Insulin Glargine,Hum.Rec.Anlog":{"brand_name":"Lantus","generic_name":"Insulin Glargine,Hum.Rec.Anlog","avg_per_unit":{"value":6.2531288785,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lantus / Insulin Glargine,Hum.Rec.Anlog: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1116800,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lantus / Insulin Glargine,Hum.Rec.Anlog, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Larin Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Larin Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.3505564231,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Larin Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7242,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Larin Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lasix|Furosemide":{"brand_name":"Lasix","generic_name":"Furosemide","avg_per_unit":{"value":0.9367542922,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lasix / Furosemide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6667,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lasix / Furosemide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Latanoprost|Latanoprost":{"brand_name":"Latanoprost","generic_name":"Latanoprost","avg_per_unit":{"value":2.3884377788,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Latanoprost / Latanoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10884075,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Latanoprost / Latanoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Latuda|Lurasidone HCl":{"brand_name":"Latuda","generic_name":"Lurasidone HCl","avg_per_unit":{"value":48.063804961,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Latuda / Lurasidone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":24193,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Latuda / Lurasidone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Leflunomide|Leflunomide":{"brand_name":"Leflunomide","generic_name":"Leflunomide","avg_per_unit":{"value":0.9940323499,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Leflunomide / Leflunomide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":578121,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Leflunomide / Leflunomide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lescol XL|Fluvastatin Sodium":{"brand_name":"Lescol XL","generic_name":"Fluvastatin Sodium","avg_per_unit":{"value":12.667299638,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lescol XL / Fluvastatin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":616,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lescol XL / Fluvastatin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lessina|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Lessina","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3876228113,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lessina / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2315,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lessina / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Letrozole|Letrozole":{"brand_name":"Letrozole","generic_name":"Letrozole","avg_per_unit":{"value":0.3358688482,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Letrozole / Letrozole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":860689,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Letrozole / Letrozole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Leucovorin Calcium*|Leucovorin Calcium":{"brand_name":"Leucovorin Calcium*","generic_name":"Leucovorin Calcium","avg_per_unit":{"value":2.3174786192,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Leucovorin Calcium* / Leucovorin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 31 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 31 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":104039,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Leucovorin Calcium* / Leucovorin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Leuprolide Acetate|Leuprolide Acetate":{"brand_name":"Leuprolide Acetate","generic_name":"Leuprolide Acetate","avg_per_unit":{"value":344.33439024,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Leuprolide Acetate / Leuprolide Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Leuprolide Acetate / Leuprolide Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Levalbuterol Tartrate HFA|Levalbuterol Tartrate":{"brand_name":"Levalbuterol Tartrate HFA","generic_name":"Levalbuterol Tartrate","avg_per_unit":{"value":3.4544528182,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levalbuterol Tartrate HFA / Levalbuterol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":251600,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levalbuterol Tartrate HFA / Levalbuterol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levetiracetam ER|Levetiracetam":{"brand_name":"Levetiracetam ER","generic_name":"Levetiracetam","avg_per_unit":{"value":0.5253736933,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levetiracetam ER / Levetiracetam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":174566,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levetiracetam ER / Levetiracetam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levetiracetam*|Levetiracetam":{"brand_name":"Levetiracetam*","generic_name":"Levetiracetam","avg_per_unit":{"value":0.2620212551,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levetiracetam* / Levetiracetam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (96 of the 119 the name join matched); NDCs of another route or with no known FDA route do not. 5 of the 96 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 108 of 119 NADAC NDCs joined to this name are priced per EA (11 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4664870,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levetiracetam* / Levetiracetam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levo-T|Levothyroxine Sodium":{"brand_name":"Levo-T","generic_name":"Levothyroxine Sodium","avg_per_unit":{"value":0.4146402494,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levo-T / Levothyroxine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9029,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levo-T / Levothyroxine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levobunolol HCl|Levobunolol HCl":{"brand_name":"Levobunolol HCl","generic_name":"Levobunolol HCl","avg_per_unit":{"value":2.9283674899,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levobunolol HCl / Levobunolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":52530,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levobunolol HCl / Levobunolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levonest|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Levonest","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.5648173445,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levonest / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":423,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levonest / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levorphanol Tartrate|Levorphanol Tartrate":{"brand_name":"Levorphanol Tartrate","generic_name":"Levorphanol Tartrate","avg_per_unit":{"value":27.794758529,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levorphanol Tartrate / Levorphanol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4464,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levorphanol Tartrate / Levorphanol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levothyroxine Sodium*|Levothyroxine Sodium":{"brand_name":"Levothyroxine Sodium*","generic_name":"Levothyroxine Sodium","avg_per_unit":{"value":0.1693802683,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levothyroxine Sodium* / Levothyroxine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 299 NADAC NDCs the name join matched to it have an FDA route including ORAL. 21 of the 299 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43253940,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levothyroxine Sodium* / Levothyroxine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levoxyl|Levothyroxine Sodium":{"brand_name":"Levoxyl","generic_name":"Levothyroxine Sodium","avg_per_unit":{"value":0.5180750744,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levoxyl / Levothyroxine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":157517,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levoxyl / Levothyroxine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levsin*|Hyoscyamine Sulfate":{"brand_name":"Levsin*","generic_name":"Hyoscyamine Sulfate","avg_per_unit":{"value":2.6709820016,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levsin* / Hyoscyamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 1 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":82,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levsin* / Hyoscyamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Levsin-Sl|Hyoscyamine Sulfate":{"brand_name":"Levsin-Sl","generic_name":"Hyoscyamine Sulfate","avg_per_unit":{"value":2.3160260478,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Levsin-Sl / Hyoscyamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":141,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Levsin-Sl / Hyoscyamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lexapro|Escitalopram Oxalate":{"brand_name":"Lexapro","generic_name":"Escitalopram Oxalate","avg_per_unit":{"value":14.043579343,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lexapro / Escitalopram Oxalate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20281,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lexapro / Escitalopram Oxalate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lidocaine-Prilocaine|Lidocaine/Prilocaine":{"brand_name":"Lidocaine-Prilocaine","generic_name":"Lidocaine/Prilocaine","avg_per_unit":{"value":0.4280976856,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lidocaine-Prilocaine / Lidocaine/Prilocaine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":421178,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lidocaine-Prilocaine / Lidocaine/Prilocaine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lidocaine|Lidocaine":{"brand_name":"Lidocaine","generic_name":"Lidocaine","avg_per_unit":{"value":2.248848298,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lidocaine / Lidocaine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1671489,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lidocaine / Lidocaine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lidocan IV|Lidocaine":{"brand_name":"Lidocan IV","generic_name":"Lidocaine","avg_per_unit":{"value":24.442534179,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lidocan IV / Lidocaine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":157,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lidocan IV / Lidocaine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Linzess|Linaclotide":{"brand_name":"Linzess","generic_name":"Linaclotide","avg_per_unit":{"value":17.685502769,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Linzess / Linaclotide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2506531,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Linzess / Linaclotide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Liothyronine Sodium*|Liothyronine Sodium":{"brand_name":"Liothyronine Sodium*","generic_name":"Liothyronine Sodium","avg_per_unit":{"value":0.419622978,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Liothyronine Sodium* / Liothyronine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 32 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":748503,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Liothyronine Sodium* / Liothyronine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lipitor|Atorvastatin Calcium":{"brand_name":"Lipitor","generic_name":"Atorvastatin Calcium","avg_per_unit":{"value":15.709199891,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lipitor / Atorvastatin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":23269,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lipitor / Atorvastatin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Liraglutide|Liraglutide":{"brand_name":"Liraglutide","generic_name":"Liraglutide","avg_per_unit":{"value":75.154881194,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Liraglutide / Liraglutide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":62254,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Liraglutide / Liraglutide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate":{"brand_name":"Lisdexamfetamine Dimesylate","generic_name":"Lisdexamfetamine Dimesylate","avg_per_unit":{"value":6.9402270345,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lisdexamfetamine Dimesylate / Lisdexamfetamine Dimesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":197537,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lisdexamfetamine Dimesylate / Lisdexamfetamine Dimesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide":{"brand_name":"Lisinopril-Hydrochlorothiazide","generic_name":"Lisinopril/Hydrochlorothiazide","avg_per_unit":{"value":0.0925116221,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lisinopril-Hydrochlorothiazide / Lisinopril/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5642341,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lisinopril-Hydrochlorothiazide / Lisinopril/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lisinopril|Lisinopril":{"brand_name":"Lisinopril","generic_name":"Lisinopril","avg_per_unit":{"value":0.0889240964,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lisinopril / Lisinopril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36247459,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lisinopril / Lisinopril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lithium Carbonate ER|Lithium Carbonate":{"brand_name":"Lithium Carbonate ER","generic_name":"Lithium Carbonate","avg_per_unit":{"value":0.2185031309,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lithium Carbonate ER / Lithium Carbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":414576,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lithium Carbonate ER / Lithium Carbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lithium Carbonate|Lithium Carbonate":{"brand_name":"Lithium Carbonate","generic_name":"Lithium Carbonate","avg_per_unit":{"value":0.1371124135,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lithium Carbonate / Lithium Carbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":724316,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lithium Carbonate / Lithium Carbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lithium Citrate|Lithium Citrate":{"brand_name":"Lithium Citrate","generic_name":"Lithium Citrate","avg_per_unit":{"value":0.4619285322,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lithium Citrate / Lithium Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1009,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lithium Citrate / Lithium Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lithostat|Acetohydroxamic Acid":{"brand_name":"Lithostat","generic_name":"Acetohydroxamic Acid","avg_per_unit":{"value":6.7250814554,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lithostat / Acetohydroxamic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1360,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lithostat / Acetohydroxamic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Livalo|Pitavastatin Calcium":{"brand_name":"Livalo","generic_name":"Pitavastatin Calcium","avg_per_unit":{"value":10.410182201,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Livalo / Pitavastatin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":143372,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Livalo / Pitavastatin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lo Loestrin Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Lo Loestrin Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":6.3113230554,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lo Loestrin Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3780,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lo Loestrin Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lo-Zumandimine|Ethinyl Estradiol/Drospirenone":{"brand_name":"Lo-Zumandimine","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.6650185755,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lo-Zumandimine / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2217,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lo-Zumandimine / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lodoco|Colchicine":{"brand_name":"Lodoco","generic_name":"Colchicine","avg_per_unit":{"value":15.736763422,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lodoco / Colchicine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":723,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lodoco / Colchicine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Loestrin Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Loestrin Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":2.5465755072,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Loestrin Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":113,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Loestrin Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lofena|Diclofenac Potassium":{"brand_name":"Lofena","generic_name":"Diclofenac Potassium","avg_per_unit":{"value":25.607756521,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lofena / Diclofenac Potassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5482,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lofena / Diclofenac Potassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lofexidine HCl|Lofexidine HCl":{"brand_name":"Lofexidine HCl","generic_name":"Lofexidine HCl","avg_per_unit":{"value":16.368358365,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lofexidine HCl / Lofexidine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":201,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lofexidine HCl / Lofexidine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lojaimiess|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Lojaimiess","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":0.5837641761,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lojaimiess / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":462,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lojaimiess / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lokelma|Sodium Zirconium Cyclosilicate":{"brand_name":"Lokelma","generic_name":"Sodium Zirconium Cyclosilicate","avg_per_unit":{"value":26.657400757,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lokelma / Sodium Zirconium Cyclosilicate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":334671,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lokelma / Sodium Zirconium Cyclosilicate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lomotil|Diphenoxylate HCl/Atropine":{"brand_name":"Lomotil","generic_name":"Diphenoxylate HCl/Atropine","avg_per_unit":{"value":2.8267135693,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lomotil / Diphenoxylate HCl/Atropine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":773,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lomotil / Diphenoxylate HCl/Atropine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Loperamide|Loperamide HCl":{"brand_name":"Loperamide","generic_name":"Loperamide HCl","avg_per_unit":{"value":0.2829222382,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Loperamide / Loperamide HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":897042,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Loperamide / Loperamide HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lopinavir-Ritonavir|Lopinavir/Ritonavir":{"brand_name":"Lopinavir-Ritonavir","generic_name":"Lopinavir/Ritonavir","avg_per_unit":{"value":4.761330676,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lopinavir-Ritonavir / Lopinavir/Ritonavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4261,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lopinavir-Ritonavir / Lopinavir/Ritonavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Loreev XR|Lorazepam":{"brand_name":"Loreev XR","generic_name":"Lorazepam","avg_per_unit":{"value":14.696498249,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Loreev XR / Lorazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4959,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Loreev XR / Lorazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Loryna|Ethinyl Estradiol/Drospirenone":{"brand_name":"Loryna","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.6847428091,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Loryna / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4438,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Loryna / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Losartan Potassium|Losartan Potassium":{"brand_name":"Losartan Potassium","generic_name":"Losartan Potassium","avg_per_unit":{"value":0.1255850435,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Losartan Potassium / Losartan Potassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36240406,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Losartan Potassium / Losartan Potassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide":{"brand_name":"Losartan-Hydrochlorothiazide","generic_name":"Losartan/Hydrochlorothiazide","avg_per_unit":{"value":0.18048743,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Losartan-Hydrochlorothiazide / Losartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5597966,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Losartan-Hydrochlorothiazide / Losartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lotemax Sm|Loteprednol Etabonate":{"brand_name":"Lotemax Sm","generic_name":"Loteprednol Etabonate","avg_per_unit":{"value":49.865126807,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lotemax Sm / Loteprednol Etabonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":54978,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lotemax Sm / Loteprednol Etabonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lotemax|Loteprednol Etabonate":{"brand_name":"Lotemax","generic_name":"Loteprednol Etabonate","avg_per_unit":{"value":88.64670166,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lotemax / Loteprednol Etabonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":25078,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lotemax / Loteprednol Etabonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lovastatin|Lovastatin":{"brand_name":"Lovastatin","generic_name":"Lovastatin","avg_per_unit":{"value":0.1214390128,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lovastatin / Lovastatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2541780,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lovastatin / Lovastatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lovenox|Enoxaparin Sodium":{"brand_name":"Lovenox","generic_name":"Enoxaparin Sodium","avg_per_unit":{"value":24.797898579,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lovenox / Enoxaparin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":950,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lovenox / Enoxaparin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Low-Ogestrel|Norgestrel-Ethinyl Estradiol":{"brand_name":"Low-Ogestrel","generic_name":"Norgestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.5589761611,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Low-Ogestrel / Norgestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3362,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Low-Ogestrel / Norgestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Loxapine|Loxapine Succinate":{"brand_name":"Loxapine","generic_name":"Loxapine Succinate","avg_per_unit":{"value":0.791088995,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Loxapine / Loxapine Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":65940,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Loxapine / Loxapine Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lubiprostone|Lubiprostone":{"brand_name":"Lubiprostone","generic_name":"Lubiprostone","avg_per_unit":{"value":1.6678126927,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lubiprostone / Lubiprostone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":440018,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lubiprostone / Lubiprostone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lucemyra|Lofexidine HCl":{"brand_name":"Lucemyra","generic_name":"Lofexidine HCl","avg_per_unit":{"value":23.962873992,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lucemyra / Lofexidine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":597,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lucemyra / Lofexidine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lumigan|Bimatoprost":{"brand_name":"Lumigan","generic_name":"Bimatoprost","avg_per_unit":{"value":96.717641471,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lumigan / Bimatoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1407999,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lumigan / Bimatoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lupron Depot|Leuprolide Acetate":{"brand_name":"Lupron Depot","generic_name":"Leuprolide Acetate","avg_per_unit":{"value":5177.8490781,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lupron Depot / Leuprolide Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":31645,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lupron Depot / Leuprolide Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lurasidone HCl|Lurasidone HCl":{"brand_name":"Lurasidone HCl","generic_name":"Lurasidone HCl","avg_per_unit":{"value":6.1925128147,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lurasidone HCl / Lurasidone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":829678,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lurasidone HCl / Lurasidone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Lybalvi|Olanzapine/Samidorphan Malate":{"brand_name":"Lybalvi","generic_name":"Olanzapine/Samidorphan Malate","avg_per_unit":{"value":53.623410207,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lybalvi / Olanzapine/Samidorphan Malate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":78389,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lybalvi / Olanzapine/Samidorphan Malate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lyleq|Norethindrone":{"brand_name":"Lyleq","generic_name":"Norethindrone","avg_per_unit":{"value":0.358283208,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lyleq / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lyleq / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Lyllana|Estradiol":{"brand_name":"Lyllana","generic_name":"Estradiol","avg_per_unit":{"value":6.8319667107,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lyllana / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":24542,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lyllana / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lyrica|Pregabalin":{"brand_name":"Lyrica","generic_name":"Pregabalin","avg_per_unit":{"value":9.6690862414,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lyrica / Pregabalin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":65724,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lyrica / Pregabalin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lyumjev Kwikpen U-100|Insulin Lispro-Aabc":{"brand_name":"Lyumjev Kwikpen U-100","generic_name":"Insulin Lispro-Aabc","avg_per_unit":{"value":32.170974331,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lyumjev Kwikpen U-100 / Insulin Lispro-Aabc: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":73122,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lyumjev Kwikpen U-100 / Insulin Lispro-Aabc, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lyumjev Kwikpen U-200|Insulin Lispro-Aabc":{"brand_name":"Lyumjev Kwikpen U-200","generic_name":"Insulin Lispro-Aabc","avg_per_unit":{"value":64.219067856,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lyumjev Kwikpen U-200 / Insulin Lispro-Aabc: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":8403,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lyumjev Kwikpen U-200 / Insulin Lispro-Aabc, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Lyumjev|Insulin Lispro-Aabc":{"brand_name":"Lyumjev","generic_name":"Insulin Lispro-Aabc","avg_per_unit":{"value":24.765261517,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Lyumjev / Insulin Lispro-Aabc: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":17978,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Lyumjev / Insulin Lispro-Aabc, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "M-Natal Plus|PNV,Calcium 72/Iron/Folic Acid":{"brand_name":"M-Natal Plus","generic_name":"PNV,Calcium 72/Iron/Folic Acid","avg_per_unit":{"value":0.1782543543,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for M-Natal Plus / PNV,Calcium 72/Iron/Folic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":21359,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for M-Natal Plus / PNV,Calcium 72/Iron/Folic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Malathion|Malathion":{"brand_name":"Malathion","generic_name":"Malathion","avg_per_unit":{"value":2.9203229392,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Malathion / Malathion: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1742,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Malathion / Malathion, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Maraviroc|Maraviroc":{"brand_name":"Maraviroc","generic_name":"Maraviroc","avg_per_unit":{"value":18.974676074,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Maraviroc / Maraviroc: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14493,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Maraviroc / Maraviroc, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Marlissa|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Marlissa","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3715331951,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Marlissa / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1201,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Marlissa / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Matzim La|Diltiazem HCl":{"brand_name":"Matzim La","generic_name":"Diltiazem HCl","avg_per_unit":{"value":1.3804810172,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Matzim La / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":47025,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Matzim La / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mavyret|Glecaprevir/Pibrentasvir":{"brand_name":"Mavyret","generic_name":"Glecaprevir/Pibrentasvir","avg_per_unit":{"value":155.83739185,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mavyret / Glecaprevir/Pibrentasvir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12457,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mavyret / Glecaprevir/Pibrentasvir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Maxalt Mlt|Rizatriptan Benzoate":{"brand_name":"Maxalt Mlt","generic_name":"Rizatriptan Benzoate","avg_per_unit":{"value":41.079294951,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Maxalt Mlt / Rizatriptan Benzoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1520,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Maxalt Mlt / Rizatriptan Benzoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Maxalt|Rizatriptan Benzoate":{"brand_name":"Maxalt","generic_name":"Rizatriptan Benzoate","avg_per_unit":{"value":40.703729824,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Maxalt / Rizatriptan Benzoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1427,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Maxalt / Rizatriptan Benzoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Maxidex|Dexamethasone":{"brand_name":"Maxidex","generic_name":"Dexamethasone","avg_per_unit":{"value":16.745663567,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Maxidex / Dexamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1040,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Maxidex / Dexamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Meclizine HCl|Meclizine HCl":{"brand_name":"Meclizine HCl","generic_name":"Meclizine HCl","avg_per_unit":{"value":0.1476966251,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Meclizine HCl / Meclizine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3025148,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Meclizine HCl / Meclizine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Medrol|Methylprednisolone":{"brand_name":"Medrol","generic_name":"Methylprednisolone","avg_per_unit":{"value":0.3360919225,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Medrol / Methylprednisolone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":898,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Medrol / Methylprednisolone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mefenamic Acid|Mefenamic Acid":{"brand_name":"Mefenamic Acid","generic_name":"Mefenamic Acid","avg_per_unit":{"value":3.7981946637,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mefenamic Acid / Mefenamic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":320,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mefenamic Acid / Mefenamic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Mefloquine HCl|Mefloquine HCl":{"brand_name":"Mefloquine HCl","generic_name":"Mefloquine HCl","avg_per_unit":{"value":4.9030488281,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mefloquine HCl / Mefloquine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8643,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mefloquine HCl / Mefloquine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Memantine HCl ER|Memantine HCl":{"brand_name":"Memantine HCl ER","generic_name":"Memantine HCl","avg_per_unit":{"value":2.2707797112,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Memantine HCl ER / Memantine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":650504,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Memantine HCl ER / Memantine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Memantine HCl|Memantine HCl":{"brand_name":"Memantine HCl","generic_name":"Memantine HCl","avg_per_unit":{"value":0.4025068862,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Memantine HCl / Memantine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 57 of 60 NADAC NDCs joined to this name are priced per EA (3 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5630610,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Memantine HCl / Memantine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Menostar|Estradiol":{"brand_name":"Menostar","generic_name":"Estradiol","avg_per_unit":{"value":38.764894339,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Menostar / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1679,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Menostar / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Meprobamate|Meprobamate":{"brand_name":"Meprobamate","generic_name":"Meprobamate","avg_per_unit":{"value":4.1382944978,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Meprobamate / Meprobamate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3285,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Meprobamate / Meprobamate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mercaptopurine|Mercaptopurine":{"brand_name":"Mercaptopurine","generic_name":"Mercaptopurine","avg_per_unit":{"value":1.3577925935,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mercaptopurine / Mercaptopurine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43042,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mercaptopurine / Mercaptopurine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Meropenem|Meropenem":{"brand_name":"Meropenem","generic_name":"Meropenem","avg_per_unit":{"value":4.3116763745,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Meropenem / Meropenem: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":94400,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Meropenem / Meropenem, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mesalamine Dr|Mesalamine":{"brand_name":"Mesalamine Dr","generic_name":"Mesalamine","avg_per_unit":{"value":2.0098889865,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mesalamine Dr / Mesalamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":47962,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mesalamine Dr / Mesalamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mesalamine ER|Mesalamine":{"brand_name":"Mesalamine ER","generic_name":"Mesalamine","avg_per_unit":{"value":1.3799184359,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mesalamine ER / Mesalamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":142036,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mesalamine ER / Mesalamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metaxalone|Metaxalone":{"brand_name":"Metaxalone","generic_name":"Metaxalone","avg_per_unit":{"value":1.516503925,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metaxalone / Metaxalone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":71567,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metaxalone / Metaxalone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metformin ER Gastric|Metformin HCl":{"brand_name":"Metformin ER Gastric","generic_name":"Metformin HCl","avg_per_unit":{"value":12.37069734,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metformin ER Gastric / Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":83001,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metformin ER Gastric / Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Metformin ER Osmotic|Metformin HCl":{"brand_name":"Metformin ER Osmotic","generic_name":"Metformin HCl","avg_per_unit":{"value":2.2030481282,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metformin ER Osmotic / Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":71458,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metformin ER Osmotic / Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metformin HCl ER|Metformin HCl":{"brand_name":"Metformin HCl ER","generic_name":"Metformin HCl","avg_per_unit":{"value":0.0599876952,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metformin HCl ER / Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10256666,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metformin HCl ER / Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metformin HCl|Metformin HCl":{"brand_name":"Metformin HCl","generic_name":"Metformin HCl","avg_per_unit":{"value":0.056431518,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metformin HCl / Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 166 of 170 NADAC NDCs joined to this name are priced per EA (4 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":23961097,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metformin HCl / Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methadone HCl*|Methadone HCl":{"brand_name":"Methadone HCl*","generic_name":"Methadone HCl","avg_per_unit":{"value":0.2098070061,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methadone HCl* / Methadone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 22 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 21 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code). 21 of 22 NADAC NDCs joined to this name are priced per EA (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":556775,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methadone HCl* / Methadone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methamphetamine HCl|Methamphetamine HCl":{"brand_name":"Methamphetamine HCl","generic_name":"Methamphetamine HCl","avg_per_unit":{"value":10.662420706,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methamphetamine HCl / Methamphetamine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":131,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methamphetamine HCl / Methamphetamine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methazolamide|Methazolamide":{"brand_name":"Methazolamide","generic_name":"Methazolamide","avg_per_unit":{"value":2.2441206761,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methazolamide / Methazolamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":42722,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methazolamide / Methazolamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methenamine Hippurate|Methenamine Hippurate":{"brand_name":"Methenamine Hippurate","generic_name":"Methenamine Hippurate","avg_per_unit":{"value":0.8708586122,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methenamine Hippurate / Methenamine Hippurate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":887845,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methenamine Hippurate / Methenamine Hippurate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methenamine Mandelate|Methenamine Mandelate":{"brand_name":"Methenamine Mandelate","generic_name":"Methenamine Mandelate","avg_per_unit":{"value":1.576652222,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methenamine Mandelate / Methenamine Mandelate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5955,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methenamine Mandelate / Methenamine Mandelate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methimazole|Methimazole":{"brand_name":"Methimazole","generic_name":"Methimazole","avg_per_unit":{"value":0.1724023974,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methimazole / Methimazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":943504,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methimazole / Methimazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methocarbamol*|Methocarbamol":{"brand_name":"Methocarbamol*","generic_name":"Methocarbamol","avg_per_unit":{"value":0.1537728918,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methocarbamol* / Methocarbamol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 42 NADAC NDCs the name join matched to it have an FDA route including ORAL. 4 of the 42 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3190991,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methocarbamol* / Methocarbamol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methscopolamine Bromide|Methscopolamine Bromide":{"brand_name":"Methscopolamine Bromide","generic_name":"Methscopolamine Bromide","avg_per_unit":{"value":1.4364931993,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methscopolamine Bromide / Methscopolamine Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4857,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methscopolamine Bromide / Methscopolamine Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylergonovine Maleate*|Methylergonovine Maleate":{"brand_name":"Methylergonovine Maleate*","generic_name":"Methylergonovine Maleate","avg_per_unit":{"value":17.990931421,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylergonovine Maleate* / Methylergonovine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (11 of the 13 the name join matched); NDCs of another route or with no known FDA route do not. 1 of the 11 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":191,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylergonovine Maleate* / Methylergonovine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylin|Methylphenidate HCl":{"brand_name":"Methylin","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":0.1573883967,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylin / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":31,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylin / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Methylphenidate ER (La)|Methylphenidate HCl":{"brand_name":"Methylphenidate ER (La)","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":3.4127400101,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylphenidate ER (La) / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25549,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylphenidate ER (La) / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylphenidate ER|Methylphenidate HCl":{"brand_name":"Methylphenidate ER","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":2.2804720672,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylphenidate ER / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":225973,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylphenidate ER / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylphenidate HCl CD|Methylphenidate HCl":{"brand_name":"Methylphenidate HCl CD","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":2.4095049311,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylphenidate HCl CD / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8038,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylphenidate HCl CD / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylphenidate HCl ER (Cd)|Methylphenidate HCl":{"brand_name":"Methylphenidate HCl ER (Cd)","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":2.2841285876,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylphenidate HCl ER (Cd) / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15437,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylphenidate HCl ER (Cd) / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylphenidate|Methylphenidate":{"brand_name":"Methylphenidate","generic_name":"Methylphenidate","avg_per_unit":{"value":9.7131507544,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylphenidate / Methylphenidate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1098,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylphenidate / Methylphenidate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Methylprednisolone Sodium Succ*|Methylprednisolone Sod Succ":{"brand_name":"Methylprednisolone Sodium Succ*","generic_name":"Methylprednisolone Sod Succ","avg_per_unit":{"value":6.1663646063,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylprednisolone Sodium Succ* / Methylprednisolone Sod Succ: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. CMS outlier flag 1: the average is substantially affected by outlier records. All 3 NADAC NDCs the name join matched to it have an FDA route including INTRAMUSCULAR and INTRAVENOUS.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16398,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylprednisolone Sodium Succ* / Methylprednisolone Sod Succ, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Methylprednisolone|Methylprednisolone":{"brand_name":"Methylprednisolone","generic_name":"Methylprednisolone","avg_per_unit":{"value":0.3389525004,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Methylprednisolone / Methylprednisolone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5855933,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Methylprednisolone / Methylprednisolone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metolazone|Metolazone":{"brand_name":"Metolazone","generic_name":"Metolazone","avg_per_unit":{"value":0.6881671187,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metolazone / Metolazone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":646377,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metolazone / Metolazone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metoprolol Succinate|Metoprolol Succinate":{"brand_name":"Metoprolol Succinate","generic_name":"Metoprolol Succinate","avg_per_unit":{"value":0.182508661,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metoprolol Succinate / Metoprolol Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":32213092,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metoprolol Succinate / Metoprolol Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metoprolol Tartrate*|Metoprolol Tartrate":{"brand_name":"Metoprolol Tartrate*","generic_name":"Metoprolol Tartrate","avg_per_unit":{"value":0.0591139867,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metoprolol Tartrate* / Metoprolol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 79 NADAC NDCs the name join matched to it have an FDA route including ORAL. 7 of the 79 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15912137,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metoprolol Tartrate* / Metoprolol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide":{"brand_name":"Metoprolol-Hydrochlorothiazide","generic_name":"Metoprolol/Hydrochlorothiazide","avg_per_unit":{"value":0.8163801936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metoprolol-Hydrochlorothiazide / Metoprolol/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":33203,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metoprolol-Hydrochlorothiazide / Metoprolol/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Metronidazole*|Metronidazole":{"brand_name":"Metronidazole*","generic_name":"Metronidazole","avg_per_unit":{"value":0.5902699727,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Metronidazole* / Metronidazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 3 NADAC NDCs the name join matched to it have an FDA route including VAGINAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":2260622,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Metronidazole* / Metronidazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mexiletine HCl|Mexiletine HCl":{"brand_name":"Mexiletine HCl","generic_name":"Mexiletine HCl","avg_per_unit":{"value":0.7153015069,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mexiletine HCl / Mexiletine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":93443,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mexiletine HCl / Mexiletine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mibelas 24 Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Mibelas 24 Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":1.1902890202,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mibelas 24 Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":319,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mibelas 24 Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Micardis HCT|Telmisartan/Hydrochlorothiazid":{"brand_name":"Micardis HCT","generic_name":"Telmisartan/Hydrochlorothiazid","avg_per_unit":{"value":4.4226399572,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Micardis HCT / Telmisartan/Hydrochlorothiazid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2874,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Micardis HCT / Telmisartan/Hydrochlorothiazid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Miconazole 3|Miconazole Nitrate":{"brand_name":"Miconazole 3","generic_name":"Miconazole Nitrate","avg_per_unit":{"value":13.784612747,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Miconazole 3 / Miconazole Nitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2811,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Miconazole 3 / Miconazole Nitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Microgestin Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Microgestin Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.4062540793,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Microgestin Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1887,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Microgestin Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Microgestin|Norethindrone Ac/Eth Estradiol":{"brand_name":"Microgestin","generic_name":"Norethindrone Ac/Eth Estradiol","avg_per_unit":{"value":0.5893888916,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Microgestin / Norethindrone Ac/Eth Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3190,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Microgestin / Norethindrone Ac/Eth Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Midodrine HCl|Midodrine HCl":{"brand_name":"Midodrine HCl","generic_name":"Midodrine HCl","avg_per_unit":{"value":0.6205252149,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Midodrine HCl / Midodrine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1625675,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Midodrine HCl / Midodrine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Miebo|Perfluorohexyloctane/PF":{"brand_name":"Miebo","generic_name":"Perfluorohexyloctane/PF","avg_per_unit":{"value":246.58747533,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Miebo / Perfluorohexyloctane/PF: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":134845,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Miebo / Perfluorohexyloctane/PF, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mili|Norgestimate-Ethinyl Estradiol":{"brand_name":"Mili","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.3497020333,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mili / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6349,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mili / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mimvey|Estradiol/Norethindrone Acet":{"brand_name":"Mimvey","generic_name":"Estradiol/Norethindrone Acet","avg_per_unit":{"value":1.5179538053,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mimvey / Estradiol/Norethindrone Acet: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3634,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mimvey / Estradiol/Norethindrone Acet, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Minivelle|Estradiol":{"brand_name":"Minivelle","generic_name":"Estradiol","avg_per_unit":{"value":27.616493919,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Minivelle / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2918,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Minivelle / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Minocycline HCl ER|Minocycline HCl":{"brand_name":"Minocycline HCl ER","generic_name":"Minocycline HCl","avg_per_unit":{"value":6.5494064494,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Minocycline HCl ER / Minocycline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":473,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Minocycline HCl ER / Minocycline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Minocycline HCl|Minocycline HCl":{"brand_name":"Minocycline HCl","generic_name":"Minocycline HCl","avg_per_unit":{"value":0.5159833998,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Minocycline HCl / Minocycline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":350488,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Minocycline HCl / Minocycline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Minoxidil|Minoxidil":{"brand_name":"Minoxidil","generic_name":"Minoxidil","avg_per_unit":{"value":0.1919988935,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Minoxidil / Minoxidil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":603619,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Minoxidil / Minoxidil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mirabegron ER|Mirabegron":{"brand_name":"Mirabegron ER","generic_name":"Mirabegron","avg_per_unit":{"value":10.171035456,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mirabegron ER / Mirabegron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":269636,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mirabegron ER / Mirabegron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mirtazapine|Mirtazapine":{"brand_name":"Mirtazapine","generic_name":"Mirtazapine","avg_per_unit":{"value":0.4640306643,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mirtazapine / Mirtazapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8338476,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mirtazapine / Mirtazapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mirvaso|Brimonidine Tartrate":{"brand_name":"Mirvaso","generic_name":"Brimonidine Tartrate","avg_per_unit":{"value":20.581173101,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mirvaso / Brimonidine Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":586,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mirvaso / Brimonidine Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Misoprostol|Misoprostol":{"brand_name":"Misoprostol","generic_name":"Misoprostol","avg_per_unit":{"value":0.6706908041,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Misoprostol / Misoprostol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":91192,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Misoprostol / Misoprostol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mitigare|Colchicine":{"brand_name":"Mitigare","generic_name":"Colchicine","avg_per_unit":{"value":6.0343414893,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mitigare / Colchicine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":44946,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mitigare / Colchicine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Modafinil|Modafinil":{"brand_name":"Modafinil","generic_name":"Modafinil","avg_per_unit":{"value":1.407066881,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Modafinil / Modafinil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":366281,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Modafinil / Modafinil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Moexipril HCl|Moexipril HCl":{"brand_name":"Moexipril HCl","generic_name":"Moexipril HCl","avg_per_unit":{"value":0.6408535361,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Moexipril HCl / Moexipril HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":17124,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Moexipril HCl / Moexipril HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mono-Linyah|Norgestimate-Ethinyl Estradiol":{"brand_name":"Mono-Linyah","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.4086138118,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mono-Linyah / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4082,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mono-Linyah / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Montelukast Sodium|Montelukast Sodium":{"brand_name":"Montelukast Sodium","generic_name":"Montelukast Sodium","avg_per_unit":{"value":0.1677932502,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Montelukast Sodium / Montelukast Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12462037,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Montelukast Sodium / Montelukast Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Morphine Sulfate ER|Morphine Sulfate":{"brand_name":"Morphine Sulfate ER","generic_name":"Morphine Sulfate","avg_per_unit":{"value":0.5055392895,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Morphine Sulfate ER / Morphine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1918463,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Morphine Sulfate ER / Morphine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Motegrity|Prucalopride Succinate":{"brand_name":"Motegrity","generic_name":"Prucalopride Succinate","avg_per_unit":{"value":17.430669794,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Motegrity / Prucalopride Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":91612,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Motegrity / Prucalopride Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Motofen|Difenoxin HCl/Atropine Sulfate":{"brand_name":"Motofen","generic_name":"Difenoxin HCl/Atropine Sulfate","avg_per_unit":{"value":6.7482852472,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Motofen / Difenoxin HCl/Atropine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":672,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Motofen / Difenoxin HCl/Atropine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Motpoly XR|Lacosamide":{"brand_name":"Motpoly XR","generic_name":"Lacosamide","avg_per_unit":{"value":20.109307359,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Motpoly XR / Lacosamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":349,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Motpoly XR / Lacosamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Mounjaro|Tirzepatide":{"brand_name":"Mounjaro","generic_name":"Tirzepatide","avg_per_unit":{"value":511.63410588,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Mounjaro / Tirzepatide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5105397,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Mounjaro / Tirzepatide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Movantik|Naloxegol Oxalate":{"brand_name":"Movantik","generic_name":"Naloxegol Oxalate","avg_per_unit":{"value":13.502918627,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Movantik / Naloxegol Oxalate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":336315,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Movantik / Naloxegol Oxalate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Moxifloxacin HCl|Moxifloxacin HCl":{"brand_name":"Moxifloxacin HCl","generic_name":"Moxifloxacin HCl","avg_per_unit":{"value":3.9237754405,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Moxifloxacin HCl / Moxifloxacin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":64055,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Moxifloxacin HCl / Moxifloxacin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Multaq|Dronedarone HCl":{"brand_name":"Multaq","generic_name":"Dronedarone HCl","avg_per_unit":{"value":12.874286746,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Multaq / Dronedarone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":318776,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Multaq / Dronedarone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Myfembree|Relugolix/Estradiol/Norethindr":{"brand_name":"Myfembree","generic_name":"Relugolix/Estradiol/Norethindr","avg_per_unit":{"value":41.520750234,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Myfembree / Relugolix/Estradiol/Norethindr: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1412,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Myfembree / Relugolix/Estradiol/Norethindr, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nabumetone|Nabumetone":{"brand_name":"Nabumetone","generic_name":"Nabumetone","avg_per_unit":{"value":0.2290667362,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nabumetone / Nabumetone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":583765,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nabumetone / Nabumetone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nadolol|Nadolol":{"brand_name":"Nadolol","generic_name":"Nadolol","avg_per_unit":{"value":0.6910543255,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nadolol / Nadolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":262253,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nadolol / Nadolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naftifine HCl|Naftifine HCl":{"brand_name":"Naftifine HCl","generic_name":"Naftifine HCl","avg_per_unit":{"value":3.8028671596,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naftifine HCl / Naftifine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":15701,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naftifine HCl / Naftifine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nalbuphine HCl|Nalbuphine HCl":{"brand_name":"Nalbuphine HCl","generic_name":"Nalbuphine HCl","avg_per_unit":{"value":4.313933754,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nalbuphine HCl / Nalbuphine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1144,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nalbuphine HCl / Nalbuphine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naloxone HCl*|Naloxone HCl":{"brand_name":"Naloxone HCl*","generic_name":"Naloxone HCl","avg_per_unit":{"value":30.896385173,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naloxone HCl* / Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes INTRAMUSCULAR and INTRAVENOUS and SUBCUTANEOUS point at this name (19 of the 27 the name join matched); NDCs of another route or with no known FDA route do not. 3 of the 19 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":715410,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naloxone HCl* / Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naltrexone HCl|Naltrexone HCl":{"brand_name":"Naltrexone HCl","generic_name":"Naltrexone HCl","avg_per_unit":{"value":1.2520970533,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naltrexone HCl / Naltrexone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":466006,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naltrexone HCl / Naltrexone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Namzaric|Memantine HCl/Donepezil HCl":{"brand_name":"Namzaric","generic_name":"Memantine HCl/Donepezil HCl","avg_per_unit":{"value":19.417970265,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Namzaric / Memantine HCl/Donepezil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":129758,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Namzaric / Memantine HCl/Donepezil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naproxen Sodium Cr|Naproxen Sodium":{"brand_name":"Naproxen Sodium Cr","generic_name":"Naproxen Sodium","avg_per_unit":{"value":6.0927008495,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naproxen Sodium Cr / Naproxen Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1814,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naproxen Sodium Cr / Naproxen Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Naproxen Sodium ER|Naproxen Sodium":{"brand_name":"Naproxen Sodium ER","generic_name":"Naproxen Sodium","avg_per_unit":{"value":7.3621472192,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naproxen Sodium ER / Naproxen Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2266,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naproxen Sodium ER / Naproxen Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naproxen Sodium|Naproxen Sodium":{"brand_name":"Naproxen Sodium","generic_name":"Naproxen Sodium","avg_per_unit":{"value":0.6887098602,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naproxen Sodium / Naproxen Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":69827,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naproxen Sodium / Naproxen Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag":{"brand_name":"Naproxen-Esomeprazole Mag","generic_name":"Naproxen/Esomeprazole Mag","avg_per_unit":{"value":14.548374657,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naproxen-Esomeprazole Mag / Naproxen/Esomeprazole Mag: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15135,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naproxen-Esomeprazole Mag / Naproxen/Esomeprazole Mag, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Naratriptan HCl|Naratriptan HCl":{"brand_name":"Naratriptan HCl","generic_name":"Naratriptan HCl","avg_per_unit":{"value":2.6923425783,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Naratriptan HCl / Naratriptan HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":92668,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Naratriptan HCl / Naratriptan HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Narcan|Naloxone HCl":{"brand_name":"Narcan","generic_name":"Naloxone HCl","avg_per_unit":{"value":55.074789117,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Narcan / Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9543,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Narcan / Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Natazia|Estradiol Valerate/Dienogest":{"brand_name":"Natazia","generic_name":"Estradiol Valerate/Dienogest","avg_per_unit":{"value":8.7913578501,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Natazia / Estradiol Valerate/Dienogest: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":219,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Natazia / Estradiol Valerate/Dienogest, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nateglinide|Nateglinide":{"brand_name":"Nateglinide","generic_name":"Nateglinide","avg_per_unit":{"value":0.3396345324,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nateglinide / Nateglinide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":149549,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nateglinide / Nateglinide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Natroba|Spinosad":{"brand_name":"Natroba","generic_name":"Spinosad","avg_per_unit":{"value":2.2217769085,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Natroba / Spinosad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":580,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Natroba / Spinosad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nayzilam|Midazolam":{"brand_name":"Nayzilam","generic_name":"Midazolam","avg_per_unit":{"value":327.2258341,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nayzilam / Midazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39175,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nayzilam / Midazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nebivolol HCl|Nebivolol HCl":{"brand_name":"Nebivolol HCl","generic_name":"Nebivolol HCl","avg_per_unit":{"value":0.7889562338,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nebivolol HCl / Nebivolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1387136,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nebivolol HCl / Nebivolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Necon|Norethindrone-Ethin. Estradiol":{"brand_name":"Necon","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.6209516316,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Necon / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":224,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Necon / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nefazodone HCl|Nefazodone HCl":{"brand_name":"Nefazodone HCl","generic_name":"Nefazodone HCl","avg_per_unit":{"value":1.7983645083,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nefazodone HCl / Nefazodone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5859,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nefazodone HCl / Nefazodone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Neffy|Epinephrine":{"brand_name":"Neffy","generic_name":"Epinephrine","avg_per_unit":{"value":340.8923825,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Neffy / Epinephrine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":269,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Neffy / Epinephrine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Neomycin Sulfate|Neomycin Sulfate":{"brand_name":"Neomycin Sulfate","generic_name":"Neomycin Sulfate","avg_per_unit":{"value":0.8801520644,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Neomycin Sulfate / Neomycin Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":89388,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Neomycin Sulfate / Neomycin Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Neoral|Cyclosporine, Modified":{"brand_name":"Neoral","generic_name":"Cyclosporine, Modified","avg_per_unit":{"value":3.9078397156,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Neoral / Cyclosporine, Modified: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1341,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Neoral / Cyclosporine, Modified, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Neupogen|Filgrastim":{"brand_name":"Neupogen","generic_name":"Filgrastim","avg_per_unit":{"value":599.02015865,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Neupogen / Filgrastim: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2908,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Neupogen / Filgrastim, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Neurontin|Gabapentin":{"brand_name":"Neurontin","generic_name":"Gabapentin","avg_per_unit":{"value":8.8754887906,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Neurontin / Gabapentin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11760,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Neurontin / Gabapentin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nevanac|Nepafenac":{"brand_name":"Nevanac","generic_name":"Nepafenac","avg_per_unit":{"value":109.81392453,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nevanac / Nepafenac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3362,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nevanac / Nepafenac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nevirapine ER|Nevirapine":{"brand_name":"Nevirapine ER","generic_name":"Nevirapine","avg_per_unit":{"value":5.6049787905,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nevirapine ER / Nevirapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5875,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nevirapine ER / Nevirapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Nevirapine|Nevirapine":{"brand_name":"Nevirapine","generic_name":"Nevirapine","avg_per_unit":{"value":0.5323078807,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nevirapine / Nevirapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5449,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nevirapine / Nevirapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nexletol|Bempedoic Acid":{"brand_name":"Nexletol","generic_name":"Bempedoic Acid","avg_per_unit":{"value":13.084685681,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nexletol / Bempedoic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":99877,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nexletol / Bempedoic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nexlizet|Bempedoic Acid/Ezetimibe":{"brand_name":"Nexlizet","generic_name":"Bempedoic Acid/Ezetimibe","avg_per_unit":{"value":13.069984286,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nexlizet / Bempedoic Acid/Ezetimibe: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":97223,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nexlizet / Bempedoic Acid/Ezetimibe, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nextstellis|Drospirenone/Estetrol":{"brand_name":"Nextstellis","generic_name":"Drospirenone/Estetrol","avg_per_unit":{"value":7.1972716125,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nextstellis / Drospirenone/Estetrol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":267,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nextstellis / Drospirenone/Estetrol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Niacin ER|Niacin":{"brand_name":"Niacin ER","generic_name":"Niacin","avg_per_unit":{"value":0.8841205847,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Niacin ER / Niacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":157341,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Niacin ER / Niacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nicardipine HCl*|Nicardipine HCl":{"brand_name":"Nicardipine HCl*","generic_name":"Nicardipine HCl","avg_per_unit":{"value":4.3730799598,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nicardipine HCl* / Nicardipine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 6 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4030,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nicardipine HCl* / Nicardipine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nifedipine ER|Nifedipine":{"brand_name":"Nifedipine ER","generic_name":"Nifedipine","avg_per_unit":{"value":0.3498947213,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nifedipine ER / Nifedipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3845740,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nifedipine ER / Nifedipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nifedipine|Nifedipine":{"brand_name":"Nifedipine","generic_name":"Nifedipine","avg_per_unit":{"value":0.5564822807,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nifedipine / Nifedipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14331,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nifedipine / Nifedipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nikki|Ethinyl Estradiol/Drospirenone":{"brand_name":"Nikki","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.648580002,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nikki / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3369,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nikki / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nimodipine|Nimodipine":{"brand_name":"Nimodipine","generic_name":"Nimodipine","avg_per_unit":{"value":2.6236149693,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nimodipine / Nimodipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2342,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nimodipine / Nimodipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nisoldipine|Nisoldipine":{"brand_name":"Nisoldipine","generic_name":"Nisoldipine","avg_per_unit":{"value":4.5870622387,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nisoldipine / Nisoldipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11997,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nisoldipine / Nisoldipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nitazoxanide|Nitazoxanide":{"brand_name":"Nitazoxanide","generic_name":"Nitazoxanide","avg_per_unit":{"value":86.084266021,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nitazoxanide / Nitazoxanide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3306,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nitazoxanide / Nitazoxanide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nitro-Bid|Nitroglycerin":{"brand_name":"Nitro-Bid","generic_name":"Nitroglycerin","avg_per_unit":{"value":0.5574506931,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nitro-Bid / Nitroglycerin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":22885,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nitro-Bid / Nitroglycerin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nitro-Dur|Nitroglycerin":{"brand_name":"Nitro-Dur","generic_name":"Nitroglycerin","avg_per_unit":{"value":50.828355126,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nitro-Dur / Nitroglycerin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1298,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nitro-Dur / Nitroglycerin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Niva Thyroid|Thyroid,Pork":{"brand_name":"Niva Thyroid","generic_name":"Thyroid,Pork","avg_per_unit":{"value":0.9172721093,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Niva Thyroid / Thyroid,Pork: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2873,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Niva Thyroid / Thyroid,Pork, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nizatidine|Nizatidine":{"brand_name":"Nizatidine","generic_name":"Nizatidine","avg_per_unit":{"value":1.3569902582,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nizatidine / Nizatidine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4084,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nizatidine / Nizatidine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nora-Be|Norethindrone":{"brand_name":"Nora-Be","generic_name":"Norethindrone","avg_per_unit":{"value":0.3425114619,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nora-Be / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1593,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nora-Be / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Norditropin Flexpro|Somatropin":{"brand_name":"Norditropin Flexpro","generic_name":"Somatropin","avg_per_unit":{"value":1069.8257198,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Norditropin Flexpro / Somatropin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":4541,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Norditropin Flexpro / Somatropin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Norethindrone|Norethindrone":{"brand_name":"Norethindrone","generic_name":"Norethindrone","avg_per_unit":{"value":0.3408264924,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Norethindrone / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":54776,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Norethindrone / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol":{"brand_name":"Norgestimate-Ethinyl Estradiol","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.4164559936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Norgestimate-Ethinyl Estradiol / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18882,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Norgestimate-Ethinyl Estradiol / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Norliqva|Amlodipine Besylate":{"brand_name":"Norliqva","generic_name":"Amlodipine Besylate","avg_per_unit":{"value":3.549231001,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Norliqva / Amlodipine Besylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":836,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Norliqva / Amlodipine Besylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nortrel|Norethindrone-Ethin. Estradiol":{"brand_name":"Nortrel","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.5584442183,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nortrel / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13939,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nortrel / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nortriptyline HCl|Nortriptyline HCl":{"brand_name":"Nortriptyline HCl","generic_name":"Nortriptyline HCl","avg_per_unit":{"value":0.1886076062,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nortriptyline HCl / Nortriptyline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 18 of 20 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1279736,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nortriptyline HCl / Nortriptyline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Norvasc|Amlodipine Besylate":{"brand_name":"Norvasc","generic_name":"Amlodipine Besylate","avg_per_unit":{"value":9.1996827897,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Norvasc / Amlodipine Besylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20746,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Norvasc / Amlodipine Besylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Norvir|Ritonavir":{"brand_name":"Norvir","generic_name":"Ritonavir","avg_per_unit":{"value":8.1970567244,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Norvir / Ritonavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1508,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Norvir / Ritonavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novarel|Chorionic Gonadotropin, Human":{"brand_name":"Novarel","generic_name":"Chorionic Gonadotropin, Human","avg_per_unit":{"value":159.15053763,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novarel / Chorionic Gonadotropin, Human: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":39,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novarel / Chorionic Gonadotropin, Human, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novolin N Flexpen|Insulin NPh Human Isophane":{"brand_name":"Novolin N Flexpen","generic_name":"Insulin NPh Human Isophane","avg_per_unit":{"value":5.6539107125,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novolin N Flexpen / Insulin NPh Human Isophane: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":57649,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novolin N Flexpen / Insulin NPh Human Isophane, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novolin N|Insulin NPh Human Isophane":{"brand_name":"Novolin N","generic_name":"Insulin NPh Human Isophane","avg_per_unit":{"value":4.4367656281,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novolin N / Insulin NPh Human Isophane: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":98923,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novolin N / Insulin NPh Human Isophane, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novolin R Flexpen|Insulin Regular, Human":{"brand_name":"Novolin R Flexpen","generic_name":"Insulin Regular, Human","avg_per_unit":{"value":5.8688794191,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novolin R Flexpen / Insulin Regular, Human: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":67239,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novolin R Flexpen / Insulin Regular, Human, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novolin R|Insulin Regular, Human":{"brand_name":"Novolin R","generic_name":"Insulin Regular, Human","avg_per_unit":{"value":4.6417163109,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novolin R / Insulin Regular, Human: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":106120,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novolin R / Insulin Regular, Human, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novolog Flexpen|Insulin Aspart":{"brand_name":"Novolog Flexpen","generic_name":"Insulin Aspart","avg_per_unit":{"value":8.896905341,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novolog Flexpen / Insulin Aspart: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1483591,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novolog Flexpen / Insulin Aspart, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Novolog|Insulin Aspart":{"brand_name":"Novolog","generic_name":"Insulin Aspart","avg_per_unit":{"value":6.9800771618,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Novolog / Insulin Aspart: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":370385,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Novolog / Insulin Aspart, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nuedexta|Dextromethorphan HBr/Quinidine":{"brand_name":"Nuedexta","generic_name":"Dextromethorphan HBr/Quinidine","avg_per_unit":{"value":26.853278886,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nuedexta / Dextromethorphan HBr/Quinidine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":158337,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nuedexta / Dextromethorphan HBr/Quinidine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nulev|Hyoscyamine Sulfate":{"brand_name":"Nulev","generic_name":"Hyoscyamine Sulfate","avg_per_unit":{"value":0.532831074,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nulev / Hyoscyamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nulev / Hyoscyamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Nuplazid|Pimavanserin Tartrate":{"brand_name":"Nuplazid","generic_name":"Pimavanserin Tartrate","avg_per_unit":{"value":165.56804872,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nuplazid / Pimavanserin Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":143328,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nuplazid / Pimavanserin Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nurtec ODT|Rimegepant Sulfate":{"brand_name":"Nurtec ODT","generic_name":"Rimegepant Sulfate","avg_per_unit":{"value":123.76821468,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nurtec ODT / Rimegepant Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":426648,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nurtec ODT / Rimegepant Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nuvessa|Metronidazole":{"brand_name":"Nuvessa","generic_name":"Metronidazole","avg_per_unit":{"value":40.245166097,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nuvessa / Metronidazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":534,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nuvessa / Metronidazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nuvigil|Armodafinil":{"brand_name":"Nuvigil","generic_name":"Armodafinil","avg_per_unit":{"value":34.264260794,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nuvigil / Armodafinil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2320,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nuvigil / Armodafinil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nyamyc|Nystatin":{"brand_name":"Nyamyc","generic_name":"Nystatin","avg_per_unit":{"value":0.5387360631,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nyamyc / Nystatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":349852,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nyamyc / Nystatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nylia|Norethindrone-Ethin. Estradiol":{"brand_name":"Nylia","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.3250076299,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nylia / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2222,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nylia / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Nystop|Nystatin":{"brand_name":"Nystop","generic_name":"Nystatin","avg_per_unit":{"value":0.5484249457,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Nystop / Nystatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":440088,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Nystop / Nystatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Octreotide Acetate|Octreotide Acetate":{"brand_name":"Octreotide Acetate","generic_name":"Octreotide Acetate","avg_per_unit":{"value":8.813043586,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Octreotide Acetate / Octreotide Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":14690,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Octreotide Acetate / Octreotide Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Odactra|Mite,D.Farinae-D.Pteronyssinus":{"brand_name":"Odactra","generic_name":"Mite,D.Farinae-D.Pteronyssinus","avg_per_unit":{"value":11.227821743,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Odactra / Mite,D.Farinae-D.Pteronyssinus: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2331,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Odactra / Mite,D.Farinae-D.Pteronyssinus, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ofloxacin*|Ofloxacin":{"brand_name":"Ofloxacin*","generic_name":"Ofloxacin","avg_per_unit":{"value":2.8214574076,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ofloxacin* / Ofloxacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes OPHTHALMIC point at this name (21 of the 31 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1475266,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ofloxacin* / Ofloxacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olanzapine ODT|Olanzapine":{"brand_name":"Olanzapine ODT","generic_name":"Olanzapine","avg_per_unit":{"value":2.3262602468,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olanzapine ODT / Olanzapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":236870,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olanzapine ODT / Olanzapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olanzapine*|Olanzapine":{"brand_name":"Olanzapine*","generic_name":"Olanzapine","avg_per_unit":{"value":0.6961710607,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olanzapine* / Olanzapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (86 of the 96 the name join matched); NDCs of another route or with no known FDA route do not. 5 of the 86 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3741398,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olanzapine* / Olanzapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl":{"brand_name":"Olanzapine-Fluoxetine HCl","generic_name":"Olanzapine/Fluoxetine HCl","avg_per_unit":{"value":7.3947034457,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olanzapine-Fluoxetine HCl / Olanzapine/Fluoxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6606,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olanzapine-Fluoxetine HCl / Olanzapine/Fluoxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olmesartan Medoxomil|Olmesartan Medoxomil":{"brand_name":"Olmesartan Medoxomil","generic_name":"Olmesartan Medoxomil","avg_per_unit":{"value":0.2569377481,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olmesartan Medoxomil / Olmesartan Medoxomil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3499458,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olmesartan Medoxomil / Olmesartan Medoxomil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide":{"brand_name":"Olmesartan-Hydrochlorothiazide","generic_name":"Olmesartan/Hydrochlorothiazide","avg_per_unit":{"value":0.4790712491,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olmesartan-Hydrochlorothiazide / Olmesartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":962983,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olmesartan-Hydrochlorothiazide / Olmesartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olopatadine HCl*|Olopatadine HCl":{"brand_name":"Olopatadine HCl*","generic_name":"Olopatadine HCl","avg_per_unit":{"value":5.7673475259,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olopatadine HCl* / Olopatadine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 3 NADAC NDCs the name join matched to it have an FDA route including NASAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":43298,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olopatadine HCl* / Olopatadine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Olumiant|Baricitinib":{"brand_name":"Olumiant","generic_name":"Baricitinib","avg_per_unit":{"value":104.76179135,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Olumiant / Baricitinib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9553,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Olumiant / Baricitinib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters":{"brand_name":"Omega-3 Acid Ethyl Esters","generic_name":"Omega-3 Acid Ethyl Esters","avg_per_unit":{"value":0.3846162528,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Omega-3 Acid Ethyl Esters / Omega-3 Acid Ethyl Esters: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":947283,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Omega-3 Acid Ethyl Esters / Omega-3 Acid Ethyl Esters, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate":{"brand_name":"Omeprazole-Sodium Bicarbonate","generic_name":"Omeprazole/Sodium Bicarbonate","avg_per_unit":{"value":28.612428796,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Omeprazole-Sodium Bicarbonate / Omeprazole/Sodium Bicarbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":93925,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Omeprazole-Sodium Bicarbonate / Omeprazole/Sodium Bicarbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Omnaris|Ciclesonide":{"brand_name":"Omnaris","generic_name":"Ciclesonide","avg_per_unit":{"value":22.872644637,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Omnaris / Ciclesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1855,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Omnaris / Ciclesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ondansetron ODT|Ondansetron":{"brand_name":"Ondansetron ODT","generic_name":"Ondansetron","avg_per_unit":{"value":0.500240343,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ondansetron ODT / Ondansetron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4929800,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ondansetron ODT / Ondansetron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ongentys|Opicapone":{"brand_name":"Ongentys","generic_name":"Opicapone","avg_per_unit":{"value":21.749437532,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ongentys / Opicapone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16686,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ongentys / Opicapone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Opvee|Nalmefene HCl":{"brand_name":"Opvee","generic_name":"Nalmefene HCl","avg_per_unit":{"value":47.935955882,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Opvee / Nalmefene HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":67,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Opvee / Nalmefene HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Opzelura|Ruxolitinib Phosphate":{"brand_name":"Opzelura","generic_name":"Ruxolitinib Phosphate","avg_per_unit":{"value":32.96330166,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Opzelura / Ruxolitinib Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":50464,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Opzelura / Ruxolitinib Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oracea|Doxycycline Monohydrate":{"brand_name":"Oracea","generic_name":"Doxycycline Monohydrate","avg_per_unit":{"value":28.579113208,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oracea / Doxycycline Monohydrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2605,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oracea / Doxycycline Monohydrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oracit|Citric Acid/Sodium Citrate":{"brand_name":"Oracit","generic_name":"Citric Acid/Sodium Citrate","avg_per_unit":{"value":0.1017151914,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oracit / Citric Acid/Sodium Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":137,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oracit / Citric Acid/Sodium Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oriahnn|Elagolix/Estradiol/Norethindrn":{"brand_name":"Oriahnn","generic_name":"Elagolix/Estradiol/Norethindrn","avg_per_unit":{"value":20.594692658,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oriahnn / Elagolix/Estradiol/Norethindrn: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":223,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oriahnn / Elagolix/Estradiol/Norethindrn, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Orilissa|Elagolix Sodium":{"brand_name":"Orilissa","generic_name":"Elagolix Sodium","avg_per_unit":{"value":36.587706084,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Orilissa / Elagolix Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2310,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Orilissa / Elagolix Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Orlistat|Orlistat":{"brand_name":"Orlistat","generic_name":"Orlistat","avg_per_unit":{"value":6.9991102114,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Orlistat / Orlistat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":266,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Orlistat / Orlistat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Orphenadrine Citrate ER|Orphenadrine Citrate":{"brand_name":"Orphenadrine Citrate ER","generic_name":"Orphenadrine Citrate","avg_per_unit":{"value":0.765048373,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Orphenadrine Citrate ER / Orphenadrine Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":65336,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Orphenadrine Citrate ER / Orphenadrine Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Orphenadrine Citrate|Orphenadrine Citrate":{"brand_name":"Orphenadrine Citrate","generic_name":"Orphenadrine Citrate","avg_per_unit":{"value":6.5531658447,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Orphenadrine Citrate / Orphenadrine Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":4522,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Orphenadrine Citrate / Orphenadrine Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oscimin|Hyoscyamine Sulfate":{"brand_name":"Oscimin","generic_name":"Hyoscyamine Sulfate","avg_per_unit":{"value":0.2525696805,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oscimin / Hyoscyamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":30,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oscimin / Hyoscyamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Osphena|Ospemifene":{"brand_name":"Osphena","generic_name":"Ospemifene","avg_per_unit":{"value":7.8876865733,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Osphena / Ospemifene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":17063,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Osphena / Ospemifene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Otezla|Apremilast":{"brand_name":"Otezla","generic_name":"Apremilast","avg_per_unit":{"value":80.680158348,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Otezla / Apremilast: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":213396,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Otezla / Apremilast, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxaprozin|Oxaprozin":{"brand_name":"Oxaprozin","generic_name":"Oxaprozin","avg_per_unit":{"value":0.8001651812,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxaprozin / Oxaprozin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16111,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxaprozin / Oxaprozin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxazepam|Oxazepam":{"brand_name":"Oxazepam","generic_name":"Oxazepam","avg_per_unit":{"value":0.9051789736,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxazepam / Oxazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":34307,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxazepam / Oxazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxcarbazepine ER|Oxcarbazepine":{"brand_name":"Oxcarbazepine ER","generic_name":"Oxcarbazepine","avg_per_unit":{"value":12.281282023,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxcarbazepine ER / Oxcarbazepine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2339,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxcarbazepine ER / Oxcarbazepine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxiconazole Nitrate|Oxiconazole Nitrate":{"brand_name":"Oxiconazole Nitrate","generic_name":"Oxiconazole Nitrate","avg_per_unit":{"value":5.1764738819,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxiconazole Nitrate / Oxiconazole Nitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":14649,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxiconazole Nitrate / Oxiconazole Nitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxistat|Oxiconazole Nitrate":{"brand_name":"Oxistat","generic_name":"Oxiconazole Nitrate","avg_per_unit":{"value":14.387171629,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxistat / Oxiconazole Nitrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":295,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxistat / Oxiconazole Nitrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxtellar XR|Oxcarbazepine":{"brand_name":"Oxtellar XR","generic_name":"Oxcarbazepine","avg_per_unit":{"value":17.960787546,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxtellar XR / Oxcarbazepine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18806,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxtellar XR / Oxcarbazepine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxybutynin Chloride ER|Oxybutynin Chloride":{"brand_name":"Oxybutynin Chloride ER","generic_name":"Oxybutynin Chloride","avg_per_unit":{"value":0.3589821631,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxybutynin Chloride ER / Oxybutynin Chloride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3420475,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxybutynin Chloride ER / Oxybutynin Chloride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxybutynin Chloride|Oxybutynin Chloride":{"brand_name":"Oxybutynin Chloride","generic_name":"Oxybutynin Chloride","avg_per_unit":{"value":0.1824661936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxybutynin Chloride / Oxybutynin Chloride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 37 of 39 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2000706,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxybutynin Chloride / Oxybutynin Chloride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen":{"brand_name":"Oxycodone-Acetaminophen","generic_name":"Oxycodone HCl/Acetaminophen","avg_per_unit":{"value":0.3346708752,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxycodone-Acetaminophen / Oxycodone HCl/Acetaminophen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8883473,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxycodone-Acetaminophen / Oxycodone HCl/Acetaminophen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Oxytrol|Oxybutynin":{"brand_name":"Oxytrol","generic_name":"Oxybutynin","avg_per_unit":{"value":82.991526575,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Oxytrol / Oxybutynin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1434,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Oxytrol / Oxybutynin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "PEG-3350 And Electrolytes|PEG3350/Sod Sulf,Bicarb,Cl/KCl":{"brand_name":"PEG-3350 And Electrolytes","generic_name":"PEG3350/Sod Sulf,Bicarb,Cl/KCl","avg_per_unit":{"value":0.0039781922,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for PEG-3350 And Electrolytes / PEG3350/Sod Sulf,Bicarb,Cl/KCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":345493,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for PEG-3350 And Electrolytes / PEG3350/Sod Sulf,Bicarb,Cl/KCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "PNV-Omega|Mv-Mins 71/Iron/Folic No.1/DHA":{"brand_name":"PNV-Omega","generic_name":"Mv-Mins 71/Iron/Folic No.1/DHA","avg_per_unit":{"value":1.6026754098,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for PNV-Omega / Mv-Mins 71/Iron/Folic No.1/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":44,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for PNV-Omega / Mv-Mins 71/Iron/Folic No.1/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pacerone|Amiodarone HCl":{"brand_name":"Pacerone","generic_name":"Amiodarone HCl","avg_per_unit":{"value":1.9883611663,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pacerone / Amiodarone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":31143,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pacerone / Amiodarone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paliperidone ER|Paliperidone":{"brand_name":"Paliperidone ER","generic_name":"Paliperidone","avg_per_unit":{"value":5.6744036765,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paliperidone ER / Paliperidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":392711,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paliperidone ER / Paliperidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Pantoprazole Sodium*|Pantoprazole Sodium":{"brand_name":"Pantoprazole Sodium*","generic_name":"Pantoprazole Sodium","avg_per_unit":{"value":0.1986643951,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pantoprazole Sodium* / Pantoprazole Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (14 of the 25 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25600657,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pantoprazole Sodium* / Pantoprazole Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paricalcitol*|Paricalcitol":{"brand_name":"Paricalcitol*","generic_name":"Paricalcitol","avg_per_unit":{"value":2.5634583433,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paricalcitol* / Paricalcitol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 6 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":27615,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paricalcitol* / Paricalcitol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paroxetine Cr|Paroxetine HCl":{"brand_name":"Paroxetine Cr","generic_name":"Paroxetine HCl","avg_per_unit":{"value":1.4107101586,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paroxetine Cr / Paroxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38204,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paroxetine Cr / Paroxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paroxetine ER|Paroxetine HCl":{"brand_name":"Paroxetine ER","generic_name":"Paroxetine HCl","avg_per_unit":{"value":1.249133181,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paroxetine ER / Paroxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":60111,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paroxetine ER / Paroxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paroxetine HCl|Paroxetine HCl":{"brand_name":"Paroxetine HCl","generic_name":"Paroxetine HCl","avg_per_unit":{"value":0.212711446,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paroxetine HCl / Paroxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 126 of 127 NADAC NDCs joined to this name are priced per EA (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3371882,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paroxetine HCl / Paroxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paroxetine Mesylate|Paroxetine Mesylate":{"brand_name":"Paroxetine Mesylate","generic_name":"Paroxetine Mesylate","avg_per_unit":{"value":3.6406325984,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paroxetine Mesylate / Paroxetine Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3191,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paroxetine Mesylate / Paroxetine Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paxil Cr|Paroxetine HCl":{"brand_name":"Paxil Cr","generic_name":"Paroxetine HCl","avg_per_unit":{"value":9.6054317178,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paxil Cr / Paroxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3152,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paxil Cr / Paroxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paxil|Paroxetine HCl":{"brand_name":"Paxil","generic_name":"Paroxetine HCl","avg_per_unit":{"value":9.4004051462,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paxil / Paroxetine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2944,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paxil / Paroxetine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Paxlovid|Nirmatrelvir/Ritonavir":{"brand_name":"Paxlovid","generic_name":"Nirmatrelvir/Ritonavir","avg_per_unit":{"value":1.8405623829,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Paxlovid / Nirmatrelvir/Ritonavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1696489,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Paxlovid / Nirmatrelvir/Ritonavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Penciclovir|Penciclovir":{"brand_name":"Penciclovir","generic_name":"Penciclovir","avg_per_unit":{"value":90.32146833,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Penciclovir / Penciclovir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":5881,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Penciclovir / Penciclovir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pentasa|Mesalamine":{"brand_name":"Pentasa","generic_name":"Mesalamine","avg_per_unit":{"value":5.0330711711,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pentasa / Mesalamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22117,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pentasa / Mesalamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pentazocine-Naloxone HCl|Pentazocine HCl/Naloxone HCl":{"brand_name":"Pentazocine-Naloxone HCl","generic_name":"Pentazocine HCl/Naloxone HCl","avg_per_unit":{"value":1.6272891225,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pentazocine-Naloxone HCl / Pentazocine HCl/Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4809,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pentazocine-Naloxone HCl / Pentazocine HCl/Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Percocet|Oxycodone HCl/Acetaminophen":{"brand_name":"Percocet","generic_name":"Oxycodone HCl/Acetaminophen","avg_per_unit":{"value":33.895243267,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Percocet / Oxycodone HCl/Acetaminophen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16125,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Percocet / Oxycodone HCl/Acetaminophen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Perforomist|Formoterol Fumarate":{"brand_name":"Perforomist","generic_name":"Formoterol Fumarate","avg_per_unit":{"value":9.11041035,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Perforomist / Formoterol Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":529,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Perforomist / Formoterol Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Perindopril Erbumine|Perindopril Erbumine":{"brand_name":"Perindopril Erbumine","generic_name":"Perindopril Erbumine","avg_per_unit":{"value":0.6509698429,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Perindopril Erbumine / Perindopril Erbumine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20287,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Perindopril Erbumine / Perindopril Erbumine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Permethrin|Permethrin":{"brand_name":"Permethrin","generic_name":"Permethrin","avg_per_unit":{"value":0.6643293878,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Permethrin / Permethrin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":208267,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Permethrin / Permethrin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Perphenazine|Perphenazine":{"brand_name":"Perphenazine","generic_name":"Perphenazine","avg_per_unit":{"value":0.8186159491,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Perphenazine / Perphenazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":193956,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Perphenazine / Perphenazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phenazopyridine HCl|Phenazopyridine HCl":{"brand_name":"Phenazopyridine HCl","generic_name":"Phenazopyridine HCl","avg_per_unit":{"value":0.5361239471,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phenazopyridine HCl / Phenazopyridine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":54387,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phenazopyridine HCl / Phenazopyridine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phenelzine Sulfate|Phenelzine Sulfate":{"brand_name":"Phenelzine Sulfate","generic_name":"Phenelzine Sulfate","avg_per_unit":{"value":0.543908582,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phenelzine Sulfate / Phenelzine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11344,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phenelzine Sulfate / Phenelzine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phenobarbital|Phenobarbital":{"brand_name":"Phenobarbital","generic_name":"Phenobarbital","avg_per_unit":{"value":0.3065731409,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phenobarbital / Phenobarbital: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 97 of 104 NADAC NDCs joined to this name are priced per EA (7 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":398979,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phenobarbital / Phenobarbital, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phentermine HCl|Phentermine HCl":{"brand_name":"Phentermine HCl","generic_name":"Phentermine HCl","avg_per_unit":{"value":0.1653700205,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phentermine HCl / Phentermine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1850,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phentermine HCl / Phentermine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phenylephrine HCl*|Phenylephrine HCl":{"brand_name":"Phenylephrine HCl*","generic_name":"Phenylephrine HCl","avg_per_unit":{"value":13.160576557,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phenylephrine HCl* / Phenylephrine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 15 NADAC NDCs the name join matched to it have an FDA route including OPHTHALMIC.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1144,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phenylephrine HCl* / Phenylephrine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phenytek|Phenytoin Sodium Extended":{"brand_name":"Phenytek","generic_name":"Phenytoin Sodium Extended","avg_per_unit":{"value":1.2401462002,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phenytek / Phenytoin Sodium Extended: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18921,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phenytek / Phenytoin Sodium Extended, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phexxi|Lactic Acid/Citric/Potassium":{"brand_name":"Phexxi","generic_name":"Lactic Acid/Citric/Potassium","avg_per_unit":{"value":5.8377724211,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phexxi / Lactic Acid/Citric/Potassium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":201,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phexxi / Lactic Acid/Citric/Potassium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Philith|Norethindrone-Ethin. Estradiol":{"brand_name":"Philith","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.7402630617,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Philith / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":234,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Philith / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Phytonadione*|Phytonadione (Vit K1)":{"brand_name":"Phytonadione*","generic_name":"Phytonadione (Vit K1)","avg_per_unit":{"value":26.629738993,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Phytonadione* / Phytonadione (Vit K1): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 10 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 10 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":89,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Phytonadione* / Phytonadione (Vit K1), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pifeltro|Doravirine":{"brand_name":"Pifeltro","generic_name":"Doravirine","avg_per_unit":{"value":58.160727565,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pifeltro / Doravirine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":42316,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pifeltro / Doravirine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pimecrolimus|Pimecrolimus":{"brand_name":"Pimecrolimus","generic_name":"Pimecrolimus","avg_per_unit":{"value":4.1890137399,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pimecrolimus / Pimecrolimus: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":70602,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pimecrolimus / Pimecrolimus, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pimozide|Pimozide":{"brand_name":"Pimozide","generic_name":"Pimozide","avg_per_unit":{"value":1.4704194255,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pimozide / Pimozide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10751,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pimozide / Pimozide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pimtrea|Desog-E.Estradiol/E.Estradiol":{"brand_name":"Pimtrea","generic_name":"Desog-E.Estradiol/E.Estradiol","avg_per_unit":{"value":0.6719324324,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pimtrea / Desog-E.Estradiol/E.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":231,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pimtrea / Desog-E.Estradiol/E.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pindolol|Pindolol":{"brand_name":"Pindolol","generic_name":"Pindolol","avg_per_unit":{"value":0.811753143,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pindolol / Pindolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":25781,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pindolol / Pindolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pioglitazone HCl|Pioglitazone HCl":{"brand_name":"Pioglitazone HCl","generic_name":"Pioglitazone HCl","avg_per_unit":{"value":0.1780020403,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pioglitazone HCl / Pioglitazone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3217957,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pioglitazone HCl / Pioglitazone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pioglitazone-Glimepiride|Pioglitazone HCl/Glimepiride":{"brand_name":"Pioglitazone-Glimepiride","generic_name":"Pioglitazone HCl/Glimepiride","avg_per_unit":{"value":4.9014438976,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pioglitazone-Glimepiride / Pioglitazone HCl/Glimepiride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3586,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pioglitazone-Glimepiride / Pioglitazone HCl/Glimepiride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl":{"brand_name":"Pioglitazone-Metformin","generic_name":"Pioglitazone HCl/Metformin HCl","avg_per_unit":{"value":0.6103451134,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pioglitazone-Metformin / Pioglitazone HCl/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48576,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pioglitazone-Metformin / Pioglitazone HCl/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam":{"brand_name":"Piperacillin-Tazobactam","generic_name":"Piperacillin Sodium/Tazobactam","avg_per_unit":{"value":4.0453466785,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Piperacillin-Tazobactam / Piperacillin Sodium/Tazobactam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":72722,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Piperacillin-Tazobactam / Piperacillin Sodium/Tazobactam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pirfenidone|Pirfenidone":{"brand_name":"Pirfenidone","generic_name":"Pirfenidone","avg_per_unit":{"value":16.168263447,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pirfenidone / Pirfenidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":57522,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pirfenidone / Pirfenidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Piroxicam|Piroxicam":{"brand_name":"Piroxicam","generic_name":"Piroxicam","avg_per_unit":{"value":0.9589308611,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Piroxicam / Piroxicam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":53621,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Piroxicam / Piroxicam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pitavastatin Calcium|Pitavastatin Calcium":{"brand_name":"Pitavastatin Calcium","generic_name":"Pitavastatin Calcium","avg_per_unit":{"value":3.502250871,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pitavastatin Calcium / Pitavastatin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":162946,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pitavastatin Calcium / Pitavastatin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Plavix|Clopidogrel Bisulfate":{"brand_name":"Plavix","generic_name":"Clopidogrel Bisulfate","avg_per_unit":{"value":7.8697148916,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Plavix / Clopidogrel Bisulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12338,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Plavix / Clopidogrel Bisulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Polymyxin B Sul-Trimethoprim|Polymyxin B Sulf/Trimethoprim":{"brand_name":"Polymyxin B Sul-Trimethoprim","generic_name":"Polymyxin B Sulf/Trimethoprim","avg_per_unit":{"value":0.8334960074,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Polymyxin B Sul-Trimethoprim / Polymyxin B Sulf/Trimethoprim: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":417816,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Polymyxin B Sul-Trimethoprim / Polymyxin B Sulf/Trimethoprim, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Portia|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Portia","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3426401952,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Portia / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3169,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Portia / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Potassium Chloride*|Potassium Chloride":{"brand_name":"Potassium Chloride*","generic_name":"Potassium Chloride","avg_per_unit":{"value":0.2435660712,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Potassium Chloride* / Potassium Chloride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 5 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14480710,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Potassium Chloride* / Potassium Chloride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Potassium Citrate ER|Potassium Citrate":{"brand_name":"Potassium Citrate ER","generic_name":"Potassium Citrate","avg_per_unit":{"value":0.606152325,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Potassium Citrate ER / Potassium Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":530320,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Potassium Citrate ER / Potassium Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Potassium Citrate-Citric Acid|Potassium Citrate/Citric Acid":{"brand_name":"Potassium Citrate-Citric Acid","generic_name":"Potassium Citrate/Citric Acid","avg_per_unit":{"value":0.0683680455,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Potassium Citrate-Citric Acid / Potassium Citrate/Citric Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":677,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Potassium Citrate-Citric Acid / Potassium Citrate/Citric Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pradaxa|Dabigatran Etexilate Mesylate":{"brand_name":"Pradaxa","generic_name":"Dabigatran Etexilate Mesylate","avg_per_unit":{"value":1.8197235966,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pradaxa / Dabigatran Etexilate Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":481836,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pradaxa / Dabigatran Etexilate Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Praluent Pen|Alirocumab":{"brand_name":"Praluent Pen","generic_name":"Alirocumab","avg_per_unit":{"value":240.84970533,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Praluent Pen / Alirocumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":442806,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Praluent Pen / Alirocumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pramipexole Dihydrochloride|Pramipexole Di-HCl":{"brand_name":"Pramipexole Dihydrochloride","generic_name":"Pramipexole Di-HCl","avg_per_unit":{"value":0.1461119107,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pramipexole Dihydrochloride / Pramipexole Di-HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1761051,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pramipexole Dihydrochloride / Pramipexole Di-HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pramipexole ER|Pramipexole Di-HCl":{"brand_name":"Pramipexole ER","generic_name":"Pramipexole Di-HCl","avg_per_unit":{"value":5.9135504767,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pramipexole ER / Pramipexole Di-HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":28008,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pramipexole ER / Pramipexole Di-HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prasugrel HCl|Prasugrel HCl":{"brand_name":"Prasugrel HCl","generic_name":"Prasugrel HCl","avg_per_unit":{"value":1.2359930046,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prasugrel HCl / Prasugrel HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":332416,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prasugrel HCl / Prasugrel HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pravastatin Sodium|Pravastatin Sodium":{"brand_name":"Pravastatin Sodium","generic_name":"Pravastatin Sodium","avg_per_unit":{"value":0.1803471204,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pravastatin Sodium / Pravastatin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9395079,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pravastatin Sodium / Pravastatin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Praziquantel|Praziquantel":{"brand_name":"Praziquantel","generic_name":"Praziquantel","avg_per_unit":{"value":54.18043263,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Praziquantel / Praziquantel: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1439,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Praziquantel / Praziquantel, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prazosin HCl|Prazosin HCl":{"brand_name":"Prazosin HCl","generic_name":"Prazosin HCl","avg_per_unit":{"value":0.3143445693,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prazosin HCl / Prazosin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1287778,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prazosin HCl / Prazosin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pred Forte|Prednisolone Acetate":{"brand_name":"Pred Forte","generic_name":"Prednisolone Acetate","avg_per_unit":{"value":29.171611128,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pred Forte / Prednisolone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3969,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pred Forte / Prednisolone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pred Mild|Prednisolone Acetate":{"brand_name":"Pred Mild","generic_name":"Prednisolone Acetate","avg_per_unit":{"value":32.097958943,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pred Mild / Prednisolone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3319,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pred Mild / Prednisolone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prednisolone Acetate|Prednisolone Acetate":{"brand_name":"Prednisolone Acetate","generic_name":"Prednisolone Acetate","avg_per_unit":{"value":5.4617567099,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prednisolone Acetate / Prednisolone Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3835608,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prednisolone Acetate / Prednisolone Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prednisolone Sodium Phosphate*|Prednisolone Sodium Phosphate":{"brand_name":"Prednisolone Sodium Phosphate*","generic_name":"Prednisolone Sodium Phosphate","avg_per_unit":{"value":0.7312583574,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prednisolone Sodium Phosphate* / Prednisolone Sodium Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 1 NADAC NDCs the name join matched to it have an FDA route including OPHTHALMIC.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":33513,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prednisolone Sodium Phosphate* / Prednisolone Sodium Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prednisone|Prednisone":{"brand_name":"Prednisone","generic_name":"Prednisone","avg_per_unit":{"value":0.1519924558,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prednisone / Prednisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 115 of 117 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15810812,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prednisone / Prednisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pregabalin ER|Pregabalin":{"brand_name":"Pregabalin ER","generic_name":"Pregabalin","avg_per_unit":{"value":5.8586674584,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pregabalin ER / Pregabalin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5417,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pregabalin ER / Pregabalin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pregabalin|Pregabalin":{"brand_name":"Pregabalin","generic_name":"Pregabalin","avg_per_unit":{"value":0.3115287011,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pregabalin / Pregabalin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 211 of 214 NADAC NDCs joined to this name are priced per EA (3 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7507278,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pregabalin / Pregabalin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Premarin*|Estrogens, Conjugated":{"brand_name":"Premarin*","generic_name":"Estrogens, Conjugated","avg_per_unit":{"value":10.783279666,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Premarin* / Estrogens, Conjugated: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 8 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":610592,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Premarin* / Estrogens, Conjugated, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Premphase|Estrogen,Con/M-Progest Acet":{"brand_name":"Premphase","generic_name":"Estrogen,Con/M-Progest Acet","avg_per_unit":{"value":8.3234539749,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Premphase / Estrogen,Con/M-Progest Acet: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":618,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Premphase / Estrogen,Con/M-Progest Acet, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prempro|Estrogen,Con/M-Progest Acet":{"brand_name":"Prempro","generic_name":"Estrogen,Con/M-Progest Acet","avg_per_unit":{"value":8.2533416218,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prempro / Estrogen,Con/M-Progest Acet: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":88870,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prempro / Estrogen,Con/M-Progest Acet, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prenatal Vitamin Plus Low Iron|PNV,Calcium 72/Iron/Folic Acid":{"brand_name":"Prenatal Vitamin Plus Low Iron","generic_name":"PNV,Calcium 72/Iron/Folic Acid","avg_per_unit":{"value":0.27465822,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prenatal Vitamin Plus Low Iron / PNV,Calcium 72/Iron/Folic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38066,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prenatal Vitamin Plus Low Iron / PNV,Calcium 72/Iron/Folic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prenate Mini|Prenatal Vit 87/Iron/Folic/DHA":{"brand_name":"Prenate Mini","generic_name":"Prenatal Vit 87/Iron/Folic/DHA","avg_per_unit":{"value":12.370435256,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prenate Mini / Prenatal Vit 87/Iron/Folic/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":63,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prenate Mini / Prenatal Vit 87/Iron/Folic/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prezcobix|Darunavir/Cobicistat":{"brand_name":"Prezcobix","generic_name":"Darunavir/Cobicistat","avg_per_unit":{"value":81.219895972,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prezcobix / Darunavir/Cobicistat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":99872,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prezcobix / Darunavir/Cobicistat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prezista|Darunavir":{"brand_name":"Prezista","generic_name":"Darunavir","avg_per_unit":{"value":53.747269764,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prezista / Darunavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12315,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prezista / Darunavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Priftin|Rifapentine":{"brand_name":"Priftin","generic_name":"Rifapentine","avg_per_unit":{"value":4.7917301314,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Priftin / Rifapentine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2888,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Priftin / Rifapentine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Primidone|Primidone":{"brand_name":"Primidone","generic_name":"Primidone","avg_per_unit":{"value":0.1812601759,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Primidone / Primidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1425514,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Primidone / Primidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proair Respiclick|Albuterol Sulfate":{"brand_name":"Proair Respiclick","generic_name":"Albuterol Sulfate","avg_per_unit":{"value":65.663606827,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proair Respiclick / Albuterol Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":55802,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proair Respiclick / Albuterol Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Probenecid-Colchicine|Probenecid/Colchicine":{"brand_name":"Probenecid-Colchicine","generic_name":"Probenecid/Colchicine","avg_per_unit":{"value":0.9156705768,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Probenecid-Colchicine / Probenecid/Colchicine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":27161,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Probenecid-Colchicine / Probenecid/Colchicine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Probenecid|Probenecid":{"brand_name":"Probenecid","generic_name":"Probenecid","avg_per_unit":{"value":0.770752112,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Probenecid / Probenecid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":57762,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Probenecid / Probenecid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prochlorperazine|Prochlorperazine":{"brand_name":"Prochlorperazine","generic_name":"Prochlorperazine","avg_per_unit":{"value":6.9117332881,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prochlorperazine / Prochlorperazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3672,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prochlorperazine / Prochlorperazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Procto-Med HC|Hydrocortisone":{"brand_name":"Procto-Med HC","generic_name":"Hydrocortisone","avg_per_unit":{"value":0.4985735294,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Procto-Med HC / Hydrocortisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":257304,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Procto-Med HC / Hydrocortisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proctofoam-HC|Hydrocortisone/Pramoxine":{"brand_name":"Proctofoam-HC","generic_name":"Hydrocortisone/Pramoxine","avg_per_unit":{"value":18.238184722,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proctofoam-HC / Hydrocortisone/Pramoxine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":12236,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proctofoam-HC / Hydrocortisone/Pramoxine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proctosol-HC|Hydrocortisone":{"brand_name":"Proctosol-HC","generic_name":"Hydrocortisone","avg_per_unit":{"value":0.4873453935,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proctosol-HC / Hydrocortisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":13760,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proctosol-HC / Hydrocortisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proctozone-HC|Hydrocortisone":{"brand_name":"Proctozone-HC","generic_name":"Hydrocortisone","avg_per_unit":{"value":0.4671422158,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proctozone-HC / Hydrocortisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":53297,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proctozone-HC / Hydrocortisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proglycem|Diazoxide":{"brand_name":"Proglycem","generic_name":"Diazoxide","avg_per_unit":{"value":12.774007716,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proglycem / Diazoxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":49,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proglycem / Diazoxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prograf*|Tacrolimus":{"brand_name":"Prograf*","generic_name":"Tacrolimus","avg_per_unit":{"value":5.9304715678,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prograf* / Tacrolimus: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 4 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4634,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prograf* / Tacrolimus, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prolensa|Bromfenac Sodium":{"brand_name":"Prolensa","generic_name":"Bromfenac Sodium","avg_per_unit":{"value":114.28338585,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prolensa / Bromfenac Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":122194,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prolensa / Bromfenac Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prolia|Denosumab":{"brand_name":"Prolia","generic_name":"Denosumab","avg_per_unit":{"value":1711.379832,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prolia / Denosumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":450858,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prolia / Denosumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Promethazine-Codeine|Promethazine HCl/Codeine":{"brand_name":"Promethazine-Codeine","generic_name":"Promethazine HCl/Codeine","avg_per_unit":{"value":0.0553357411,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Promethazine-Codeine / Promethazine HCl/Codeine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1137,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Promethazine-Codeine / Promethazine HCl/Codeine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Promethazine-DM|Promethazine/Dextromethorphan":{"brand_name":"Promethazine-DM","generic_name":"Promethazine/Dextromethorphan","avg_per_unit":{"value":0.0503617648,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Promethazine-DM / Promethazine/Dextromethorphan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":13336,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Promethazine-DM / Promethazine/Dextromethorphan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Promethegan|Promethazine HCl":{"brand_name":"Promethegan","generic_name":"Promethazine HCl","avg_per_unit":{"value":5.0445246961,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Promethegan / Promethazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18532,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Promethegan / Promethazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Prometrium|Progesterone, Micronized":{"brand_name":"Prometrium","generic_name":"Progesterone, Micronized","avg_per_unit":{"value":17.693776579,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Prometrium / Progesterone, Micronized: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1031,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Prometrium / Progesterone, Micronized, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Propafenone HCl ER|Propafenone HCl":{"brand_name":"Propafenone HCl ER","generic_name":"Propafenone HCl","avg_per_unit":{"value":1.6524568552,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Propafenone HCl ER / Propafenone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":68242,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Propafenone HCl ER / Propafenone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Propafenone HCl|Propafenone HCl":{"brand_name":"Propafenone HCl","generic_name":"Propafenone HCl","avg_per_unit":{"value":0.3081222165,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Propafenone HCl / Propafenone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":197089,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Propafenone HCl / Propafenone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proparacaine HCl|Proparacaine HCl":{"brand_name":"Proparacaine HCl","generic_name":"Proparacaine HCl","avg_per_unit":{"value":1.824673541,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proparacaine HCl / Proparacaine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1040,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proparacaine HCl / Proparacaine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Propranolol HCl ER|Propranolol HCl":{"brand_name":"Propranolol HCl ER","generic_name":"Propranolol HCl","avg_per_unit":{"value":0.5794462644,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Propranolol HCl ER / Propranolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1123421,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Propranolol HCl ER / Propranolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Propranolol HCl*|Propranolol HCl":{"brand_name":"Propranolol HCl*","generic_name":"Propranolol HCl","avg_per_unit":{"value":0.1535517396,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Propranolol HCl* / Propranolol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (74 of the 94 the name join matched); NDCs of another route or with no known FDA route do not. 9 of the 74 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code). 91 of 94 NADAC NDCs joined to this name are priced per EA (3 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3038695,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Propranolol HCl* / Propranolol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Propylthiouracil|Propylthiouracil":{"brand_name":"Propylthiouracil","generic_name":"Propylthiouracil","avg_per_unit":{"value":0.4575513956,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Propylthiouracil / Propylthiouracil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38295,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Propylthiouracil / Propylthiouracil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Proscar|Finasteride":{"brand_name":"Proscar","generic_name":"Finasteride","avg_per_unit":{"value":5.0678415352,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Proscar / Finasteride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1210,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Proscar / Finasteride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Protriptyline HCl|Protriptyline HCl":{"brand_name":"Protriptyline HCl","generic_name":"Protriptyline HCl","avg_per_unit":{"value":2.7076836493,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Protriptyline HCl / Protriptyline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5889,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Protriptyline HCl / Protriptyline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Provigil|Modafinil":{"brand_name":"Provigil","generic_name":"Modafinil","avg_per_unit":{"value":72.952411491,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Provigil / Modafinil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2880,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Provigil / Modafinil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pulmicort|Budesonide":{"brand_name":"Pulmicort","generic_name":"Budesonide","avg_per_unit":{"value":5.5302678934,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pulmicort / Budesonide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":638,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pulmicort / Budesonide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pulmozyme|Dornase Alfa":{"brand_name":"Pulmozyme","generic_name":"Dornase Alfa","avg_per_unit":{"value":50.066882446,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pulmozyme / Dornase Alfa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":443,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pulmozyme / Dornase Alfa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pylera|Bismuth/Metronid/Tetracycline":{"brand_name":"Pylera","generic_name":"Bismuth/Metronid/Tetracycline","avg_per_unit":{"value":2.4842167039,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pylera / Bismuth/Metronid/Tetracycline: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":538,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pylera / Bismuth/Metronid/Tetracycline, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pyrazinamide|Pyrazinamide":{"brand_name":"Pyrazinamide","generic_name":"Pyrazinamide","avg_per_unit":{"value":3.1693895341,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pyrazinamide / Pyrazinamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2444,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pyrazinamide / Pyrazinamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pyridium|Phenazopyridine HCl":{"brand_name":"Pyridium","generic_name":"Phenazopyridine HCl","avg_per_unit":{"value":5.1724795899,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pyridium / Phenazopyridine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":353,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pyridium / Phenazopyridine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pyridostigmine Bromide ER|Pyridostigmine Bromide":{"brand_name":"Pyridostigmine Bromide ER","generic_name":"Pyridostigmine Bromide","avg_per_unit":{"value":6.6947675893,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pyridostigmine Bromide ER / Pyridostigmine Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16981,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pyridostigmine Bromide ER / Pyridostigmine Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Pyrimethamine|Pyrimethamine":{"brand_name":"Pyrimethamine","generic_name":"Pyrimethamine","avg_per_unit":{"value":290.53855946,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Pyrimethamine / Pyrimethamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":515,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Pyrimethamine / Pyrimethamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Qbrelis|Lisinopril":{"brand_name":"Qbrelis","generic_name":"Lisinopril","avg_per_unit":{"value":4.2156736596,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Qbrelis / Lisinopril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1132,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Qbrelis / Lisinopril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Qnasl Children|Beclomethasone Dipropionate":{"brand_name":"Qnasl Children","generic_name":"Beclomethasone Dipropionate","avg_per_unit":{"value":43.039684836,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Qnasl Children / Beclomethasone Dipropionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":372,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Qnasl Children / Beclomethasone Dipropionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Qnasl|Beclomethasone Dipropionate":{"brand_name":"Qnasl","generic_name":"Beclomethasone Dipropionate","avg_per_unit":{"value":27.663187323,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Qnasl / Beclomethasone Dipropionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":10598,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Qnasl / Beclomethasone Dipropionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quetiapine Fumarate ER|Quetiapine Fumarate":{"brand_name":"Quetiapine Fumarate ER","generic_name":"Quetiapine Fumarate","avg_per_unit":{"value":1.3832006516,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quetiapine Fumarate ER / Quetiapine Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":504595,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quetiapine Fumarate ER / Quetiapine Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quetiapine Fumarate|Quetiapine Fumarate":{"brand_name":"Quetiapine Fumarate","generic_name":"Quetiapine Fumarate","avg_per_unit":{"value":0.3146482607,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quetiapine Fumarate / Quetiapine Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9340374,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quetiapine Fumarate / Quetiapine Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quillichew ER|Methylphenidate HCl":{"brand_name":"Quillichew ER","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":12.468842798,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quillichew ER / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":644,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quillichew ER / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quillivant XR|Methylphenidate HCl":{"brand_name":"Quillivant XR","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":2.3562214715,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quillivant XR / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":308,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quillivant XR / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quinidine Gluconate|Quinidine Gluconate":{"brand_name":"Quinidine Gluconate","generic_name":"Quinidine Gluconate","avg_per_unit":{"value":5.0840574082,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quinidine Gluconate / Quinidine Gluconate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1933,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quinidine Gluconate / Quinidine Gluconate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quinine Sulfate|Quinine Sulfate":{"brand_name":"Quinine Sulfate","generic_name":"Quinine Sulfate","avg_per_unit":{"value":1.7310402388,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quinine Sulfate / Quinine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3064,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quinine Sulfate / Quinine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Qulipta|Atogepant":{"brand_name":"Qulipta","generic_name":"Atogepant","avg_per_unit":{"value":35.982898478,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Qulipta / Atogepant: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":209816,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Qulipta / Atogepant, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Quviviq|Daridorexant HCl":{"brand_name":"Quviviq","generic_name":"Daridorexant HCl","avg_per_unit":{"value":16.299492827,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Quviviq / Daridorexant HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":46269,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Quviviq / Daridorexant HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Qvar Redihaler|Beclomethasone Dipropionate":{"brand_name":"Qvar Redihaler","generic_name":"Beclomethasone Dipropionate","avg_per_unit":{"value":23.770610649,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Qvar Redihaler / Beclomethasone Dipropionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":222782,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Qvar Redihaler / Beclomethasone Dipropionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rabeprazole Sodium|Rabeprazole Sodium":{"brand_name":"Rabeprazole Sodium","generic_name":"Rabeprazole Sodium","avg_per_unit":{"value":0.5724673326,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rabeprazole Sodium / Rabeprazole Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":282501,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rabeprazole Sodium / Rabeprazole Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Raloxifene HCl|Raloxifene HCl":{"brand_name":"Raloxifene HCl","generic_name":"Raloxifene HCl","avg_per_unit":{"value":0.6433858398,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Raloxifene HCl / Raloxifene HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":707799,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Raloxifene HCl / Raloxifene HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ramelteon|Ramelteon":{"brand_name":"Ramelteon","generic_name":"Ramelteon","avg_per_unit":{"value":3.0301971474,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ramelteon / Ramelteon: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":221935,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ramelteon / Ramelteon, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ramipril|Ramipril":{"brand_name":"Ramipril","generic_name":"Ramipril","avg_per_unit":{"value":0.1178101967,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ramipril / Ramipril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1539276,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ramipril / Ramipril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ranolazine ER|Ranolazine":{"brand_name":"Ranolazine ER","generic_name":"Ranolazine","avg_per_unit":{"value":0.7843550747,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ranolazine ER / Ranolazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1248783,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ranolazine ER / Ranolazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rasagiline Mesylate|Rasagiline Mesylate":{"brand_name":"Rasagiline Mesylate","generic_name":"Rasagiline Mesylate","avg_per_unit":{"value":3.2972061315,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rasagiline Mesylate / Rasagiline Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":146909,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rasagiline Mesylate / Rasagiline Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rasuvo|Methotrexate/PF":{"brand_name":"Rasuvo","generic_name":"Methotrexate/PF","avg_per_unit":{"value":367.06070596,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rasuvo / Methotrexate/PF: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":31894,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rasuvo / Methotrexate/PF, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rebif Rebidose|Interferon Beta-1a/Albumin":{"brand_name":"Rebif Rebidose","generic_name":"Interferon Beta-1a/Albumin","avg_per_unit":{"value":1760.7486442,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rebif Rebidose / Interferon Beta-1a/Albumin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":6097,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rebif Rebidose / Interferon Beta-1a/Albumin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Reclipsen|Desogestrel-Ethinyl Estradiol":{"brand_name":"Reclipsen","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.4590583842,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Reclipsen / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":349,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Reclipsen / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rectiv|Nitroglycerin":{"brand_name":"Rectiv","generic_name":"Nitroglycerin","avg_per_unit":{"value":20.828443866,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rectiv / Nitroglycerin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":3218,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rectiv / Nitroglycerin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Relafen Ds|Nabumetone":{"brand_name":"Relafen Ds","generic_name":"Nabumetone","avg_per_unit":{"value":52.224140918,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Relafen Ds / Nabumetone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":610,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Relafen Ds / Nabumetone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Relpax|Eletriptan Hydrobromide":{"brand_name":"Relpax","generic_name":"Eletriptan Hydrobromide","avg_per_unit":{"value":77.503285008,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Relpax / Eletriptan Hydrobromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2201,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Relpax / Eletriptan Hydrobromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Remeron|Mirtazapine":{"brand_name":"Remeron","generic_name":"Mirtazapine","avg_per_unit":{"value":5.7628690796,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Remeron / Mirtazapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2169,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Remeron / Mirtazapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Renvela|Sevelamer Carbonate":{"brand_name":"Renvela","generic_name":"Sevelamer Carbonate","avg_per_unit":{"value":6.3858470738,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Renvela / Sevelamer Carbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":27433,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Renvela / Sevelamer Carbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Repaglinide|Repaglinide":{"brand_name":"Repaglinide","generic_name":"Repaglinide","avg_per_unit":{"value":0.184735768,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Repaglinide / Repaglinide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":360327,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Repaglinide / Repaglinide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Repatha Sureclick|Evolocumab":{"brand_name":"Repatha Sureclick","generic_name":"Evolocumab","avg_per_unit":{"value":269.54405416,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Repatha Sureclick / Evolocumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1943941,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Repatha Sureclick / Evolocumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Repatha Syringe|Evolocumab":{"brand_name":"Repatha Syringe","generic_name":"Evolocumab","avg_per_unit":{"value":271.07779559,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Repatha Syringe / Evolocumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":233776,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Repatha Syringe / Evolocumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Restasis Multidose|Cyclosporine":{"brand_name":"Restasis Multidose","generic_name":"Cyclosporine","avg_per_unit":{"value":111.93625282,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Restasis Multidose / Cyclosporine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":79985,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Restasis Multidose / Cyclosporine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Restasis|Cyclosporine":{"brand_name":"Restasis","generic_name":"Cyclosporine","avg_per_unit":{"value":10.198412846,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Restasis / Cyclosporine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1360998,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Restasis / Cyclosporine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Retacrit|Epoetin Alfa-Epbx":{"brand_name":"Retacrit","generic_name":"Epoetin Alfa-Epbx","avg_per_unit":{"value":205.9911759,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Retacrit / Epoetin Alfa-Epbx: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":47809,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Retacrit / Epoetin Alfa-Epbx, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rexulti|Brexpiprazole":{"brand_name":"Rexulti","generic_name":"Brexpiprazole","avg_per_unit":{"value":49.563884964,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rexulti / Brexpiprazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":598492,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rexulti / Brexpiprazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Reyvow|Lasmiditan Succinate":{"brand_name":"Reyvow","generic_name":"Lasmiditan Succinate","avg_per_unit":{"value":91.200975927,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Reyvow / Lasmiditan Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11829,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Reyvow / Lasmiditan Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rezvoglar Kwikpen|Insulin Glargine-Aglr":{"brand_name":"Rezvoglar Kwikpen","generic_name":"Insulin Glargine-Aglr","avg_per_unit":{"value":6.3045165108,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rezvoglar Kwikpen / Insulin Glargine-Aglr: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":6554,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rezvoglar Kwikpen / Insulin Glargine-Aglr, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rhofade|Oxymetazoline HCl":{"brand_name":"Rhofade","generic_name":"Oxymetazoline HCl","avg_per_unit":{"value":19.985296316,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rhofade / Oxymetazoline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1474,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rhofade / Oxymetazoline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rhopressa|Netarsudil Mesylate":{"brand_name":"Rhopressa","generic_name":"Netarsudil Mesylate","avg_per_unit":{"value":126.18151347,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rhopressa / Netarsudil Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":353836,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rhopressa / Netarsudil Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ribavirin*|Ribavirin":{"brand_name":"Ribavirin*","generic_name":"Ribavirin","avg_per_unit":{"value":1.4636539766,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ribavirin* / Ribavirin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 1 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1989,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ribavirin* / Ribavirin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ridaura|Auranofin":{"brand_name":"Ridaura","generic_name":"Auranofin","avg_per_unit":{"value":25.911420305,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ridaura / Auranofin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":635,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ridaura / Auranofin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rifabutin|Rifabutin":{"brand_name":"Rifabutin","generic_name":"Rifabutin","avg_per_unit":{"value":8.3059478433,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rifabutin / Rifabutin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15599,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rifabutin / Rifabutin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rifampin*|Rifampin":{"brand_name":"Rifampin*","generic_name":"Rifampin","avg_per_unit":{"value":0.9842151751,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rifampin* / Rifampin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 14 NADAC NDCs the name join matched to it have an FDA route including ORAL. 2 of the 14 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":111925,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rifampin* / Rifampin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Riluzole|Riluzole":{"brand_name":"Riluzole","generic_name":"Riluzole","avg_per_unit":{"value":1.9319688169,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Riluzole / Riluzole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":51268,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Riluzole / Riluzole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Risedronate Sodium Dr|Risedronate Sodium":{"brand_name":"Risedronate Sodium Dr","generic_name":"Risedronate Sodium","avg_per_unit":{"value":27.836471223,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Risedronate Sodium Dr / Risedronate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14586,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Risedronate Sodium Dr / Risedronate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Risedronate Sodium|Risedronate Sodium":{"brand_name":"Risedronate Sodium","generic_name":"Risedronate Sodium","avg_per_unit":{"value":23.92271488,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Risedronate Sodium / Risedronate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":267663,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Risedronate Sodium / Risedronate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Risperdal Consta|Risperidone Microspheres":{"brand_name":"Risperdal Consta","generic_name":"Risperidone Microspheres","avg_per_unit":{"value":981.64879804,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Risperdal Consta / Risperidone Microspheres: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":83485,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Risperdal Consta / Risperidone Microspheres, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Risperidone ODT|Risperidone":{"brand_name":"Risperidone ODT","generic_name":"Risperidone","avg_per_unit":{"value":2.9989234804,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Risperidone ODT / Risperidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":67508,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Risperidone ODT / Risperidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Risperidone|Risperidone":{"brand_name":"Risperidone","generic_name":"Risperidone","avg_per_unit":{"value":0.2708646313,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Risperidone / Risperidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 83 of 88 NADAC NDCs joined to this name are priced per EA (5 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3699848,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Risperidone / Risperidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ritalin La|Methylphenidate HCl":{"brand_name":"Ritalin La","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":12.299820679,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ritalin La / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1202,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ritalin La / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ritalin|Methylphenidate HCl":{"brand_name":"Ritalin","generic_name":"Methylphenidate HCl","avg_per_unit":{"value":1.3571709919,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ritalin / Methylphenidate HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5652,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ritalin / Methylphenidate HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ritonavir|Ritonavir":{"brand_name":"Ritonavir","generic_name":"Ritonavir","avg_per_unit":{"value":2.4737171348,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ritonavir / Ritonavir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":49932,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ritonavir / Ritonavir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rivelsa|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Rivelsa","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":2.8164217033,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rivelsa / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rivelsa / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Rizatriptan|Rizatriptan Benzoate":{"brand_name":"Rizatriptan","generic_name":"Rizatriptan Benzoate","avg_per_unit":{"value":1.5334012299,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rizatriptan / Rizatriptan Benzoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":736383,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rizatriptan / Rizatriptan Benzoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rocklatan|Netarsudil Mesylat/Latanoprost":{"brand_name":"Rocklatan","generic_name":"Netarsudil Mesylat/Latanoprost","avg_per_unit":{"value":132.88056784,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rocklatan / Netarsudil Mesylat/Latanoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":329580,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rocklatan / Netarsudil Mesylat/Latanoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Roflumilast|Roflumilast":{"brand_name":"Roflumilast","generic_name":"Roflumilast","avg_per_unit":{"value":2.0789737335,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Roflumilast / Roflumilast: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":349373,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Roflumilast / Roflumilast, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ropinirole ER|Ropinirole HCl":{"brand_name":"Ropinirole ER","generic_name":"Ropinirole HCl","avg_per_unit":{"value":1.8233699506,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ropinirole ER / Ropinirole HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":75416,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ropinirole ER / Ropinirole HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ropinirole HCl|Ropinirole HCl":{"brand_name":"Ropinirole HCl","generic_name":"Ropinirole HCl","avg_per_unit":{"value":0.1684061691,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ropinirole HCl / Ropinirole HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3405431,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ropinirole HCl / Ropinirole HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rosuvastatin Calcium|Rosuvastatin Calcium":{"brand_name":"Rosuvastatin Calcium","generic_name":"Rosuvastatin Calcium","avg_per_unit":{"value":0.1871935527,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rosuvastatin Calcium / Rosuvastatin Calcium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":30813501,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rosuvastatin Calcium / Rosuvastatin Calcium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Roxicodone|Oxycodone HCl":{"brand_name":"Roxicodone","generic_name":"Oxycodone HCl","avg_per_unit":{"value":7.9515995347,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Roxicodone / Oxycodone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1525,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Roxicodone / Oxycodone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rozerem|Ramelteon":{"brand_name":"Rozerem","generic_name":"Ramelteon","avg_per_unit":{"value":11.478706687,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rozerem / Ramelteon: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1774,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rozerem / Ramelteon, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ryaltris|Olopatadine HCl/Mometasone":{"brand_name":"Ryaltris","generic_name":"Olopatadine HCl/Mometasone","avg_per_unit":{"value":8.341081438,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ryaltris / Olopatadine HCl/Mometasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":9849,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ryaltris / Olopatadine HCl/Mometasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Rybelsus|Semaglutide":{"brand_name":"Rybelsus","generic_name":"Semaglutide","avg_per_unit":{"value":30.593366014,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Rybelsus / Semaglutide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1251733,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Rybelsus / Semaglutide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ryclora|Dexchlorpheniramine Maleate":{"brand_name":"Ryclora","generic_name":"Dexchlorpheniramine Maleate","avg_per_unit":{"value":2.583641532,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ryclora / Dexchlorpheniramine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":84,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ryclora / Dexchlorpheniramine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Salsalate|Salsalate":{"brand_name":"Salsalate","generic_name":"Salsalate","avg_per_unit":{"value":0.7702190273,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Salsalate / Salsalate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4281,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Salsalate / Salsalate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sancuso|Granisetron":{"brand_name":"Sancuso","generic_name":"Granisetron","avg_per_unit":{"value":669.52195488,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sancuso / Granisetron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3171,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sancuso / Granisetron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres":{"brand_name":"Sandostatin Lar Depot","generic_name":"Octreotide Acetate,Mi-Spheres","avg_per_unit":{"value":5143.2486805,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sandostatin Lar Depot / Octreotide Acetate,Mi-Spheres: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9621,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sandostatin Lar Depot / Octreotide Acetate,Mi-Spheres, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Saphris|Asenapine Maleate":{"brand_name":"Saphris","generic_name":"Asenapine Maleate","avg_per_unit":{"value":19.610080948,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Saphris / Asenapine Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6204,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Saphris / Asenapine Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Savaysa|Edoxaban Tosylate":{"brand_name":"Savaysa","generic_name":"Edoxaban Tosylate","avg_per_unit":{"value":13.80584296,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Savaysa / Edoxaban Tosylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7868,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Savaysa / Edoxaban Tosylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Savella|Milnacipran HCl":{"brand_name":"Savella","generic_name":"Milnacipran HCl","avg_per_unit":{"value":7.9569480921,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Savella / Milnacipran HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":82321,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Savella / Milnacipran HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Saxagliptin HCl|Saxagliptin HCl":{"brand_name":"Saxagliptin HCl","generic_name":"Saxagliptin HCl","avg_per_unit":{"value":5.3315980893,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Saxagliptin HCl / Saxagliptin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":46636,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Saxagliptin HCl / Saxagliptin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Saxagliptin-Metformin ER|Saxagliptin HCl/Metformin HCl":{"brand_name":"Saxagliptin-Metformin ER","generic_name":"Saxagliptin HCl/Metformin HCl","avg_per_unit":{"value":7.835184076,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Saxagliptin-Metformin ER / Saxagliptin HCl/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9249,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Saxagliptin-Metformin ER / Saxagliptin HCl/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Scopolamine|Scopolamine":{"brand_name":"Scopolamine","generic_name":"Scopolamine","avg_per_unit":{"value":11.601742769,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Scopolamine / Scopolamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":398915,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Scopolamine / Scopolamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Secuado|Asenapine":{"brand_name":"Secuado","generic_name":"Asenapine","avg_per_unit":{"value":48.155240466,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Secuado / Asenapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4499,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Secuado / Asenapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Segluromet|Ertugliflozin/Metformin":{"brand_name":"Segluromet","generic_name":"Ertugliflozin/Metformin","avg_per_unit":{"value":5.6047124194,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Segluromet / Ertugliflozin/Metformin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2129,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Segluromet / Ertugliflozin/Metformin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Selegiline HCl|Selegiline HCl":{"brand_name":"Selegiline HCl","generic_name":"Selegiline HCl","avg_per_unit":{"value":0.9994398084,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Selegiline HCl / Selegiline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":50495,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Selegiline HCl / Selegiline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Selenium Sulfide|Selenium Sulfide":{"brand_name":"Selenium Sulfide","generic_name":"Selenium Sulfide","avg_per_unit":{"value":0.1032970558,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Selenium Sulfide / Selenium Sulfide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":52560,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Selenium Sulfide / Selenium Sulfide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Selzentry|Maraviroc":{"brand_name":"Selzentry","generic_name":"Maraviroc","avg_per_unit":{"value":27.284508765,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Selzentry / Maraviroc: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2034,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Selzentry / Maraviroc, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Serevent Diskus|Salmeterol Xinafoate":{"brand_name":"Serevent Diskus","generic_name":"Salmeterol Xinafoate","avg_per_unit":{"value":6.8946509306,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Serevent Diskus / Salmeterol Xinafoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":61638,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Serevent Diskus / Salmeterol Xinafoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Seroquel XR|Quetiapine Fumarate":{"brand_name":"Seroquel XR","generic_name":"Quetiapine Fumarate","avg_per_unit":{"value":18.875400004,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Seroquel XR / Quetiapine Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7036,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Seroquel XR / Quetiapine Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Serostim|Somatropin":{"brand_name":"Serostim","generic_name":"Somatropin","avg_per_unit":{"value":684.06662534,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Serostim / Somatropin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5396,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Serostim / Somatropin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sertraline HCl|Sertraline HCl":{"brand_name":"Sertraline HCl","generic_name":"Sertraline HCl","avg_per_unit":{"value":0.1539318401,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sertraline HCl / Sertraline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 136 of 140 NADAC NDCs joined to this name are priced per EA (4 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16148462,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sertraline HCl / Sertraline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Setlakin|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Setlakin","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.5019181136,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Setlakin / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1717,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Setlakin / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sevelamer Carbonate|Sevelamer Carbonate":{"brand_name":"Sevelamer Carbonate","generic_name":"Sevelamer Carbonate","avg_per_unit":{"value":0.8446283571,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sevelamer Carbonate / Sevelamer Carbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":767039,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sevelamer Carbonate / Sevelamer Carbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sevelamer HCl|Sevelamer HCl":{"brand_name":"Sevelamer HCl","generic_name":"Sevelamer HCl","avg_per_unit":{"value":3.4897680516,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sevelamer HCl / Sevelamer HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":36810,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sevelamer HCl / Sevelamer HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sharobel|Norethindrone":{"brand_name":"Sharobel","generic_name":"Norethindrone","avg_per_unit":{"value":0.3282290474,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sharobel / Norethindrone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1190,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sharobel / Norethindrone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Siklos|Hydroxyurea":{"brand_name":"Siklos","generic_name":"Hydroxyurea","avg_per_unit":{"value":33.565099475,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Siklos / Hydroxyurea: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":765,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Siklos / Hydroxyurea, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sildenafil Citrate|Sildenafil Citrate":{"brand_name":"Sildenafil Citrate","generic_name":"Sildenafil Citrate","avg_per_unit":{"value":1.4569229086,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sildenafil Citrate / Sildenafil Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 104 of 113 NADAC NDCs joined to this name are priced per EA (9 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":837854,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sildenafil Citrate / Sildenafil Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Silodosin|Silodosin":{"brand_name":"Silodosin","generic_name":"Silodosin","avg_per_unit":{"value":1.3744867004,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Silodosin / Silodosin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":300158,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Silodosin / Silodosin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Silvadene|Silver Sulfadiazine":{"brand_name":"Silvadene","generic_name":"Silver Sulfadiazine","avg_per_unit":{"value":0.1528065497,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Silvadene / Silver Sulfadiazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1023,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Silvadene / Silver Sulfadiazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Silver Sulfadiazine|Silver Sulfadiazine":{"brand_name":"Silver Sulfadiazine","generic_name":"Silver Sulfadiazine","avg_per_unit":{"value":0.1284515732,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Silver Sulfadiazine / Silver Sulfadiazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":340038,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Silver Sulfadiazine / Silver Sulfadiazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Simbrinza|Brinzolamide/Brimonidine Tart":{"brand_name":"Simbrinza","generic_name":"Brinzolamide/Brimonidine Tart","avg_per_unit":{"value":25.054419089,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Simbrinza / Brinzolamide/Brimonidine Tart: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":301984,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Simbrinza / Brinzolamide/Brimonidine Tart, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Simpesse|L-Norgest/E.Estradiol-E.Estrad":{"brand_name":"Simpesse","generic_name":"L-Norgest/E.Estradiol-E.Estrad","avg_per_unit":{"value":0.63743347,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Simpesse / L-Norgest/E.Estradiol-E.Estrad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3379,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Simpesse / L-Norgest/E.Estradiol-E.Estrad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Simponi|Golimumab":{"brand_name":"Simponi","generic_name":"Golimumab","avg_per_unit":{"value":11330.001272,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Simponi / Golimumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":25616,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Simponi / Golimumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Simvastatin|Simvastatin":{"brand_name":"Simvastatin","generic_name":"Simvastatin","avg_per_unit":{"value":0.1109939577,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Simvastatin / Simvastatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":15052578,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Simvastatin / Simvastatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sinemet|Carbidopa/Levodopa":{"brand_name":"Sinemet","generic_name":"Carbidopa/Levodopa","avg_per_unit":{"value":1.2860586517,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sinemet / Carbidopa/Levodopa: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":844,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sinemet / Carbidopa/Levodopa, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Singulair|Montelukast Sodium":{"brand_name":"Singulair","generic_name":"Montelukast Sodium","avg_per_unit":{"value":8.3436698936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Singulair / Montelukast Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11085,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Singulair / Montelukast Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sitagliptin-Metformin|Sitagliptin/Metformin HCl":{"brand_name":"Sitagliptin-Metformin","generic_name":"Sitagliptin/Metformin HCl","avg_per_unit":{"value":3.5010899822,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sitagliptin-Metformin / Sitagliptin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":220,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sitagliptin-Metformin / Sitagliptin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sitagliptin|Sitagliptin":{"brand_name":"Sitagliptin","generic_name":"Sitagliptin","avg_per_unit":{"value":4.5664289451,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sitagliptin / Sitagliptin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10247,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sitagliptin / Sitagliptin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sivextro*|Tedizolid Phosphate":{"brand_name":"Sivextro*","generic_name":"Tedizolid Phosphate","avg_per_unit":{"value":421.26362737,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sivextro* / Tedizolid Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 3 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 3 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1534,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sivextro* / Tedizolid Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Slynd|Drospirenone":{"brand_name":"Slynd","generic_name":"Drospirenone","avg_per_unit":{"value":6.8558314988,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Slynd / Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6063,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Slynd / Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sodium Bicarbonate|Sodium Bicarbonate":{"brand_name":"Sodium Bicarbonate","generic_name":"Sodium Bicarbonate","avg_per_unit":{"value":0.2496278678,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sodium Bicarbonate / Sodium Bicarbonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":8519,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sodium Bicarbonate / Sodium Bicarbonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sodium Citrate-Citric Acid|Citric Acid/Sodium Citrate":{"brand_name":"Sodium Citrate-Citric Acid","generic_name":"Citric Acid/Sodium Citrate","avg_per_unit":{"value":0.0235757689,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sodium Citrate-Citric Acid / Citric Acid/Sodium Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1199,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sodium Citrate-Citric Acid / Citric Acid/Sodium Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate":{"brand_name":"Sodium Polystyrene Sulfonate*","generic_name":"Sodium Polystyrene Sulfonate","avg_per_unit":{"value":0.1830210948,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sodium Polystyrene Sulfonate* / Sodium Polystyrene Sulfonate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 10 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":50770,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sodium Polystyrene Sulfonate* / Sodium Polystyrene Sulfonate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sofosbuvir-Velpatasvir|Sofosbuvir/Velpatasvir":{"brand_name":"Sofosbuvir-Velpatasvir","generic_name":"Sofosbuvir/Velpatasvir","avg_per_unit":{"value":280.57703358,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sofosbuvir-Velpatasvir / Sofosbuvir/Velpatasvir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13464,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sofosbuvir-Velpatasvir / Sofosbuvir/Velpatasvir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Solifenacin Succinate|Solifenacin Succinate":{"brand_name":"Solifenacin Succinate","generic_name":"Solifenacin Succinate","avg_per_unit":{"value":0.821628455,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Solifenacin Succinate / Solifenacin Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1379426,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Solifenacin Succinate / Solifenacin Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Soliqua 100-33|Insulin Glargine/Lixisenatide":{"brand_name":"Soliqua 100-33","generic_name":"Insulin Glargine/Lixisenatide","avg_per_unit":{"value":56.01146559,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Soliqua 100-33 / Insulin Glargine/Lixisenatide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":273407,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Soliqua 100-33 / Insulin Glargine/Lixisenatide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Solosec|Secnidazole":{"brand_name":"Solosec","generic_name":"Secnidazole","avg_per_unit":{"value":280.7194,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Solosec / Secnidazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":190,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Solosec / Secnidazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Soma|Carisoprodol":{"brand_name":"Soma","generic_name":"Carisoprodol","avg_per_unit":{"value":10.076802992,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Soma / Carisoprodol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1511,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Soma / Carisoprodol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Soolantra|IVermectin":{"brand_name":"Soolantra","generic_name":"IVermectin","avg_per_unit":{"value":15.259988462,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Soolantra / IVermectin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1911,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Soolantra / IVermectin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sotalol Af|Sotalol HCl":{"brand_name":"Sotalol Af","generic_name":"Sotalol HCl","avg_per_unit":{"value":0.2327276762,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sotalol Af / Sotalol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":54999,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sotalol Af / Sotalol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sotalol|Sotalol HCl":{"brand_name":"Sotalol","generic_name":"Sotalol HCl","avg_per_unit":{"value":0.1616812703,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sotalol / Sotalol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1092985,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sotalol / Sotalol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sotylize|Sotalol HCl":{"brand_name":"Sotylize","generic_name":"Sotalol HCl","avg_per_unit":{"value":2.1110587289,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sotylize / Sotalol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":35,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sotylize / Sotalol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Spinosad|Spinosad":{"brand_name":"Spinosad","generic_name":"Spinosad","avg_per_unit":{"value":1.7154246798,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Spinosad / Spinosad: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1426,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Spinosad / Spinosad, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Spiriva Handihaler|Tiotropium Bromide":{"brand_name":"Spiriva Handihaler","generic_name":"Tiotropium Bromide","avg_per_unit":{"value":16.603715978,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Spiriva Handihaler / Tiotropium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":619477,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Spiriva Handihaler / Tiotropium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Spiriva Respimat|Tiotropium Bromide":{"brand_name":"Spiriva Respimat","generic_name":"Tiotropium Bromide","avg_per_unit":{"value":119.52169697,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Spiriva Respimat / Tiotropium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1276042,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Spiriva Respimat / Tiotropium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Spironolactone|Spironolactone":{"brand_name":"Spironolactone","generic_name":"Spironolactone","avg_per_unit":{"value":0.1325565044,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Spironolactone / Spironolactone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 82 of 88 NADAC NDCs joined to this name are priced per EA (6 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9081323,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Spironolactone / Spironolactone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sporanox|Itraconazole":{"brand_name":"Sporanox","generic_name":"Itraconazole","avg_per_unit":{"value":12.40157776,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sporanox / Itraconazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":82,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sporanox / Itraconazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Spravato|Esketamine HCl":{"brand_name":"Spravato","generic_name":"Esketamine HCl","avg_per_unit":{"value":394.88652874,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Spravato / Esketamine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":84544,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Spravato / Esketamine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sprintec|Norgestimate-Ethinyl Estradiol":{"brand_name":"Sprintec","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.3448998829,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sprintec / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19885,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sprintec / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Spritam|Levetiracetam":{"brand_name":"Spritam","generic_name":"Levetiracetam","avg_per_unit":{"value":10.472927875,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Spritam / Levetiracetam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1498,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Spritam / Levetiracetam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sprycel|Dasatinib":{"brand_name":"Sprycel","generic_name":"Dasatinib","avg_per_unit":{"value":438.00015371,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sprycel / Dasatinib: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38789,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sprycel / Dasatinib, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ssd|Silver Sulfadiazine":{"brand_name":"Ssd","generic_name":"Silver Sulfadiazine","avg_per_unit":{"value":0.1238505503,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ssd / Silver Sulfadiazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":287522,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ssd / Silver Sulfadiazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Steglatro|Ertugliflozin Pidolate":{"brand_name":"Steglatro","generic_name":"Ertugliflozin Pidolate","avg_per_unit":{"value":11.452199956,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Steglatro / Ertugliflozin Pidolate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":38152,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Steglatro / Ertugliflozin Pidolate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Steglujan|Ertugliflozin/Sitagliptin Phos":{"brand_name":"Steglujan","generic_name":"Ertugliflozin/Sitagliptin Phos","avg_per_unit":{"value":17.483542832,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Steglujan / Ertugliflozin/Sitagliptin Phos: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1119,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Steglujan / Ertugliflozin/Sitagliptin Phos, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Stelara*|Ustekinumab":{"brand_name":"Stelara*","generic_name":"Ustekinumab","avg_per_unit":{"value":26534.266689,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Stelara* / Ustekinumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 2 NADAC NDCs the name join matched to it have an FDA route including SUBCUTANEOUS.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":132865,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Stelara* / Ustekinumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Stiolto Respimat|Tiotropium Br/Olodaterol HCl":{"brand_name":"Stiolto Respimat","generic_name":"Tiotropium Br/Olodaterol HCl","avg_per_unit":{"value":113.31549263,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Stiolto Respimat / Tiotropium Br/Olodaterol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":695441,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Stiolto Respimat / Tiotropium Br/Olodaterol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Striverdi Respimat|Olodaterol HCl":{"brand_name":"Striverdi Respimat","generic_name":"Olodaterol HCl","avg_per_unit":{"value":63.856140848,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Striverdi Respimat / Olodaterol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":12563,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Striverdi Respimat / Olodaterol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Stromectol|IVermectin":{"brand_name":"Stromectol","generic_name":"IVermectin","avg_per_unit":{"value":4.5452968037,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Stromectol / IVermectin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Stromectol / IVermectin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Suboxone|Buprenorphine HCl/Naloxone HCl":{"brand_name":"Suboxone","generic_name":"Buprenorphine HCl/Naloxone HCl","avg_per_unit":{"value":9.3012530765,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Suboxone / Buprenorphine HCl/Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":149372,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Suboxone / Buprenorphine HCl/Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Suflave|PEG 3350/Sod Sulf,Chlr/Pot/Mag":{"brand_name":"Suflave","generic_name":"PEG 3350/Sod Sulf,Chlr/Pot/Mag","avg_per_unit":{"value":61.402954489,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Suflave / PEG 3350/Sod Sulf,Chlr/Pot/Mag: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":30370,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Suflave / PEG 3350/Sod Sulf,Chlr/Pot/Mag, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sulfadiazine|Sulfadiazine":{"brand_name":"Sulfadiazine","generic_name":"Sulfadiazine","avg_per_unit":{"value":12.637988728,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sulfadiazine / Sulfadiazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":477,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sulfadiazine / Sulfadiazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Sulfamylon|Mafenide Acetate":{"brand_name":"Sulfamylon","generic_name":"Mafenide Acetate","avg_per_unit":{"value":1.2548438564,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sulfamylon / Mafenide Acetate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":447,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sulfamylon / Mafenide Acetate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sulfasalazine Dr|Sulfasalazine":{"brand_name":"Sulfasalazine Dr","generic_name":"Sulfasalazine","avg_per_unit":{"value":0.2078219887,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sulfasalazine Dr / Sulfasalazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":131521,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sulfasalazine Dr / Sulfasalazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sulfasalazine|Sulfasalazine":{"brand_name":"Sulfasalazine","generic_name":"Sulfasalazine","avg_per_unit":{"value":0.1252132936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sulfasalazine / Sulfasalazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":451008,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sulfasalazine / Sulfasalazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sulindac|Sulindac":{"brand_name":"Sulindac","generic_name":"Sulindac","avg_per_unit":{"value":0.2660344012,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sulindac / Sulindac: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":154502,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sulindac / Sulindac, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sumatriptan Succ-Naproxen Sod|Sumatriptan Succ/Naproxen Sod":{"brand_name":"Sumatriptan Succ-Naproxen Sod","generic_name":"Sumatriptan Succ/Naproxen Sod","avg_per_unit":{"value":34.189478808,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sumatriptan Succ-Naproxen Sod / Sumatriptan Succ/Naproxen Sod: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4828,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sumatriptan Succ-Naproxen Sod / Sumatriptan Succ/Naproxen Sod, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sumatriptan|Sumatriptan":{"brand_name":"Sumatriptan","generic_name":"Sumatriptan","avg_per_unit":{"value":21.972180939,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sumatriptan / Sumatriptan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48243,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sumatriptan / Sumatriptan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sunosi|Solriamfetol HCl":{"brand_name":"Sunosi","generic_name":"Solriamfetol HCl","avg_per_unit":{"value":28.558283671,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sunosi / Solriamfetol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20031,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sunosi / Solriamfetol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sutab|Sod Sulf/Pot Chloride/Mag Sulf":{"brand_name":"Sutab","generic_name":"Sod Sulf/Pot Chloride/Mag Sulf","avg_per_unit":{"value":6.7387374188,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sutab / Sod Sulf/Pot Chloride/Mag Sulf: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":156816,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sutab / Sod Sulf/Pot Chloride/Mag Sulf, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Syeda|Ethinyl Estradiol/Drospirenone":{"brand_name":"Syeda","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.708065658,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Syeda / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2523,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Syeda / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Symbicort|Budesonide/Formoterol Fumarate":{"brand_name":"Symbicort","generic_name":"Budesonide/Formoterol Fumarate","avg_per_unit":{"value":21.939005619,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Symbicort / Budesonide/Formoterol Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1913647,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Symbicort / Budesonide/Formoterol Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Sympazan|Clobazam":{"brand_name":"Sympazan","generic_name":"Clobazam","avg_per_unit":{"value":33.566373563,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Sympazan / Clobazam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1456,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Sympazan / Clobazam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Symproic|Naldemedine Tosylate":{"brand_name":"Symproic","generic_name":"Naldemedine Tosylate","avg_per_unit":{"value":15.007307008,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Symproic / Naldemedine Tosylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18888,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Symproic / Naldemedine Tosylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Symtuza|Darunavir/Cob/Emtri/Tenof Alaf":{"brand_name":"Symtuza","generic_name":"Darunavir/Cob/Emtri/Tenof Alaf","avg_per_unit":{"value":154.87774506,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Symtuza / Darunavir/Cob/Emtri/Tenof Alaf: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":91050,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Symtuza / Darunavir/Cob/Emtri/Tenof Alaf, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Synjardy XR|Empagliflozin/Metformin HCl":{"brand_name":"Synjardy XR","generic_name":"Empagliflozin/Metformin HCl","avg_per_unit":{"value":13.729876773,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Synjardy XR / Empagliflozin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":310733,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Synjardy XR / Empagliflozin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Synjardy|Empagliflozin/Metformin HCl":{"brand_name":"Synjardy","generic_name":"Empagliflozin/Metformin HCl","avg_per_unit":{"value":9.6094317358,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Synjardy / Empagliflozin/Metformin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":187400,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Synjardy / Empagliflozin/Metformin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Synthroid|Levothyroxine Sodium":{"brand_name":"Synthroid","generic_name":"Levothyroxine Sodium","avg_per_unit":{"value":0.9878042384,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Synthroid / Levothyroxine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4990576,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Synthroid / Levothyroxine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Taclonex|Calcipotriene/Betamethasone":{"brand_name":"Taclonex","generic_name":"Calcipotriene/Betamethasone","avg_per_unit":{"value":21.084348248,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Taclonex / Calcipotriene/Betamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":202,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Taclonex / Calcipotriene/Betamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tadalafil|Tadalafil":{"brand_name":"Tadalafil","generic_name":"Tadalafil","avg_per_unit":{"value":5.3682028207,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tadalafil / Tadalafil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":365541,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tadalafil / Tadalafil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Tadliq|Tadalafil":{"brand_name":"Tadliq","generic_name":"Tadalafil","avg_per_unit":{"value":12.219438313,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tadliq / Tadalafil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":71,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tadliq / Tadalafil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Taltz Autoinjector|Ixekizumab":{"brand_name":"Taltz Autoinjector","generic_name":"Ixekizumab","avg_per_unit":{"value":6734.6845574,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Taltz Autoinjector / Ixekizumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":73919,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Taltz Autoinjector / Ixekizumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tamoxifen Citrate|Tamoxifen Citrate":{"brand_name":"Tamoxifen Citrate","generic_name":"Tamoxifen Citrate","avg_per_unit":{"value":0.3907972031,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tamoxifen Citrate / Tamoxifen Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":383294,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tamoxifen Citrate / Tamoxifen Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tamsulosin HCl|Tamsulosin HCl":{"brand_name":"Tamsulosin HCl","generic_name":"Tamsulosin HCl","avg_per_unit":{"value":0.1790838799,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tamsulosin HCl / Tamsulosin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":21583278,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tamsulosin HCl / Tamsulosin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tanlor|Methocarbamol":{"brand_name":"Tanlor","generic_name":"Methocarbamol","avg_per_unit":{"value":19.347104898,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tanlor / Methocarbamol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tanlor / Methocarbamol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tarina 24 Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Tarina 24 Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.8796031746,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tarina 24 Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":89,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tarina 24 Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tarina Fe 1-20 Eq|Norethindrone-E.Estradiol-Iron":{"brand_name":"Tarina Fe 1-20 Eq","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":0.424407253,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tarina Fe 1-20 Eq / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":646,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tarina Fe 1-20 Eq / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Taron-C DHA|Mvn-Min75/Iron/Iron Ps/Om3/DHA":{"brand_name":"Taron-C DHA","generic_name":"Mvn-Min75/Iron/Iron Ps/Om3/DHA","avg_per_unit":{"value":0.7799122807,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Taron-C DHA / Mvn-Min75/Iron/Iron Ps/Om3/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":53,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Taron-C DHA / Mvn-Min75/Iron/Iron Ps/Om3/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tasimelteon|Tasimelteon":{"brand_name":"Tasimelteon","generic_name":"Tasimelteon","avg_per_unit":{"value":538.77464313,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tasimelteon / Tasimelteon: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1852,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tasimelteon / Tasimelteon, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tavaborole|Tavaborole":{"brand_name":"Tavaborole","generic_name":"Tavaborole","avg_per_unit":{"value":50.713886397,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tavaborole / Tavaborole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":34010,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tavaborole / Tavaborole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Taytulla|Norethindrone-E.Estradiol-Iron":{"brand_name":"Taytulla","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":8.5548125,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Taytulla / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":45,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Taytulla / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tazarotene|Tazarotene":{"brand_name":"Tazarotene","generic_name":"Tazarotene","avg_per_unit":{"value":3.9514281638,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tazarotene / Tazarotene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":11842,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tazarotene / Tazarotene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tegretol XR|Carbamazepine":{"brand_name":"Tegretol XR","generic_name":"Carbamazepine","avg_per_unit":{"value":3.972543883,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tegretol XR / Carbamazepine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":28016,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tegretol XR / Carbamazepine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tekturna|Aliskiren Hemifumarate":{"brand_name":"Tekturna","generic_name":"Aliskiren Hemifumarate","avg_per_unit":{"value":11.321906674,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tekturna / Aliskiren Hemifumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1180,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tekturna / Aliskiren Hemifumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Telmisartan-Amlodipine|Telmisartan/Amlodipine":{"brand_name":"Telmisartan-Amlodipine","generic_name":"Telmisartan/Amlodipine","avg_per_unit":{"value":2.3438494522,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Telmisartan-Amlodipine / Telmisartan/Amlodipine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":24841,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Telmisartan-Amlodipine / Telmisartan/Amlodipine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Telmisartan|Telmisartan":{"brand_name":"Telmisartan","generic_name":"Telmisartan","avg_per_unit":{"value":0.3796651351,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Telmisartan / Telmisartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1293200,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Telmisartan / Telmisartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Temazepam|Temazepam":{"brand_name":"Temazepam","generic_name":"Temazepam","avg_per_unit":{"value":0.3590463782,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Temazepam / Temazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2218319,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Temazepam / Temazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Temozolomide|Temozolomide":{"brand_name":"Temozolomide","generic_name":"Temozolomide","avg_per_unit":{"value":52.056510736,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Temozolomide / Temozolomide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":58,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Temozolomide / Temozolomide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate":{"brand_name":"Tenofovir Disoproxil Fumarate","generic_name":"Tenofovir Disoproxil Fumarate","avg_per_unit":{"value":3.1625473427,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tenofovir Disoproxil Fumarate / Tenofovir Disoproxil Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":82072,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tenofovir Disoproxil Fumarate / Tenofovir Disoproxil Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Tenormin|Atenolol":{"brand_name":"Tenormin","generic_name":"Atenolol","avg_per_unit":{"value":12.567059783,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tenormin / Atenolol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2584,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tenormin / Atenolol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Terazosin HCl|Terazosin HCl":{"brand_name":"Terazosin HCl","generic_name":"Terazosin HCl","avg_per_unit":{"value":0.2333655359,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Terazosin HCl / Terazosin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1320017,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Terazosin HCl / Terazosin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Terbinafine HCl|Terbinafine HCl":{"brand_name":"Terbinafine HCl","generic_name":"Terbinafine HCl","avg_per_unit":{"value":0.27931083,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Terbinafine HCl / Terbinafine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":799100,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Terbinafine HCl / Terbinafine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Terbutaline Sulfate*|Terbutaline Sulfate":{"brand_name":"Terbutaline Sulfate*","generic_name":"Terbutaline Sulfate","avg_per_unit":{"value":2.1237414071,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Terbutaline Sulfate* / Terbutaline Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 10 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3748,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Terbutaline Sulfate* / Terbutaline Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Teriflunomide|Teriflunomide":{"brand_name":"Teriflunomide","generic_name":"Teriflunomide","avg_per_unit":{"value":42.141985894,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Teriflunomide / Teriflunomide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":58096,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Teriflunomide / Teriflunomide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Teriparatide|Teriparatide":{"brand_name":"Teriparatide","generic_name":"Teriparatide","avg_per_unit":{"value":962.43749536,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Teriparatide / Teriparatide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":81093,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Teriparatide / Teriparatide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Testim|Testosterone":{"brand_name":"Testim","generic_name":"Testosterone","avg_per_unit":{"value":3.7224417272,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Testim / Testosterone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":882,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Testim / Testosterone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Testosterone Cypionate|Testosterone Cypionate":{"brand_name":"Testosterone Cypionate","generic_name":"Testosterone Cypionate","avg_per_unit":{"value":8.32789082,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Testosterone Cypionate / Testosterone Cypionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1118253,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Testosterone Cypionate / Testosterone Cypionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Testosterone Enanthate|Testosterone Enanthate":{"brand_name":"Testosterone Enanthate","generic_name":"Testosterone Enanthate","avg_per_unit":{"value":12.85997771,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Testosterone Enanthate / Testosterone Enanthate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10421,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Testosterone Enanthate / Testosterone Enanthate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tetrabenazine|Tetrabenazine":{"brand_name":"Tetrabenazine","generic_name":"Tetrabenazine","avg_per_unit":{"value":20.501795292,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tetrabenazine / Tetrabenazine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":28043,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tetrabenazine / Tetrabenazine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tetracycline HCl|Tetracycline HCl":{"brand_name":"Tetracycline HCl","generic_name":"Tetracycline HCl","avg_per_unit":{"value":1.9489390707,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tetracycline HCl / Tetracycline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":49202,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tetracycline HCl / Tetracycline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Texacort|Hydrocortisone":{"brand_name":"Texacort","generic_name":"Hydrocortisone","avg_per_unit":{"value":6.6526426047,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Texacort / Hydrocortisone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":195,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Texacort / Hydrocortisone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Thalitone|Chlorthalidone":{"brand_name":"Thalitone","generic_name":"Chlorthalidone","avg_per_unit":{"value":3.5614837998,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Thalitone / Chlorthalidone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3517,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Thalitone / Chlorthalidone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Theophylline ER|Theophylline Anhydrous":{"brand_name":"Theophylline ER","generic_name":"Theophylline Anhydrous","avg_per_unit":{"value":1.2928518836,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Theophylline ER / Theophylline Anhydrous: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":163518,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Theophylline ER / Theophylline Anhydrous, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Theophylline|Theophylline Anhydrous":{"brand_name":"Theophylline","generic_name":"Theophylline Anhydrous","avg_per_unit":{"value":0.1300034621,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Theophylline / Theophylline Anhydrous: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2430,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Theophylline / Theophylline Anhydrous, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Thioridazine HCl|Thioridazine HCl":{"brand_name":"Thioridazine HCl","generic_name":"Thioridazine HCl","avg_per_unit":{"value":0.6446632744,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Thioridazine HCl / Thioridazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":26141,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Thioridazine HCl / Thioridazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Thiothixene|Thiothixene":{"brand_name":"Thiothixene","generic_name":"Thiothixene","avg_per_unit":{"value":1.2880413546,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Thiothixene / Thiothixene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":22519,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Thiothixene / Thiothixene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Thrivite Rx|Prenatal Vit,Calc76/Iron/Folic":{"brand_name":"Thrivite Rx","generic_name":"Prenatal Vit,Calc76/Iron/Folic","avg_per_unit":{"value":0.5852629105,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Thrivite Rx / Prenatal Vit,Calc76/Iron/Folic: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":312,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Thrivite Rx / Prenatal Vit,Calc76/Iron/Folic, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Thyquidity|Levothyroxine Sodium":{"brand_name":"Thyquidity","generic_name":"Levothyroxine Sodium","avg_per_unit":{"value":1.30890766,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Thyquidity / Levothyroxine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":984,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Thyquidity / Levothyroxine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tiadylt ER|Diltiazem HCl":{"brand_name":"Tiadylt ER","generic_name":"Diltiazem HCl","avg_per_unit":{"value":0.4015117527,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tiadylt ER / Diltiazem HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":200287,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tiadylt ER / Diltiazem HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tiagabine HCl|Tiagabine HCl":{"brand_name":"Tiagabine HCl","generic_name":"Tiagabine HCl","avg_per_unit":{"value":3.7574934885,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tiagabine HCl / Tiagabine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":16260,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tiagabine HCl / Tiagabine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Timolol Maleate*|Timolol Maleate":{"brand_name":"Timolol Maleate*","generic_name":"Timolol Maleate","avg_per_unit":{"value":2.0099054218,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Timolol Maleate* / Timolol Maleate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes OPHTHALMIC point at this name (10 of the 12 the name join matched); NDCs of another route or with no known FDA route do not.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2958063,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Timolol Maleate* / Timolol Maleate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tinidazole|Tinidazole":{"brand_name":"Tinidazole","generic_name":"Tinidazole","avg_per_unit":{"value":3.0730267586,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tinidazole / Tinidazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9278,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tinidazole / Tinidazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tiotropium Bromide|Tiotropium Bromide":{"brand_name":"Tiotropium Bromide","generic_name":"Tiotropium Bromide","avg_per_unit":{"value":11.961403717,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tiotropium Bromide / Tiotropium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":172243,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tiotropium Bromide / Tiotropium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tivicay|Dolutegravir Sodium":{"brand_name":"Tivicay","generic_name":"Dolutegravir Sodium","avg_per_unit":{"value":74.366084727,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tivicay / Dolutegravir Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":255731,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tivicay / Dolutegravir Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tizanidine HCl|Tizanidine HCl":{"brand_name":"Tizanidine HCl","generic_name":"Tizanidine HCl","avg_per_unit":{"value":0.1386103938,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tizanidine HCl / Tizanidine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6984387,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tizanidine HCl / Tizanidine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tlando|Testosterone Undecanoate":{"brand_name":"Tlando","generic_name":"Testosterone Undecanoate","avg_per_unit":{"value":6.0066132122,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tlando / Testosterone Undecanoate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":802,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tlando / Testosterone Undecanoate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tobradex St|Tobramycin/Dexamethasone":{"brand_name":"Tobradex St","generic_name":"Tobramycin/Dexamethasone","avg_per_unit":{"value":46.446430843,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tobradex St / Tobramycin/Dexamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":24550,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tobradex St / Tobramycin/Dexamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tobradex|Tobramycin/Dexamethasone":{"brand_name":"Tobradex","generic_name":"Tobramycin/Dexamethasone","avg_per_unit":{"value":75.941318288,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tobradex / Tobramycin/Dexamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":56574,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tobradex / Tobramycin/Dexamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tobramycin-Dexamethasone|Tobramycin/Dexamethasone":{"brand_name":"Tobramycin-Dexamethasone","generic_name":"Tobramycin/Dexamethasone","avg_per_unit":{"value":8.598572662,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tobramycin-Dexamethasone / Tobramycin/Dexamethasone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":518468,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tobramycin-Dexamethasone / Tobramycin/Dexamethasone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tobrex|Tobramycin":{"brand_name":"Tobrex","generic_name":"Tobramycin","avg_per_unit":{"value":74.450200006,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tobrex / Tobramycin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":4802,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tobrex / Tobramycin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tolterodine Tartrate ER|Tolterodine Tartrate":{"brand_name":"Tolterodine Tartrate ER","generic_name":"Tolterodine Tartrate","avg_per_unit":{"value":1.5872500945,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tolterodine Tartrate ER / Tolterodine Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":646179,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tolterodine Tartrate ER / Tolterodine Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tolterodine Tartrate|Tolterodine Tartrate":{"brand_name":"Tolterodine Tartrate","generic_name":"Tolterodine Tartrate","avg_per_unit":{"value":0.7946932246,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tolterodine Tartrate / Tolterodine Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":163394,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tolterodine Tartrate / Tolterodine Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tolvaptan|Tolvaptan":{"brand_name":"Tolvaptan","generic_name":"Tolvaptan","avg_per_unit":{"value":177.81039082,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tolvaptan / Tolvaptan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7103,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tolvaptan / Tolvaptan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Topamax|Topiramate":{"brand_name":"Topamax","generic_name":"Topiramate","avg_per_unit":{"value":15.991956381,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Topamax / Topiramate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":21528,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Topamax / Topiramate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Topiramate ER|Topiramate":{"brand_name":"Topiramate ER","generic_name":"Topiramate","avg_per_unit":{"value":13.194634376,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Topiramate ER / Topiramate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":35445,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Topiramate ER / Topiramate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Topiramate|Topiramate":{"brand_name":"Topiramate","generic_name":"Topiramate","avg_per_unit":{"value":0.1222358612,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Topiramate / Topiramate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. 86 of 88 NADAC NDCs joined to this name are priced per EA (2 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3304484,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Topiramate / Topiramate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Toprol XL|Metoprolol Succinate":{"brand_name":"Toprol XL","generic_name":"Metoprolol Succinate","avg_per_unit":{"value":1.4525236921,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Toprol XL / Metoprolol Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":37862,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Toprol XL / Metoprolol Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Toremifene Citrate|Toremifene Citrate":{"brand_name":"Toremifene Citrate","generic_name":"Toremifene Citrate","avg_per_unit":{"value":25.762924863,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Toremifene Citrate / Toremifene Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":893,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Toremifene Citrate / Toremifene Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Torsemide|Torsemide":{"brand_name":"Torsemide","generic_name":"Torsemide","avg_per_unit":{"value":0.2186571197,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Torsemide / Torsemide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2998501,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Torsemide / Torsemide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tosymra|Sumatriptan":{"brand_name":"Tosymra","generic_name":"Sumatriptan","avg_per_unit":{"value":107.19458602,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tosymra / Sumatriptan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":473,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tosymra / Sumatriptan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Toujeo Solostar|Insulin Glargine,Hum.Rec.Anlog":{"brand_name":"Toujeo Solostar","generic_name":"Insulin Glargine,Hum.Rec.Anlog","avg_per_unit":{"value":88.886535841,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Toujeo Solostar / Insulin Glargine,Hum.Rec.Anlog: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":762959,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Toujeo Solostar / Insulin Glargine,Hum.Rec.Anlog, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tovet Emollient|Clobetasol Propionate/Emoll":{"brand_name":"Tovet Emollient","generic_name":"Clobetasol Propionate/Emoll","avg_per_unit":{"value":3.6664374282,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tovet Emollient / Clobetasol Propionate/Emoll: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":88,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tovet Emollient / Clobetasol Propionate/Emoll, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tradjenta|Linagliptin":{"brand_name":"Tradjenta","generic_name":"Linagliptin","avg_per_unit":{"value":16.562900837,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tradjenta / Linagliptin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1446832,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tradjenta / Linagliptin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tramadol HCl ER|Tramadol HCl":{"brand_name":"Tramadol HCl ER","generic_name":"Tramadol HCl","avg_per_unit":{"value":2.1363544556,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tramadol HCl ER / Tramadol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":223842,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tramadol HCl ER / Tramadol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen":{"brand_name":"Tramadol HCl-Acetaminophen","generic_name":"Tramadol HCl/Acetaminophen","avg_per_unit":{"value":0.2209847466,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tramadol HCl-Acetaminophen / Tramadol HCl/Acetaminophen: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":286567,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tramadol HCl-Acetaminophen / Tramadol HCl/Acetaminophen, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tramadol HCl|Tramadol HCl":{"brand_name":"Tramadol HCl","generic_name":"Tramadol HCl","avg_per_unit":{"value":0.1109017757,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tramadol HCl / Tramadol HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":12939330,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tramadol HCl / Tramadol HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trandolapril|Trandolapril":{"brand_name":"Trandolapril","generic_name":"Trandolapril","avg_per_unit":{"value":0.2483312977,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trandolapril / Trandolapril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":58724,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trandolapril / Trandolapril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tranylcypromine Sulfate|Tranylcypromine Sulfate":{"brand_name":"Tranylcypromine Sulfate","generic_name":"Tranylcypromine Sulfate","avg_per_unit":{"value":1.0517943261,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tranylcypromine Sulfate / Tranylcypromine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11298,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tranylcypromine Sulfate / Tranylcypromine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Travatan Z|Travoprost":{"brand_name":"Travatan Z","generic_name":"Travoprost","avg_per_unit":{"value":91.832976992,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Travatan Z / Travoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":21212,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Travatan Z / Travoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Travoprost|Travoprost":{"brand_name":"Travoprost","generic_name":"Travoprost","avg_per_unit":{"value":30.773386333,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Travoprost / Travoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":476526,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Travoprost / Travoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trazodone HCl|Trazodone HCl":{"brand_name":"Trazodone HCl","generic_name":"Trazodone HCl","avg_per_unit":{"value":0.1467299232,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trazodone HCl / Trazodone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":18424765,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trazodone HCl / Trazodone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trelegy Ellipta|Fluticasone/Umeclidin/Vilanter":{"brand_name":"Trelegy Ellipta","generic_name":"Fluticasone/Umeclidin/Vilanter","avg_per_unit":{"value":10.518825318,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trelegy Ellipta / Fluticasone/Umeclidin/Vilanter: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6250872,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trelegy Ellipta / Fluticasone/Umeclidin/Vilanter, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tresiba Flextouch U-100|Insulin Degludec":{"brand_name":"Tresiba Flextouch U-100","generic_name":"Insulin Degludec","avg_per_unit":{"value":32.08456827,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tresiba Flextouch U-100 / Insulin Degludec: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1281963,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tresiba Flextouch U-100 / Insulin Degludec, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tresiba Flextouch U-200|Insulin Degludec":{"brand_name":"Tresiba Flextouch U-200","generic_name":"Insulin Degludec","avg_per_unit":{"value":63.981928838,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tresiba Flextouch U-200 / Insulin Degludec: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":893822,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tresiba Flextouch U-200 / Insulin Degludec, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tresiba|Insulin Degludec":{"brand_name":"Tresiba","generic_name":"Insulin Degludec","avg_per_unit":{"value":32.170508477,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tresiba / Insulin Degludec: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":51551,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tresiba / Insulin Degludec, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tretinoin*|Tretinoin":{"brand_name":"Tretinoin*","generic_name":"Tretinoin","avg_per_unit":{"value":1.9699991389,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tretinoin* / Tretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes TOPICAL point at this name (53 of the 58 the name join matched); NDCs of another route or with no known FDA route do not. 53 of 58 NADAC NDCs joined to this name are priced per GM (5 per EA): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":235091,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tretinoin* / Tretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trexall|Methotrexate Sodium":{"brand_name":"Trexall","generic_name":"Methotrexate Sodium","avg_per_unit":{"value":41.736517318,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trexall / Methotrexate Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7121,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trexall / Methotrexate Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Estarylla|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Estarylla","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.4465294496,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Estarylla / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3858,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Estarylla / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Legest Fe|Norethindrone-E.Estradiol-Iron":{"brand_name":"Tri-Legest Fe","generic_name":"Norethindrone-E.Estradiol-Iron","avg_per_unit":{"value":1.2415734755,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Legest Fe / Norethindrone-E.Estradiol-Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":406,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Legest Fe / Norethindrone-E.Estradiol-Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Linyah|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Linyah","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.4222492967,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Linyah / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2756,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Linyah / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Lo-Estarylla|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Lo-Estarylla","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.5453832498,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Lo-Estarylla / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2654,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Lo-Estarylla / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Lo-Marzia|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Lo-Marzia","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.465034546,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Lo-Marzia / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2707,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Lo-Marzia / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Lo-Mili|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Lo-Mili","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.502048985,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Lo-Mili / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5121,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Lo-Mili / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Lo-Sprintec|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Lo-Sprintec","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.5362779931,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Lo-Sprintec / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":213,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Lo-Sprintec / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Mili|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Mili","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.4248210794,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Mili / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2291,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Mili / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Sprintec|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Sprintec","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.3951834961,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Sprintec / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11352,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Sprintec / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Vylibra Lo|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Vylibra Lo","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.3353905447,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Vylibra Lo / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":97,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Vylibra Lo / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tri-Vylibra|Norgestimate-Ethinyl Estradiol":{"brand_name":"Tri-Vylibra","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.2990708479,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tri-Vylibra / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":93,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tri-Vylibra / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Triamterene|Triamterene":{"brand_name":"Triamterene","generic_name":"Triamterene","avg_per_unit":{"value":6.3769589525,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Triamterene / Triamterene: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9470,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Triamterene / Triamterene, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Triazolam|Triazolam":{"brand_name":"Triazolam","generic_name":"Triazolam","avg_per_unit":{"value":1.337463657,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Triazolam / Triazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":98073,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Triazolam / Triazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tribenzor|Olmesartan/Amlodipin/HCThiazid":{"brand_name":"Tribenzor","generic_name":"Olmesartan/Amlodipin/HCThiazid","avg_per_unit":{"value":14.194409947,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tribenzor / Olmesartan/Amlodipin/HCThiazid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2198,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tribenzor / Olmesartan/Amlodipin/HCThiazid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tricitrates|Sod/Pot/K Cit/Sod Cit/Cit Acid":{"brand_name":"Tricitrates","generic_name":"Sod/Pot/K Cit/Sod Cit/Cit Acid","avg_per_unit":{"value":0.0903418505,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tricitrates / Sod/Pot/K Cit/Sod Cit/Cit Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":100,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tricitrates / Sod/Pot/K Cit/Sod Cit/Cit Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tridacaine III|Lidocaine":{"brand_name":"Tridacaine III","generic_name":"Lidocaine","avg_per_unit":{"value":44.411160131,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tridacaine III / Lidocaine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":37,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tridacaine III / Lidocaine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trientine HCl|Trientine HCl":{"brand_name":"Trientine HCl","generic_name":"Trientine HCl","avg_per_unit":{"value":40.23970646,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trientine HCl / Trientine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":923,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trientine HCl / Trientine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Trifluoperazine HCl|Trifluoperazine HCl":{"brand_name":"Trifluoperazine HCl","generic_name":"Trifluoperazine HCl","avg_per_unit":{"value":0.8350683371,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trifluoperazine HCl / Trifluoperazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":37157,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trifluoperazine HCl / Trifluoperazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trifluridine|Trifluridine":{"brand_name":"Trifluridine","generic_name":"Trifluridine","avg_per_unit":{"value":20.130049866,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trifluridine / Trifluridine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10540,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trifluridine / Trifluridine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trihexyphenidyl HCl|Trihexyphenidyl HCl":{"brand_name":"Trihexyphenidyl HCl","generic_name":"Trihexyphenidyl HCl","avg_per_unit":{"value":0.1630331829,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trihexyphenidyl HCl / Trihexyphenidyl HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":207570,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trihexyphenidyl HCl / Trihexyphenidyl HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trijardy XR|Empaglifloz/Linaglip/Metformin":{"brand_name":"Trijardy XR","generic_name":"Empaglifloz/Linaglip/Metformin","avg_per_unit":{"value":14.154849246,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trijardy XR / Empaglifloz/Linaglip/Metformin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":112533,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trijardy XR / Empaglifloz/Linaglip/Metformin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trimethoprim|Trimethoprim":{"brand_name":"Trimethoprim","generic_name":"Trimethoprim","avg_per_unit":{"value":1.1151806105,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trimethoprim / Trimethoprim: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":186969,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trimethoprim / Trimethoprim, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trinatal Rx 1|Prenatal Vit27,Calcium/Iron/FA":{"brand_name":"Trinatal Rx 1","generic_name":"Prenatal Vit27,Calcium/Iron/FA","avg_per_unit":{"value":0.2657124854,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trinatal Rx 1 / Prenatal Vit27,Calcium/Iron/FA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1550,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trinatal Rx 1 / Prenatal Vit27,Calcium/Iron/FA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trintellix|Vortioxetine Hydrobromide":{"brand_name":"Trintellix","generic_name":"Vortioxetine Hydrobromide","avg_per_unit":{"value":16.061348194,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trintellix / Vortioxetine Hydrobromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":610008,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trintellix / Vortioxetine Hydrobromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Triumeq|Abacavir/Dolutegravir/Lamivudi":{"brand_name":"Triumeq","generic_name":"Abacavir/Dolutegravir/Lamivudi","avg_per_unit":{"value":123.56024562,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Triumeq / Abacavir/Dolutegravir/Lamivudi: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":143167,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Triumeq / Abacavir/Dolutegravir/Lamivudi, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trokendi XR|Topiramate":{"brand_name":"Trokendi XR","generic_name":"Topiramate","avg_per_unit":{"value":31.935196793,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trokendi XR / Topiramate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9755,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trokendi XR / Topiramate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tropicamide|Tropicamide":{"brand_name":"Tropicamide","generic_name":"Tropicamide","avg_per_unit":{"value":1.4607605145,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tropicamide / Tropicamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1067,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tropicamide / Tropicamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trospium Chloride ER|Trospium Chloride":{"brand_name":"Trospium Chloride ER","generic_name":"Trospium Chloride","avg_per_unit":{"value":3.2277338884,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trospium Chloride ER / Trospium Chloride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":127898,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trospium Chloride ER / Trospium Chloride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trospium Chloride|Trospium Chloride":{"brand_name":"Trospium Chloride","generic_name":"Trospium Chloride","avg_per_unit":{"value":0.5953284071,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trospium Chloride / Trospium Chloride: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":448238,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trospium Chloride / Trospium Chloride, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Trulicity|Dulaglutide":{"brand_name":"Trulicity","generic_name":"Dulaglutide","avg_per_unit":{"value":467.74913984,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Trulicity / Dulaglutide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":4305141,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Trulicity / Dulaglutide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Truvada|Emtricitabine/Tenofovir (Tdf)":{"brand_name":"Truvada","generic_name":"Emtricitabine/Tenofovir (Tdf)","avg_per_unit":{"value":57.852879997,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Truvada / Emtricitabine/Tenofovir (Tdf): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1932,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Truvada / Emtricitabine/Tenofovir (Tdf), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tudorza Pressair|Aclidinium Bromide":{"brand_name":"Tudorza Pressair","generic_name":"Aclidinium Bromide","avg_per_unit":{"value":383.17802456,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tudorza Pressair / Aclidinium Bromide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7487,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tudorza Pressair / Aclidinium Bromide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Turqoz|Norgestrel-Ethinyl Estradiol":{"brand_name":"Turqoz","generic_name":"Norgestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.5858476119,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Turqoz / Norgestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1148,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Turqoz / Norgestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Twyneo|Tretinoin/Benzoyl Peroxide":{"brand_name":"Twyneo","generic_name":"Tretinoin/Benzoyl Peroxide","avg_per_unit":{"value":14.951572464,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Twyneo / Tretinoin/Benzoyl Peroxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":88,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Twyneo / Tretinoin/Benzoyl Peroxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tyblume|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Tyblume","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.7705892212,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tyblume / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":165,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tyblume / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tyenne*|Tocilizumab-Aazg":{"brand_name":"Tyenne*","generic_name":"Tocilizumab-Aazg","avg_per_unit":{"value":796.10229739,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tyenne* / Tocilizumab-Aazg: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 2 NADAC NDCs the name join matched to it have an FDA route including SUBCUTANEOUS.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":494,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tyenne* / Tocilizumab-Aazg, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Tyrvaya|Varenicline Tartrate":{"brand_name":"Tyrvaya","generic_name":"Varenicline Tartrate","avg_per_unit":{"value":76.537805017,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Tyrvaya / Varenicline Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":90460,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Tyrvaya / Varenicline Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ubrelvy|Ubrogepant":{"brand_name":"Ubrelvy","generic_name":"Ubrogepant","avg_per_unit":{"value":102.07014542,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ubrelvy / Ubrogepant: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":328213,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ubrelvy / Ubrogepant, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Uloric|Febuxostat":{"brand_name":"Uloric","generic_name":"Febuxostat","avg_per_unit":{"value":10.317934118,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Uloric / Febuxostat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7458,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Uloric / Febuxostat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Unithroid|Levothyroxine Sodium":{"brand_name":"Unithroid","generic_name":"Levothyroxine Sodium","avg_per_unit":{"value":0.5812210113,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Unithroid / Levothyroxine Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":94138,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Unithroid / Levothyroxine Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Urea|Urea":{"brand_name":"Urea","generic_name":"Urea","avg_per_unit":{"value":0.6226874776,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Urea / Urea: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":226,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Urea / Urea, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Uro-Mp|Meth/Meblue/Sod Phos/Psal/Hyos":{"brand_name":"Uro-Mp","generic_name":"Meth/Meblue/Sod Phos/Psal/Hyos","avg_per_unit":{"value":2.0458491228,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Uro-Mp / Meth/Meblue/Sod Phos/Psal/Hyos: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":31,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Uro-Mp / Meth/Meblue/Sod Phos/Psal/Hyos, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Urogesic-Blue|Methenam/Sod Phos/Mblue/Hyoscy":{"brand_name":"Urogesic-Blue","generic_name":"Methenam/Sod Phos/Mblue/Hyoscy","avg_per_unit":{"value":4.6083778289,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Urogesic-Blue / Methenam/Sod Phos/Mblue/Hyoscy: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":339,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Urogesic-Blue / Methenam/Sod Phos/Mblue/Hyoscy, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ursodiol|Ursodiol":{"brand_name":"Ursodiol","generic_name":"Ursodiol","avg_per_unit":{"value":1.1969563061,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ursodiol / Ursodiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":488500,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ursodiol / Ursodiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vagifem|Estradiol":{"brand_name":"Vagifem","generic_name":"Estradiol","avg_per_unit":{"value":19.970414246,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vagifem / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7733,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vagifem / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Valacyclovir|Valacyclovir HCl":{"brand_name":"Valacyclovir","generic_name":"Valacyclovir HCl","avg_per_unit":{"value":0.7954796908,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Valacyclovir / Valacyclovir HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3299119,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Valacyclovir / Valacyclovir HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide":{"brand_name":"Valsartan-Hydrochlorothiazide","generic_name":"Valsartan/Hydrochlorothiazide","avg_per_unit":{"value":0.4140835631,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Valsartan-Hydrochlorothiazide / Valsartan/Hydrochlorothiazide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1711897,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Valsartan-Hydrochlorothiazide / Valsartan/Hydrochlorothiazide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Valsartan|Valsartan":{"brand_name":"Valsartan","generic_name":"Valsartan","avg_per_unit":{"value":0.3372162121,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Valsartan / Valsartan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4691604,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Valsartan / Valsartan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Valtoco|Diazepam":{"brand_name":"Valtoco","generic_name":"Diazepam","avg_per_unit":{"value":354.1331418,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Valtoco / Diazepam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20987,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Valtoco / Diazepam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Valtrex|Valacyclovir HCl":{"brand_name":"Valtrex","generic_name":"Valacyclovir HCl","avg_per_unit":{"value":16.369147311,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Valtrex / Valacyclovir HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4107,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Valtrex / Valacyclovir HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vandazole|Metronidazole":{"brand_name":"Vandazole","generic_name":"Metronidazole","avg_per_unit":{"value":0.9449308513,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vandazole / Metronidazole: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":3115,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vandazole / Metronidazole, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vardenafil HCl|Vardenafil HCl":{"brand_name":"Vardenafil HCl","generic_name":"Vardenafil HCl","avg_per_unit":{"value":17.551947809,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vardenafil HCl / Vardenafil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4738,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vardenafil HCl / Vardenafil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Varenicline Tartrate|Varenicline Tartrate":{"brand_name":"Varenicline Tartrate","generic_name":"Varenicline Tartrate","avg_per_unit":{"value":3.5033720128,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Varenicline Tartrate / Varenicline Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":569550,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Varenicline Tartrate / Varenicline Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Velivet|Desogestrel-Ethinyl Estradiol":{"brand_name":"Velivet","generic_name":"Desogestrel-Ethinyl Estradiol","avg_per_unit":{"value":0.8451208389,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Velivet / Desogestrel-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":720,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Velivet / Desogestrel-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Velphoro|Sucroferric Oxyhydroxide":{"brand_name":"Velphoro","generic_name":"Sucroferric Oxyhydroxide","avg_per_unit":{"value":17.290504276,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Velphoro / Sucroferric Oxyhydroxide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":156980,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Velphoro / Sucroferric Oxyhydroxide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Veltassa|Patiromer Calcium Sorbitex":{"brand_name":"Veltassa","generic_name":"Patiromer Calcium Sorbitex","avg_per_unit":{"value":34.143678352,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Veltassa / Patiromer Calcium Sorbitex: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":163389,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Veltassa / Patiromer Calcium Sorbitex, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vemlidy|Tenofovir Alafenamide":{"brand_name":"Vemlidy","generic_name":"Tenofovir Alafenamide","avg_per_unit":{"value":47.417139647,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vemlidy / Tenofovir Alafenamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":128867,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vemlidy / Tenofovir Alafenamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Venlafaxine HCl ER|Venlafaxine HCl":{"brand_name":"Venlafaxine HCl ER","generic_name":"Venlafaxine HCl","avg_per_unit":{"value":0.3468962538,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Venlafaxine HCl ER / Venlafaxine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5423191,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Venlafaxine HCl ER / Venlafaxine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Venlafaxine HCl|Venlafaxine HCl":{"brand_name":"Venlafaxine HCl","generic_name":"Venlafaxine HCl","avg_per_unit":{"value":0.2757329043,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Venlafaxine HCl / Venlafaxine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":731696,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Venlafaxine HCl / Venlafaxine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ventolin HFA|Albuterol Sulfate":{"brand_name":"Ventolin HFA","generic_name":"Albuterol Sulfate","avg_per_unit":{"value":3.0545597215,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ventolin HFA / Albuterol Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":2272575,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ventolin HFA / Albuterol Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Veozah|Fezolinetant":{"brand_name":"Veozah","generic_name":"Fezolinetant","avg_per_unit":{"value":17.768407203,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Veozah / Fezolinetant: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":52827,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Veozah / Fezolinetant, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Verapamil ER PM|Verapamil HCl":{"brand_name":"Verapamil ER PM","generic_name":"Verapamil HCl","avg_per_unit":{"value":5.1033685906,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Verapamil ER PM / Verapamil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":51938,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Verapamil ER PM / Verapamil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Verapamil ER|Verapamil HCl":{"brand_name":"Verapamil ER","generic_name":"Verapamil HCl","avg_per_unit":{"value":0.3399526391,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Verapamil ER / Verapamil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1065275,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Verapamil ER / Verapamil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Verapamil HCl*|Verapamil HCl":{"brand_name":"Verapamil HCl*","generic_name":"Verapamil HCl","avg_per_unit":{"value":0.1004363587,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Verapamil HCl* / Verapamil HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 13 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":232510,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Verapamil HCl* / Verapamil HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Veregen|Sinecatechins":{"brand_name":"Veregen","generic_name":"Sinecatechins","avg_per_unit":{"value":51.677178241,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Veregen / Sinecatechins: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":126,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Veregen / Sinecatechins, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Verquvo|Vericiguat":{"brand_name":"Verquvo","generic_name":"Vericiguat","avg_per_unit":{"value":21.876845211,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Verquvo / Vericiguat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":49590,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Verquvo / Vericiguat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vestura|Ethinyl Estradiol/Drospirenone":{"brand_name":"Vestura","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.5449141506,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vestura / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1256,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vestura / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vevye|Cyclosporine":{"brand_name":"Vevye","generic_name":"Cyclosporine","avg_per_unit":{"value":366.29738894,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vevye / Cyclosporine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":15393,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vevye / Cyclosporine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Viagra|Sildenafil Citrate":{"brand_name":"Viagra","generic_name":"Sildenafil Citrate","avg_per_unit":{"value":82.095274692,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Viagra / Sildenafil Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":398,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Viagra / Sildenafil Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Viberzi|Eluxadoline":{"brand_name":"Viberzi","generic_name":"Eluxadoline","avg_per_unit":{"value":26.175694556,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Viberzi / Eluxadoline: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":34827,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Viberzi / Eluxadoline, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vienva|Levonorgestrel/Ethin.Estradiol":{"brand_name":"Vienva","generic_name":"Levonorgestrel/Ethin.Estradiol","avg_per_unit":{"value":0.3738324007,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vienva / Levonorgestrel/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9836,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vienva / Levonorgestrel/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vigamox|Moxifloxacin HCl":{"brand_name":"Vigamox","generic_name":"Moxifloxacin HCl","avg_per_unit":{"value":60.704013491,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vigamox / Moxifloxacin HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":489,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vigamox / Moxifloxacin HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Viibryd|Vilazodone HCl":{"brand_name":"Viibryd","generic_name":"Vilazodone HCl","avg_per_unit":{"value":11.0648066,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Viibryd / Vilazodone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13120,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Viibryd / Vilazodone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vilazodone HCl|Vilazodone HCl":{"brand_name":"Vilazodone HCl","generic_name":"Vilazodone HCl","avg_per_unit":{"value":2.4550512235,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vilazodone HCl / Vilazodone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":348016,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vilazodone HCl / Vilazodone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Viorele|Desog-E.Estradiol/E.Estradiol":{"brand_name":"Viorele","generic_name":"Desog-E.Estradiol/E.Estradiol","avg_per_unit":{"value":0.6059249878,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Viorele / Desog-E.Estradiol/E.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1347,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Viorele / Desog-E.Estradiol/E.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Viread|Tenofovir Disoproxil Fumarate":{"brand_name":"Viread","generic_name":"Tenofovir Disoproxil Fumarate","avg_per_unit":{"value":38.912348136,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Viread / Tenofovir Disoproxil Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1825,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Viread / Tenofovir Disoproxil Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vitafol Fe Plus|PNV 102/Iron/Folate/DHA":{"brand_name":"Vitafol Fe Plus","generic_name":"PNV 102/Iron/Folate/DHA","avg_per_unit":{"value":4.2893787879,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vitafol Fe Plus / PNV 102/Iron/Folate/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":14,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vitafol Fe Plus / PNV 102/Iron/Folate/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Vitafol Gummies|PNV 112/Iron/Folic/Om3/DHA/EPA":{"brand_name":"Vitafol Gummies","generic_name":"PNV 112/Iron/Folic/Om3/DHA/EPA","avg_per_unit":{"value":1.5328504834,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vitafol Gummies / PNV 112/Iron/Folic/Om3/DHA/EPA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":76,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vitafol Gummies / PNV 112/Iron/Folic/Om3/DHA/EPA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vitafol Ultra|PNV 67/Iron Ps/Folate No.1/DHA":{"brand_name":"Vitafol Ultra","generic_name":"PNV 67/Iron Ps/Folate No.1/DHA","avg_per_unit":{"value":4.3565041152,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vitafol Ultra / PNV 67/Iron Ps/Folate No.1/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":122,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vitafol Ultra / PNV 67/Iron Ps/Folate No.1/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vitafol-Ob|Prenatal Vit 10/Iron Fum/Folic":{"brand_name":"Vitafol-Ob","generic_name":"Prenatal Vit 10/Iron Fum/Folic","avg_per_unit":{"value":4.1520526316,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vitafol-Ob / Prenatal Vit 10/Iron Fum/Folic: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":42,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vitafol-Ob / Prenatal Vit 10/Iron Fum/Folic, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vitafol-One|Prenatal 26/Iron Ps/Folic/DHA":{"brand_name":"Vitafol-One","generic_name":"Prenatal 26/Iron Ps/Folic/DHA","avg_per_unit":{"value":3.91484254,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vitafol-One / Prenatal 26/Iron Ps/Folic/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":37,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vitafol-One / Prenatal 26/Iron Ps/Folic/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vitamin D2|Ergocalciferol (Vitamin D2)":{"brand_name":"Vitamin D2","generic_name":"Ergocalciferol (Vitamin D2)","avg_per_unit":{"value":0.8654841276,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vitamin D2 / Ergocalciferol (Vitamin D2): all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1731570,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vitamin D2 / Ergocalciferol (Vitamin D2), all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vivelle-Dot|Estradiol":{"brand_name":"Vivelle-Dot","generic_name":"Estradiol","avg_per_unit":{"value":18.290945396,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vivelle-Dot / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10989,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vivelle-Dot / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vivitrol|Naltrexone Microspheres":{"brand_name":"Vivitrol","generic_name":"Naltrexone Microspheres","avg_per_unit":{"value":1621.974214,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vivitrol / Naltrexone Microspheres: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":44521,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vivitrol / Naltrexone Microspheres, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Volnea|Desog-E.Estradiol/E.Estradiol":{"brand_name":"Volnea","generic_name":"Desog-E.Estradiol/E.Estradiol","avg_per_unit":{"value":0.4788221971,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Volnea / Desog-E.Estradiol/E.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1841,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Volnea / Desog-E.Estradiol/E.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Voquezna Dual Pak|Vonoprazan/Amoxicillin":{"brand_name":"Voquezna Dual Pak","generic_name":"Vonoprazan/Amoxicillin","avg_per_unit":{"value":6.9887239151,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Voquezna Dual Pak / Vonoprazan/Amoxicillin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":195,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Voquezna Dual Pak / Vonoprazan/Amoxicillin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Voquezna Triple Pak|Vonoprazan/Amoxicillin/Clarith":{"brand_name":"Voquezna Triple Pak","generic_name":"Vonoprazan/Amoxicillin/Clarith","avg_per_unit":{"value":6.9652502401,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Voquezna Triple Pak / Vonoprazan/Amoxicillin/Clarith: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":317,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Voquezna Triple Pak / Vonoprazan/Amoxicillin/Clarith, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Voquezna|Vonoprazan Fumarate":{"brand_name":"Voquezna","generic_name":"Vonoprazan Fumarate","avg_per_unit":{"value":20.760010497,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Voquezna / Vonoprazan Fumarate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":37589,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Voquezna / Vonoprazan Fumarate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vraylar|Cariprazine HCl":{"brand_name":"Vraylar","generic_name":"Cariprazine HCl","avg_per_unit":{"value":48.734458078,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vraylar / Cariprazine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":766962,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vraylar / Cariprazine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vtama|Tapinarof":{"brand_name":"Vtama","generic_name":"Tapinarof","avg_per_unit":{"value":23.009775895,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vtama / Tapinarof: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":18599,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vtama / Tapinarof, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vuity|Pilocarpine HCl":{"brand_name":"Vuity","generic_name":"Pilocarpine HCl","avg_per_unit":{"value":28.530641843,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vuity / Pilocarpine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":2220,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vuity / Pilocarpine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vusion|Miconazole Nitrate/Zinc Ox/Pet":{"brand_name":"Vusion","generic_name":"Miconazole Nitrate/Zinc Ox/Pet","avg_per_unit":{"value":11.0951,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vusion / Miconazole Nitrate/Zinc Ox/Pet: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":52,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vusion / Miconazole Nitrate/Zinc Ox/Pet, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vyfemla|Norethindrone-Ethin. Estradiol":{"brand_name":"Vyfemla","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.6643555901,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vyfemla / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":360,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vyfemla / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vylibra|Norgestimate-Ethinyl Estradiol":{"brand_name":"Vylibra","generic_name":"Norgestimate-Ethinyl Estradiol","avg_per_unit":{"value":0.3365924658,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vylibra / Norgestimate-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":81,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vylibra / Norgestimate-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vytorin|Ezetimibe/Simvastatin":{"brand_name":"Vytorin","generic_name":"Ezetimibe/Simvastatin","avg_per_unit":{"value":12.400528797,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vytorin / Ezetimibe/Simvastatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":5246,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vytorin / Ezetimibe/Simvastatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vyvanse|Lisdexamfetamine Dimesylate":{"brand_name":"Vyvanse","generic_name":"Lisdexamfetamine Dimesylate","avg_per_unit":{"value":12.880097108,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vyvanse / Lisdexamfetamine Dimesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":212410,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vyvanse / Lisdexamfetamine Dimesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Vyzulta|Latanoprostene Bunod":{"brand_name":"Vyzulta","generic_name":"Latanoprostene Bunod","avg_per_unit":{"value":98.838168853,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Vyzulta / Latanoprostene Bunod: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":292207,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Vyzulta / Latanoprostene Bunod, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Warfarin Sodium|Warfarin Sodium":{"brand_name":"Warfarin Sodium","generic_name":"Warfarin Sodium","avg_per_unit":{"value":0.1367417144,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Warfarin Sodium / Warfarin Sodium: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4665402,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Warfarin Sodium / Warfarin Sodium, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Welchol|Colesevelam HCl":{"brand_name":"Welchol","generic_name":"Colesevelam HCl","avg_per_unit":{"value":6.2489048098,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Welchol / Colesevelam HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3853,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Welchol / Colesevelam HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Wellbutrin SR|Bupropion HCl":{"brand_name":"Wellbutrin SR","generic_name":"Bupropion HCl","avg_per_unit":{"value":8.8796272216,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Wellbutrin SR / Bupropion HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6091,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Wellbutrin SR / Bupropion HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Wera|Norethindrone-Ethin. Estradiol":{"brand_name":"Wera","generic_name":"Norethindrone-Ethin. Estradiol","avg_per_unit":{"value":0.6291607043,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Wera / Norethindrone-Ethin. Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":465,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Wera / Norethindrone-Ethin. Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Wescap-Pn DHA|Multivit 47/Iron/Folate 1/DHA":{"brand_name":"Wescap-Pn DHA","generic_name":"Multivit 47/Iron/Folate 1/DHA","avg_per_unit":{"value":1.4803335786,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Wescap-Pn DHA / Multivit 47/Iron/Folate 1/DHA: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":119,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Wescap-Pn DHA / Multivit 47/Iron/Folate 1/DHA, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Wescaps|B Complex W-C No.20/Folic Acid":{"brand_name":"Wescaps","generic_name":"B Complex W-C No.20/Folic Acid","avg_per_unit":{"value":0.5366564417,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Wescaps / B Complex W-C No.20/Folic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. Outlier_Flag_2024 is blank in the file.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Wescaps / B Complex W-C No.20/Folic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":null}, "Westab Plus|PNV,Calcium 72/Iron/Folic Acid":{"brand_name":"Westab Plus","generic_name":"PNV,Calcium 72/Iron/Folic Acid","avg_per_unit":{"value":0.457111869,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Westab Plus / PNV,Calcium 72/Iron/Folic Acid: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":19402,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Westab Plus / PNV,Calcium 72/Iron/Folic Acid, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Winlevi|Clascoterone":{"brand_name":"Winlevi","generic_name":"Clascoterone","avg_per_unit":{"value":9.6424993113,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Winlevi / Clascoterone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":1883,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Winlevi / Clascoterone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Wixela Inhub|Fluticasone Propion/Salmeterol":{"brand_name":"Wixela Inhub","generic_name":"Fluticasone Propion/Salmeterol","avg_per_unit":{"value":1.5802110476,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Wixela Inhub / Fluticasone Propion/Salmeterol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":1281804,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Wixela Inhub / Fluticasone Propion/Salmeterol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Wymzya Fe|Noreth-Ethinyl Estradiol/Iron":{"brand_name":"Wymzya Fe","generic_name":"Noreth-Ethinyl Estradiol/Iron","avg_per_unit":{"value":1.6090270936,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Wymzya Fe / Noreth-Ethinyl Estradiol/Iron: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Wymzya Fe / Noreth-Ethinyl Estradiol/Iron, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xaciato|Clindamycin Phosphate":{"brand_name":"Xaciato","generic_name":"Clindamycin Phosphate","avg_per_unit":{"value":19.340096685,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xaciato / Clindamycin Phosphate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":65,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xaciato / Clindamycin Phosphate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xadago|Safinamide Mesylate":{"brand_name":"Xadago","generic_name":"Safinamide Mesylate","avg_per_unit":{"value":37.323213575,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xadago / Safinamide Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4385,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xadago / Safinamide Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xalatan|Latanoprost":{"brand_name":"Xalatan","generic_name":"Latanoprost","avg_per_unit":{"value":97.680037999,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xalatan / Latanoprost: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":10322,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xalatan / Latanoprost, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xanax|Alprazolam":{"brand_name":"Xanax","generic_name":"Alprazolam","avg_per_unit":{"value":7.7766724346,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xanax / Alprazolam: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20242,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xanax / Alprazolam, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xarelto|Rivaroxaban":{"brand_name":"Xarelto","generic_name":"Rivaroxaban","avg_per_unit":{"value":17.677331878,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xarelto / Rivaroxaban: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. 18 of 19 NADAC NDCs joined to this name are priced per EA (1 per ML): CMS's average mixes those units.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":6660246,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xarelto / Rivaroxaban, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xatmep|Methotrexate":{"brand_name":"Xatmep","generic_name":"Methotrexate","avg_per_unit":{"value":19.763117633,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xatmep / Methotrexate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":238,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xatmep / Methotrexate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xcopri|Cenobamate":{"brand_name":"Xcopri","generic_name":"Cenobamate","avg_per_unit":{"value":38.427469331,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xcopri / Cenobamate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":117028,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xcopri / Cenobamate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xeljanz XR|Tofacitinib Citrate":{"brand_name":"Xeljanz XR","generic_name":"Tofacitinib Citrate","avg_per_unit":{"value":190.71278516,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xeljanz XR / Tofacitinib Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":94342,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xeljanz XR / Tofacitinib Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xeljanz|Tofacitinib Citrate":{"brand_name":"Xeljanz","generic_name":"Tofacitinib Citrate","avg_per_unit":{"value":93.68269074,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xeljanz / Tofacitinib Citrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":48637,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xeljanz / Tofacitinib Citrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xelstrym|Dextroamphetamine":{"brand_name":"Xelstrym","generic_name":"Dextroamphetamine","avg_per_unit":{"value":15.86111961,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xelstrym / Dextroamphetamine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":417,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xelstrym / Dextroamphetamine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xenical|Orlistat":{"brand_name":"Xenical","generic_name":"Orlistat","avg_per_unit":{"value":5.6766387627,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xenical / Orlistat: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":198,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xenical / Orlistat, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xgeva|Denosumab":{"brand_name":"Xgeva","generic_name":"Denosumab","avg_per_unit":{"value":1850.8215438,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xgeva / Denosumab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":17654,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xgeva / Denosumab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xhance|Fluticasone Propionate":{"brand_name":"Xhance","generic_name":"Fluticasone Propionate","avg_per_unit":{"value":37.715894091,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xhance / Fluticasone Propionate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":25053,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xhance / Fluticasone Propionate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xigduo XR|Dapaglifloz Propaned/Metformin":{"brand_name":"Xigduo XR","generic_name":"Dapaglifloz Propaned/Metformin","avg_per_unit":{"value":13.607295617,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xigduo XR / Dapaglifloz Propaned/Metformin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":215012,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xigduo XR / Dapaglifloz Propaned/Metformin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xiidra|Lifitegrast":{"brand_name":"Xiidra","generic_name":"Lifitegrast","avg_per_unit":{"value":11.187889441,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xiidra / Lifitegrast: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":477354,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xiidra / Lifitegrast, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xofluza|Baloxavir Marboxil":{"brand_name":"Xofluza","generic_name":"Baloxavir Marboxil","avg_per_unit":{"value":158.91877173,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xofluza / Baloxavir Marboxil: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7723,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xofluza / Baloxavir Marboxil, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xopenex HFA|Levalbuterol Tartrate":{"brand_name":"Xopenex HFA","generic_name":"Levalbuterol Tartrate","avg_per_unit":{"value":4.5736133902,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xopenex HFA / Levalbuterol Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":15310,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xopenex HFA / Levalbuterol Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xulane|Norelgestromin/Ethin.Estradiol":{"brand_name":"Xulane","generic_name":"Norelgestromin/Ethin.Estradiol","avg_per_unit":{"value":28.002470735,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xulane / Norelgestromin/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4153,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xulane / Norelgestromin/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xultophy 100-3.6|Insulin Degludec/Liraglutide":{"brand_name":"Xultophy 100-3.6","generic_name":"Insulin Degludec/Liraglutide","avg_per_unit":{"value":81.566408423,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xultophy 100-3.6 / Insulin Degludec/Liraglutide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":57197,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xultophy 100-3.6 / Insulin Degludec/Liraglutide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Xyosted|Testosterone Enanthate":{"brand_name":"Xyosted","generic_name":"Testosterone Enanthate","avg_per_unit":{"value":301.73644577,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Xyosted / Testosterone Enanthate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":36669,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Xyosted / Testosterone Enanthate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Yasmin 28|Ethinyl Estradiol/Drospirenone":{"brand_name":"Yasmin 28","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":4.5987713956,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Yasmin 28 / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":153,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Yasmin 28 / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Yaz|Ethinyl Estradiol/Drospirenone":{"brand_name":"Yaz","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":5.8911336668,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Yaz / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":288,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Yaz / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Yuflyma(Cf) Autoinjector|Adalimumab-Aaty":{"brand_name":"Yuflyma(Cf) Autoinjector","generic_name":"Adalimumab-Aaty","avg_per_unit":{"value":3487.7681118,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Yuflyma(Cf) Autoinjector / Adalimumab-Aaty: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":739,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Yuflyma(Cf) Autoinjector / Adalimumab-Aaty, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Yupelri|Revefenacin":{"brand_name":"Yupelri","generic_name":"Revefenacin","avg_per_unit":{"value":16.807794626,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Yupelri / Revefenacin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":5673,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Yupelri / Revefenacin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Yuvafem|Estradiol":{"brand_name":"Yuvafem","generic_name":"Estradiol","avg_per_unit":{"value":7.0463898474,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Yuvafem / Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":203105,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Yuvafem / Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zafemy|Norelgestromin/Ethin.Estradiol":{"brand_name":"Zafemy","generic_name":"Norelgestromin/Ethin.Estradiol","avg_per_unit":{"value":30.246481057,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zafemy / Norelgestromin/Ethin.Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":4351,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zafemy / Norelgestromin/Ethin.Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zafirlukast|Zafirlukast":{"brand_name":"Zafirlukast","generic_name":"Zafirlukast","avg_per_unit":{"value":0.9996416268,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zafirlukast / Zafirlukast: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":66341,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zafirlukast / Zafirlukast, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zaleplon|Zaleplon":{"brand_name":"Zaleplon","generic_name":"Zaleplon","avg_per_unit":{"value":0.5191013447,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zaleplon / Zaleplon: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":176024,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zaleplon / Zaleplon, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zarontin|Ethosuximide":{"brand_name":"Zarontin","generic_name":"Ethosuximide","avg_per_unit":{"value":1.1324652397,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zarontin / Ethosuximide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":298,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zarontin / Ethosuximide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zarxio|Filgrastim-Sndz":{"brand_name":"Zarxio","generic_name":"Filgrastim-Sndz","avg_per_unit":{"value":526.7568166,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zarxio / Filgrastim-Sndz: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":24638,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zarxio / Filgrastim-Sndz, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zavzpret|Zavegepant HCl":{"brand_name":"Zavzpret","generic_name":"Zavegepant HCl","avg_per_unit":{"value":177.45654458,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zavzpret / Zavegepant HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7727,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zavzpret / Zavegepant HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zegalogue Autoinjector|Dasiglucagon HCl":{"brand_name":"Zegalogue Autoinjector","generic_name":"Dasiglucagon HCl","avg_per_unit":{"value":494.76577814,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zegalogue Autoinjector / Dasiglucagon HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":390,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zegalogue Autoinjector / Dasiglucagon HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zegalogue Syringe|Dasiglucagon HCl":{"brand_name":"Zegalogue Syringe","generic_name":"Dasiglucagon HCl","avg_per_unit":{"value":498.54880952,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zegalogue Syringe / Dasiglucagon HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":15,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zegalogue Syringe / Dasiglucagon HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Zembrace Symtouch|Sumatriptan Succinate":{"brand_name":"Zembrace Symtouch","generic_name":"Sumatriptan Succinate","avg_per_unit":{"value":379.30264183,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zembrace Symtouch / Sumatriptan Succinate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":1408,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zembrace Symtouch / Sumatriptan Succinate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zenatane|Isotretinoin":{"brand_name":"Zenatane","generic_name":"Isotretinoin","avg_per_unit":{"value":3.4678273505,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zenatane / Isotretinoin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":3444,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zenatane / Isotretinoin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zenzedi|Dextroamphetamine Sulfate":{"brand_name":"Zenzedi","generic_name":"Dextroamphetamine Sulfate","avg_per_unit":{"value":6.5994669556,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zenzedi / Dextroamphetamine Sulfate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":562,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zenzedi / Dextroamphetamine Sulfate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zepbound|Tirzepatide":{"brand_name":"Zepbound","generic_name":"Tirzepatide","avg_per_unit":{"value":509.13009512,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zepbound / Tirzepatide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":353,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zepbound / Tirzepatide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zerviate|Cetirizine HCl":{"brand_name":"Zerviate","generic_name":"Cetirizine HCl","avg_per_unit":{"value":7.3119738101,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zerviate / Cetirizine HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":10118,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zerviate / Cetirizine HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zestril|Lisinopril":{"brand_name":"Zestril","generic_name":"Lisinopril","avg_per_unit":{"value":12.561805472,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zestril / Lisinopril: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2794,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zestril / Lisinopril, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zetia|Ezetimibe":{"brand_name":"Zetia","generic_name":"Ezetimibe","avg_per_unit":{"value":12.442027581,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zetia / Ezetimibe: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7124,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zetia / Ezetimibe, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zidovudine|Zidovudine":{"brand_name":"Zidovudine","generic_name":"Zidovudine","avg_per_unit":{"value":0.7291252706,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zidovudine / Zidovudine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2642,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zidovudine / Zidovudine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zileuton ER|Zileuton":{"brand_name":"Zileuton ER","generic_name":"Zileuton","avg_per_unit":{"value":16.485834586,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zileuton ER / Zileuton: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":11167,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zileuton ER / Zileuton, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zioptan|Tafluprost/PF":{"brand_name":"Zioptan","generic_name":"Tafluprost/PF","avg_per_unit":{"value":8.1328384443,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zioptan / Tafluprost/PF: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":20424,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zioptan / Tafluprost/PF, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ziprasidone HCl|Ziprasidone HCl":{"brand_name":"Ziprasidone HCl","generic_name":"Ziprasidone HCl","avg_per_unit":{"value":1.0569441942,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ziprasidone HCl / Ziprasidone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":634457,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ziprasidone HCl / Ziprasidone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ziprasidone Mesylate|Ziprasidone Mesylate":{"brand_name":"Ziprasidone Mesylate","generic_name":"Ziprasidone Mesylate","avg_per_unit":{"value":35.172355861,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ziprasidone Mesylate / Ziprasidone Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2734,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ziprasidone Mesylate / Ziprasidone Mesylate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zirgan|Ganciclovir":{"brand_name":"Zirgan","generic_name":"Ganciclovir","avg_per_unit":{"value":93.039165241,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zirgan / Ganciclovir: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":18703,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zirgan / Ganciclovir, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zocor|Simvastatin":{"brand_name":"Zocor","generic_name":"Simvastatin","avg_per_unit":{"value":8.099876546,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zocor / Simvastatin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":2681,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zocor / Simvastatin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zolmitriptan ODT|Zolmitriptan":{"brand_name":"Zolmitriptan ODT","generic_name":"Zolmitriptan","avg_per_unit":{"value":8.8869799867,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zolmitriptan ODT / Zolmitriptan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. CMS outlier flag 1: the average is substantially affected by outlier records.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":9586,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zolmitriptan ODT / Zolmitriptan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":true}, "Zolmitriptan*|Zolmitriptan":{"brand_name":"Zolmitriptan*","generic_name":"Zolmitriptan","avg_per_unit":{"value":13.854985509,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zolmitriptan* / Zolmitriptan: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes ORAL point at this name (14 of the 18 the name join matched); NDCs of another route or with no known FDA route do not. 2 of the 14 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":43539,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zolmitriptan* / Zolmitriptan, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zoloft|Sertraline HCl":{"brand_name":"Zoloft","generic_name":"Sertraline HCl","avg_per_unit":{"value":13.812373296,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zoloft / Sertraline HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":13450,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zoloft / Sertraline HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zolpidem Tartrate ER|Zolpidem Tartrate":{"brand_name":"Zolpidem Tartrate ER","generic_name":"Zolpidem Tartrate","avg_per_unit":{"value":0.811676219,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zolpidem Tartrate ER / Zolpidem Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":371133,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zolpidem Tartrate ER / Zolpidem Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zolpidem Tartrate*|Zolpidem Tartrate":{"brand_name":"Zolpidem Tartrate*","generic_name":"Zolpidem Tartrate","avg_per_unit":{"value":0.1810704689,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zolpidem Tartrate* / Zolpidem Tartrate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 28 NADAC NDCs the name join matched to it have an FDA route including ORAL. 1 of the 28 NDCs that point at this name is not listed in the FDA NDC Directory as a package of its own; its route was taken from FDA's record for the same product (labeler and product code).","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":7548054,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zolpidem Tartrate* / Zolpidem Tartrate, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zomacton|Somatropin":{"brand_name":"Zomacton","generic_name":"Somatropin","avg_per_unit":{"value":515.44893386,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zomacton / Somatropin: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":46,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zomacton / Somatropin, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zonisade|Zonisamide":{"brand_name":"Zonisade","generic_name":"Zonisamide","avg_per_unit":{"value":2.5704903299,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zonisade / Zonisamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":3923,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zonisade / Zonisamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zonisamide|Zonisamide":{"brand_name":"Zonisamide","generic_name":"Zonisamide","avg_per_unit":{"value":0.2282144321,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zonisamide / Zonisamide: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on generic name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":412533,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zonisamide / Zonisamide, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zoryve|Roflumilast":{"brand_name":"Zoryve","generic_name":"Roflumilast","avg_per_unit":{"value":14.1527191,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zoryve / Roflumilast: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's GM. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"GM","period":"2024-01-01/2024-12-31"},"claims":{"value":29028,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zoryve / Roflumilast, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zovia 1-35|Ethynodiol D-Ethinyl Estradiol":{"brand_name":"Zovia 1-35","generic_name":"Ethynodiol D-Ethinyl Estradiol","avg_per_unit":{"value":0.5164429371,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zovia 1-35 / Ethynodiol D-Ethinyl Estradiol: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":639,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zovia 1-35 / Ethynodiol D-Ethinyl Estradiol, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Ztlido|Lidocaine":{"brand_name":"Ztlido","generic_name":"Lidocaine","avg_per_unit":{"value":11.642545535,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Ztlido / Lidocaine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":81208,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Ztlido / Lidocaine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zubsolv|Buprenorphine HCl/Naloxone HCl":{"brand_name":"Zubsolv","generic_name":"Buprenorphine HCl/Naloxone HCl","avg_per_unit":{"value":11.147488521,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zubsolv / Buprenorphine HCl/Naloxone HCl: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":49425,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zubsolv / Buprenorphine HCl/Naloxone HCl, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zumandimine|Ethinyl Estradiol/Drospirenone":{"brand_name":"Zumandimine","generic_name":"Ethinyl Estradiol/Drospirenone","avg_per_unit":{"value":0.5938440784,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zumandimine / Ethinyl Estradiol/Drospirenone: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":222,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zumandimine / Ethinyl Estradiol/Drospirenone, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zylet|Tobramycin/Lotepred Etab":{"brand_name":"Zylet","generic_name":"Tobramycin/Lotepred Etab","avg_per_unit":{"value":63.606383937,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zylet / Tobramycin/Lotepred Etab: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on brand name.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"ML","period":"2024-01-01/2024-12-31"},"claims":{"value":8050,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zylet / Tobramycin/Lotepred Etab, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false}, "Zyprexa*|Olanzapine":{"brand_name":"Zyprexa*","generic_name":"Olanzapine","avg_per_unit":{"value":29.027167734,"kind":"usd","state":"filed","reason":"Part D 2024 average spend per dosage unit for Zyprexa* / Olanzapine: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's EA. Joined on brand name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. All 2 NADAC NDCs the name join matched to it have an FDA route including ORAL.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"EA","period":"2024-01-01/2024-12-31"},"claims":{"value":8883,"kind":"count","state":"filed","reason":"Part D 2024 claims (fills incl. refills) for Zyprexa* / Olanzapine, all makers, strengths and forms.","source_name":"Medicare Part D","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug","source_file":"DSD_PTD_RY26_P04_V10_DY24_BGM.csv","effective_date":"2024-01-01","retrieved_date":"2026-10-18","as_of_date":"2026-06-25","per":"claim","period":"2024-01-01/2024-12-31"},"outlier":false} }, "part_b_codes": { "J0129":{"hcpcs":"J0129","hcpcs_dosage":"10 MG","short_description":"Abatacept injection","payment_limit":{"value":45.937,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0129, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0129 only in the settings CMS describes for this code; the file's short description of it is 'Abatacept injection'. Notes column for this code: '\"lesser of\" methodology applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0129 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '\"lesser of\" methodology applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["E.R. Squibb & Sons, L.L.C."]}, "J0169":{"hcpcs":"J0169","hcpcs_dosage":"0.1 MG","short_description":"Inj epinephrine (adrenalin)","payment_limit":{"value":0.869,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0169, dollars per 0.1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0169 only in the settings CMS describes for this code; the file's short description of it is 'Inj epinephrine (adrenalin)'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0169 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Endo USA, Inc.","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc."]}, "J0278":{"hcpcs":"J0278","hcpcs_dosage":"100 MG","short_description":"Amikacin sulfate injection","payment_limit":{"value":0.612,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0278, dollars per 100 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0278 only in the settings CMS describes for this code; the file's short description of it is 'Amikacin sulfate injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"100 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0278 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Mullan Pharmaceutical Inc.","Sagent Pharmaceuticals"]}, "J0282":{"hcpcs":"J0282","hcpcs_dosage":"30 MG","short_description":"Amiodarone hcl","payment_limit":{"value":0.384,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0282, dollars per 30 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0282 only in the settings CMS describes for this code; the file's short description of it is 'Amiodarone hcl'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"30 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0282 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Mylan Institutional LLC","Sagent Pharmaceuticals","Slate Run Pharmaceuticals"]}, "J0401":{"hcpcs":"J0401","hcpcs_dosage":"1 MG","short_description":"Inj, abilify maintena, 1 mg","payment_limit":{"value":7.456,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0401, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0401 only in the settings CMS describes for this code; the file's short description of it is 'Inj, abilify maintena, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0401 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Otsuka America Pharmaceuticals Inc."]}, "J0402":{"hcpcs":"J0402","hcpcs_dosage":"1 MG","short_description":"Inj, abilify asimtufii, 1 mg","payment_limit":{"value":6.185,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0402, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0402 only in the settings CMS describes for this code; the file's short description of it is 'Inj, abilify asimtufii, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0402 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Otsuka America Pharmaceuticals Inc."]}, "J0665":{"hcpcs":"J0665","hcpcs_dosage":"0.5 MG","short_description":"Inj, bupivacaine, nos, 0.5mg","payment_limit":{"value":0.01,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0665, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0665 only in the settings CMS describes for this code; the file's short description of it is 'Inj, bupivacaine, nos, 0.5mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0665 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Brookfield Pharmaceuticals, LLC","Eugia US LLC","Fosun Pharma Usa Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Northstar RxLLC","Pfizer Inc","Somerset Pharma, LLC","Xellia Pharmaceuticals USA, LLC."]}, "J0690":{"hcpcs":"J0690","hcpcs_dosage":"500 MG","short_description":"Cefazolin sodium injection","payment_limit":{"value":0.781,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0690, dollars per 500 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0690 only in the settings CMS describes for this code; the file's short description of it is 'Cefazolin sodium injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"500 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0690 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Apotex Corp","B. Braun Medical Inc.","Civica, Inc.","FreseniUS Kabi USA, LLC","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Sagent Pharmaceuticals","Sandoz Inc.","WG Critical Care, LLC"]}, "J0696":{"hcpcs":"J0696","hcpcs_dosage":"250 MG","short_description":"Ceftriaxone sodium injection","payment_limit":{"value":0.39,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0696, dollars per 250 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0696 only in the settings CMS describes for this code; the file's short description of it is 'Ceftriaxone sodium injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"250 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0696 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Apotex Corp","B. Braun Medical Inc.","Baxter Healthcare Corporation","Civica, Inc.","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Sagent Pharmaceuticals","Sandoz Inc.","WG Critical Care, LLC"]}, "J0702":{"hcpcs":"J0702","hcpcs_dosage":"3 MG & 3 MG","short_description":"Betamethasone acet&sod phosp","payment_limit":{"value":7.175,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0702, dollars per 3 MG & 3 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0702 only in the settings CMS describes for this code; the file's short description of it is 'Betamethasone acet&sod phosp'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"3 MG & 3 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0702 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Regent, Inc.","Organon LLC"]}, "J0713":{"hcpcs":"J0713","hcpcs_dosage":"500 MG","short_description":"Inj ceftazidime per 500 mg","payment_limit":{"value":1.549,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0713, dollars per 500 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0713 only in the settings CMS describes for this code; the file's short description of it is 'Inj ceftazidime per 500 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"500 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0713 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Pfizer Inc","Sagent Pharmaceuticals","WG Critical Care, LLC"]}, "J0717":{"hcpcs":"J0717","hcpcs_dosage":"1 MG","short_description":"Certolizumab pegol inj 1mg","payment_limit":{"value":3.14,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0717, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0717 only in the settings CMS describes for this code; the file's short description of it is 'Certolizumab pegol inj 1mg'. Notes column for this code: '\"lesser of\" methodology applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0717 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '\"lesser of\" methodology applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["UCB, INC.","UCB, Inc."]}, "J0725":{"hcpcs":"J0725","hcpcs_dosage":"1000 UNITS","short_description":"Chorionic gonadotropin/1000u","payment_limit":{"value":14.439,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0725, dollars per 1000 UNITS, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0725 only in the settings CMS describes for this code; the file's short description of it is 'Chorionic gonadotropin/1000u'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1000 UNITS","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0725 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Ferring Pharmaceuticals Inc.","FreseniUS Kabi USA, LLC","Organon LLC"]}, "J0770":{"hcpcs":"J0770","hcpcs_dosage":"150 MG","short_description":"Colistimethate sodium inj","payment_limit":{"value":18.051,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0770, dollars per 150 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0770 only in the settings CMS describes for this code; the file's short description of it is 'Colistimethate sodium inj'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"150 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0770 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Endo USA, Inc.","FreseniUS Kabi USA, LLC","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals Usa Inc.","Xellia Pharmaceuticals USA, LLC."]}, "J0878":{"hcpcs":"J0878","hcpcs_dosage":"1 MG","short_description":"Daptomycin injection","payment_limit":{"value":0.027,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0878, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0878 only in the settings CMS describes for this code; the file's short description of it is 'Daptomycin injection'. Notes column for this code: 'AMP-based payment limit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0878 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'AMP-based payment limit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Accord Healthcare Inc","Apotex Corp","BE Pharmaceuticals Inc.","Biocon Pharma Inc","BluePoint Laboratories","Civica, Inc.","Dr. Reddy's Laboratories Inc.","Eugia US LLC","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Mylan Institutional LLC","Northstar RxLLC","Sagent Pharmaceuticals","Xellia Pharmaceuticals USA, LLC."]}, "J0897":{"hcpcs":"J0897","hcpcs_dosage":"1 MG","short_description":"Denosumab injection","payment_limit":{"value":29.856,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J0897, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J0897 only in the settings CMS describes for this code; the file's short description of it is 'Denosumab injection'. Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":17.885,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J0897 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amgen Inc"]}, "J1000":{"hcpcs":"J1000","hcpcs_dosage":"5 MG","short_description":"Depo-estradiol cypionate inj","payment_limit":{"value":53.805,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1000, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1000 only in the settings CMS describes for this code; the file's short description of it is 'Depo-estradiol cypionate inj'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1000 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Pfizer Inc"]}, "J1010":{"hcpcs":"J1010","hcpcs_dosage":"1 MG","short_description":"Inj, methylpred acetate 1 mg","payment_limit":{"value":0.123,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1010, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1010 only in the settings CMS describes for this code; the file's short description of it is 'Inj, methylpred acetate 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1010 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Amneal Pharmaceuticals, LLC","Endo USA, Inc.","Eugia US LLC","Pfizer Inc","Sagent Pharmaceuticals","Sandoz Inc."]}, "J1071":{"hcpcs":"J1071","hcpcs_dosage":"1 MG","short_description":"Inj testosterone cypionate","payment_limit":{"value":0.023,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1071, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1071 only in the settings CMS describes for this code; the file's short description of it is 'Inj testosterone cypionate'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1071 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Actavis Pharma, Inc.","Alvogen, Inc.","Cipla USA, Inc.","Eugia US LLC","Hikma Pharmaceuticals USA Inc.","Northstar RxLLC","Padagis US LLC","Pfizer Inc","Xiromed, LLC"]}, "J1100":{"hcpcs":"J1100","hcpcs_dosage":"1 MG","short_description":"Dexamethasone sodium phos","payment_limit":{"value":0.099,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1100, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1100 only in the settings CMS describes for this code; the file's short description of it is 'Dexamethasone sodium phos'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1100 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Armas Pharmaceuticals Inc.","Civica, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Mylan Institutional LLC","Phlow Corporation","Sagent Pharmaceuticals","Somerset Pharma, LLC"]}, "J1171":{"hcpcs":"J1171","hcpcs_dosage":"0.1 MG","short_description":"Inj, hydromorphone, 0.1 mg","payment_limit":{"value":0.224,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1171, dollars per 0.1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1171 only in the settings CMS describes for this code; the file's short description of it is 'Inj, hydromorphone, 0.1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1171 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Teva Parenteral Medicines, Inc."]}, "J1200":{"hcpcs":"J1200","hcpcs_dosage":"50 MG","short_description":"Diphenhydramine hcl injectio","payment_limit":{"value":0.855,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1200, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1200 only in the settings CMS describes for this code; the file's short description of it is 'Diphenhydramine hcl injectio'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1200 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Armas Pharmaceuticals Inc.","Avenacy Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Micro Labs Limited","Sagent Pharmaceuticals"]}, "J1308":{"hcpcs":"J1308","hcpcs_dosage":"0.25 MG","short_description":"Inj, famotidine, 0.25 mg","payment_limit":{"value":0.009,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1308, dollars per 0.25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1308 only in the settings CMS describes for this code; the file's short description of it is 'Inj, famotidine, 0.25 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1308 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Athenex Pharmaceutical Division, LLC","Baxter Healthcare Corporation","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Hikma Pharmaceuticals USA Inc.","Mylan Institutional LLC","Sagent Pharmaceuticals"]}, "J1335":{"hcpcs":"J1335","hcpcs_dosage":"500 MG","short_description":"Ertapenem injection","payment_limit":{"value":5.826,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1335, dollars per 500 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1335 only in the settings CMS describes for this code; the file's short description of it is 'Ertapenem injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"500 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1335 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Apotex Corp","BluePoint Laboratories","Dr. Reddy's Laboratories Inc.","Endo USA, Inc.","Eugia US LLC","Fosun Pharma USA Inc.","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Northstar RxLLC","Pfizer Inc","Sagent Pharmaceuticals","WG Critical Care, LLC"]}, "J1380":{"hcpcs":"J1380","hcpcs_dosage":"10 MG","short_description":"Estradiol valerate 10 mg inj","payment_limit":{"value":7.693,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1380, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1380 only in the settings CMS describes for this code; the file's short description of it is 'Estradiol valerate 10 mg inj'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1380 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Regent, Inc.","Endo USA, Inc.","Hikma Pharmaceuticals USA Inc.","Padagis US LLC","Xiromed, LLC"]}, "J1442":{"hcpcs":"J1442","hcpcs_dosage":"1 MCG","short_description":"Inj filgrastim excl biosimil","payment_limit":{"value":0.994,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1442, dollars per 1 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1442 only in the settings CMS describes for this code; the file's short description of it is 'Inj filgrastim excl biosimil'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1442 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amgen Inc"]}, "J1580":{"hcpcs":"J1580","hcpcs_dosage":"80 MG","short_description":"Garamycin gentamicin inj","payment_limit":{"value":1.849,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1580, dollars per 80 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1580 only in the settings CMS describes for this code; the file's short description of it is 'Garamycin gentamicin inj'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"80 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1580 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Baxter Healthcare Corporation","Eugia US LLC","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Pfizer Inc"]}, "J1596":{"hcpcs":"J1596","hcpcs_dosage":"0.1 MG","short_description":"Inj, glycopyrrolate, 0.1 mg","payment_limit":{"value":0.33,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1596, dollars per 0.1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1596 only in the settings CMS describes for this code; the file's short description of it is 'Inj, glycopyrrolate, 0.1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1596 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Alembic Pharmaceuticals Inc.","American Regent, Inc.","Amneal Pharmaceuticals, LLC","Apotex Corp","Athenex Pharmaceutical Division, LLC","BE Pharmaceuticals Inc.","Civica, Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Piramal Critical Care Inc","Sagent Pharmaceuticals","Sandoz Inc.","Somerset Pharma, LLC","Xiromed, LLC"]}, "J1610":{"hcpcs":"J1610","hcpcs_dosage":"1 MG","short_description":"Glucagon hydrochloride/1 mg","payment_limit":{"value":105.492,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1610, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1610 only in the settings CMS describes for this code; the file's short description of it is 'Glucagon hydrochloride/1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1610 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Amphastar Pharmaceuticals, Inc.","Cipla Usa, Inc.","Mylan Pharmaceuticals Inc.","Novo Nordisk, Inc."]}, "J1611":{"hcpcs":"J1611","hcpcs_dosage":"1 MG","short_description":"Inj glucagon hcl, fresenius","payment_limit":{"value":134.892,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1611, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1611 only in the settings CMS describes for this code; the file's short description of it is 'Inj glucagon hcl, fresenius'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1611 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC"]}, "J1628":{"hcpcs":"J1628","hcpcs_dosage":"1 MG","short_description":"Inj., guselkumab, 1 mg","payment_limit":{"value":66.998,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1628, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1628 only in the settings CMS describes for this code; the file's short description of it is 'Inj., guselkumab, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1628 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Janssen Biotech, Inc."]}, "J1630":{"hcpcs":"J1630","hcpcs_dosage":"5 MG","short_description":"Haloperidol injection","payment_limit":{"value":0.632,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1630, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1630 only in the settings CMS describes for this code; the file's short description of it is 'Haloperidol injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1630 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Mylan Institutional LLC","Sagent Pharmaceuticals"]}, "J1631":{"hcpcs":"J1631","hcpcs_dosage":"50 MG","short_description":"Haloperidol decanoate inj","payment_limit":{"value":4.847,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1631, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1631 only in the settings CMS describes for this code; the file's short description of it is 'Haloperidol decanoate inj'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1631 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Armas Pharmaceuticals Inc.","BluePoint Laboratories","Caplin Steriles USA Inc.","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Janssen Pharmaceuticals, Inc.","Lifestar Pharma","Meitheal Pharmaceuticals Inc.","Mylan Institutional LLC","Northstar RxLLC","Patriot Pharmaceuticals, LLC","Sagent Pharmaceuticals","Somerset Pharma, LLC","Zydus Pharmaceuticals (USA) Inc."]}, "J1644":{"hcpcs":"J1644","hcpcs_dosage":"1000 UNITS","short_description":"Inj heparin sodium per 1000u","payment_limit":{"value":0.201,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1644, dollars per 1000 UNITS, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1644 only in the settings CMS describes for this code; the file's short description of it is 'Inj heparin sodium per 1000u'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1000 UNITS","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1644 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["B. Braun Medical Inc.","BE Pharmaceuticals Inc.","Baxter Healthcare Corporation","Civica, Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hepalink USA, Inc.","Hikma Pharmaceuticals USA Inc.","McKesson Corporation dba SKY Packaging","Meitheal Pharmaceuticals Inc.","Mylan Institutional LLC","Northstar RxLLC","Pfizer Inc","Phlow Corporation","Sagent Pharmaceuticals","Sandoz Inc."]}, "J1650":{"hcpcs":"J1650","hcpcs_dosage":"10 MG","short_description":"Inj enoxaparin sodium","payment_limit":{"value":0.497,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1650, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1650 only in the settings CMS describes for this code; the file's short description of it is 'Inj enoxaparin sodium'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1650 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amphastar Pharmaceuticals, Inc.","Apotex Corp","BE Pharmaceuticals Inc.","BluePoint Laboratories","Civica, Inc.","FreseniUS Kabi USA, LLC","Hepalink USA, Inc.","Meitheal Pharmaceuticals Inc.","Northstar RxLLC","Sagent Pharmaceuticals","Sandoz Inc.","Sanofi-Aventis U.S. LLC","Zydus Pharmaceuticals (USA) Inc."]}, "J1652":{"hcpcs":"J1652","hcpcs_dosage":"0.5 MG","short_description":"Fondaparinux sodium","payment_limit":{"value":0.798,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1652, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1652 only in the settings CMS describes for this code; the file's short description of it is 'Fondaparinux sodium'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1652 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Dr. Reddy's Laboratories Inc.","Eugia US LLC","Mylan Institutional LLC","Sandoz Inc.","Zydus Pharmaceuticals (USA) Inc."]}, "J1720":{"hcpcs":"J1720","hcpcs_dosage":"100 MG","short_description":"Hydrocortisone sodium succ i","payment_limit":{"value":23.149,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1720, dollars per 100 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1720 only in the settings CMS describes for this code; the file's short description of it is 'Hydrocortisone sodium succ i'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"100 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1720 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Apotex Corp","Cipla USA, Inc.","HF Acquisition Co. LLC, DBA HealthFirst","Pfizer Inc","Zydus Pharmaceuticals (USA) Inc."]}, "J1740":{"hcpcs":"J1740","hcpcs_dosage":"1 MG","short_description":"Ibandronate sodium injection","payment_limit":{"value":43.68,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1740, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1740 only in the settings CMS describes for this code; the file's short description of it is 'Ibandronate sodium injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1740 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Apotex Corp","Eugia US LLC","Sagent Pharmaceuticals"]}, "J1750":{"hcpcs":"J1750","hcpcs_dosage":"50 MG","short_description":"Inj iron dextran","payment_limit":{"value":19.005,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1750, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1750 only in the settings CMS describes for this code; the file's short description of it is 'Inj iron dextran'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1750 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Allergan, Inc.","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc."]}, "J1811":{"hcpcs":"J1811","hcpcs_dosage":"50 UNITS","short_description":"Fiasp for insulin pump use","payment_limit":{"value":1.181,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1811, dollars per 50 UNITS, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1811 only in the settings CMS describes for this code; the file's short description of it is 'Fiasp for insulin pump use'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 UNITS","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1811 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Novo Nordisk, Inc"]}, "J1813":{"hcpcs":"J1813","hcpcs_dosage":"50 UNITS","short_description":"Lyumjev for insulin pump use","payment_limit":{"value":3.903,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1813, dollars per 50 UNITS, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1813 only in the settings CMS describes for this code; the file's short description of it is 'Lyumjev for insulin pump use'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 UNITS","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1813 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Eli Lilly and Company"]}, "J1817":{"hcpcs":"J1817","hcpcs_dosage":"50 UNITS","short_description":"Insulin for insulin pump use","payment_limit":{"value":3.116,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1817, dollars per 50 UNITS, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1817 only in the settings CMS describes for this code; the file's short description of it is 'Insulin for insulin pump use'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 UNITS","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1817 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Eli Lilly and Company","Novo Nordisk, Inc","Sanofi-Aventis U.S. LLC"]}, "J1885":{"hcpcs":"J1885","hcpcs_dosage":"15 MG","short_description":"Ketorolac tromethamine inj","payment_limit":{"value":0.569,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1885, dollars per 15 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1885 only in the settings CMS describes for this code; the file's short description of it is 'Ketorolac tromethamine inj'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"15 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1885 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Alembic Pharmaceuticals Inc.","Athenex Pharmaceutical Division, LLC","Baxter Healthcare Corporation","Caplin Steriles USA Inc.","Civica, Inc.","Fosun Pharma USA Inc.","FreseniUS Kabi USA, LLC","Glenmark Pharmaceuticals Inc., USA","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Nephron SC, Inc.","Northstar RxLLC","Pfizer Inc","Sagent Pharmaceuticals","Sola Pharmaceuticals"]}, "J1920":{"hcpcs":"J1920","hcpcs_dosage":"5 MG","short_description":"Inj, labetalol hcl, 5mg","payment_limit":{"value":0.588,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1920, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1920 only in the settings CMS describes for this code; the file's short description of it is 'Inj, labetalol hcl, 5mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1920 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amneal Pharmaceuticals, LLC","Baxter Healthcare Corporation","Caplin Steriles USA Inc.","Civica, Inc.","Fosun Pharma USA Inc.","HF Acquisition Co. LLC, DBA HealthFirst","Hikma Pharmaceuticals USA Inc.","Mullan Pharmaceutical Inc.","Northstar RxLLC","Pfizer Inc","Sagent Pharmaceuticals"]}, "J1938":{"hcpcs":"J1938","hcpcs_dosage":"1 MG","short_description":"Inj, furosemide, 1 mg","payment_limit":{"value":0.018,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1938, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1938 only in the settings CMS describes for this code; the file's short description of it is 'Inj, furosemide, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1938 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Accord Healthcare Inc","Amneal Pharmaceuticals, LLC","Athenex Pharmaceutical Division, LLC","Avenacy Inc.","Baxter Healthcare Corporation","Civica, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Northstar RxLLC","Pfizer Inc","Phlow Corporation","Sagent Pharmaceuticals"]}, "J1943":{"hcpcs":"J1943","hcpcs_dosage":"1 MG","short_description":"Inj., aristada initio, 1 mg","payment_limit":{"value":3.459,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1943, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1943 only in the settings CMS describes for this code; the file's short description of it is 'Inj., aristada initio, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1943 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Alkermes, Inc."]}, "J1944":{"hcpcs":"J1944","hcpcs_dosage":"1 MG","short_description":"Aripiprazole lauroxil 1 mg","payment_limit":{"value":3.55,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1944, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1944 only in the settings CMS describes for this code; the file's short description of it is 'Aripiprazole lauroxil 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1944 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Alkermes, Inc."]}, "J1950":{"hcpcs":"J1950","hcpcs_dosage":"3.75 MG","short_description":"Leuprolide acetate /3.75 mg","payment_limit":{"value":1799.052,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J1950, dollars per 3.75 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J1950 only in the settings CMS describes for this code; the file's short description of it is 'Leuprolide acetate /3.75 mg'. Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"3.75 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":18.505,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J1950 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["AbbVie Inc."]}, "J2060":{"hcpcs":"J2060","hcpcs_dosage":"2 MG","short_description":"Lorazepam injection","payment_limit":{"value":2.197,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2060, dollars per 2 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2060 only in the settings CMS describes for this code; the file's short description of it is 'Lorazepam injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"2 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2060 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Civica, Inc.","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Pfizer Inc"]}, "J2185":{"hcpcs":"J2185","hcpcs_dosage":"100 MG","short_description":"Meropenem","payment_limit":{"value":0.358,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2185, dollars per 100 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2185 only in the settings CMS describes for this code; the file's short description of it is 'Meropenem'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"100 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2185 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amneal Pharmaceuticals, LLC","Armas Pharmaceuticals Inc.","Civica, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Sagent Pharmaceuticals","Sandoz Inc.","WG Critical Care, LLC","Xellia Pharmaceuticals USA, LLC."]}, "J2250":{"hcpcs":"J2250","hcpcs_dosage":"1 MG","short_description":"Inj midazolam hydrochloride","payment_limit":{"value":0.167,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2250, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2250 only in the settings CMS describes for this code; the file's short description of it is 'Inj midazolam hydrochloride'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2250 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Almaject, Inc.","Athenex Pharmaceutical Division, LLC","Civica, Inc.","FreseniUS Kabi USA, LLC","Henry Schein Inc.","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Sagent Pharmaceuticals","Somerset Pharma, LLC"]}, "J2270":{"hcpcs":"J2270","hcpcs_dosage":"10 MG","short_description":"Morphine sulfate injection","payment_limit":{"value":7.259,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2270, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2270 only in the settings CMS describes for this code; the file's short description of it is 'Morphine sulfate injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2270 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Civica, Inc.","Hikma Pharmaceuticals USA Inc.","Pfizer Inc"]}, "J2300":{"hcpcs":"J2300","hcpcs_dosage":"10 MG","short_description":"Inj nalbuphine hydrochloride","payment_limit":{"value":4.071,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2300, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2300 only in the settings CMS describes for this code; the file's short description of it is 'Inj nalbuphine hydrochloride'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2300 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Pfizer Inc","Somerset Pharma, LLC"]}, "J2312":{"hcpcs":"J2312","hcpcs_dosage":"0.01 MG","short_description":"Inj naloxone hcl nos, 0.01mg","payment_limit":{"value":0.076,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2312, dollars per 0.01 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2312 only in the settings CMS describes for this code; the file's short description of it is 'Inj naloxone hcl nos, 0.01mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.01 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2312 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Baxter Healthcare Corporation","Civica, Inc.","Dr. Reddy's Laboratories Inc.","Endo USA, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Lifestar Pharma","Mylan Institutional LLC","Northstar RxLLC","Pfizer Inc","Somerset Pharma, LLC"]}, "J2315":{"hcpcs":"J2315","hcpcs_dosage":"1 MG","short_description":"Naltrexone, depot form","payment_limit":{"value":4.537,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2315, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2315 only in the settings CMS describes for this code; the file's short description of it is 'Naltrexone, depot form'. Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":19.283,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2315 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Alkermes, Inc."]}, "J2353":{"hcpcs":"J2353","hcpcs_dosage":"1 MG","short_description":"Octreotide injection, depot","payment_limit":{"value":211.321,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2353, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2353 only in the settings CMS describes for this code; the file's short description of it is 'Octreotide injection, depot'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2353 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Mylan Institutional LLC","Novartis Pharmaceuticals Corporation","Teva Pharmaceuticals USA, Inc."]}, "J2354":{"hcpcs":"J2354","hcpcs_dosage":"25 MCG","short_description":"Octreotide inj, non-depot","payment_limit":{"value":0.574,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2354, dollars per 25 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2354 only in the settings CMS describes for this code; the file's short description of it is 'Octreotide inj, non-depot'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"25 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2354 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC","Glenmark Pharmaceuticals Inc., USA","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Mylan Institutional LLC","Novartis Pharmaceuticals Corporation","Sagent Pharmaceuticals"]}, "J2359":{"hcpcs":"J2359","hcpcs_dosage":"0.5 MG","short_description":"Inj. olanzapine, 0.5mg","payment_limit":{"value":0.615,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2359, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2359 only in the settings CMS describes for this code; the file's short description of it is 'Inj. olanzapine, 0.5mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2359 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Regent, Inc.","Eugia US LLC","Glenmark Pharmaceuticals Inc., USA","Hikma Pharmaceuticals USA Inc.","Northstar RxLLC","PAI Holdings, LLC","Sandoz Inc.","XGen Pharmaceuticals DJB, Inc."]}, "J2360":{"hcpcs":"J2360","hcpcs_dosage":"60 MG","short_description":"Orphenadrine injection","payment_limit":{"value":6.274,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2360, dollars per 60 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2360 only in the settings CMS describes for this code; the file's short description of it is 'Orphenadrine injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"60 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2360 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Hikma Pharmaceuticals USA Inc.","Sagent Pharmaceuticals"]}, "J2405":{"hcpcs":"J2405","hcpcs_dosage":"1 MG","short_description":"Ondansetron hcl injection","payment_limit":{"value":0.084,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2405, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2405 only in the settings CMS describes for this code; the file's short description of it is 'Ondansetron hcl injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2405 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Accord Healthcare Inc","Apotex Corp","Athenex Pharmaceutical Division, LLC","Baxter Healthcare Corporation","Civica, Inc.","Fosun Pharma USA Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Sagent Pharmaceuticals"]}, "J2426":{"hcpcs":"J2426","hcpcs_dosage":"1 MG","short_description":"Inj, invega sustenna, 1 mg","payment_limit":{"value":15.437,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2426, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2426 only in the settings CMS describes for this code; the file's short description of it is 'Inj, invega sustenna, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2426 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Janssen Pharmaceuticals, Inc."]}, "J2427":{"hcpcs":"J2427","hcpcs_dosage":"1MG","short_description":"Inj, invega hafyera/trinza","payment_limit":{"value":13.246,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2427, dollars per 1MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2427 only in the settings CMS describes for this code; the file's short description of it is 'Inj, invega hafyera/trinza'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2427 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Janssen Pharmaceuticals, Inc."]}, "J2543":{"hcpcs":"J2543","hcpcs_dosage":"1.125 GM","short_description":"Piperacillin/tazobactam","payment_limit":{"value":1.183,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2543, dollars per 1.125 GM, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2543 only in the settings CMS describes for this code; the file's short description of it is 'Piperacillin/tazobactam'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1.125 GM","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2543 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Apollo Pharmaceuticals","Apollo Pharmaceuticals Inc.","Apotex Corp","Armas Pharmaceuticals Inc.","Athenex Pharmaceutical Division, LLC","Avenacy Inc.","B. Braun Medical Inc.","Baxter Healthcare Corporation","BluePoint Laboratories","Civica, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","Pfizer Inc","Piramal Critical Care Inc","Sagent Pharmaceuticals","Sandoz Inc.","WG Critical Care, LLC"]}, "J2550":{"hcpcs":"J2550","hcpcs_dosage":"50 MG","short_description":"Promethazine hcl injection","payment_limit":{"value":3.241,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2550, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2550 only in the settings CMS describes for this code; the file's short description of it is 'Promethazine hcl injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2550 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","XGen Pharmaceuticals DJB, Inc."]}, "J2597":{"hcpcs":"J2597","hcpcs_dosage":"1 MCG","short_description":"Inj desmopressin acetate","payment_limit":{"value":3.475,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2597, dollars per 1 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2597 only in the settings CMS describes for this code; the file's short description of it is 'Inj desmopressin acetate'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2597 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Athenex Pharmaceutical Division, LLC","Avenacy Inc.","Dr. Reddy's Laboratories Inc.","Ferring Pharmaceuticals Inc.","FreseniUS Kabi USA, LLC","Nordic Pharma, Inc","Sagent Pharmaceuticals","Sun Pharmaceutical Industries, Inc.","XGen Pharmaceuticals DJB, Inc."]}, "J2675":{"hcpcs":"J2675","hcpcs_dosage":"50 MG","short_description":"Inj progesterone per 50 mg","payment_limit":{"value":0.623,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2675, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2675 only in the settings CMS describes for this code; the file's short description of it is 'Inj progesterone per 50 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2675 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Actavis Pharma, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Xiromed, LLC"]}, "J2680":{"hcpcs":"J2680","hcpcs_dosage":"25 MG","short_description":"Fluphenazine decanoate 25 mg","payment_limit":{"value":6.174,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2680, dollars per 25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2680 only in the settings CMS describes for this code; the file's short description of it is 'Fluphenazine decanoate 25 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2680 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Endo USA, Inc.","Eugia US LLC","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Mylan Institutional LLC","Novadoz Pharmaceuticals LLC","Sagent Pharmaceuticals"]}, "J2704":{"hcpcs":"J2704","hcpcs_dosage":"10 MG","short_description":"Inj, propofol, 10 mg","payment_limit":{"value":0.093,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2704, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2704 only in the settings CMS describes for this code; the file's short description of it is 'Inj, propofol, 10 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2704 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amneal Pharmaceuticals Private Limited","Amneal Pharmaceuticals, LLC","Avenacy Inc.","Civica, Inc.","Dr. Reddy's Laboratories Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals, Inc.","Northstar RxLLC","Pfizer Inc","Sagent Pharmaceuticals"]}, "J2765":{"hcpcs":"J2765","hcpcs_dosage":"10 MG","short_description":"Metoclopramide hcl injection","payment_limit":{"value":0.891,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2765, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2765 only in the settings CMS describes for this code; the file's short description of it is 'Metoclopramide hcl injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2765 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Avenacy Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Heritage Pharmaceuticals Inc.","Pfizer Inc","Teva Parenteral Medicines, Inc."]}, "J2794":{"hcpcs":"J2794","hcpcs_dosage":"0.5 MG","short_description":"Inj risperdal consta, 0.5 mg","payment_limit":{"value":10.662,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2794, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2794 only in the settings CMS describes for this code; the file's short description of it is 'Inj risperdal consta, 0.5 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2794 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amneal Pharmaceuticals, LLC","Janssen Pharmaceuticals, Inc.","Lupin Pharmaceuticals, Inc.","Teva Pharmaceuticals USA, Inc."]}, "J2798":{"hcpcs":"J2798","hcpcs_dosage":"0.5 mg","short_description":"Inj., perseris, 0.5 mg","payment_limit":{"value":12.191,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2798, dollars per 0.5 mg, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2798 only in the settings CMS describes for this code; the file's short description of it is 'Inj., perseris, 0.5 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 mg","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2798 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Indivior Inc."]}, "J2799":{"hcpcs":"J2799","hcpcs_dosage":"1 MG","short_description":"Inj, uzedy, 1 mg","payment_limit":{"value":26.227,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2799, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2799 only in the settings CMS describes for this code; the file's short description of it is 'Inj, uzedy, 1 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2799 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Nupathe Inc"]}, "J2919":{"hcpcs":"J2919","hcpcs_dosage":"5 MG","short_description":"Inj, methylpred sod succ 5mg","payment_limit":{"value":0.255,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2919, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2919 only in the settings CMS describes for this code; the file's short description of it is 'Inj, methylpred sod succ 5mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2919 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Civica, Inc.","Dr. Reddy's Laboratories Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Pfizer Inc"]}, "J2997":{"hcpcs":"J2997","hcpcs_dosage":"1 MG","short_description":"Alteplase recombinant","payment_limit":{"value":98.416,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J2997, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J2997 only in the settings CMS describes for this code; the file's short description of it is 'Alteplase recombinant'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J2997 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Genentech, Inc."]}, "J3010":{"hcpcs":"J3010","hcpcs_dosage":"0.1 MG","short_description":"Fentanyl citrate injection","payment_limit":{"value":1.362,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3010, dollars per 0.1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3010 only in the settings CMS describes for this code; the file's short description of it is 'Fentanyl citrate injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3010 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Civica, Inc.","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Phlow Corporation"]}, "J3121":{"hcpcs":"J3121","hcpcs_dosage":"1 MG","short_description":"Inj testostero enanthate 1mg","payment_limit":{"value":0.052,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3121, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3121 only in the settings CMS describes for this code; the file's short description of it is 'Inj testostero enanthate 1mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3121 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Hikma Pharmaceuticals USA Inc."]}, "J3260":{"hcpcs":"J3260","hcpcs_dosage":"80 MG","short_description":"Tobramycin sulfate injection","payment_limit":{"value":2.345,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3260, dollars per 80 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3260 only in the settings CMS describes for this code; the file's short description of it is 'Tobramycin sulfate injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"80 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3260 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Baxter Healthcare Corporation","Eugia US LLC","Fosun Pharma USA Inc.","FreseniUS Kabi USA, LLC","Mylan Institutional LLC","Northstar RxLLC","Pfizer Inc","Slate Run Pharmaceuticals","XGen Pharmaceuticals DJB, Inc.","Xiromed, LLC"]}, "J3301":{"hcpcs":"J3301","hcpcs_dosage":"10 MG","short_description":"Triamcinolone acet inj nos","payment_limit":{"value":0.787,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3301, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3301 only in the settings CMS describes for this code; the file's short description of it is 'Triamcinolone acet inj nos'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3301 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Amneal Pharmaceuticals, LLC","Dr. Reddy's Laboratories Inc.","E.R. Squibb & Sons, L.L.C.","Eugia US LLC","Hikma Pharmaceuticals USA Inc.","Long Grove Pharmaceuticals, LLC","Mylan Institutional LLC","Northstar RxLLC","Teva Parenteral Medicines, Inc."]}, "J3373":{"hcpcs":"J3373","hcpcs_dosage":"10 MG","short_description":"Inj, vancomycin hcl, 10 mg","payment_limit":{"value":0.032,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3373, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3373 only in the settings CMS describes for this code; the file's short description of it is 'Inj, vancomycin hcl, 10 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3373 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Athenex Pharmaceutical Division, LLC","Baxter Healthcare Corporation","BluePoint Laboratories","Civica, Inc.","FreseniUS Kabi USA, LLC","Glenmark Pharmaceuticals Inc., USA","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Mylan Institutional LLC","Northstar RxLLC","Pfizer Inc","Sagent Pharmaceuticals","Slate Run Pharmaceuticals","Xellia Pharmaceuticals USA, LLC."]}, "J3411":{"hcpcs":"J3411","hcpcs_dosage":"100 MG","short_description":"Thiamine hcl 100 mg","payment_limit":{"value":1.486,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3411, dollars per 100 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3411 only in the settings CMS describes for this code; the file's short description of it is 'Thiamine hcl 100 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"100 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3411 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Armas Pharmaceuticals Inc.","Caplin Steriles USA Inc.","Dr. Reddy's Laboratories Inc.","Eugia US LLC","Fosun Pharma USA Inc.","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Heritage Pharmaceuticals Inc.","Hikma Pharmaceuticals USA Inc.","Mylan Institutional LLC","Northstar RxLLC","Sagent Pharmaceuticals"]}, "J3420":{"hcpcs":"J3420","hcpcs_dosage":"1000 MCG","short_description":"Vitamin b12 injection","payment_limit":{"value":0.648,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3420, dollars per 1000 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3420 only in the settings CMS describes for this code; the file's short description of it is 'Vitamin b12 injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1000 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3420 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Regent, Inc.","BluePoint Laboratories","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","Henry Schein Inc.","Hikma Pharmaceuticals USA Inc.","Lifestar Pharma","Meitheal Pharmaceuticals Inc.","Northstar RxLLC","Sagent Pharmaceuticals","Somerset Pharma, LLC","Vitruvias Therapeutics, Inc.","Zydus Pharmaceuticals (USA) Inc."]}, "J3425":{"hcpcs":"J3425","hcpcs_dosage":"10 MCG","short_description":"Hydroxocobalamin im 10mcg","payment_limit":{"value":0.007,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3425, dollars per 10 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3425 only in the settings CMS describes for this code; the file's short description of it is 'Hydroxocobalamin im 10mcg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3425 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Actavis Pharma, Inc."]}, "J3473":{"hcpcs":"J3473","hcpcs_dosage":"1 USP UNIT","short_description":"Hyaluronidase recombinant","payment_limit":{"value":0.364,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3473, dollars per 1 USP UNIT, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3473 only in the settings CMS describes for this code; the file's short description of it is 'Hyaluronidase recombinant'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 USP UNIT","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3473 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Antares Pharma, Inc.","HF Acquisition Co. LLC, DBA HealthFirst"]}, "J3486":{"hcpcs":"J3486","hcpcs_dosage":"10 MG","short_description":"Ziprasidone mesylate","payment_limit":{"value":5.94,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3486, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3486 only in the settings CMS describes for this code; the file's short description of it is 'Ziprasidone mesylate'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3486 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Dr. Reddy's Laboratories Inc.","Fosun Pharma USA Inc.","HF Acquisition Co. LLC, DBA HealthFirst","Novadoz Pharmaceuticals LLC","Viatris Specialty LLC"]}, "J3489":{"hcpcs":"J3489","hcpcs_dosage":"1 MG","short_description":"Zoledronic acid 1mg","payment_limit":{"value":17.673,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J3489, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J3489 only in the settings CMS describes for this code; the file's short description of it is 'Zoledronic acid 1mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J3489 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Accord Healthcare Inc","Athenex Pharmaceutical Division, LLC","BluePoint Laboratories","Dr. Reddy's Laboratories Inc.","Fosun Pharma USA Inc.","FreseniUS Kabi USA, LLC","Heritage Pharmaceuticals Inc.","Meitheal Pharmaceuticals Inc.","Mylan Institutional LLC","Northstar RxLLC","Sagent Pharmaceuticals","Sandoz Inc."]}, "J7120":{"hcpcs":"J7120","hcpcs_dosage":"1000 CC","short_description":"Ringers lactate infusion","payment_limit":{"value":2.369,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7120, dollars per 1000 CC, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7120 only in the settings CMS describes for this code; the file's short description of it is 'Ringers lactate infusion'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1000 CC","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7120 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["B. Braun Medical Inc.","Baxter Healthcare Corporation","FreseniUS Kabi USA, LLC","HF Acquisition Co. LLC, DBA HealthFirst","ICu Medical Inc."]}, "J7500":{"hcpcs":"J7500","hcpcs_dosage":"50 MG","short_description":"Azathioprine oral 50mg","payment_limit":{"value":0.103,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7500, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7500 only in the settings CMS describes for this code; the file's short description of it is 'Azathioprine oral 50mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7500 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Health Packaging","Amneal Pharmaceuticals, LLC","Ascend Laboratories, LLC","Bausch Health US, LLC","Glenmark Pharmaceuticals Inc., USA"]}, "J7502":{"hcpcs":"J7502","hcpcs_dosage":"100 MG","short_description":"Cyclosporine oral 100 mg","payment_limit":{"value":1.455,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7502, dollars per 100 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7502 only in the settings CMS describes for this code; the file's short description of it is 'Cyclosporine oral 100 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"100 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7502 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["AbbVie Inc.","American Health Packaging","Apotex Corp","Heritage Pharmaceuticals Inc.","Ivax Pharmaceuticals, Inc.","Novartis Pharmaceuticals Corporation","Teva Pharmaceuticals USA, Inc."]}, "J7507":{"hcpcs":"J7507","hcpcs_dosage":"1 MG","short_description":"Tacrolimus imme rel oral 1mg","payment_limit":{"value":0.162,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7507, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7507 only in the settings CMS describes for this code; the file's short description of it is 'Tacrolimus imme rel oral 1mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7507 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Accord Healthcare Inc","American Health Packaging","Ascend Laboratories, LLC","Astellas Pharma US, Inc.","Biocon Pharma Inc","Civica, Inc.","Dr. Reddy's Laboratories Inc.","Glenmark Pharmaceuticals Inc., USA","Major Pharmaceuticals","Mylan Pharmaceuticals Inc.","Northstar RxLLC","Quallent Pharmaceuticals","Sandoz Inc.","Strides Pharma Science Limited"]}, "J7508":{"hcpcs":"J7508","hcpcs_dosage":"0.1 MG","short_description":"Tacrol astagraf ex rel oral","payment_limit":{"value":0.604,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7508, dollars per 0.1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7508 only in the settings CMS describes for this code; the file's short description of it is 'Tacrol astagraf ex rel oral'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7508 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Astellas Pharma US, Inc."]}, "J7509":{"hcpcs":"J7509","hcpcs_dosage":"4 MG","short_description":"Methylprednisolone oral","payment_limit":{"value":0.128,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7509, dollars per 4 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7509 only in the settings CMS describes for this code; the file's short description of it is 'Methylprednisolone oral'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"4 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7509 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Health Packaging","BluePoint Laboratories","Chartwell","Major Pharmaceuticals","Mylan Pharmaceuticals Inc.","Pfizer Inc","Preferred Pharmaceuticals Inc","Zydus Pharmaceuticals (USA) Inc."]}, "J7510":{"hcpcs":"J7510","hcpcs_dosage":"5 MG","short_description":"Prednisolone oral per 5 mg","payment_limit":{"value":0.498,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7510, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7510 only in the settings CMS describes for this code; the file's short description of it is 'Prednisolone oral per 5 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7510 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Amneal Pharmaceuticals, LLC","Chartwell","Heritage Pharmaceuticals Inc.","Hisun Pharmaceuticals USA, Inc","Lannett Company, Inc.","PAI Holdings, LLC","Preferred Pharmaceuticals Inc","Seton Pharmaceuticals"]}, "J7512":{"hcpcs":"J7512","hcpcs_dosage":"1 MG","short_description":"Prednisone ir or dr oral 1mg","payment_limit":{"value":0.004,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7512, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7512 only in the settings CMS describes for this code; the file's short description of it is 'Prednisone ir or dr oral 1mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7512 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Actavis Pharma, Inc.","American Health Packaging","Chartwell","Hikma Pharmaceuticals USA Inc.","Major Pharmaceuticals","Mylan Pharmaceuticals Inc.","PD-Rx Pharmaceuticals, Inc.","Preferred Pharmaceuticals Inc","Preferred Pharmaceuticals, Inc.","Strides Pharma Science Limited"]}, "J7515":{"hcpcs":"J7515","hcpcs_dosage":"25 MG","short_description":"Cyclosporine oral 25 mg","payment_limit":{"value":0.576,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7515, dollars per 25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7515 only in the settings CMS describes for this code; the file's short description of it is 'Cyclosporine oral 25 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7515 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["AbbVie Inc.","American Health Packaging","Apotex Corp","Heritage Pharmaceuticals Inc.","Novartis Pharmaceuticals Corporation","Teva Pharmaceuticals USA, Inc."]}, "J7518":{"hcpcs":"J7518","hcpcs_dosage":"180 MG","short_description":"Mycophenolic acid","payment_limit":{"value":0.257,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7518, dollars per 180 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7518 only in the settings CMS describes for this code; the file's short description of it is 'Mycophenolic acid'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"180 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7518 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Accord healthcare Inc","American Health Packaging","Apotex Corp","Archis Pharma LLC","Ascend Laboratories, LLC","Aurobindo Pharma Usa, Inc.","AvPAK","Biocon Pharma Inc","Major Pharmaceuticals","Novartis Pharmaceuticals Corporation","Slate Run Pharmaceuticals","TWI Pharmaceuticals, Inc."]}, "J7520":{"hcpcs":"J7520","hcpcs_dosage":"1 MG","short_description":"Sirolimus, oral","payment_limit":{"value":0.609,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7520, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7520 only in the settings CMS describes for this code; the file's short description of it is 'Sirolimus, oral'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7520 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Health Packaging","Amneal Pharmaceuticals, LLC","Apotex Corp","Ascend Laboratories, LLC","AvPAK","Dr. Reddy's Laboratories Inc.","Glenmark Pharmaceuticals Inc., USA","Mylan Pharmaceuticals Inc.","Northstar RxLLC","Novadoz Pharmaceuticals LLC","Pfizer Inc"]}, "J7521":{"hcpcs":"J7521","hcpcs_dosage":"0.1 MG","short_description":"Tacrolim granules oral susp","payment_limit":{"value":1.328,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7521, dollars per 0.1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7521 only in the settings CMS describes for this code; the file's short description of it is 'Tacrolim granules oral susp'. Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":0.997,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7521 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Inflation-adjusted coinsurance'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Astellas Pharma US, Inc."]}, "J7524":{"hcpcs":"J7524","hcpcs_dosage":"5 MG","short_description":"Mycophenol mofetil oral 5 mg","payment_limit":{"value":0.002,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7524, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7524 only in the settings CMS describes for this code; the file's short description of it is 'Mycophenol mofetil oral 5 mg'. Notes column for this code: 'Added October 2026'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7524 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Added October 2026'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Health Packaging","Ascend Laboratories, LLC","Aurobindo Pharma Usa, Inc.","AvPAK","Genentech, Inc.","Heritage Pharmaceuticals Inc.","Major Pharmaceuticals","Sandoz Inc.","Strides Pharma Science Limited","Teva Pharmaceuticals USA, Inc."]}, "J7527":{"hcpcs":"J7527","hcpcs_dosage":"0.25 MG","short_description":"Oral everolimus","payment_limit":{"value":1.126,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7527, dollars per 0.25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7527 only in the settings CMS describes for this code; the file's short description of it is 'Oral everolimus'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7527 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Ascend Laboratories, LLC","Biocon Pharma Inc","Breckenridge Pharmaceutical, Inc.","Endo USA, Inc.","Hikma Pharmaceuticals USA Inc.","Novartis Pharmaceuticals Corporation"]}, "J7529":{"hcpcs":"J7529","hcpcs_dosage":"5 MG","short_description":"Mycop mofetil susp oral 5 mg","payment_limit":{"value":0.034,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7529, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7529 only in the settings CMS describes for this code; the file's short description of it is 'Mycop mofetil susp oral 5 mg'. Notes column for this code: 'Added October 2026'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7529 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Added October 2026'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Ascend Laboratories, LLC","Aurobindo Pharma Usa, Inc.","Genentech, Inc.","Heritage Pharmaceuticals Inc.","Lannett Company, Inc.","Northstar Rx Llc"]}, "J7605":{"hcpcs":"J7605","hcpcs_dosage":"15 mcg","short_description":"Arformoterol non-comp unit","payment_limit":{"value":0.542,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7605, dollars per 15 mcg, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7605 only in the settings CMS describes for this code; the file's short description of it is 'Arformoterol non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"15 mcg","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7605 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Alembic Pharmaceuticals Inc.","American Health Packaging","Cipla USA, Inc.","Dr. Reddy's Laboratories Inc.","Fosun Pharma USA Inc.","Ingenus Pharmaceuticals LLC","Lifestar Pharma","Lupin Pharmaceuticals, Inc.","Micro Labs Limited","Northstar RxLLC","Ritedose Pharmaceuticals, LLC","Slate Run Pharmaceuticals"]}, "J7606":{"hcpcs":"J7606","hcpcs_dosage":"20 MCG","short_description":"Formoterol fumarate, inh","payment_limit":{"value":1.373,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7606, dollars per 20 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7606 only in the settings CMS describes for this code; the file's short description of it is 'Formoterol fumarate, inh'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"20 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7606 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Alembic Pharmaceuticals Inc.","Aucta Pharmaceuticals, Inc.","Dr. Reddy's Laboratories Inc.","Ingenus Pharmaceuticals LLC","Lifestar Pharma","Lupin Pharmaceuticals, Inc.","Micro Labs Limited","Mylan Pharmaceuticals Inc.","Northstar RxLLC","Rhodes Pharmaceuticals","Ritedose Pharmaceuticals, LLC","Teva Pharmaceuticals USA, Inc.","Viatris Specialty LLC"]}, "J7608":{"hcpcs":"J7608","hcpcs_dosage":"1 GM","short_description":"Acetylcysteine non-comp unit","payment_limit":{"value":6.398,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7608, dollars per 1 GM, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7608 only in the settings CMS describes for this code; the file's short description of it is 'Acetylcysteine non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 GM","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7608 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Regent, Inc.","Cameron Pharmaceuticals, LLC","FreseniUS Kabi USA, LLC","Pfizer Inc","Somerset Pharma, LLC"]}, "J7611":{"hcpcs":"J7611","hcpcs_dosage":"1 MG","short_description":"Albuterol non-comp con","payment_limit":{"value":0.206,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7611, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7611 only in the settings CMS describes for this code; the file's short description of it is 'Albuterol non-comp con'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7611 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Chartwell","Nephron SC, Inc.","Rising Pharma Holdings, Inc.","Ritedose Pharmaceuticals, LLC"]}, "J7612":{"hcpcs":"J7612","hcpcs_dosage":"0.5 MG","short_description":"Levalbuterol non-comp con","payment_limit":{"value":0.304,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7612, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7612 only in the settings CMS describes for this code; the file's short description of it is 'Levalbuterol non-comp con'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7612 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Mylan Pharmaceuticals Inc."]}, "J7613":{"hcpcs":"J7613","hcpcs_dosage":"1 MG","short_description":"Albuterol non-comp unit","payment_limit":{"value":0.066,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7613, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7613 only in the settings CMS describes for this code; the file's short description of it is 'Albuterol non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7613 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Actavis Pharma, Inc.","American Health Packaging","Chartwell","Ingenus Pharmaceuticals LLC","Mylan Pharmaceuticals Inc.","Nephron SC, Inc.","Ritedose Pharmaceuticals, LLC","Sun Pharmaceutical Global FZE."]}, "J7614":{"hcpcs":"J7614","hcpcs_dosage":"0.5 MG","short_description":"Levalbuterol non-comp unit","payment_limit":{"value":0.076,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7614, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7614 only in the settings CMS describes for this code; the file's short description of it is 'Levalbuterol non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7614 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Amneal Pharmaceuticals, LLC","Burel Pharmaceuticals, LLC","Impax Laboratories, LLC","Mylan Pharmaceuticals Inc.","Ritedose Pharmaceuticals, LLC","Teva Pharmaceuticals USA, Inc."]}, "J7620":{"hcpcs":"J7620","hcpcs_dosage":"2.5 MG/0.5 MG","short_description":"Albuterol ipratrop non-comp","payment_limit":{"value":0.197,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7620, dollars per 2.5 MG/0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7620 only in the settings CMS describes for this code; the file's short description of it is 'Albuterol ipratrop non-comp'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"2.5 MG/0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7620 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Health Packaging","Chartwell","Cipla USA, Inc.","Mylan Pharmaceuticals Inc.","Nephron SC, Inc.","Preferred Pharmaceuticals Inc","Rising Pharma Holdings, Inc.","Ritedose Pharmaceuticals, LLC","Sun Pharmaceutical Global FZE."]}, "J7626":{"hcpcs":"J7626","hcpcs_dosage":"0.5 MG","short_description":"Budesonide non-comp unit","payment_limit":{"value":0.923,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7626, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7626 only in the settings CMS describes for this code; the file's short description of it is 'Budesonide non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7626 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Health Packaging","AstraZeneca Pharmaceuticals LP","Chartwell","Cipla USA, Inc.","Exelan Pharmaceuticals, Inc.","Impax Laboratories, LLC","Lupin Pharmaceuticals, Inc.","Nephron SC, Inc.","Northstar RxLLC","Rising Pharma Holdings, Inc.","Ritedose Pharmaceuticals, LLC","Sun Pharmaceutical Global FZE.","Teva Pharmaceuticals USA, Inc."]}, "J7631":{"hcpcs":"J7631","hcpcs_dosage":"10 MG","short_description":"Cromolyn sodium noncomp unit","payment_limit":{"value":0.385,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7631, dollars per 10 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7631 only in the settings CMS describes for this code; the file's short description of it is 'Cromolyn sodium noncomp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"10 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7631 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Ivax Pharmaceuticals, Inc.","Ritedose Pharmaceuticals, LLC"]}, "J7639":{"hcpcs":"J7639","hcpcs_dosage":"1 MG","short_description":"Dornase alfa non-comp unit","payment_limit":{"value":56.806,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7639, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7639 only in the settings CMS describes for this code; the file's short description of it is 'Dornase alfa non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7639 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Genentech, Inc."]}, "J7644":{"hcpcs":"J7644","hcpcs_dosage":"1 MG","short_description":"Ipratropium bromide non-comp","payment_limit":{"value":0.445,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7644, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7644 only in the settings CMS describes for this code; the file's short description of it is 'Ipratropium bromide non-comp'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7644 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Health Packaging","Chartwell","Mylan Pharmaceuticals Inc.","Nephron SC, Inc.","Rising Pharma Holdings, Inc.","Ritedose Pharmaceuticals, LLC","Sun Pharmaceutical Global FZE."]}, "J7677":{"hcpcs":"J7677","hcpcs_dosage":"1 MCG","short_description":"Revefenacin inh non-com 1mcg","payment_limit":{"value":0.2,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7677, dollars per 1 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7677 only in the settings CMS describes for this code; the file's short description of it is 'Revefenacin inh non-com 1mcg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7677 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Viatris Specialty LLC"]}, "J7682":{"hcpcs":"J7682","hcpcs_dosage":"300 MG","short_description":"Tobramycin non-comp unit","payment_limit":{"value":11.404,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J7682, dollars per 300 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J7682 only in the settings CMS describes for this code; the file's short description of it is 'Tobramycin non-comp unit'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"300 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J7682 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["American Health Packaging","Amneal Pharmaceuticals, LLC","Chiesi USA, Inc.","Dr. Reddy's Laboratories Inc.","Genericus, Inc.","Lifestar Pharma","Lupin Pharmaceuticals, Inc.","Micro Labs Limited","Northstar RxLLC","PARI Respiratory Equipment","Prasco Laboratories","Ritedose Pharmaceuticals, LLC","Sun Pharmaceutical Global FZE.","Teva Pharmaceuticals USA, Inc.","Viatris Specialty LLC"]}, "J8501":{"hcpcs":"J8501","hcpcs_dosage":"5 MG","short_description":"Oral aprepitant","payment_limit":{"value":2.511,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8501, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8501 only in the settings CMS describes for this code; the file's short description of it is 'Oral aprepitant'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8501 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["BluePoint Laboratories","Glenmark Pharmaceuticals Inc., USA","Merck Sharp & Dohme LLC","Sandoz Inc.","Torrent Pharmaceuticals Limited"]}, "J8515":{"hcpcs":"J8515","hcpcs_dosage":"0.25 MG","short_description":"Cabergoline, oral 0.25mg","payment_limit":{"value":0.337,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8515, dollars per 0.25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8515 only in the settings CMS describes for this code; the file's short description of it is 'Cabergoline, oral 0.25mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8515 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Amneal Pharmaceuticals, LLC"]}, "J8522":{"hcpcs":"J8522","hcpcs_dosage":"50 MG","short_description":"Capecitabine, oral, 50 mg","payment_limit":{"value":0.029,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8522, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8522 only in the settings CMS describes for this code; the file's short description of it is 'Capecitabine, oral, 50 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8522 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Accord Healthcare Inc","American Health Packaging","Ascend Laboratories, LLC","Aurobindo Pharma Usa, Inc.","BluePoint Laboratories","Cipla USA, Inc.","Dr. Reddy's Laboratories Inc.","Genentech, Inc.","H2 Pharma LLC","Lifestar Pharma","Novadoz Pharmaceuticals LLC","Quallent Pharmaceuticals","Teva Pharmaceuticals USA, Inc."]}, "J8530":{"hcpcs":"J8530","hcpcs_dosage":"25 MG","short_description":"Cyclophosphamide oral 25 mg","payment_limit":{"value":1.233,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8530, dollars per 25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8530 only in the settings CMS describes for this code; the file's short description of it is 'Cyclophosphamide oral 25 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8530 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Baxter Healthcare Corporation","Cipla USA, Inc.","Hikma Pharmaceuticals USA Inc."]}, "J8540":{"hcpcs":"J8540","hcpcs_dosage":"0.25 MG","short_description":"Oral dexamethasone","payment_limit":{"value":0.022,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8540, dollars per 0.25 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8540 only in the settings CMS describes for this code; the file's short description of it is 'Oral dexamethasone'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.25 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8540 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","ANI Pharmaceuticals, Inc.","American Health Packaging","Apotex Corp","Hikma Pharmaceuticals USA Inc.","Major Pharmaceuticals","Northstar RxLLC","PD-Rx Pharmaceuticals, Inc.","Prasco Laboratories","Preferred Pharmaceuticals Inc"]}, "J8610":{"hcpcs":"J8610","hcpcs_dosage":"2.5 MG","short_description":"Methotrexate oral 2.5 mg","payment_limit":{"value":0.157,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8610, dollars per 2.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8610 only in the settings CMS describes for this code; the file's short description of it is 'Methotrexate oral 2.5 mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"2.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8610 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","Accord Healthcare Inc","Aurobindo Pharma USA, Inc.","AvPAK","Barr Pharmaceuticals, Inc.","Chartwell","Hikma Pharmaceuticals USA Inc.","Major Pharmaceuticals","Mylan Institutional Inc.","Mylan Pharmaceuticals Inc.","Sun Pharmaceutical Global FZE.","Teva Women's Health LLC"]}, "J8612":{"hcpcs":"J8612","hcpcs_dosage":"2.5 MG","short_description":"Oral methotrexate (xatmep)","payment_limit":{"value":22.855,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8612, dollars per 2.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8612 only in the settings CMS describes for this code; the file's short description of it is 'Oral methotrexate (xatmep)'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"2.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8612 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Azurity Pharmaceuticals, Inc."]}, "J8700":{"hcpcs":"J8700","hcpcs_dosage":"5 MG","short_description":"Temozolomide","payment_limit":{"value":0.208,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J8700, dollars per 5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J8700 only in the settings CMS describes for this code; the file's short description of it is 'Temozolomide'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J8700 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Accord Healthcare Inc","Amneal Pharmaceuticals, LLC","AvPAK","Sun Pharmaceutical Global FZE."]}, "J9030":{"hcpcs":"J9030","hcpcs_dosage":"1 MG","short_description":"Bcg live intravesical 1mg","payment_limit":{"value":3.532,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J9030, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J9030 only in the settings CMS describes for this code; the file's short description of it is 'Bcg live intravesical 1mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J9030 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Merck Sharp & Dohme LLC"]}, "J9040":{"hcpcs":"J9040","hcpcs_dosage":"15 UNITS","short_description":"Bleomycin sulfate injection","payment_limit":{"value":23.12,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J9040, dollars per 15 UNITS, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J9040 only in the settings CMS describes for this code; the file's short description of it is 'Bleomycin sulfate injection'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"15 UNITS","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J9040 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Meitheal Pharmaceuticals Inc.","Northstar RxLLC","Pfizer Inc"]}, "J9217":{"hcpcs":"J9217","hcpcs_dosage":"7.5 MG","short_description":"Leuprolide acetate suspnsion","payment_limit":{"value":188.849,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J9217, dollars per 7.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J9217 only in the settings CMS describes for this code; the file's short description of it is 'Leuprolide acetate suspnsion'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"7.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J9217 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["AbbVie Inc.","Tolmar Inc."]}, "J9260":{"hcpcs":"J9260","hcpcs_dosage":"50 MG","short_description":"Inj methotrexate sodium 50mg","payment_limit":{"value":2.909,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS J9260, dollars per 50 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under J9260 only in the settings CMS describes for this code; the file's short description of it is 'Inj methotrexate sodium 50mg'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"50 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS J9260 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["ACCORD HEALTHCARE INC","Accord Healthcare Inc","FreseniUS Kabi USA, LLC","Hikma Pharmaceuticals USA Inc.","Pfizer Inc","Teva Parenteral Medicines, Inc."]}, "Q0162":{"hcpcs":"Q0162","hcpcs_dosage":"1 MG","short_description":"Ondansetron oral","payment_limit":{"value":0.016,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q0162, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q0162 only in the settings CMS describes for this code; the file's short description of it is 'Ondansetron oral'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q0162 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["A-S Medication Solutions","American Health Packaging","AvPAK","BluePoint Laboratories","Chartwell","Dr. Reddy's Laboratories Inc.","Glenmark Pharmaceuticals Inc., USA","Lifsa Drugs LLC","Major Pharmaceuticals","Northstar RxLLC","PD-Rx Pharmaceuticals, Inc.","PREFERRED PHARMACEUTICALS, INC.","Preferred Pharmaceuticals Inc"]}, "Q0166":{"hcpcs":"Q0166","hcpcs_dosage":"1 MG","short_description":"Granisetron hcl 1 mg oral","payment_limit":{"value":0.774,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q0166, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q0166 only in the settings CMS describes for this code; the file's short description of it is 'Granisetron hcl 1 mg oral'. Notes column for this code: 'Added October 2026'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q0166 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: 'Added October 2026'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Breckenridge Pharmaceutical, Inc."]}, "Q0167":{"hcpcs":"Q0167","hcpcs_dosage":"2.5 MG","short_description":"Dronabinol 2.5mg oral","payment_limit":{"value":2.092,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q0167, dollars per 2.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q0167 only in the settings CMS describes for this code; the file's short description of it is 'Dronabinol 2.5mg oral'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"2.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q0167 in the Part B payment limit file (column 'Co-insurance Percentage').","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Ascend Laboratories, LLC","Major Pharmaceuticals","ThePharmaNetwork, LLC"]}, "Q5099":{"hcpcs":"Q5099","hcpcs_dosage":"1 MG","short_description":"Inj ustekinumab-stba, 1 mg","payment_limit":{"value":2.89,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5099, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5099 only in the settings CMS describes for this code; the file's short description of it is 'Inj ustekinumab-stba, 1 mg'. Notes column for this code: '\"lesser of\" methodology applied; 8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5099 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '\"lesser of\" methodology applied; 8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Celltrion USA, INC.","Celltrion USA, Inc."]}, "Q5100":{"hcpcs":"Q5100","hcpcs_dosage":"1 MG","short_description":"Inj ustekinumab-kfce, 1 mg","payment_limit":{"value":3.08,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5100, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5100 only in the settings CMS describes for this code; the file's short description of it is 'Inj ustekinumab-kfce, 1 mg'. Notes column for this code: '\"lesser of\" methodology applied; 8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5100 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '\"lesser of\" methodology applied; 8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Biocon Biologics Inc"]}, "Q5101":{"hcpcs":"Q5101","hcpcs_dosage":"1 MCG","short_description":"Injection, zarxio","payment_limit":{"value":0.338,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5101, dollars per 1 MCG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5101 only in the settings CMS describes for this code; the file's short description of it is 'Injection, zarxio'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MCG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5101 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Sandoz Inc."]}, "Q5108":{"hcpcs":"Q5108","hcpcs_dosage":"0.5 MG","short_description":"Injection, fulphila","payment_limit":{"value":55.964,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5108, dollars per 0.5 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5108 only in the settings CMS describes for this code; the file's short description of it is 'Injection, fulphila'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"0.5 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5108 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Biocon Biologics Inc","Viatris - Greenstone LLC"]}, "Q5135":{"hcpcs":"Q5135","hcpcs_dosage":"1 MG","short_description":"Inj, tyenne, 1 mg","payment_limit":{"value":4.37,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5135, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5135 only in the settings CMS describes for this code; the file's short description of it is 'Inj, tyenne, 1 mg'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5135 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC"]}, "Q5136":{"hcpcs":"Q5136","hcpcs_dosage":"1 MG","short_description":"Inj. denosumab-bbdz, 1 mg","payment_limit":{"value":26.991,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5136, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5136 only in the settings CMS describes for this code; the file's short description of it is 'Inj. denosumab-bbdz, 1 mg'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5136 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Sandoz Inc."]}, "Q5157":{"hcpcs":"Q5157","hcpcs_dosage":"1 MG","short_description":"Inj, denosumab-bmwo, 1 mg","payment_limit":{"value":24.002,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5157, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5157 only in the settings CMS describes for this code; the file's short description of it is 'Inj, denosumab-bmwo, 1 mg'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5157 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Celltrion USA, Inc."]}, "Q5158":{"hcpcs":"Q5158","hcpcs_dosage":"1 MG","short_description":"Inj, denosumab-bnht, 1 mg","payment_limit":{"value":28.702,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5158, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5158 only in the settings CMS describes for this code; the file's short description of it is 'Inj, denosumab-bnht, 1 mg'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5158 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["FreseniUS Kabi USA, LLC"]}, "Q5162":{"hcpcs":"Q5162","hcpcs_dosage":"1 MG","short_description":"Inj, denosumab-nxxp, 1 mg","payment_limit":{"value":15.336,"kind":"usd","state":"filed","reason":"Medicare Part B payment allowance limit for HCPCS Q5162, dollars per 1 MG, quarter 2026-10-01/2026-12-31 (column 'Payment Limit'). CMS: generally 106% of the manufacturer-reported average sales price; presence in the file does not mean Medicare covers the drug. Part B pays under Q5162 only in the settings CMS describes for this code; the file's short description of it is 'Inj, denosumab-nxxp, 1 mg'. Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"1 MG","period":"2026-10-01/2026-12-31"},"coinsurance_pct":{"value":20,"kind":"percent","state":"filed","reason":"Beneficiary coinsurance percentage printed for HCPCS Q5162 in the Part B payment limit file (column 'Co-insurance Percentage'). Notes column for this code: '8% of reference add-on applied'.","source_name":"Medicare Part B","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-medicare-part-b-payment-limit-files-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"labelers":["Organon LLC"]} }, "rows": [ {"ndc":"24385005452","name":"12HR NASAL DECONGEST ER 120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-054-52","proprietary_name":"good neighbor pharmacy nasal decongestant","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Amerisource Bergen","package_description":"10 BLISTER PACK in 1 CARTON (24385-054-52) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000065601","name":"12HR NASAL DECONGEST ER 120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0656-1","proprietary_name":"12 Hour Nasal Decongestant","nonproprietary_name":"Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"CARDINAL HEALTH","package_description":"1 BLISTER PACK in 1 CARTON (70000-0656-1) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122038576","name":"24H NASAL ALLERGY 55 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-385-76","proprietary_name":"Good Neighbor Pharmacy 24 Hour Nasal Allergy","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, SPRAY in 1 CARTON (46122-385-76) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000036201","name":"24HR ALLERGY(LEVOCETIRZN) 5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0362-1","proprietary_name":"24HR Allergy Relief","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (70000-0362-1) / 5 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000036202","name":"24HR ALLERGY(LEVOCETIRZN) 5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0362-2","proprietary_name":"24HR Allergy Relief","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0362-2) / 35 TABLET, COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672206200","name":"3-DAY VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2062-0","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (51672-2062-0) / 21 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.3124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122006271","name":"8 HOUR ACETAMINOPHEN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904756160","name":"8HR ARTHRITIS PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7561-60","proprietary_name":"8hr arthritis pain relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0904-7561-60)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062978","name":"8HR ARTHRITIS PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-629-78","proprietary_name":"8 Hour Arthritis Pain","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-629-78) / 100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000062703","name":"8HR ARTHRITIS PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0627-3","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc","package_description":"225 TABLET in 1 BOTTLE (70000-0627-3)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000073301","name":"8HR ARTHRITIS PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0733-1","proprietary_name":"8HR Arthritis Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0733-1) / 100 TABLET, EXTENDED RELEASE in 1 BOTTLE"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000073401","name":"8HR MUSCLE ACHE-PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0734-1","proprietary_name":"8HR Muscle Aches and Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0734-1) / 100 TABLET, EXTENDED RELEASE in 1 BOTTLE"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378410591","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4105-91","proprietary_name":"Abacavir Sulfate","nonproprietary_name":"abacavir sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0378-4105-91) / 60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904687404","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6874-04","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6874-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904687406","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6874-06","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6874-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"31722055760","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-557-60","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-557-60)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"50268004911","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"50268004912","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-049-12","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-049-12) / 1 TABLET in 1 BLISTER PACK (50268-049-11)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"51079020401","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"51079020406","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-204-06","proprietary_name":"Abacavir Sulfate","nonproprietary_name":"abacavir sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Institutional Inc.","package_description":"50 BLISTER PACK in 1 CARTON (51079-204-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-204-01)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"65862007360","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-073-60","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-073-60)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084002111","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084002121","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-021-21","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-021-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-021-11)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69097051403","name":"ABACAVIR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-514-03","proprietary_name":"Abacavir","nonproprietary_name":"Abacavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69097-514-03)","pharm_classes":["Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.54555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir|Abacavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"31722083830","name":"ABACAVIR-LAMIVUDINE 600-300 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-838-30","proprietary_name":"ABACAVIR and LAMIVUDINE","nonproprietary_name":"ABACAVIR and LAMIVUDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-838-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.48365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir-Lamivudine|Abacavir Sulfate/Lamivudine","basis":"generic"},"part_b":null}, {"ndc":"42385096230","name":"ABACAVIR-LAMIVUDINE 600-300 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-962-30","proprietary_name":"Abacavir and Lamivudine","nonproprietary_name":"Abacavir and Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 300 mg/1","labeler":"Laurus Labs Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42385-962-30)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.48365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir-Lamivudine|Abacavir Sulfate/Lamivudine","basis":"generic"},"part_b":null}, {"ndc":"65862033530","name":"ABACAVIR-LAMIVUDINE 600-300 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-335-30","proprietary_name":"Abacavir and Lamivudine","nonproprietary_name":"Abacavir and Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-335-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.48365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir-Lamivudine|Abacavir Sulfate/Lamivudine","basis":"generic"},"part_b":null}, {"ndc":"69097036202","name":"ABACAVIR-LAMIVUDINE 600-300 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-362-02","proprietary_name":"Abacavir and Lamivudine","nonproprietary_name":"Abacavir and lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 300 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-362-02)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.48365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abacavir-Lamivudine|Abacavir Sulfate/Lamivudine","basis":"generic"},"part_b":null}, {"ndc":"70700033084","name":"ABIGALE 1 MG-0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"70700033085","name":"ABIGALE 1 MG-0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-330-85","proprietary_name":"ABIGALE","nonproprietary_name":"estradiol and norethindrone acetate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-330-85) / 1 BLISTER PACK in 1 POUCH (70700-330-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"70700030384","name":"ABIGALE LO 0.5-0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"70700030385","name":"ABIGALE LO 0.5-0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-303-85","proprietary_name":"ABIGALE LO","nonproprietary_name":"estradiol and norethindrone acetate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1; .1 mg/1","labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-303-85) / 1 BLISTER PACK in 1 POUCH (70700-303-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"59148000813","name":"ABILIFY 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-008-13","proprietary_name":"ABILIFY","nonproprietary_name":"ARIPIPRAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59148-008-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":18.61552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abilify|Aripiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148000913","name":"ABILIFY 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-009-13","proprietary_name":"ABILIFY","nonproprietary_name":"ARIPIPRAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59148-009-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":18.65186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abilify|Aripiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148000613","name":"ABILIFY 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-006-13","proprietary_name":"ABILIFY","nonproprietary_name":"ARIPIPRAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59148-006-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":18.65546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abilify|Aripiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148001013","name":"ABILIFY 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-010-13","proprietary_name":"ABILIFY","nonproprietary_name":"ARIPIPRAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59148-010-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":26.25042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abilify|Aripiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148001113","name":"ABILIFY 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-011-13","proprietary_name":"ABILIFY","nonproprietary_name":"ARIPIPRAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59148-011-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":26.23171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abilify|Aripiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148000713","name":"ABILIFY 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-007-13","proprietary_name":"ABILIFY","nonproprietary_name":"ARIPIPRAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59148-007-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":18.6836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abilify|Aripiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148010280","name":"ABILIFY ASIMTUFII 720 MG/2.4 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-102-80","proprietary_name":"Abilify Asimtufii","nonproprietary_name":"Aripiprazole","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"720 mg/2.4mL","labeler":"Otsuka America Pharmaceutical, Inc","package_description":"1 SYRINGE in 1 CARTON (59148-102-80) / 2.4 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1785.22689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Abilify Asimtufii|Aripiprazole","basis":"brand"},"part_b":{"hcpcs":"J0402","bill_units_per_package":{"value":720,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0402 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (720 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (59148-102-80) / 2.4 mL in 1 SYRINGE) gives 2.4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59148011480","name":"ABILIFY ASIMTUFII 960 MG/3.2 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-114-80","proprietary_name":"Abilify Asimtufii","nonproprietary_name":"Aripiprazole","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"960 mg/3.2mL","labeler":"Otsuka America Pharmaceutical, Inc","package_description":"1 SYRINGE in 1 CARTON (59148-114-80) / 3.2 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1782.92743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Abilify Asimtufii|Aripiprazole","basis":"brand"},"part_b":{"hcpcs":"J0402","bill_units_per_package":{"value":960,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0402 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (960 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3.2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (59148-114-80) / 3.2 mL in 1 SYRINGE) gives 3.2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59148004580","name":"ABILIFY MAINTENA ER 300 MG SYR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-045-80","proprietary_name":"ABILIFY MAINTENA","nonproprietary_name":"aripiprazole","dosage_form":"KIT","route":null,"strength":null,"labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 KIT in 1 CARTON (59148-045-80) * 1.5 mL in 1 SYRINGE * 5 mL in 1 SYRINGE"},"nadac":{"value":2139.08683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0401","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0401 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (59148-045-80) * 1.5 mL in 1 SYRINGE * 5 mL in 1 SYRINGE) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59148001870","name":"ABILIFY MAINTENA ER 300 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2141.14811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59148001871","name":"ABILIFY MAINTENA ER 300 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2141.14811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0401","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0401 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"59148023212","name":"ABILIFY MAINTENA ER 300 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-232-12","proprietary_name":"ABILIFY MAINTENA","nonproprietary_name":"aripiprazole","dosage_form":"KIT","route":null,"strength":null,"labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 KIT in 1 CARTON (59148-232-12) * 1.5 mL in 1 VIAL, SINGLE-USE (59148-235-70) * 2.5 mL in 1 VIAL, SINGLE-USE (59148-100-12)"},"nadac":{"value":2141.14811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0401","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0401 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (59148-232-12) * 1.5 mL in 1 VIAL, SINGLE-USE (59148-235-70) * 2.5 mL in 1 VIAL, SINGLE-USE (59148-100-12)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59148007280","name":"ABILIFY MAINTENA ER 400 MG SYR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-072-80","proprietary_name":"ABILIFY MAINTENA","nonproprietary_name":"aripiprazole","dosage_form":"KIT","route":null,"strength":null,"labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 KIT in 1 CARTON (59148-072-80) * 1.9 mL in 1 SYRINGE * 5 mL in 1 SYRINGE"},"nadac":{"value":2853.24574,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0401","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0401 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (59148-072-80) * 1.9 mL in 1 SYRINGE * 5 mL in 1 SYRINGE) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59148001970","name":"ABILIFY MAINTENA ER 400 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2857.76593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59148001971","name":"ABILIFY MAINTENA ER 400 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2857.76593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0401","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0401 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"59148024512","name":"ABILIFY MAINTENA ER 400 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-245-12","proprietary_name":"ABILIFY MAINTENA","nonproprietary_name":"aripiprazole","dosage_form":"KIT","route":null,"strength":null,"labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 KIT in 1 CARTON (59148-245-12) * 1.9 mL in 1 VIAL, SINGLE-USE (59148-238-90) * 2.5 mL in 1 VIAL, SINGLE-USE (59148-100-12)"},"nadac":{"value":2857.76593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0401","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0401 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (59148-245-12) * 1.9 mL in 1 VIAL, SINGLE-USE (59148-238-90) * 2.5 mL in 1 VIAL, SINGLE-USE (59148-100-12)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00143959721","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9597-21","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 TABLET in 1 BOTTLE (0143-9597-21)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00378692078","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6920-78","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"120 TABLET in 1 BOTTLE, PLASTIC (0378-6920-78)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00904694804","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6948-04","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6948-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"16714096301","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-963-01","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"120 TABLET in 1 BOTTLE (16714-963-01)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"43598035804","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-358-04","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"120 TABLET in 1 BOTTLE (43598-358-04)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268003211","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268003212","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-032-12","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-032-12) / 1 TABLET in 1 BLISTER PACK (50268-032-11)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60219116507","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1165-7","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"120 TABLET in 1 BOTTLE (60219-1165-7)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505432701","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4327-1","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Apotex Corp.","package_description":"120 TABLET in 1 BOTTLE (60505-4327-1)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60687079011","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687079021","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-790-21","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-790-21) / 1 TABLET in 1 BLISTER PACK (60687-790-11)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980041812","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-418-12","proprietary_name":"Abiraterone acetate","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET in 1 BOTTLE (64980-418-12)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68001048907","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-489-07","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"120 TABLET in 1 BOTTLE (68001-489-07)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68462013508","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-135-08","proprietary_name":"abiraterone acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"120 TABLET in 1 BOTTLE (68462-135-08)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"69238116507","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1165-7","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"120 TABLET in 1 BOTTLE (69238-1165-7)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71921017820","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-178-20","proprietary_name":"abiraterone acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Florida Pharmaceutical Products, LLC.","package_description":"120 TABLET in 1 BOTTLE (71921-178-20)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72205003092","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-030-92","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"120 TABLET in 1 BOTTLE (72205-030-92)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72205028492","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-284-92","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (72205-284-92)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72603011001","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-110-01","proprietary_name":"abiraterone acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"120 TABLET in 1 BOTTLE (72603-110-01)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"75907022404","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-224-04","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"120 TABLET in 1 BOTTLE (75907-224-04)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"82009013912","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-139-12","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"120 TABLET in 1 BOTTLE (82009-139-12)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"82249001012","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-010-12","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"CivicaScript, LLC","package_description":"120 TABLET in 1 BOTTLE, PLASTIC (82249-010-12)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"82293000110","name":"ABIRATERONE ACETATE 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-001-10","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (82293-001-10)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00378692191","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6921-91","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6921-91)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"43598046860","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-468-60","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"60 TABLET in 1 BOTTLE (43598-468-60)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60219175406","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1754-6","proprietary_name":"ABIRATERONE ACETATE","nonproprietary_name":"ABIRATERONE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"60 TABLET in 1 BOTTLE (60219-1754-6)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505476406","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4764-6","proprietary_name":"abiraterone acetate","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-4764-6)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68001067306","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-673-06","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET in 1 BOTTLE (68001-673-06)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68462088260","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-882-60","proprietary_name":"abiraterone acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET in 1 BOTTLE (68462-882-60)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"69238175406","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1754-6","proprietary_name":"ABIRATERONE ACETATE","nonproprietary_name":"ABIRATERONE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"60 TABLET in 1 BOTTLE (69238-1754-6)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71921017706","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-177-06","proprietary_name":"Abiraterone acetate","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (71921-177-06)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72205028560","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-285-60","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-285-60)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72603011101","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-111-01","proprietary_name":"abiraterone acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"60 TABLET in 1 BOTTLE (72603-111-01)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"82009014060","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-140-60","proprietary_name":"Abiraterone","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (82009-140-60)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"82293000210","name":"ABIRATERONE ACETATE 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-002-10","proprietary_name":"Abiraterone Acetate","nonproprietary_name":"abiraterone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (82293-002-10)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":2.59443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"82249001112","name":"ABIRTEGA 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-011-12","proprietary_name":"Abirtega","nonproprietary_name":"Abiraterone acetate","dosage_form":"TABLET","route":"ORAL; ORAL","strength":"250 mg/1","labeler":"CivicaScript, LLC","package_description":"120 TABLET in 1 BOTTLE, PLASTIC (82249-011-12)","pharm_classes":["Cytochrome P450 17A1 Inhibitor [EPC]","Cytochrome P450 17A1 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":0.77414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Abiraterone Acetate|Abiraterone Acetate","basis":"generic"},"part_b":null}, {"ndc":"10631011631","name":"ABSORICA 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10631-116-31","proprietary_name":"Absorica","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (10631-116-31) / 10 CAPSULE in 1 BLISTER PACK (10631-116-69)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":35.74413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"10631011669","name":"ABSORICA 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":35.74413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"10631011731","name":"ABSORICA 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-117-31","proprietary_name":"Absorica","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (10631-117-31) / 10 CAPSULE in 1 BLISTER PACK (10631-117-69)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":38.20855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"10631011769","name":"ABSORICA 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":38.20855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"10631011831","name":"ABSORICA 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10631-118-31","proprietary_name":"Absorica","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (10631-118-31) / 10 CAPSULE in 1 BLISTER PACK (10631-118-69)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":38.21939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"10631011869","name":"ABSORICA 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":38.21939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"10631000331","name":"ABSORICA LD 16 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10631-003-31","proprietary_name":"Absorica LD","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"16 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (10631-003-31) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":38.4106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica Ld|Isotretinoin, Micronized","basis":"brand"},"part_b":null}, {"ndc":"10631000531","name":"ABSORICA LD 24 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-005-31","proprietary_name":"Absorica LD","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"24 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (10631-005-31) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":42.22828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica Ld|Isotretinoin, Micronized","basis":"brand"},"part_b":null}, {"ndc":"10631000731","name":"ABSORICA LD 32 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-007-31","proprietary_name":"Absorica LD","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"32 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (10631-007-31) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":42.42393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Absorica Ld|Isotretinoin, Micronized","basis":"brand"},"part_b":null}, {"ndc":"00378633380","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6333-80","proprietary_name":"Acamprosate Calcium","nonproprietary_name":"acamprosate calcium enteric-coated","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0378-6333-80)"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904721304","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7213-04","proprietary_name":"Acamprosate Calcium","nonproprietary_name":"Acamprosate Calcium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7213-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687012125","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-121-25","proprietary_name":"Acamprosate Calcium","nonproprietary_name":"Acamprosate Calcium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-121-25) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-121-95)"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687012195","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382056928","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-569-28","proprietary_name":"acamprosate calcium","nonproprietary_name":"acamprosate calcium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (68382-569-28)"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462043518","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-435-18","proprietary_name":"Acamprosate Calcium","nonproprietary_name":"Acamprosate Calcium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (68462-435-18)"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"69452035325","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-353-25","proprietary_name":"Acamprosate Calcium","nonproprietary_name":"Acamprosate Calcium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Bionpharma Inc.,","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-353-25)"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"70069086018","name":"ACAMPROSATE CALC DR 333 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-860-18","proprietary_name":"ACAMPROSATE CALCIUM","nonproprietary_name":"ACAMPROSATE CALCIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (70069-860-18)"},"nadac":{"value":0.58908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acamprosate Calcium|Acamprosate Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054014225","name":"ACARBOSE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0142-25","proprietary_name":"Acarbose","nonproprietary_name":"Acarbose","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0142-25)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.27398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"23155014901","name":"ACARBOSE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-149-01","proprietary_name":"Acarbose","nonproprietary_name":"Acarbose","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-149-01)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.27398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"62135045590","name":"ACARBOSE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-455-90","proprietary_name":"Acarbose","nonproprietary_name":"acarbose","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-455-90)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.27398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"64380076006","name":"ACARBOSE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-760-06","proprietary_name":"Acarbose","nonproprietary_name":"acarbose","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-760-06)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.27398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"00054014025","name":"ACARBOSE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0140-25","proprietary_name":"Acarbose","nonproprietary_name":"Acarbose","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0140-25)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.17982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"23155014701","name":"ACARBOSE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-147-01","proprietary_name":"Acarbose","nonproprietary_name":"Acarbose","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-147-01)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.17982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"62135045390","name":"ACARBOSE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-453-90","proprietary_name":"Acarbose","nonproprietary_name":"acarbose","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-453-90)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.17982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"64380075806","name":"ACARBOSE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-758-06","proprietary_name":"Acarbose","nonproprietary_name":"acarbose","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-758-06)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.17982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"00054014125","name":"ACARBOSE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0141-25","proprietary_name":"Acarbose","nonproprietary_name":"Acarbose","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0141-25)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.16905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"23155014801","name":"ACARBOSE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-148-01","proprietary_name":"Acarbose","nonproprietary_name":"Acarbose","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-148-01)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.16905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"62135045490","name":"ACARBOSE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-454-90","proprietary_name":"Acarbose","nonproprietary_name":"acarbose","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-454-90)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.16905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"64380075906","name":"ACARBOSE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-759-06","proprietary_name":"Acarbose","nonproprietary_name":"acarbose","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-759-06)","pharm_classes":["alpha Glucosidase Inhibitors [MoA]","alpha-Glucosidase Inhibitor [EPC]"]},"nadac":{"value":0.16905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acarbose|Acarbose","basis":"generic"},"part_b":null}, {"ndc":"73059000160","name":"ACCRUFER 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73059-001-60","proprietary_name":"ACCRUFER","nonproprietary_name":"Ferric Maltol","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Shield TX (UK) Ltd","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (73059-001-60) / 60 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Iron [CS]","Parenteral Iron Replacement [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":10.08501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268005011","name":"ACEBUTOLOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.61477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acebutolol HCl|Acebutolol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005015","name":"ACEBUTOLOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-050-15","proprietary_name":"Acebutolol Hydrochloride","nonproprietary_name":"Acebutolol Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-050-15) / 1 CAPSULE in 1 BLISTER PACK (50268-050-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.61477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acebutolol HCl|Acebutolol HCl","basis":"generic"},"part_b":null}, {"ndc":"53746066901","name":"ACEBUTOLOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-669-01","proprietary_name":"Acebutolol Hydrochloride","nonproprietary_name":"Acebutolol Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (53746-669-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.61477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acebutolol HCl|Acebutolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559025501","name":"ACEBUTOLOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-255-01","proprietary_name":"Acebutolol Hydrochloride","nonproprietary_name":"Acebutolol Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-255-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.61477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acebutolol HCl|Acebutolol HCl","basis":"generic"},"part_b":null}, {"ndc":"53746067001","name":"ACEBUTOLOL 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-670-01","proprietary_name":"Acebutolol Hydrochloride","nonproprietary_name":"Acebutolol Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (53746-670-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.84101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acebutolol HCl|Acebutolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559025601","name":"ACEBUTOLOL 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-256-01","proprietary_name":"Acebutolol Hydrochloride","nonproprietary_name":"Acebutolol Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-256-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.84101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acebutolol HCl|Acebutolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904748159","name":"ACETAMINOPHEN 1,000 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7481-59","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SOLUTION","route":"ORAL","strength":"1000 mg/30mL","labeler":"Major Pharmaceuticals","package_description":"237 mL in 1 BOTTLE, PLASTIC (0904-7481-59)"},"nadac":{"value":0.0192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54859080916","name":"ACETAMINOPHEN 160 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-809-16","proprietary_name":"Liquid Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"LLORENS PHARMACEUTICALS INTERNATIONAL DIVISION","package_description":"473 mL in 1 BOTTLE (54859-809-16)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367032304","name":"ACETAMINOPHEN 160 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-323-04","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"118 mL in 1 BOTTLE, PLASTIC (69367-323-04)"},"nadac":{"value":0.02406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367032316","name":"ACETAMINOPHEN 160 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-323-16","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (69367-323-16)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237030412","name":"ACETAMINOPHEN 160 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-304-12","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SOLUTION","route":"ORAL","strength":"160 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118 mL in 1 BOTTLE, PLASTIC (57237-304-12)"},"nadac":{"value":0.02406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237030416","name":"ACETAMINOPHEN 160 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-304-16","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SOLUTION","route":"ORAL","strength":"160 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (57237-304-16)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122043078","name":"ACETAMINOPHEN 325 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-430-78","proprietary_name":"Acetaminophen Regular Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1","labeler":"Amerisource Bergen","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (46122-430-78)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132701","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1327-01","proprietary_name":"Rugby Regular Strength Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"RUGBY LABORATORIES","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0536-1327-01)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132706","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1327-06","proprietary_name":"Rugby Regular Strength Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"RUGBY LABORATORIES","package_description":"50 TABLET in 1 BOTTLE, PLASTIC (0536-1327-06)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132710","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1327-10","proprietary_name":"Rugby Regular Strength Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"RUGBY LABORATORIES","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0536-1327-10)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904677361","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6773-61","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-6773-61) / 10 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483034001","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-340-01","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"TIME CAP LABS INC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (49483-340-01)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483034010","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-340-10","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"TIME CAP LABS INC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (49483-340-10)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237034601","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-346-01","proprietary_name":"Acetaminophen","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-346-01)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237034610","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-346-10","proprietary_name":"Acetaminophen","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-346-10)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599467909","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-4679-9","proprietary_name":"McKesson Acetaminophen 325","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1","labeler":"McKesson Medical-Surgical, Inc.","package_description":"250 PACKET in 1 BOX (68599-4679-9) / 2 TABLET, COATED in 1 PACKET"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000101","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0001-1","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"AARNA USA INC.","package_description":"100 TABLET in 1 BOTTLE (82568-0001-1)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000102","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0001-2","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"AARNA USA INC.","package_description":"1000 TABLET in 1 BOTTLE (82568-0001-2)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000103","name":"ACETAMINOPHEN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0001-3","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"AARNA USA INC.","package_description":"100 TABLET in 1 PACKAGE (82568-0001-3)"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536141347","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536141348","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1413-48","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rugby Laboratories","package_description":"50 POUCH in 1 CARTON (0536-1413-48) / 2 TABLET, FILM COATED in 1 POUCH (0536-1413-47)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672024","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6720-24","proprietary_name":"acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6720-24) / 24 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672040","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6720-40","proprietary_name":"acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-6720-40)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672051","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6720-51","proprietary_name":"acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6720-51) / 50 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672059","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6720-59","proprietary_name":"acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6720-59) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672060","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6720-60","proprietary_name":"acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (0904-6720-60)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672080","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6720-80","proprietary_name":"acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET in 1 BOTTLE (0904-6720-80)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237034705","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-347-05","proprietary_name":"Acetaminophen","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-347-05)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000037301","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0373-1","proprietary_name":"leader Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0373-1) / 24 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000037302","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0373-2","proprietary_name":"leader Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0373-2) / 50 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000037305","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0373-5","proprietary_name":"leader Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"500 TABLET in 1 BOTTLE (70000-0373-5)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016101","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-161-01","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (70010-161-01) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016105","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-161-05","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-161-05)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016110","name":"ACETAMINOPHEN 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-161-10","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-161-10)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536129229","name":"ACETAMINOPHEN 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1292-29","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0536-1292-29) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000031201","name":"ACETAMINOPHEN 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0312-1","proprietary_name":"Acetaminophen Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0312-1) / 50 TABLET, COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000031202","name":"ACETAMINOPHEN 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0312-2","proprietary_name":"Acetaminophen Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0312-2) / 100 TABLET, COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536117201","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1172-01","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rugby Laboratories","package_description":"100 TABLET in 1 BOTTLE (0536-1172-01)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904673059","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6730-59","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6730-59) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904673060","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6730-60","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (0904-6730-60)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904673061","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6730-61","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-6730-61) / 10 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904673080","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6730-80","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET in 1 BOTTLE (0904-6730-80)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483034101","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-341-01","proprietary_name":"ACETAMINOPHEN Extra Strength","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABS INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-341-01)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483034110","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-341-10","proprietary_name":"ACETAMINOPHEN Extra Strength","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABS INC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (49483-341-10)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483034150","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-341-50","proprietary_name":"ACETAMINOPHEN Extra Strength","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABS INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-341-50)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599468103","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-4681-3","proprietary_name":"Acetaminophen","nonproprietary_name":"Pain reliever","dosage_form":"TABLET","route":"ORAL","strength":".5 g/g","labeler":"McKesson","package_description":".5 g in 1 POUCH (68599-4681-3)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000003601","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0036-1","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"100 TABLET in 1 BOTTLE (70000-0036-1)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000041001","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0410-1","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0410-1) / 60 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000041002","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0410-2","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"100 TABLET in 1 BOTTLE (70000-0410-2)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000070901","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0709-1","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"500 TABLET in 1 BOTTLE (70000-0709-1)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000201","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0002-1","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"AARNA USA INC.","package_description":"100 TABLET in 1 BOTTLE (82568-0002-1)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000202","name":"ACETAMINOPHEN 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0002-2","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"AARNA USA INC.","package_description":"1000 TABLET in 1 BOTTLE (82568-0002-2)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904753259","name":"ACETAMINOPHEN 500 MG/15 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7532-59","proprietary_name":"Major Extra Strength Acetaminophen Liquid","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"500 mg/15mL","labeler":"Major Pharmaceuticals","package_description":"237 mL in 1 BOTTLE (0904-7532-59)"},"nadac":{"value":0.0192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802073000","name":"ACETAMINOPHEN 650 MG SUPPOS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-730-00","proprietary_name":"acetaminophen pain reliever fever reducer","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"650 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 SUPPOSITORY in 1 BLISTER PACK (45802-730-00)"},"nadac":{"value":0.34938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802073030","name":"ACETAMINOPHEN 650 MG SUPPOS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-730-30","proprietary_name":"acetaminophen pain reliever fever reducer","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"650 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"12 BLISTER PACK in 1 CARTON (45802-730-30) / 1 SUPPOSITORY in 1 BLISTER PACK"},"nadac":{"value":0.34938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802073033","name":"ACETAMINOPHEN 650 MG SUPPOS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-730-33","proprietary_name":"acetaminophen pain reliever fever reducer","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"650 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"100 BLISTER PACK in 1 CARTON (45802-730-33) / 1 SUPPOSITORY in 1 BLISTER PACK"},"nadac":{"value":0.34938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904688365","name":"ACETAMINOPHEN ER 650 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6883-65","proprietary_name":"major acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"Major Pharmaceuticals","package_description":"400 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0904-6883-65)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904731427","name":"ACETAMINOPHEN ER 650 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7314-27","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"400 TABLET in 1 BOTTLE (0904-7314-27)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904731460","name":"ACETAMINOPHEN ER 650 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7314-60","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"100 TABLET in 1 BOTTLE (0904-7314-60)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483069901","name":"ACETAMINOPHEN ER 650 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-699-01","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen tablet extended release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (49483-699-01)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016001","name":"ACETAMINOPHEN ER 650 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-160-01","proprietary_name":"ACETAMINOPHEN","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-160-01)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687092411","name":"ACETAMINOPHEN ER 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687092421","name":"ACETAMINOPHEN ER 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-924-21","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-924-21) / 1 TABLET in 1 BLISTER PACK (60687-924-11)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001049500","name":"ACETAMINOPHEN ER 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-495-00","proprietary_name":"Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-495-00) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904673151","name":"ACETAMINOPHEN PM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6731-51","proprietary_name":"Acetaminophen PM","nonproprietary_name":"Acetaminophen, Diphenhydramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 500 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6731-51) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000041101","name":"ACETAMINOPHEN PM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0411-1","proprietary_name":"Acetaminophen, Diphenhydramine Hydrochloride","nonproprietary_name":"Acetaminophen, Diphenhydramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0411-1) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000041103","name":"ACETAMINOPHEN PM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0411-3","proprietary_name":"Acetaminophen, Diphenhydramine Hydrochloride","nonproprietary_name":"Acetaminophen, Diphenhydramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0411-3) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048301","name":"ACETAMINOPHEN-COD #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0483-01","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0483-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.26941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107005801","name":"ACETAMINOPHEN-COD #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-058-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 15 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-058-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.26941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380044801","name":"ACETAMINOPHEN-COD #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-448-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 15 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-448-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.26941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850064101","name":"ACETAMINOPHEN-COD #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-641-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 15 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-641-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.26941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850064105","name":"ACETAMINOPHEN-COD #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-641-05","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 15 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"500 TABLET in 1 BOTTLE (64850-641-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.26941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930005412","name":"ACETAMINOPHEN-COD #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-054-12","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 15 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-054-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.26941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048401","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0484-01","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0484-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048403","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0484-03","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET in 1 BOTTLE (0406-0484-03)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048410","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0484-10","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"SpecGx LLC","package_description":"1000 TABLET in 1 BOTTLE (0406-0484-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048423","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0484-23","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0484-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048462","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0484-62","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0484-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107005901","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-059-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-059-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107005999","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-059-99","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (13107-059-99)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380044601","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-446-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-446-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850064201","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-642-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-642-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850064205","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-642-05","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"500 TABLET in 1 BOTTLE (64850-642-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162003310","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-033-10","proprietary_name":"Acetaminophen and Codeine","nonproprietary_name":"Acetaminophen and Codeine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-033-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930005512","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-055-12","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-055-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930005552","name":"ACETAMINOPHEN-COD #3 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-055-52","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 30 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-055-52)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.25557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048501","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0485-01","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0485-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406048505","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0485-05","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0485-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107006001","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-060-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-060-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107006005","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-060-05","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-060-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107006099","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-060-99","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (13107-060-99)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380044701","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-447-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-447-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380044702","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-447-02","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE (64380-447-02)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850064301","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-643-01","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-643-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850064305","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-643-05","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"500 TABLET in 1 BOTTLE (64850-643-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930005612","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-056-12","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-056-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930005652","name":"ACETAMINOPHEN-COD #4 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-056-52","proprietary_name":"ACETAMINOPHEN AND CODEINE PHOSPHATE","nonproprietary_name":"acetaminophen and codeine phosphate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 60 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-056-52)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.38902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64950037416","name":"ACETAMINOPHEN-CODEINE 120 MG-12 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-374-16","proprietary_name":"Acetaminophen and Codeine Phosphate","nonproprietary_name":"Acetaminophen and Codeine Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"120 mg/5mL; 12 mg/5mL","labeler":"Genus Lifesciences Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (64950-374-16)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.46877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672425801","name":"ACETAMINOPHEN-IBUPROFEN 250-125 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4258-1","proprietary_name":"Acetaminophen 250 mg and Ibuprofen 125 mg","nonproprietary_name":"Acetaminophen 250 mg and Ibuprofen 125 mg Tablets","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4258-1) / 216 TABLET in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672425804","name":"ACETAMINOPHEN-IBUPROFEN 250-125 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4258-4","proprietary_name":"Acetaminophen 250 mg and Ibuprofen 125 mg","nonproprietary_name":"Acetaminophen 250 mg and Ibuprofen 125 mg Tablets","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4258-4) / 72 TABLET in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155028701","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-287-01","proprietary_name":"acetazolamide","nonproprietary_name":"acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-287-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"52817020010","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-200-10","proprietary_name":"ACETAZOLAMIDE","nonproprietary_name":"ACETAZOLAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"TRUPHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (52817-200-10)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"59651090501","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-905-01","proprietary_name":"ACETAZOLAMIDE","nonproprietary_name":"ACETAZOLAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-905-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"62135060712","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-607-12","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-607-12)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"64380083306","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-833-06","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-833-06)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"70756072011","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-720-11","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-720-11)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"70954003330","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-033-30","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-033-30)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"71930000812","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-008-12","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-008-12)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"72578014901","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-149-01","proprietary_name":"acetaZOLAMIDE","nonproprietary_name":"acetaZOLAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-149-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"72888004701","name":"ACETAZOLAMIDE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-047-01","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-047-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.09649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"00904666361","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6663-61","proprietary_name":"acetazolamide","nonproprietary_name":"acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6663-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"23155028801","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-288-01","proprietary_name":"acetazolamide","nonproprietary_name":"acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-288-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"50268005411","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"50268005415","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-054-15","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-054-15) / 1 TABLET in 1 BLISTER PACK (50268-054-11)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"52817020110","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-201-10","proprietary_name":"ACETAZOLAMIDE","nonproprietary_name":"ACETAZOLAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"TRUPHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (52817-201-10)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"59651090601","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-906-01","proprietary_name":"ACETAZOLAMIDE","nonproprietary_name":"ACETAZOLAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-906-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"62135060812","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-608-12","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-608-12)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"64380083406","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-834-06","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-834-06)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"70756072111","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-721-11","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-721-11)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"70954003430","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-034-30","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-034-30)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"71930000912","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-009-12","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-009-12)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"72578015001","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-150-01","proprietary_name":"acetaZOLAMIDE","nonproprietary_name":"acetaZOLAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-150-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"72888004801","name":"ACETAZOLAMIDE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-048-01","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-048-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.13397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"16729033101","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-331-01","proprietary_name":"acetazolamide","nonproprietary_name":"acetazolamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16729-331-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"23155012001","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"23155078701","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-787-01","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (23155-787-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"42571024301","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-243-01","proprietary_name":"ACETAZOLAMIDE EXTENDED-RELEASE","nonproprietary_name":"Acetazolamide extended-release","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-243-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"50268004211","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"50268004212","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-042-12","proprietary_name":"ACETAZOLAMIDE EXTENDED-RELEASE","nonproprietary_name":"Acetazolamide Extended-Release","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-042-12) / 1 CAPSULE in 1 BLISTER PACK (50268-042-11)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"60687057811","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"60687057821","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-578-21","proprietary_name":"acetazolamide","nonproprietary_name":"acetazolamide","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-578-21) / 1 CAPSULE in 1 BLISTER PACK (60687-578-11)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"62135061260","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-612-60","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 PACKAGE (62135-612-60)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"69367020901","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-209-01","proprietary_name":"Acetazolamide","nonproprietary_name":"Acetazolamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69367-209-01)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"70710159101","name":"ACETAZOLAMIDE ER 500 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1591-1","proprietary_name":"acetazolamide","nonproprietary_name":"acetazolamide","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70710-1591-1)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.28822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acetazolamide ER|Acetazolamide","basis":"generic"},"part_b":null}, {"ndc":"52817081615","name":"ACETIC ACID 2% EAR SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-816-15","proprietary_name":"Acetic Acid","nonproprietary_name":"Acetic Acid","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"20.65 mg/mL","labeler":"TruPharma, LLC","package_description":"1 BOTTLE in 1 CARTON (52817-816-15) / 15 mL in 1 BOTTLE"},"nadac":{"value":1.49018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetic Acid*|Acetic Acid","basis":"generic"},"part_b":null}, {"ndc":"62135080151","name":"ACETIC ACID 2% EAR SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-801-51","proprietary_name":"ACETIC ACID","nonproprietary_name":"ACETIC ACID","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"20 mg/mL","labeler":"Chartwell RX, LLC","package_description":"15 mL in 1 BOTTLE (62135-801-51)"},"nadac":{"value":1.49018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetic Acid*|Acetic Acid","basis":"generic"},"part_b":null}, {"ndc":"00409330703","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3307-03","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"Hospira, Inc.","package_description":"3 VIAL in 1 CARTON (0409-3307-03) / 30 mL in 1 VIAL (0409-3307-11)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.63561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":9,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (0409-3307-03) / 30 mL in 1 VIAL (0409-3307-11)) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409330711","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.9656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic","route_from":"fda_product","route":"ORAL; RESPIRATORY (INHALATION)","product_ndc":"0409-3307","inner_of":["0409-3307-03"]},"part_b":null}, {"ndc":"00517750425","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-7504-25","proprietary_name":"Acetylcysteine","nonproprietary_name":"acetylcysteine","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"American Regent, Inc.","package_description":"25 VIAL, GLASS in 1 TRAY (0517-7504-25) / 4 mL in 1 VIAL, GLASS","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.55393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, GLASS in 1 TRAY (0517-7504-25) / 4 mL in 1 VIAL, GLASS) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42494043525","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-435-25","proprietary_name":"Acetylcysteine","nonproprietary_name":"Acetylcysteine","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"Cameron Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (42494-435-25) / 4 mL in 1 VIAL","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.55393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (42494-435-25) / 4 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069122","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.9656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic","route_from":"fda_product","route":"ORAL; RESPIRATORY (INHALATION)","product_ndc":"63323-691","inner_of":["63323-691-30"]},"part_b":null}, {"ndc":"63323069130","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-691-30","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"3 VIAL in 1 CARTON (63323-691-30) / 30 mL in 1 VIAL (63323-691-22)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.63561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":9,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (63323-691-30) / 30 mL in 1 VIAL (63323-691-22)) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069310","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-693-10","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"3 VIAL in 1 CARTON (63323-693-10) / 10 mL in 1 VIAL (63323-693-22)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.9656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (63323-693-10) / 10 mL in 1 VIAL (63323-693-22)) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069504","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-695-04","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 CARTON (63323-695-04) / 4 mL in 1 VIAL (63323-695-22)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.55393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (63323-695-04) / 4 mL in 1 VIAL (63323-695-22)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069001825","name":"ACETYLCYSTEINE 10% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-018-25","proprietary_name":"Acetylcysteine","nonproprietary_name":"Acetylcysteine","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"25 VIAL in 1 CARTON (70069-018-25) / 4 mL in 1 VIAL (70069-018-01)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.55393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70069-018-25) / 4 mL in 1 VIAL (70069-018-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409330803","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3308-03","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Hospira, Inc.","package_description":"3 VIAL in 1 CARTON (0409-3308-03) / 30 mL in 1 VIAL (0409-3308-11)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.73709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":18,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (0409-3308-03) / 30 mL in 1 VIAL (0409-3308-11)) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517760425","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-7604-25","proprietary_name":"Acetylcysteine","nonproprietary_name":"acetylcysteine","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"American Regent, Inc.","package_description":"25 VIAL, GLASS in 1 TRAY (0517-7604-25) / 4 mL in 1 VIAL, GLASS","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, GLASS in 1 TRAY (0517-7604-25) / 4 mL in 1 VIAL, GLASS) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42494043625","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-436-25","proprietary_name":"Acetylcysteine","nonproprietary_name":"Acetylcysteine","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Cameron Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (42494-436-25) / 4 mL in 1 VIAL","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (42494-436-25) / 4 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069030","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-690-30","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"3 VIAL in 1 CARTON (63323-690-30) / 30 mL in 1 VIAL (63323-690-22)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.73709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":18,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (63323-690-30) / 30 mL in 1 VIAL (63323-690-22)) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069044","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-690-44","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"3 VIAL in 1 CARTON (63323-690-44) / 30 mL in 1 VIAL (63323-690-41)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.73709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":18,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (63323-690-44) / 30 mL in 1 VIAL (63323-690-41)) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069404","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-694-04","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 CARTON (63323-694-04) / 4 mL in 1 VIAL (63323-694-22)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (63323-694-04) / 4 mL in 1 VIAL (63323-694-22)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323069444","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-694-44","proprietary_name":"Acetylcysteine","nonproprietary_name":"ACETYLCYSTEINE","dosage_form":"SOLUTION","route":"ORAL; RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 CARTON (63323-694-44) / 4 mL in 1 VIAL (63323-694-41)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (63323-694-44) / 4 mL in 1 VIAL (63323-694-41)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069001925","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-019-25","proprietary_name":"Acetylcysteine","nonproprietary_name":"Acetylcysteine","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"25 VIAL in 1 CARTON (70069-019-25) / 4 mL in 1 VIAL (70069-019-01)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":2.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70069-019-25) / 4 mL in 1 VIAL (70069-019-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069002003","name":"ACETYLCYSTEINE 20% VIAL (NOT FOR INJECTION)","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-020-03","proprietary_name":"Acetylcysteine","nonproprietary_name":"Acetylcysteine","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"200 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"3 VIAL in 1 CARTON (70069-020-03) / 30 mL in 1 VIAL (70069-020-01)","pharm_classes":["Antidote [EPC]","Antidote for Acetaminophen Overdose [EPC]","Decreased Respiratory Secretion Viscosity [PE]","Increased Glutathione Concentration [PE]","Mucolytic [EPC]","Reduction Activity [MoA]"]},"nadac":{"value":0.73709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acetylcysteine*|Acetylcysteine","basis":"generic"},"part_b":{"hcpcs":"J7608","bill_units_per_package":{"value":18,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7608 (1 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL in 1 CARTON (70069-020-03) / 30 mL in 1 VIAL (70069-020-01)) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00904772714","name":"ACID GONE ANTACID LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7727-14","proprietary_name":"ACID GONE ANTACID","nonproprietary_name":"aluminum hydroxide and magnesium carbonate","dosage_form":"LIQUID","route":"ORAL","strength":"95 mg/15mL; 358 mg/15mL","labeler":"Major Pharmaceuticals","package_description":"355 mL in 1 BOTTLE (0904-7727-14)"},"nadac":{"value":0.01275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904536560","name":"ACID GONE TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5365-60","proprietary_name":"Acid Gone Antacid Extra Strength","nonproprietary_name":"aluminum hydroxide and magnesium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1; 105 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0904-5365-60)"},"nadac":{"value":0.04408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122039465","name":"ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483072001","name":"ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-720-01","proprietary_name":"Maximum Strength Acid Reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"TIME CAP LABORATORIES,INC","package_description":"100 TABLET in 1 BOTTLE (49483-720-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000004901","name":"ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0049-1","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"LEADER/ CARDINAL HEALTH 110, INC.","package_description":"1 BOTTLE in 1 CARTON (70000-0049-1) / 25 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000065401","name":"ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0654-1","proprietary_name":"Leader Acid Reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0654-1) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000071001","name":"ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0710-1","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0710-1) / 200 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000041601","name":"ACID REDUCER COMPLETE TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0416-1","proprietary_name":"leader acid reducer complete","nonproprietary_name":"Famotidine, Calcium Carbonate, Magnesium Hydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1; 800 mg/1; 165 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"25 TABLET, CHEWABLE in 1 BOTTLE (70000-0416-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.2578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058201","name":"ACID REDUCER COMPLETE TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0582-1","proprietary_name":"leader acid reducer complete","nonproprietary_name":"famotidine, calcium carbonate and magnesium hydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1; 800 mg/1; 165 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"50 TABLET, CHEWABLE in 1 BOTTLE (70000-0582-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.2578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000023201","name":"ACID REDUCER DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0232-1","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0232-1) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000023202","name":"ACID REDUCER DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000023203","name":"ACID REDUCER DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0232-3","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"3 BOTTLE in 1 CARTON (70000-0232-3) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093113556","name":"ACITRETIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1135-56","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-1135-56)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.59463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00115175008","name":"ACITRETIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1750-08","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0115-1750-08)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.59463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00378702093","name":"ACITRETIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7020-93","proprietary_name":"Acitretin","nonproprietary_name":"acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0378-7020-93)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.59463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"42794008008","name":"ACITRETIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-080-08","proprietary_name":"ACITRETIN","nonproprietary_name":"ACITRETIN","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE (42794-080-08)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.59463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"62332074130","name":"ACITRETIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-741-30","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-741-30)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.59463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00093113856","name":"ACITRETIN 17.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1138-56","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"17.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-1138-56)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.51838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00115175108","name":"ACITRETIN 17.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1751-08","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"17.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0115-1751-08)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.51838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"42794008108","name":"ACITRETIN 17.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-081-08","proprietary_name":"ACITRETIN","nonproprietary_name":"ACITRETIN","dosage_form":"CAPSULE","route":"ORAL","strength":"17.5 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE (42794-081-08)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.51838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"62332074230","name":"ACITRETIN 17.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-742-30","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"17.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-742-30)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.51838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00093113656","name":"ACITRETIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1136-56","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-1136-56)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.5423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00115175308","name":"ACITRETIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1753-08","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0115-1753-08)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.5423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00378702393","name":"ACITRETIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7023-93","proprietary_name":"Acitretin","nonproprietary_name":"acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0378-7023-93)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.5423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"42794008308","name":"ACITRETIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-083-08","proprietary_name":"ACITRETIN","nonproprietary_name":"ACITRETIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE (42794-083-08)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.5423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"62332074330","name":"ACITRETIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-743-30","proprietary_name":"Acitretin","nonproprietary_name":"Acitretin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-743-30)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.5423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Acitretin|Acitretin","basis":"generic"},"part_b":null}, {"ndc":"00536105625","name":"ACNE MEDICATION 10% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.23145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536105656","name":"ACNE MEDICATION 10% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1056-56","proprietary_name":"Rugby Benzoyl Peroxide Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"100 mg/mL","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1056-56) / 42.5 mL in 1 TUBE"},"nadac":{"value":0.08433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536105875","name":"ACNE MEDICATION 10% LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.07402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536105525","name":"ACNE MEDICATION 5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1055-25","proprietary_name":"Rugby Benzoyl Peroxide Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/mL","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1055-25) / 60 mL in 1 TUBE"},"nadac":{"value":0.2175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536105556","name":"ACNE MEDICATION 5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1055-56","proprietary_name":"Rugby Benzoyl Peroxide Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/mL","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1055-56) / 42.5 mL in 1 TUBE"},"nadac":{"value":0.08392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"50242014301","name":"ACTEMRA ACTPEN 162 MG/0.9 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50242-143-01","proprietary_name":"Actemra ACTPen","nonproprietary_name":"tocilizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"162 mg/.9mL","labeler":"Genentech, Inc.","package_description":"1 SYRINGE, GLASS in 1 BOX (50242-143-01) / .9 mL in 1 SYRINGE, GLASS","pharm_classes":["Interleukin 6 Receptor Antagonists [MoA]","Interleukin-6 Receptor Antagonist [EPC]"]},"nadac":{"value":1279.05778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Actemra Actpen|Tocilizumab","basis":"brand"},"part_b":null}, {"ndc":"00430047203","name":"ACTONEL 35 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0430-0472-03","proprietary_name":"Actonel","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30.1 mg/1; 4.9 mg/1","labeler":"Allergan, Inc.","package_description":"4 TABLET, FILM COATED in 1 DOSE PACK (0430-0472-03)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":81.8555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Actonel|Risedronate Sodium","basis":"brand"},"part_b":null}, {"ndc":"00023927705","name":"ACULAR LS 0.4% OPHTH SOL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9277-05","proprietary_name":"ACULAR LS","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9277-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":54.455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":12.67371,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Acular Ls|Ketorolac Tromethamine","basis":"brand"},"part_b":null}, {"ndc":"00904751961","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7519-61","proprietary_name":"ACYCLOVIR","nonproprietary_name":"acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7519-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155022901","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-229-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-229-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155022905","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-229-05","proprietary_name":"ACYCLOVIR","nonproprietary_name":"acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-229-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155096201","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-962-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-962-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505004206","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0042-6","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-0042-6)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442011401","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-114-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"12 BOTTLE, PLASTIC in 1 BOX (61442-114-01) / 100 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442011405","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-114-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"12 BOTTLE, PLASTIC in 1 BOX (61442-114-05) / 500 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135003950","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-039-50","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"50 CAPSULE in 1 BOTTLE (62135-039-50)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69076014601","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69076-146-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Quinn Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (69076-146-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71921014601","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-146-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"100 CAPSULE in 1 BOTTLE (71921-146-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72241002805","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-028-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72241-028-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000201","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-002-01","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-002-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000205","name":"ACYCLOVIR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-002-05","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (72578-002-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00472008216","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0082-16","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Actavis Pharma, Inc.","package_description":"473 mL in 1 BOTTLE (0472-0082-16)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155048551","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722068147","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-681-47","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (31722-681-47)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135080347","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-803-47","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-803-47)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954018810","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-188-10","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (70954-188-10)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205017072","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-170-72","proprietary_name":"Acyclovir suspension","nonproprietary_name":"Acyclovir","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE (72205-170-72)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888007917","name":"ACYCLOVIR 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-079-17","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Advagen Pharma Limited","package_description":"473 mL in 1 BOTTLE (72888-079-17)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.07643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904750761","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7507-61","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7507-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155022701","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-227-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-227-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155022705","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-227-05","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-227-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722077701","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-777-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-777-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722077705","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-777-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-777-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006111","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006115","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-061-15","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOTTLE, UNIT-DOSE (50268-061-15) / 1 TABLET in 1 BLISTER PACK (50268-061-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651096501","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-965-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-965-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651096505","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-965-05","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-965-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505530601","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-5306-1","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-5306-1)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085601","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-856-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-856-01) / 1 TABLET in 1 BLISTER PACK (60687-856-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085611","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085665","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-856-65","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-856-65) / 1 TABLET in 1 BLISTER PACK (60687-856-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442011201","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-112-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-112-01) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442011205","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-112-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"12 BOTTLE, PLASTIC in 1 BOX (61442-112-05) / 500 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079101","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-791-01","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-791-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079105","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-791-05","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-791-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367013701","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-137-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-137-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367013705","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-137-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-137-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452029020","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-290-20","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-290-20)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452029030","name":"ACYCLOVIR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-290-30","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Bionpharma Inc.","package_description":"500 TABLET in 1 BOTTLE (69452-290-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093363020","name":"ACYCLOVIR 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3630-20","proprietary_name":"Acyclovir","nonproprietary_name":"acyclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-3630-20) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":8.99159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004475","name":"ACYCLOVIR 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-044-75","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-044-75) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":8.99159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136105","name":"ACYCLOVIR 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1361-5","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1361-5) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":8.99159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332042305","name":"ACYCLOVIR 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-423-05","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-423-05) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":8.99159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162083614","name":"ACYCLOVIR 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-836-14","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (65162-836-14) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":8.99159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578010105","name":"ACYCLOVIR 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-101-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-101-05) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":8.99159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668051501","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-515-01","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"15 g in 1 TUBE (13668-515-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668051502","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-515-02","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 g in 1 TUBE (13668-515-02)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714088501","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-885-01","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CARTON (16714-885-01) / 15 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714088502","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-885-02","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CARTON (16714-885-02) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342043930","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-439-30","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-439-30) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136001","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1360-1","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1360-1) / 15 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136002","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1360-2","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1360-2) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162083594","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-835-94","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (65162-835-94) / 15 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162083596","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-835-96","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (65162-835-96) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462074617","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-746-17","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-746-17) / 15 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462074635","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-746-35","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-746-35) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010715","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-107-15","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Xiromed, LLC","package_description":"1 TUBE in 1 CARTON (70700-107-15) / 15 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010716","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-107-16","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Xiromed, LLC","package_description":"1 TUBE in 1 CARTON (70700-107-16) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008201","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-082-01","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-082-01) / 15 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.52214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008206","name":"ACYCLOVIR 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-082-06","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-082-06) / 30 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.34585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"23155022801","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-228-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-228-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155022805","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-228-05","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-228-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722077801","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-778-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-778-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722077805","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-778-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-778-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006211","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006215","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-062-15","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOTTLE, UNIT-DOSE (50268-062-15) / 1 TABLET in 1 BLISTER PACK (50268-062-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651096601","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-966-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-966-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651096605","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-966-05","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-966-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505530701","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-5307-1","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-5307-1)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086701","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-867-01","proprietary_name":"ACYCLOVIR","nonproprietary_name":"ACYCLOVIR","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-867-01) / 1 TABLET in 1 BLISTER PACK (60687-867-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086711","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442011301","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-113-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-113-01) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442011305","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-113-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"12 BOTTLE, PLASTIC in 1 BOX (61442-113-05) / 500 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135001950","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-019-50","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Chartwell RX, LLC","package_description":"50 TABLET in 1 BOTTLE (62135-019-50)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079201","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-792-01","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-792-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079205","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-792-05","proprietary_name":"acyclovir","nonproprietary_name":"acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-792-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367013801","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-138-01","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-138-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367013805","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-138-05","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-138-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452029120","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-291-20","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-291-20)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452029130","name":"ACYCLOVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-291-30","proprietary_name":"Acyclovir","nonproprietary_name":"Acyclovir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Bionpharma Inc.","package_description":"500 TABLET in 1 BOTTLE (69452-291-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.19403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65219061299","name":"ADALIMUMAB-AACF(CF) PEN 40 MG/0.8 ML (2 PACK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-612-99","proprietary_name":"Adalimumab-aacf","nonproprietary_name":"adalimumab","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"Fresenius Kabi USA, LLC","package_description":"1 KIT in 1 CARTON (65219-612-99) * .8 mL in 1 SYRINGE, GLASS (65219-610-02) * 1 SWAB in 1 POUCH (65219-332-95)"},"nadac":{"value":872.71667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72606002209","name":"ADALIMUMAB-AATY(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72606-022-09","proprietary_name":"Adalimumab","nonproprietary_name":"adalimumab-aaty","dosage_form":"KIT","route":null,"strength":null,"labeler":"CELLTRION USA, Inc.","package_description":"1 KIT in 1 CARTON (72606-022-09) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":501.46018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adalimumab-Aaty(Cf) Autoinj(2)|Adalimumab-Aaty","basis":"generic"},"part_b":null}, {"ndc":"72606002210","name":"ADALIMUMAB-AATY(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72606-022-10","proprietary_name":"Adalimumab","nonproprietary_name":"adalimumab-aaty","dosage_form":"KIT","route":null,"strength":null,"labeler":"CELLTRION USA, Inc.","package_description":"2 KIT in 1 CARTON (72606-022-10) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":490.03675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adalimumab-Aaty(Cf) Autoinj(2)|Adalimumab-Aaty","basis":"generic"},"part_b":null}, {"ndc":"61314032720","name":"ADALIMUMAB-ADAZ(CF) PEN 40 MG/0.4 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-327-20","proprietary_name":"Adalimumab","nonproprietary_name":"adalimumab-adaz","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Sandoz Inc","package_description":"2 SYRINGE in 1 CARTON (61314-327-20) / .4 mL in 1 SYRINGE","pharm_classes":["Antibodies, Monoclonal [CS]","Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":1587.81765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00597057550","name":"ADALIMUMAB-ADBM(CF) PEN 40 MG/0.4 ML","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0575-50","proprietary_name":"Adalimumab-adbm","nonproprietary_name":"Adalimumab-adbm","dosage_form":"KIT","route":null,"strength":null,"labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"2 KIT in 1 CARTON (0597-0575-50) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY (0597-0570-32) / .4 mL in 1 SYRINGE * 2 PACKET in 1 TRAY / 1 mL in 1 PACKET"},"nadac":{"value":639.19458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009014422","name":"ADALIMUMAB-ADBM(CF) PEN 40 MG/0.4 ML","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-144-22","proprietary_name":"Adalimumab-adbm","nonproprietary_name":"Adalimumab-adbm","dosage_form":"KIT","route":null,"strength":null,"labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"2 KIT in 1 CARTON (82009-144-22) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY (82009-145-11) / .4 mL in 1 SYRINGE * 2 PACKET in 1 TRAY / 1 mL in 1 PACKET"},"nadac":{"value":639.19458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00597054522","name":"ADALIMUMAB-ADBM(CF) PEN 40 MG/0.8 ML","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0545-22","proprietary_name":"Adalimumab-adbm","nonproprietary_name":"Adalimumab-adbm","dosage_form":"KIT","route":null,"strength":null,"labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"2 KIT in 1 CARTON (0597-0545-22) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY (0597-0540-10) / .8 mL in 1 SYRINGE * 2 PACKET in 1 TRAY / 1 mL in 1 PACKET"},"nadac":{"value":639.57857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009014822","name":"ADALIMUMAB-ADBM(CF) PEN 40 MG/0.8 ML","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-148-22","proprietary_name":"Adalimumab-adbm","nonproprietary_name":"Adalimumab-adbm","dosage_form":"KIT","route":null,"strength":null,"labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"2 KIT in 1 CARTON (82009-148-22) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY (82009-149-11) / .8 mL in 1 SYRINGE * 2 PACKET in 1 TRAY / 1 mL in 1 PACKET"},"nadac":{"value":639.57857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00168042446","name":"ADAPALENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0424-46","proprietary_name":"Adapalene","nonproprietary_name":"adapalene","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0424-46) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.85454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"45802045384","name":"ADAPALENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-453-84","proprietary_name":"Adapalene","nonproprietary_name":"Adapalene","dosage_form":"CREAM","route":"TOPICAL","strength":".1 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-453-84) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.85454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"00536141220","name":"ADAPALENE 0.1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1412-20","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"RUGBY LABORATORIES, INC.","package_description":"1 TUBE in 1 CARTON (0536-1412-20) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.4655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536141226","name":"ADAPALENE 0.1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1412-26","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"RUGBY LABORATORIES, INC.","package_description":"1 TUBE in 1 CARTON (0536-1412-26) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.33648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672215001","name":"ADAPALENE 0.1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2150-1","proprietary_name":"Adapalene","nonproprietary_name":"Adapalene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2150-1) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.4655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672215006","name":"ADAPALENE 0.1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2150-6","proprietary_name":"Adapalene","nonproprietary_name":"Adapalene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2150-6) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.33648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000066601","name":"ADAPALENE 0.1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0666-1","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Cardinal Health","package_description":"1 TUBE in 1 CARTON (70000-0666-1) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.4655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472012645","name":"ADAPALENE 0.3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0126-45","proprietary_name":"adapalene","nonproprietary_name":"adapalene","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0126-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.50376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"21922005106","name":"ADAPALENE 0.3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-051-06","proprietary_name":"Adapalene Gel USP, 0.3%","nonproprietary_name":"Adapalene Gel USP, 0.3%","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-051-06) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.50376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672137706","name":"ADAPALENE 0.3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1377-6","proprietary_name":"Adapalene","nonproprietary_name":"Adapalene","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1377-6) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.50376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"62332054945","name":"ADAPALENE 0.3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-549-45","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-549-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.50376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"68308066625","name":"ADAPALENE 0.3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-666-25","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Mayne Pharma Commercial LLC.","package_description":"1 TUBE in 1 CARTON (68308-666-25) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.50376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"21922005150","name":"ADAPALENE 0.3% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-051-50","proprietary_name":"Adapalene Gel USP, 0.3%","nonproprietary_name":"Adapalene Gel USP, 0.3%","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (21922-051-50) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.85025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332054946","name":"ADAPALENE 0.3% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-549-46","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (62332-549-46) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.85025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"68308066645","name":"ADAPALENE 0.3% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-666-45","proprietary_name":"ADAPALENE","nonproprietary_name":"ADAPALENE","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g","labeler":"Mayne Pharma Commercial LLC.","package_description":"1 BOTTLE, PUMP in 1 CARTON (68308-666-45) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.85025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene|Adapalene","basis":"generic"},"part_b":null}, {"ndc":"21922005250","name":"ADAPALENE-BNZYL PEROX 0.1-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-052-50","proprietary_name":"Adapalene and Benzoyl Peroxide Gel, 0.1%/2.5%","nonproprietary_name":"Adapalene and Benzoyl Peroxide Gel, 0.1%/2.5%","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g; 25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (21922-052-50) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.36818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802084601","name":"ADAPALENE-BNZYL PEROX 0.1-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-846-01","proprietary_name":"adapalene and benzoyl peroxide","nonproprietary_name":"Adapalene and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":".1 g/100g; 2.5 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"45 g in 1 BOTTLE, PUMP (45802-846-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.36818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"51672136403","name":"ADAPALENE-BNZYL PEROX 0.1-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1364-3","proprietary_name":"ADAPALENE and BENZOYL PEROXIDE","nonproprietary_name":"ADAPALENE and BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g; 25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1364-3) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.36818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"68462030147","name":"ADAPALENE-BNZYL PEROX 0.1-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-301-47","proprietary_name":"adapalene and benzoyl peroxide","nonproprietary_name":"adapalene and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g; 25 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE, PUMP in 1 CARTON (68462-301-47) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.36818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"00480315445","name":"ADAPALENE-BNZYL PEROX 0.3-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3154-45","proprietary_name":"Adapalene and benzoyl peroxide","nonproprietary_name":"Adapalene and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0480-3154-45) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"45802085345","name":"ADAPALENE-BNZYL PEROX 0.3-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-853-45","proprietary_name":"ADAPALENE AND BENZOYL PEROXIDE","nonproprietary_name":"adapalene and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"45 g in 1 BOTTLE, PUMP (45802-853-45)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"51672138409","name":"ADAPALENE-BNZYL PEROX 0.3-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1384-9","proprietary_name":"Adapalene and Benzoyl Peroxide","nonproprietary_name":"ADAPALENE and BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1384-9) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"62332066245","name":"ADAPALENE-BNZYL PEROX 0.3-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-662-45","proprietary_name":"ADAPALENE AND BENZOYL PEROXIDE","nonproprietary_name":"adapalene and benzoyl peroxide topical","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (62332-662-45) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"68308066245","name":"ADAPALENE-BNZYL PEROX 0.3-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-662-45","proprietary_name":"adapalene and benzoyl peroxide","nonproprietary_name":"adapalene and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (68308-662-45) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"72578011904","name":"ADAPALENE-BNZYL PEROX 0.3-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-119-04","proprietary_name":"Adapalene and benzoyl peroxide","nonproprietary_name":"Adapalene and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE, PUMP in 1 BOTTLE, PUMP (72578-119-04) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Adapalene-Benzoyl Peroxide|Adapalene/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"57844011001","name":"ADDERALL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57844-110-01","proprietary_name":"Adderall","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (57844-110-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.18777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"57844011501","name":"ADDERALL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57844-115-01","proprietary_name":"Adderall","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (57844-115-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.3115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"57844012001","name":"ADDERALL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57844-120-01","proprietary_name":"Adderall","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (57844-120-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"57844013001","name":"ADDERALL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57844-130-01","proprietary_name":"Adderall","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (57844-130-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.24144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"57844010501","name":"ADDERALL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57844-105-01","proprietary_name":"Adderall","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (57844-105-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.20358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"54092038301","name":"ADDERALL XR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-383-01","proprietary_name":"Adderall XR","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-383-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.80855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall XR|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"54092038501","name":"ADDERALL XR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-385-01","proprietary_name":"Adderall XR","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-385-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.81243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall XR|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"54092038701","name":"ADDERALL XR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-387-01","proprietary_name":"Adderall XR","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-387-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.80582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall XR|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"54092038901","name":"ADDERALL XR 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-389-01","proprietary_name":"Adderall XR","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-389-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.80588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall XR|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"54092039101","name":"ADDERALL XR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-391-01","proprietary_name":"Adderall XR","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-391-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.80831,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall XR|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"54092038101","name":"ADDERALL XR 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-381-01","proprietary_name":"Adderall XR","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-381-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.83383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adderall XR|Dextroamphetamine/Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"42794000308","name":"ADEFOVIR DIPIVOXIL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42794-003-08","proprietary_name":"ADEFOVIR DIPIVOXIL","nonproprietary_name":"ADEFOVIR DIPIVOXIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (42794-003-08) / 30 TABLET in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":21.73128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adefovir Dipivoxil|Adefovir Dipivoxil","basis":"generic"},"part_b":null}, {"ndc":"60505394703","name":"ADEFOVIR DIPIVOXIL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3947-3","proprietary_name":"Adefovir dipivoxil","nonproprietary_name":"adefovir dipivoxil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-3947-3) / 30 TABLET in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":21.73128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adefovir Dipivoxil|Adefovir Dipivoxil","basis":"generic"},"part_b":null}, {"ndc":"00024592410","name":"ADMELOG 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5924-10","proprietary_name":"ADMELOG","nonproprietary_name":"insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 U/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0024-5924-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":9.39379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Admelog|Insulin Lispro","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0024-5924-10) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00024592605","name":"ADMELOG 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5926-05","proprietary_name":"ADMELOG","nonproprietary_name":"insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 U/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"1 VIAL in 1 CARTON (0024-5926-05) / 3 mL in 1 VIAL","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":12.56125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Admelog|Insulin Lispro","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":6,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0024-5926-05) / 3 mL in 1 VIAL) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00024592505","name":"ADMELOG SOLOSTAR 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5925-05","proprietary_name":"ADMELOG","nonproprietary_name":"insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 U/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"5 SYRINGE in 1 CARTON (0024-5925-05) / 3 mL in 1 SYRINGE (0024-5925-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":12.10918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 SYRINGE in 1 CARTON (0024-5925-05) / 3 mL in 1 SYRINGE (0024-5925-01)) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42023015925","name":"ADRENALIN 1 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42023-159-25","proprietary_name":"Adrenalin","nonproprietary_name":"epinephrine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Par Health USA, LLC","package_description":"25 VIAL in 1 CARTON (42023-159-25) / 1 mL in 1 VIAL (42023-159-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":7.79554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-28","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Adrenalin|Epinephrine","basis":"brand"},"part_b":{"hcpcs":"J0169","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0169 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (42023-159-25) / 1 mL in 1 VIAL (42023-159-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00173069500","name":"ADVAIR 100-50 DISKUS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0695-00","proprietary_name":"ADVAIR DISKUS","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 100 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0695-00) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.48669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.07358,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Advair Diskus|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173069600","name":"ADVAIR 250-50 DISKUS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0696-00","proprietary_name":"ADVAIR DISKUS","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 250 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0696-00) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":3.12275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.24514,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Advair Diskus|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173069700","name":"ADVAIR 500-50 DISKUS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0697-00","proprietary_name":"ADVAIR DISKUS","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 500 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0697-00) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":4.2281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.63625,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Advair Diskus|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173071620","name":"ADVAIR HFA 115-21 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0716-20","proprietary_name":"ADVAIR HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"115 ug/1; 21 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0716-20) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.39279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":20.70767,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Advair HFA|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173071622","name":"ADVAIR HFA 115-21 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0716-22","proprietary_name":"ADVAIR HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"115 ug/1; 21 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0716-22) / 60 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":18.73125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Advair HFA|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173071720","name":"ADVAIR HFA 230-21 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0717-20","proprietary_name":"ADVAIR HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"230 ug/1; 21 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0717-20) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":35.01808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":26.74598,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Advair HFA|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173071722","name":"ADVAIR HFA 230-21 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0717-22","proprietary_name":"ADVAIR HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"230 ug/1; 21 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0717-22) / 60 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":30.53125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Advair HFA|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173071520","name":"ADVAIR HFA 45-21 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0715-20","proprietary_name":"ADVAIR HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"45 ug/1; 21 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0715-20) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":19.9752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":16.6775,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Advair HFA|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00173071522","name":"ADVAIR HFA 45-21 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0715-22","proprietary_name":"ADVAIR HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"45 ug/1; 21 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0715-22) / 60 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":20.01825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Advair HFA|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"24208061701","name":"ADVANCED EYE RELIEF 0.2% DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-617-01","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (24208-617-01) / 3.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.98349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70165002030","name":"ADZENYS XR-ODT 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-020-30","proprietary_name":"Adzenys XR-ODT","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"12.5 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"30 BLISTER PACK in 1 CARTON (70165-020-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":19.20538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":15.96228,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adzenys XR-ODT|Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"70165002530","name":"ADZENYS XR-ODT 15.7 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-025-30","proprietary_name":"Adzenys XR-ODT","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15.7 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"30 BLISTER PACK in 1 CARTON (70165-025-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":19.16368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":15.92901,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adzenys XR-ODT|Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"70165003030","name":"ADZENYS XR-ODT 18.8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-030-30","proprietary_name":"Adzenys XR-ODT","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"18.8 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"30 BLISTER PACK in 1 CARTON (70165-030-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":19.21085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":15.61431,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adzenys XR-ODT|Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"70165000530","name":"ADZENYS XR-ODT 3.1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-005-30","proprietary_name":"Adzenys XR-ODT","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"3.1 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"30 BLISTER PACK in 1 CARTON (70165-005-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":19.20464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":15.84156,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adzenys XR-ODT|Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"70165001030","name":"ADZENYS XR-ODT 6.3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-010-30","proprietary_name":"Adzenys XR-ODT","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"6.3 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"30 BLISTER PACK in 1 CARTON (70165-010-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":19.20888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":16.07321,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adzenys XR-ODT|Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"70165001530","name":"ADZENYS XR-ODT 9.4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-015-30","proprietary_name":"Adzenys XR-ODT","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"9.4 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"30 BLISTER PACK in 1 CARTON (70165-015-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":19.18353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":16.21781,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Adzenys XR-ODT|Amphetamine","basis":"brand"},"part_b":null}, {"ndc":"47918087890","name":"AFREZZA ((REGULAR INSULIN) 8 UNIT CARTRIDGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47918-878-90","proprietary_name":"AFREZZA","nonproprietary_name":"INSULIN HUMAN","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"8 [arb'U]/1","labeler":"Mannkind Corporation","package_description":"3 POUCH in 1 CARTON (47918-878-90) / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":10.3754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Afrezza|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"47918089190","name":"AFREZZA (REGULAR INSULIN) 12 UNIT CARTRIDGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"47918-891-90","proprietary_name":"AFREZZA","nonproprietary_name":"INSULIN HUMAN","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"12 [arb'U]/1","labeler":"Mannkind Corporation","package_description":"3 POUCH in 1 CARTON (47918-891-90) / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":15.65297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Afrezza|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"47918087490","name":"AFREZZA (REGULAR INSULIN) 4 UNIT CARTRIDGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47918-874-90","proprietary_name":"AFREZZA","nonproprietary_name":"INSULIN HUMAN","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"4 [arb'U]/1","labeler":"Mannkind Corporation","package_description":"3 POUCH in 1 CARTON (47918-874-90) / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":5.20552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Afrezza|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"47918090218","name":"AFREZZA (REGULAR INSULIN) 60-4 UNIT/60-8 UNIT/60-12 UNIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47918-902-18","proprietary_name":"AFREZZA","nonproprietary_name":"INSULIN HUMAN","dosage_form":"KIT","route":"RESPIRATORY (INHALATION)","strength":null,"labeler":"Mannkind Corporation","package_description":"1 KIT in 1 CARTON (47918-902-18) * 2 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE * 2 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE * 2 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE"},"nadac":{"value":10.33288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Afrezza|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"47918088018","name":"AFREZZA (REGULAR INSULIN) 90-4 UNIT / 90-8 UNIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47918-880-18","proprietary_name":"AFREZZA","nonproprietary_name":"INSULIN HUMAN","dosage_form":"KIT","route":"RESPIRATORY (INHALATION)","strength":null,"labeler":"Mannkind Corporation","package_description":"1 KIT in 1 CARTON (47918-880-18) * 3 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE * 3 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE"},"nadac":{"value":7.78053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Afrezza|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"47918089818","name":"AFREZZA (REGULAR INSULIN) 90-8 UNIT / 90-12 UNIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"47918-898-18","proprietary_name":"AFREZZA","nonproprietary_name":"INSULIN HUMAN","dosage_form":"KIT","route":"RESPIRATORY (INHALATION)","strength":null,"labeler":"Mannkind Corporation","package_description":"1 KIT in 1 CARTON (47918-898-18) * 3 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE * 3 POUCH in 1 PACKAGE, COMBINATION / 2 BLISTER PACK in 1 POUCH / 15 CARTRIDGE in 1 BLISTER PACK / 1 POWDER, METERED in 1 CARTRIDGE"},"nadac":{"value":13.03769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Afrezza|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"55513084301","name":"AIMOVIG 140 MG/ML AUTOINJECTOR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-843-01","proprietary_name":"AIMOVIG","nonproprietary_name":"erenumab-aooe","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"140 mg/mL","labeler":"Amgen, Inc","package_description":"1 SYRINGE in 1 CARTON (55513-843-01) / 1 mL in 1 SYRINGE"},"nadac":{"value":753.32586,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55513084101","name":"AIMOVIG 70 MG/ML AUTOINJECTOR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-841-01","proprietary_name":"AIMOVIG","nonproprietary_name":"erenumab-aooe","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"70 mg/mL","labeler":"Amgen, Inc","package_description":"1 SYRINGE, GLASS in 1 CARTON (55513-841-01) / 1 mL in 1 SYRINGE, GLASS"},"nadac":{"value":753.57097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00310908012","name":"AIRSUPRA 90-80 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-9080-12","proprietary_name":"AIRSUPRA","nonproprietary_name":"Albuterol sulfate and budesonide","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1; 80 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 INHALER in 1 CARTON (0310-9080-12) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":45.03471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Airsupra|Albuterol Sulfate/Budesonide","basis":"brand"},"part_b":null}, {"ndc":"51759020210","name":"AJOVY 225 MG/1.5 ML AUTOINJECT","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-202-10","proprietary_name":"AJOVY","nonproprietary_name":"fremanezumab-vfrm","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"225 mg/1.5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 CONTAINER in 1 CARTON (51759-202-10) / 1.5 mL in 1 CONTAINER"},"nadac":{"value":508.17066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ajovy Autoinjector|Fremanezumab-Vfrm","basis":"brand"},"part_b":null}, {"ndc":"51759020222","name":"AJOVY 225 MG/1.5 ML AUTOINJECTOR (3 PACK)","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-202-22","proprietary_name":"AJOVY","nonproprietary_name":"fremanezumab-vfrm","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"225 mg/1.5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 CONTAINER in 1 CARTON (51759-202-22) / 1.5 mL in 1 CONTAINER"},"nadac":{"value":507.447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ajovy Autoinjector|Fremanezumab-Vfrm","basis":"brand"},"part_b":null}, {"ndc":"51759020410","name":"AJOVY 225 MG/1.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-204-10","proprietary_name":"AJOVY","nonproprietary_name":"fremanezumab-vfrm","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"225 mg/1.5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (51759-204-10) / 1.5 mL in 1 SYRINGE, GLASS"},"nadac":{"value":508.50721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ajovy Syringe|Fremanezumab-Vfrm","basis":"brand"},"part_b":null}, {"ndc":"00299593545","name":"AKLIEF 0.005% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0299-5935-45","proprietary_name":"AKLIEF","nonproprietary_name":"trifarotene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Galderma Laboratories, L.P.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0299-5935-45) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":16.36232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Aklief|Trifarotene","basis":"brand"},"part_b":null}, {"ndc":"50991078360","name":"ALA-HIST IR 2 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50991-783-60","proprietary_name":"ALA-HIST IR","nonproprietary_name":"Dexbrompheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Poly Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (50991-783-60)"},"nadac":{"value":0.66057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50991078490","name":"ALAHIST CF TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":0.67164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50991078890","name":"ALAHIST PE 2-7.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50991-788-90","proprietary_name":"Alahist PE","nonproprietary_name":"Dexbrompheniramine Maleate, Phenylephrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 7.5 mg/1","labeler":"Poly Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (50991-788-90)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.65686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591271202","name":"ALBENDAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2712-02","proprietary_name":"Albendazole","nonproprietary_name":"Albendazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"2 TABLET, FILM COATED in 1 BOTTLE (0591-2712-02)","pharm_classes":["Anthelmintic [EPC]","Cytochrome P450 1A Inducers [MoA]"]},"nadac":{"value":4.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Albendazole|Albendazole","basis":"generic"},"part_b":null}, {"ndc":"31722093502","name":"ALBENDAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Albendazole|Albendazole","basis":"generic"},"part_b":null}, {"ndc":"42799011002","name":"ALBENDAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-110-02","proprietary_name":"Albendazole","nonproprietary_name":"Albendazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"2 TABLET in 1 BOTTLE (42799-110-02)","pharm_classes":["Anthelmintic [EPC]","Cytochrome P450 1A Inducers [MoA]"]},"nadac":{"value":4.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Albendazole|Albendazole","basis":"generic"},"part_b":null}, {"ndc":"43598045202","name":"ALBENDAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-452-02","proprietary_name":"Albendazole","nonproprietary_name":"Albendazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"2 TABLET, FILM COATED in 1 BOTTLE (43598-452-02)","pharm_classes":["Anthelmintic [EPC]","Cytochrome P450 1A Inducers [MoA]"]},"nadac":{"value":4.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Albendazole|Albendazole","basis":"generic"},"part_b":null}, {"ndc":"72205005108","name":"ALBENDAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-051-08","proprietary_name":"Albendazole","nonproprietary_name":"Albendazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"2 TABLET in 1 BOTTLE (72205-051-08)","pharm_classes":["Anthelmintic [EPC]","Cytochrome P450 1A Inducers [MoA]"]},"nadac":{"value":4.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Albendazole|Albendazole","basis":"generic"},"part_b":null}, {"ndc":"00487990130","name":"ALBUTEROL 2.5 MG/0.5 ML SOL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9901-30","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/.5mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-9901-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH / .5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.51582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7611","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7611 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"64980064203","name":"ALBUTEROL 2.5 MG/0.5 ML SOL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-642-03","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/.5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 POUCH in 1 CARTON (64980-642-03) / 1 VIAL, SINGLE-DOSE in 1 POUCH / .5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.51582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7611","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7611 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"76204002701","name":"ALBUTEROL 2.5 MG/0.5 ML SOL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-027-01","proprietary_name":"Albuterol Sulfate Inhalation Solution, 0.5%","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/.5mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-027-01) / 1 VIAL in 1 POUCH (76204-027-11) / .5 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.51582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7611","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7611 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00054074287","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0742-87","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 CANISTER in 1 CARTON (0054-0742-87) / 200 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.12002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00093317431","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3174-31","proprietary_name":"Albuterol Sulfate HFA","nonproprietary_name":"Albuterol Sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 INHALER in 1 CARTON (0093-3174-31) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.54049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00781729685","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7296-85","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"108 ug/1","labeler":"Sandoz Inc","package_description":"1 CANISTER in 1 CARTON (0781-7296-85) / 200 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.12002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"17270074000","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17270-0740-0","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Armstrong Pharmaceuticals, Inc.","package_description":"1 INHALER in 1 CARTON (17270-0740-0) / 200 INHALANT in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.54049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"45802008801","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-088-01","proprietary_name":"albuterol sulfate","nonproprietary_name":"albuterol sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 INHALER in 1 CARTON (45802-088-01) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.54049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"60687066291","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-662-91","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"American Health Packaging","package_description":"1 CANISTER in 1 CARTON (60687-662-91) / 200 INHALANT in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.12002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"66993001968","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-019-68","proprietary_name":"Albuterol Sulfate HFA","nonproprietary_name":"albuterol sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-019-68) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.82548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68180096301","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-963-01","proprietary_name":"Albuterol sulfate","nonproprietary_name":"Albuterol sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 CANISTER in 1 CARTON (68180-963-01) / 200 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.54049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69097002160","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-021-60","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol Sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Cipla USA Inc.","package_description":"1 INHALER in 1 CARTON (69097-021-60) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.82548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69097014260","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-142-60","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"albuterol sulfate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Cipla USA Inc.","package_description":"1 CANISTER in 1 CARTON (69097-142-60) / 200 INHALANT in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.12002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69238129101","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1291-1","proprietary_name":"Albuterol Sulfate Inhalation","nonproprietary_name":"Albuterol Sulfate","dosage_form":"INHALANT","route":"ORAL","strength":"90 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 CANISTER in 1 CARTON (69238-1291-1) / 200 INHALANT in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.54049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"76282067942","name":"ALBUTEROL HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-679-42","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"albuterol sulfate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1 CANISTER in 1 CARTON (76282-679-42) / 200 INHALANT in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.12002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Albuterol Sulfate HFA|Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00378705752","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7057-52","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-7057-52) / 5 VIAL in 1 POUCH (0378-7057-98) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.19407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.63 per item) x PKG QTY is 15.75; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 POUCH in 1 CARTON (0378-7057-52) / 5 VIAL in 1 POUCH (0378-7057-98) / 3 mL in 1 VIAL) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487030101","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-0301-01","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-0301-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.25227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":19,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.63 per item) x PKG QTY is 18.9; CMS prints the whole number 19.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-0301-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00591346753","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.19407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.63 per item) x PKG QTY is 15.75; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"50742039225","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-392-25","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"5 POUCH in 1 CARTON (50742-392-25) / 5 VIAL in 1 POUCH (50742-392-05) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.19407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.63 per item) x PKG QTY is 15.75; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 POUCH in 1 CARTON (50742-392-25) / 5 VIAL in 1 POUCH (50742-392-05) / 3 mL in 1 VIAL) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59651018330","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-183-30","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"ALBUTEROL SULFATE","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Aurobindo Pharma Limited","package_description":"6 POUCH in 1 CARTON (59651-183-30) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.25227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204001001","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-010-01","proprietary_name":"Albuterol Sulfate Inhalation Solution","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-010-01) / 1 VIAL in 1 POUCH (76204-010-11) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.25227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":19,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.63 per item) x PKG QTY is 18.9; CMS prints the whole number 19.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-010-01) / 1 VIAL in 1 POUCH (76204-010-11) / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204001055","name":"ALBUTEROL SUL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-010-55","proprietary_name":"Albuterol Sulfate Inhalation Solution","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"25 POUCH in 1 CARTON (76204-010-55) / 5 VIAL in 1 POUCH (76204-010-05) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.19407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.63 per item) x PKG QTY is 15.75; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00378705852","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7058-52","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-7058-52) / 5 VIAL in 1 POUCH (0378-7058-98) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.1979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 POUCH in 1 CARTON (0378-7058-52) / 5 VIAL in 1 POUCH (0378-7058-98) / 3 mL in 1 VIAL) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487990401","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9904-01","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-9904-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.22622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":38,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 37.5; CMS prints the whole number 38.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-9904-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487990425","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.1979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00591346853","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.1979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"50742039325","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-393-25","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"5 POUCH in 1 CARTON (50742-393-25) / 5 VIAL in 1 POUCH (50742-393-05) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.1979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 POUCH in 1 CARTON (50742-393-25) / 5 VIAL in 1 POUCH (50742-393-05) / 3 mL in 1 VIAL) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59651018430","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-184-30","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"ALBUTEROL SULFATE","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Aurobindo Pharma Limited","package_description":"6 POUCH in 1 CARTON (59651-184-30) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.22622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204001101","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-011-01","proprietary_name":"Albuterol Sulfate Inhalation Solution","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-011-01) / 1 VIAL in 1 POUCH (76204-011-11) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.22622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":38,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 37.5; CMS prints the whole number 38.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-011-01) / 1 VIAL in 1 POUCH (76204-011-11) / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204001155","name":"ALBUTEROL SUL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-011-55","proprietary_name":"Albuterol Sulfate Inhalation Solution","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"25 POUCH in 1 CARTON (76204-011-55) / 5 VIAL in 1 POUCH (76204-011-05) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.1979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00378827052","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8270-52","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-8270-52) / 25 AMPULE in 1 POUCH (0378-8270-62) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-8270-52) / 25 AMPULE in 1 POUCH (0378-8270-62) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378827055","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8270-55","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8270-55) / 1 AMPULE in 1 POUCH (0378-8270-31) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0378-8270-55) / 1 AMPULE in 1 POUCH (0378-8270-31) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378827091","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8270-91","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 POUCH in 1 CARTON (0378-8270-91) / 30 AMPULE in 1 POUCH (0378-8270-64) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (0378-8270-91) / 30 AMPULE in 1 POUCH (0378-8270-64) / 3 mL in 1 AMPULE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378827093","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8270-93","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-8270-93) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-8270-93) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487950101","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9501-01","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-9501-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-9501-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487950103","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9501-03","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"1 POUCH in 1 CARTON (0487-9501-03) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0487-9501-03) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487950125","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9501-25","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"1 POUCH in 1 CARTON (0487-9501-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0487-9501-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487950160","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9501-60","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"2 POUCH in 1 CARTON (0487-9501-60) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (0487-9501-60) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335070349","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-703-49","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"albuterol sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".83 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5 POUCH in 1 CARTON (47335-703-49) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 POUCH in 1 CARTON (47335-703-49) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335070352","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-703-52","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"albuterol sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".83 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 CARTON (47335-703-52) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (47335-703-52) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335070354","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-703-54","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"albuterol sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".83 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"12 POUCH in 1 CARTON (47335-703-54) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (47335-703-54) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60687039583","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-395-83","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-395-83) / 1 AMPULE in 1 POUCH (60687-395-79) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (60687-395-83) / 1 AMPULE in 1 POUCH (60687-395-79) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65862085825","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-858-25","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"ALBUTEROL SULFATE","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".83 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"5 POUCH in 1 CARTON (65862-858-25) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862085830","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-858-30","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"ALBUTEROL SULFATE","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".83 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"6 POUCH in 1 CARTON (65862-858-30) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862085860","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-858-60","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"ALBUTEROL SULFATE","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".83 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"12 POUCH in 1 CARTON (65862-858-60) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204020001","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-200-01","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-200-01) / 1 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-200-01) / 1 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204020025","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-200-25","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-200-25) / 25 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-200-25) / 25 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204020030","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-200-30","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-200-30) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-200-30) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204020060","name":"ALBUTEROL SUL 2.5 MG/3 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-200-60","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"2 POUCH in 1 CARTON (76204-200-60) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7613","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7613 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (76204-200-60) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62135018947","name":"ALBUTEROL SULF 2 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-189-47","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"Albuterol Sulfate","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 CONTAINER (62135-189-47)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752010212","name":"ALBUTEROL SULF 2 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-102-12","proprietary_name":"ALBUTEROL SULFATE","nonproprietary_name":"ALBUTEROL SULFATE","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"473 mL in 1 BOTTLE (70752-102-12)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"53489017601","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-176-01","proprietary_name":"albuterol sulfate","nonproprietary_name":"albuterol sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (53489-176-01)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135067190","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-671-90","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-671-90)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980044201","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-442-01","proprietary_name":"Albuterol","nonproprietary_name":"albuterol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-442-01)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084094925","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-949-25","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-949-25) / 1 TABLET in 1 BLISTER PACK (68084-949-95)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084094995","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238134401","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1344-1","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1344-1)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710106101","name":"ALBUTEROL SULFATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1061-1","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1061-1)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53489017701","name":"ALBUTEROL SULFATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-177-01","proprietary_name":"albuterol sulfate","nonproprietary_name":"albuterol sulfate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (53489-177-01)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.40437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135067290","name":"ALBUTEROL SULFATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-672-90","proprietary_name":"Albuterol Sulfate","nonproprietary_name":"Albuterol Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-672-90)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.40437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980044301","name":"ALBUTEROL SULFATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-443-01","proprietary_name":"Albuterol","nonproprietary_name":"albuterol","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-443-01)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.40437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238134501","name":"ALBUTEROL SULFATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1345-1","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1345-1)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.40437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710106201","name":"ALBUTEROL SULFATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1062-1","proprietary_name":"Albuterol","nonproprietary_name":"Albuterol","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1062-1)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.40437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672131601","name":"ALCLOMETASONE DIPR 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1316-1","proprietary_name":"Alclometasone Dipropionate","nonproprietary_name":"Alclometasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1316-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.86094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alclometasone Dipropionate|Alclometasone Dipropionate","basis":"generic"},"part_b":null}, {"ndc":"51672131603","name":"ALCLOMETASONE DIPR 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1316-3","proprietary_name":"Alclometasone Dipropionate","nonproprietary_name":"Alclometasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1316-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.50016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alclometasone Dipropionate|Alclometasone Dipropionate","basis":"generic"},"part_b":null}, {"ndc":"51672131606","name":"ALCLOMETASONE DIPR 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1316-6","proprietary_name":"Alclometasone Dipropionate","nonproprietary_name":"Alclometasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1316-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alclometasone Dipropionate|Alclometasone Dipropionate","basis":"generic"},"part_b":null}, {"ndc":"51672130601","name":"ALCLOMETASONE DIPRO 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1306-1","proprietary_name":"Alclometasone dipropionate","nonproprietary_name":"Alclometasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1306-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.18698,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alclometasone Dipropionate|Alclometasone Dipropionate","basis":"generic"},"part_b":null}, {"ndc":"51672130603","name":"ALCLOMETASONE DIPRO 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1306-3","proprietary_name":"Alclometasone dipropionate","nonproprietary_name":"Alclometasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1306-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.21729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alclometasone Dipropionate|Alclometasone Dipropionate","basis":"generic"},"part_b":null}, {"ndc":"51672130606","name":"ALCLOMETASONE DIPRO 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1306-6","proprietary_name":"Alclometasone dipropionate","nonproprietary_name":"Alclometasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1306-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.56806,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alclometasone Dipropionate|Alclometasone Dipropionate","basis":"generic"},"part_b":null}, {"ndc":"68599580405","name":"ALCOHOL 70% PREP PADS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.01362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82098081410","name":"ALCOHOL 70% PREP PADS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82098-814-10","proprietary_name":"Alcohol Prep Pads","nonproprietary_name":"70%Isopropyl Alcohol","dosage_form":"SWAB","route":"TOPICAL","strength":".7 mL/mL","labeler":"Raya Pharmaceuticals LLC","package_description":".7 mL in 1 POUCH (82098-814-10)"},"nadac":{"value":0.01362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054028259","name":"ALENDRONATE SOD 70 MG/75 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0282-59","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"SOLUTION","route":"ORAL","strength":"70 mg/75mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"4 BOTTLE, UNIT-DOSE in 1 CARTON (0054-0282-59) / 75 mL in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.68257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954026410","name":"ALENDRONATE SOD 70 MG/75 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-264-10","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"SOLUTION","route":"ORAL","strength":"70 mg/75mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"4 BOTTLE in 1 CARTON (70954-264-10) / 75 mL in 1 BOTTLE","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.68257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714063101","name":"ALENDRONATE SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-631-01","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-631-01)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.11123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714063102","name":"ALENDRONATE SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-631-02","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-631-02)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.11123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"64980034001","name":"ALENDRONATE SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-340-01","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-340-01)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.11123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"64980034003","name":"ALENDRONATE SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-340-03","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-340-03)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.11123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714063201","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-632-01","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"NorthStar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-632-01) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714063202","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-632-02","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"NorthStar Rx LLC","package_description":"5 BLISTER PACK in 1 CARTON (16714-632-02) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"64980034114","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-341-14","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (64980-341-14) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862032804","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-328-04","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-328-04) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097022316","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-223-16","proprietary_name":"ALENDRONATE SODIUM","nonproprietary_name":"Alendronate sodium","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Cipla USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69097-223-16) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097022376","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-223-76","proprietary_name":"ALENDRONATE SODIUM","nonproprietary_name":"Alendronate sodium","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Cipla USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (69097-223-76) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282068145","name":"ALENDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714063301","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-633-01","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"NorthStar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-633-01) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714063302","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-633-02","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"NorthStar Rx LLC","package_description":"5 BLISTER PACK in 1 CARTON (16714-633-02) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"64980034201","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-342-01","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-342-01)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"64980034214","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-342-14","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (64980-342-14) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862032904","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-329-04","proprietary_name":"Alendronate Sodium","nonproprietary_name":"Alendronate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-329-04) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097022416","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-224-16","proprietary_name":"ALENDRONATE SODIUM","nonproprietary_name":"Alendronate sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"Cipla USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69097-224-16) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097022476","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-224-76","proprietary_name":"ALENDRONATE SODIUM","nonproprietary_name":"Alendronate sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"Cipla USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (69097-224-76) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282068245","name":"ALENDRONATE SODIUM 70 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alendronate Sodium|Alendronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"46122045773","name":"ALERT AID 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-457-73","proprietary_name":"Alert Aid","nonproprietary_name":"Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-457-73) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.08299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300015501","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-155-01","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (29300-155-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"29300015519","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-155-19","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (29300-155-19)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237011490","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-114-90","proprietary_name":"Alfuzosin Hydrochloride","nonproprietary_name":"Alfuzosin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (57237-114-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"60505285009","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2850-9","proprietary_name":"Alfuzosin Hydrochloride","nonproprietary_name":"Alfuzosin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-2850-9)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030201","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-302-01","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (76282-302-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030205","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-302-05","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (76282-302-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030210","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-302-10","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (76282-302-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030212","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-302-12","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"120 TABLET, EXTENDED RELEASE in 1 BOTTLE (76282-302-12)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030290","name":"ALFUZOSIN HCL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-302-90","proprietary_name":"Alfuzosin hydrochloride","nonproprietary_name":"Alfuzosin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (76282-302-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alfuzosin HCl ER|Alfuzosin HCl","basis":"generic"},"part_b":null}, {"ndc":"49884042411","name":"ALISKIREN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-424-11","proprietary_name":"ALISKIREN","nonproprietary_name":"ALISKIREN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-424-11)","pharm_classes":["Renin Inhibitor [EPC]","Renin Inhibitors [MoA]"]},"nadac":{"value":3.93745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993014130","name":"ALISKIREN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-141-30","proprietary_name":"Aliskiren","nonproprietary_name":"aliskiren hemifumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (66993-141-30)","pharm_classes":["Renin Inhibitor [EPC]","Renin Inhibitors [MoA]"]},"nadac":{"value":3.93745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aliskiren|Aliskiren Hemifumarate","basis":"generic"},"part_b":null}, {"ndc":"49884042511","name":"ALISKIREN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-425-11","proprietary_name":"ALISKIREN","nonproprietary_name":"ALISKIREN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-425-11)","pharm_classes":["Renin Inhibitor [EPC]","Renin Inhibitors [MoA]"]},"nadac":{"value":5.85836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993014230","name":"ALISKIREN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-142-30","proprietary_name":"Aliskiren","nonproprietary_name":"aliskiren hemifumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (66993-142-30)","pharm_classes":["Renin Inhibitor [EPC]","Renin Inhibitors [MoA]"]},"nadac":{"value":5.85836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aliskiren|Aliskiren Hemifumarate","basis":"generic"},"part_b":null}, {"ndc":"24385099865","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-998-65","proprietary_name":"good neighbor pharmacy all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-998-65) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385099874","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-998-74","proprietary_name":"good neighbor pharmacy all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"14 BLISTER PACK in 1 CARTON (24385-998-74) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385099875","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-998-75","proprietary_name":"good neighbor pharmacy all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-998-75) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000004701","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0047-1","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride Allergy","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"LEADER/ CARDINAL HEALTH 110, INC.","package_description":"365 TABLET in 1 BOTTLE (70000-0047-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000038001","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0380-1","proprietary_name":"leader all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"14 BLISTER PACK in 1 CARTON (70000-0380-1) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000038002","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0380-2","proprietary_name":"leader all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0380-2) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000038004","name":"ALL DAY ALLERGY 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0380-4","proprietary_name":"leader all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0380-4) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113214762","name":"ALL DAY ALLERGY-D 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2147-62","proprietary_name":"All Day Allergy D","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"L. Perrigo Company","package_description":"24 BLISTER PACK in 1 CARTON (0113-2147-62) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062662","name":"ALL DAY ALLERGY-D TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-626-62","proprietary_name":"good neighbor pharmacy all day allergy d","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Amerisource Bergen","package_description":"24 BLISTER PACK in 1 CARTON (46122-626-62) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017103","name":"ALL DAY PAIN RELIEF 220 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0171-3","proprietary_name":"Leader All Day Pain Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0171-3) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017105","name":"ALL DAY PAIN RELIEF 220 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0171-5","proprietary_name":"Leader All Day Pain Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0171-5) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017106","name":"ALL DAY PAIN RELIEF 220 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0171-6","proprietary_name":"Leader All Day Pain Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0171-6) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000020102","name":"ALL DAY PAIN RLF 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0201-2","proprietary_name":"Leader All Day Pain Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0201-2) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000020105","name":"ALL DAY PAIN RLF 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0201-5","proprietary_name":"Leader All Day Pain Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0201-5) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000020106","name":"ALL DAY PAIN RLF 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0201-6","proprietary_name":"Leader All Day Pain Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0201-6) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536109306","name":"ALL DAY RELIEF 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1093-06","proprietary_name":"Rugby All Day Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1093-06) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536109311","name":"ALL DAY RELIEF 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1093-11","proprietary_name":"Rugby All Day Relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1093-11) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536109406","name":"ALL DAY RELIEF 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1094-06","proprietary_name":"rugby all day relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1094-06) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536109411","name":"ALL DAY RELIEF 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1094-11","proprietary_name":"rugby all day relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1094-11) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060501","name":"ALL DAY SINUS-COLD-D 220-120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0605-1","proprietary_name":"Leader All Day Sinus and Cold D","nonproprietary_name":"Naproxen sodium, Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"220 mg/1; 120 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"20 BLISTER PACK in 1 CARTON (70000-0605-1) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.2443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904646509","name":"ALL-NITE COLD-FLU RELIEF LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6465-09","proprietary_name":"all nite","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Major Pharmaceuticals","package_description":"237 mL in 1 BOTTLE (0904-6465-09)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536100601","name":"ALLER-CHLOR 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1006-01","proprietary_name":"Aller-chlor","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0536-1006-01) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536100610","name":"ALLER-CHLOR 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1006-10","proprietary_name":"Aller-chlor","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0536-1006-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483006101","name":"ALLER-G-TIME 25 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-061-01","proprietary_name":"ALLERGY RELIEF","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-061-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483006110","name":"ALLER-G-TIME 25 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-061-10","proprietary_name":"ALLERGY RELIEF","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-061-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000059801","name":"ALLERGY (DIPHEN) 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0598-1","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (70000-0598-1) / 12 CAPSULE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50844032907","name":"ALLERGY (DIPHEN) 25 MG MINITAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50844-329-07","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"L.N.K. International, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (50844-329-07) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660052601","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-526-01","proprietary_name":"Loratadine Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"100 TABLET in 1 BOTTLE (51660-526-01)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660052605","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-526-05","proprietary_name":"Loratadine Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"500 TABLET in 1 BOTTLE (51660-526-05)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660052631","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-526-31","proprietary_name":"Loratadine Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"30 TABLET in 1 BLISTER PACK (51660-526-31)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660052653","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-526-53","proprietary_name":"Loratadine Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"300 TABLET in 1 BOTTLE (51660-526-53)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230031701","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230031703","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032801","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-328-01","proprietary_name":"LORATADINE","nonproprietary_name":"LORATADINE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-328-01) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032803","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-328-03","proprietary_name":"LORATADINE","nonproprietary_name":"LORATADINE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"300 TABLET in 1 BOTTLE (69230-328-03)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000021307","name":"ALLERGY (LORATADINE) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0213-7","proprietary_name":"Leader Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0213-7) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385047978","name":"ALLERGY 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-479-78","proprietary_name":"Good Neighbor Pharmacy allergy","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-479-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904001224","name":"ALLERGY 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0012-24","proprietary_name":"Allergy","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-0012-24) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904001259","name":"ALLERGY 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0012-59","proprietary_name":"Allergy","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-0012-59) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904001261","name":"ALLERGY 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0012-61","proprietary_name":"Allergy","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-0012-61) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904001280","name":"ALLERGY 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0012-80","proprietary_name":"Allergy","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0904-0012-80)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113777760","name":"ALLERGY D-12HR 5-120 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-7777-60","proprietary_name":"perrigo allergy d","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"L. Perrigo Company","package_description":"20 BLISTER PACK in 1 CARTON (0113-7777-60) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113900422","name":"ALLERGY D-24HR 10-240 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-9004-22","proprietary_name":"allergy d","nonproprietary_name":"loratadine, pseudoephedrine sulfate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"L. Perrigo Company","package_description":"15 BLISTER PACK in 1 CARTON (0113-9004-22) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000021101","name":"ALLERGY MULTI-SYMPTOM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0211-1","proprietary_name":"Allergy Multi-Symptom","nonproprietary_name":"Acetaminophen, Chlorpheniramine Maleate, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 2 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0211-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000063502","name":"ALLERGY NASAL 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0635-2","proprietary_name":"Leader Allergy Nasal","nonproprietary_name":"mometasone furoate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70000-0635-2) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.71412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000021301","name":"ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0213-1","proprietary_name":"Leader Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"10 BLISTER PACK in 1 CARTON (70000-0213-1) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000021303","name":"ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0213-3","proprietary_name":"Leader Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0213-3) / 70 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000021304","name":"ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0213-4","proprietary_name":"Leader Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0213-4) / 90 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000021306","name":"ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0213-6","proprietary_name":"Leader Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0213-6) / 300 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058301","name":"ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0583-1","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cardinal Health","package_description":"2 BLISTER PACK in 1 CARTON (70000-0583-1) / 10 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54859081116","name":"ALLERGY RELIEF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-811-16","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"LLORENS PHARMACEUTICALS INTERNATIONAL DIVISION","package_description":"473 mL in 1 BOTTLE (54859-811-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230030001","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-300-01","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Camber Consumer Care","package_description":"1 BOTTLE in 1 CARTON (69230-300-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230030005","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-300-05","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Camber Consumer Care","package_description":"500 TABLET in 1 BOTTLE (69230-300-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230030030","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-300-30","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Camber Consumer Care","package_description":"1 BOTTLE in 1 CARTON (69230-300-30) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072501","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0725-1","proprietary_name":"Leader 24HR Allergy Relief","nonproprietary_name":"fexofenadine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0725-1) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072502","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0725-2","proprietary_name":"Leader 24HR Allergy Relief","nonproprietary_name":"fexofenadine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0725-2) / 70 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072503","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0725-3","proprietary_name":"Leader 24HR Allergy Relief","nonproprietary_name":"fexofenadine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0725-3) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072504","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0725-4","proprietary_name":"Leader 24HR Allergy Relief","nonproprietary_name":"fexofenadine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"15 BLISTER PACK in 1 CARTON (70000-0725-4) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072601","name":"ALLERGY RELIEF 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0726-1","proprietary_name":"24HR Allergy Relief","nonproprietary_name":"Fexofenadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 BOTTLE in 1 CARTON (70000-0726-1) / 180 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044062","name":"ALLERGY RELIEF 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-440-62","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-440-62) / 12 CAPSULE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044078","name":"ALLERGY RELIEF 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-440-78","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-440-78) / 100 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058501","name":"ALLERGY RELIEF 25 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0585-1","proprietary_name":"Allergy Relief Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0585-1) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000013601","name":"ALLERGY RELIEF 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0136-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0136-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000013602","name":"ALLERGY RELIEF 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0136-2","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"4 BLISTER PACK in 1 CARTON (70000-0136-2) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000013603","name":"ALLERGY RELIEF 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0136-3","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0136-3) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000016002","name":"ALLERGY RELIEF 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0160-2","proprietary_name":"Allergy Relief 4 Hour","nonproprietary_name":"Chlorpheniramine maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0160-2) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385053126","name":"ALLERGY RELIEF 5 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-531-26","proprietary_name":"Good Neighbor Pharmacy Childrens Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"AmerisourceBergen","package_description":"1 BOTTLE in 1 CARTON (24385-531-26) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000011001","name":"ALLERGY RELIEF 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.89591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000050401","name":"ALLERGY RELIEF D-12 TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0504-1","proprietary_name":"Leader Allergy Relief D12","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"10 BLISTER PACK in 1 CARTON (70000-0504-1) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000050402","name":"ALLERGY RELIEF D-12 TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0504-2","proprietary_name":"Leader Allergy Relief D12","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"20 BLISTER PACK in 1 CARTON (70000-0504-2) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000050403","name":"ALLERGY RELIEF D-12 TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0504-3","proprietary_name":"Leader Allergy Relief D12","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"30 BLISTER PACK in 1 CARTON (70000-0504-3) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000016201","name":"ALLERGY RELIEF D-24HR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0162-1","proprietary_name":"Leader Allergy Relief D-24","nonproprietary_name":"Loratadine and Pseudoephedrine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Cardinal Health","package_description":"10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (70000-0162-1)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000016202","name":"ALLERGY RELIEF D-24HR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0162-2","proprietary_name":"Leader Allergy Relief D-24","nonproprietary_name":"Loratadine and Pseudoephedrine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Cardinal Health","package_description":"15 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (70000-0162-2)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000004201","name":"ALLERGY RELIEF-D TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0042-1","proprietary_name":"Leader Allergy Relief D","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"24 BLISTER PACK in 1 CARTON (70000-0042-1) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660049169","name":"ALLERGY RELIEF-NASAL DECONG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-491-69","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"10 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (51660-491-69)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660072404","name":"ALLERGY RELIEF-NASAL DECONG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-724-04","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (51660-724-04) / 5 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660072415","name":"ALLERGY RELIEF-NASAL DECONG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-724-15","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51660-724-15) / 15 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660072469","name":"ALLERGY RELIEF-NASAL DECONG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-724-69","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51660-724-69) / 10 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483069250","name":"ALLERGY RLF (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-692-50","proprietary_name":"Cetirizine Hydrochloride Tablets,10 mg","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"500 TABLET in 1 BOTTLE (49483-692-50)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660093953","name":"ALLERGY RLF (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-939-53","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"300 TABLET in 1 BOTTLE (51660-939-53)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230030401","name":"ALLERGY RLF (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-304-01","proprietary_name":"Allergy Relief","nonproprietary_name":"Cetirizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care","package_description":"1 BOTTLE, PLASTIC in 1 BOX (69230-304-01) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230030405","name":"ALLERGY RLF (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-304-05","proprietary_name":"Allergy Relief","nonproprietary_name":"Cetirizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care","package_description":"500 TABLET in 1 BOTTLE (69230-304-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230030430","name":"ALLERGY RLF (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-304-30","proprietary_name":"Allergy Relief","nonproprietary_name":"Cetirizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care","package_description":"1 BOTTLE, PLASTIC in 1 BOX (69230-304-30) / 30 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483068201","name":"ALLERGY RLF (CETRZN) 5 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-682-01","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"100 TABLET in 1 BOTTLE (49483-682-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058601","name":"ALLERGY RLF (FEXO) 60 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0586-1","proprietary_name":"12HR Allergy Relief","nonproprietary_name":"Fexofenadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"CARDINAL HEALTH","package_description":"1 BLISTER PACK in 1 CARTON (70000-0586-1) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660094024","name":"ALLERGY RLF-DECONG ER 5-120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-940-24","proprietary_name":"Allergy relief-D","nonproprietary_name":"Cetirizine Hydrochloride and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"4 BLISTER PACK in 1 CARTON (51660-940-24) / 6 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122016752","name":"ALLERGY-CONGES RELF ER TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-167-52","proprietary_name":"Loratadine and Pseudoephedrine Sulfate","nonproprietary_name":"Loratadine and Pseudoephedrine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Amerisource Bergen","package_description":"10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (46122-167-52)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122038322","name":"ALLERGY-CONGES RELF ER TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-383-22","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"15 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (46122-383-22)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113200760","name":"ALLERGY-CONGESTION RLF 12H TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2007-60","proprietary_name":"Allergy and Congestion Relief","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"L. Perrigo Company","package_description":"20 BLISTER PACK in 1 CARTON (0113-2007-60) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483024201","name":"ALLERGY-TIME 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-242-01","proprietary_name":"Allergy Time","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Time Cap Labs Inc","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (49483-242-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483024210","name":"ALLERGY-TIME 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-242-10","proprietary_name":"Allergy Time","nonproprietary_name":"Chlorpheniramine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Time Cap Labs Inc","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (49483-242-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378013701","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0137-01","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (0378-0137-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00378013710","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0137-10","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (0378-0137-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00591554310","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5543-10","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-5543-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00603211521","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2115-21","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2115-21)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00603211532","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2115-32","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-2115-32)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00904704161","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7041-61","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7041-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16571088309","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-883-09","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-883-09)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16571088310","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-883-10","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-883-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16714057601","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-576-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-576-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16714057602","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-576-02","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-576-02)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16714057603","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-576-03","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-576-03)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16714057604","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-576-04","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (16714-576-04)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"23155069301","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-693-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-693-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"23155069310","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-693-10","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-693-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"29300034901","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-349-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-349-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"29300034905","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-349-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-349-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"31722025201","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-252-01","proprietary_name":"ALLOPURINOL","nonproprietary_name":"ALLOPURINOL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-252-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"31722025205","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-252-05","proprietary_name":"ALLOPURINOL","nonproprietary_name":"ALLOPURINOL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-252-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"31722025210","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-252-10","proprietary_name":"ALLOPURINOL","nonproprietary_name":"ALLOPURINOL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-252-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"51079020501","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"51079020520","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-205-20","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-205-20) / 1 TABLET in 1 BLISTER PACK (51079-205-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"53489015601","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-156-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-156-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"53489015605","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-156-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (53489-156-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"53489015610","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-156-10","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (53489-156-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"55111072901","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-729-01","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-729-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"55111072910","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-729-10","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (55111-729-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"59651028501","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-285-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-285-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"59651028599","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-285-99","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-285-99)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"60687067701","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-677-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-677-01) / 1 TABLET in 1 BLISTER PACK (60687-677-11)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"60687067711","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"62135051631","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-516-31","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-516-31)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"62135051690","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-516-90","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-516-90)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315029101","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-291-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-291-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315029105","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-291-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-291-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315029110","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-291-10","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-291-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"70710120900","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1209-0","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1209-0)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"70710120901","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1209-1","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1209-1)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"71921024001","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-240-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"100 TABLET in 1 BOTTLE (71921-240-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"71921024050","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-240-50","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"500 TABLET in 1 BOTTLE (71921-240-50)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"71921024060","name":"ALLOPURINOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-240-60","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1000 TABLET in 1 BOTTLE (71921-240-60)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16571088409","name":"ALLOPURINOL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-884-09","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-884-09)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":1.84028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315040909","name":"ALLOPURINOL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-409-09","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Leading Pharma, LLC","package_description":"90 TABLET in 1 BOTTLE (69315-409-09)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":1.84028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"70710200909","name":"ALLOPURINOL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2009-9","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 TABLET in 1 BOTTLE (70710-2009-9)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":1.84028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"71921024109","name":"ALLOPURINOL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-241-09","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"90 TABLET in 1 BOTTLE (71921-241-09)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":1.84028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00378018101","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0181-01","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (0378-0181-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00378018105","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0181-05","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (0378-0181-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00591554401","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5544-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5544-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00591554405","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5544-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-5544-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00603211621","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2116-21","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2116-21)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00603211628","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2116-28","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0603-2116-28)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00603211632","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2116-32","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-2116-32)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00904657261","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6572-61","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6572-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16571088509","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-885-09","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-885-09)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16571088550","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-885-50","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-885-50)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16714057701","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-577-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-577-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"16714057702","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-577-02","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-577-02)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"23155069401","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"23155069405","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-694-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-694-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"29300035001","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-350-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-350-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"29300035005","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-350-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-350-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"31722025301","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-253-01","proprietary_name":"ALLOPURINOL","nonproprietary_name":"ALLOPURINOL","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-253-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"31722025305","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-253-05","proprietary_name":"ALLOPURINOL","nonproprietary_name":"ALLOPURINOL","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-253-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"31722025310","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-253-10","proprietary_name":"ALLOPURINOL","nonproprietary_name":"ALLOPURINOL","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-253-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"51079020601","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"51079020620","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-206-20","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-206-20) / 1 TABLET in 1 BLISTER PACK (51079-206-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"53489015701","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-157-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-157-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"53489015705","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"53489015710","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-157-10","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (53489-157-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"55111073001","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-730-01","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-730-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"55111073005","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-730-05","proprietary_name":"Allopurinol","nonproprietary_name":"allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-730-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"59651028601","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-286-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-286-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"59651028605","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-286-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-286-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"60687068801","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-688-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-688-01) / 1 TABLET in 1 BLISTER PACK (60687-688-11)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"60687068811","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"62135051731","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-517-31","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-517-31)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"62135051790","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-517-90","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-517-90)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315029201","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-292-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-292-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315029205","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-292-05","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-292-05)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"69315029210","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-292-10","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-292-10)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"70710121001","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1210-1","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1210-1)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"70710121005","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1210-5","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (70710-1210-5)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"71921024201","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-242-01","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"100 TABLET in 1 BOTTLE (71921-242-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"71921024250","name":"ALLOPURINOL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-242-50","proprietary_name":"Allopurinol","nonproprietary_name":"Allopurinol","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"500 TABLET in 1 BOTTLE (71921-242-50)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Allopurinol|Allopurinol","basis":"generic"},"part_b":null}, {"ndc":"00536001583","name":"ALMACONE-2 LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-0015-83","proprietary_name":"ALMACONE DOUBLE STRENGTH","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 400 mg/5mL; 40 mg/5mL","labeler":"RUGBY LABORATORIES","package_description":"355 mL in 1 BOTTLE (0536-0015-83)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093526119","name":"ALMOTRIPTAN MALATE 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.85661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Almotriptan Malate|Almotriptan Malate","basis":"generic"},"part_b":null}, {"ndc":"00093526129","name":"ALMOTRIPTAN MALATE 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5261-29","proprietary_name":"Almotriptan Malate","nonproprietary_name":"Almotriptan Malate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (0093-5261-29) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0093-5261-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.85661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Almotriptan Malate|Almotriptan Malate","basis":"generic"},"part_b":null}, {"ndc":"00378524632","name":"ALMOTRIPTAN MALATE 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.85661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378524685","name":"ALMOTRIPTAN MALATE 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5246-85","proprietary_name":"Almotriptan Malate","nonproprietary_name":"Almotriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 BLISTER PACK in 1 CARTON (0378-5246-85) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-5246-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.85661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241004221","name":"ALMOTRIPTAN MALATE 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-042-21","proprietary_name":"almotriptan","nonproprietary_name":"almotriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"2 BLISTER PACK in 1 CARTON (27241-042-21) / 6 TABLET, FILM COATED in 1 BLISTER PACK (27241-042-68)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.85661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241004268","name":"ALMOTRIPTAN MALATE 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.85661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093526018","name":"ALMOTRIPTAN MALATE 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5260-18","proprietary_name":"Almotriptan Malate","nonproprietary_name":"Almotriptan Malate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0093-5260-18) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0093-5260-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.50912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Almotriptan Malate|Almotriptan Malate","basis":"generic"},"part_b":null}, {"ndc":"00093526019","name":"ALMOTRIPTAN MALATE 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.50912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Almotriptan Malate|Almotriptan Malate","basis":"generic"},"part_b":null}, {"ndc":"00378524532","name":"ALMOTRIPTAN MALATE 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.50912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378524585","name":"ALMOTRIPTAN MALATE 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5245-85","proprietary_name":"Almotriptan Malate","nonproprietary_name":"Almotriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0378-5245-85) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-5245-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.50912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241004111","name":"ALMOTRIPTAN MALATE 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-041-11","proprietary_name":"almotriptan","nonproprietary_name":"almotriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (27241-041-11) / 6 TABLET, FILM COATED in 1 BLISTER PACK (27241-041-68)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.50912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241004168","name":"ALMOTRIPTAN MALATE 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.50912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802010365","name":"ALOGLIPTIN 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-103-65","proprietary_name":"Alogliptin","nonproprietary_name":"Alogliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (45802-103-65)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":4.95683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alogliptin|Alogliptin Benzoate","basis":"generic"},"part_b":null}, {"ndc":"45802015065","name":"ALOGLIPTIN 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-150-65","proprietary_name":"Alogliptin","nonproprietary_name":"Alogliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (45802-150-65)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":4.9069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alogliptin|Alogliptin Benzoate","basis":"generic"},"part_b":null}, {"ndc":"45802008765","name":"ALOGLIPTIN 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-087-65","proprietary_name":"Alogliptin","nonproprietary_name":"Alogliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (45802-087-65)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alogliptin|Alogliptin Benzoate","basis":"generic"},"part_b":null}, {"ndc":"45802021172","name":"ALOGLIPTIN-METFORMIN 12.5-1000","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-211-72","proprietary_name":"alogliptin and metformin hydrochloride","nonproprietary_name":"alogliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 1000 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (45802-211-72)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":2.46491,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alogliptin-Metformin|Alogliptin Benz/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"45802016972","name":"ALOGLIPTIN-METFORMIN 12.5-500","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-169-72","proprietary_name":"alogliptin and metformin hydrochloride","nonproprietary_name":"alogliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 500 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (45802-169-72)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":2.3206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alogliptin-Metformin|Alogliptin Benz/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"45802035165","name":"ALOGLIPTIN-PIOGLIT 25-15 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-351-65","proprietary_name":"Alogliptin and Pioglitazone","nonproprietary_name":"Alogliptin Benzoate and Pioglitazone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 15 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (45802-351-65)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":4.7314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alogliptin-Pioglitazone|Alogliptin Benz/Pioglitazone","basis":"generic"},"part_b":null}, {"ndc":"53746024830","name":"ALOSETRON HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-248-30","proprietary_name":"Alosetron Hydrochloride","nonproprietary_name":"Alosetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (53746-248-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":2.01861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"65162024803","name":"ALOSETRON HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-248-03","proprietary_name":"Alosetron Hydrochloride","nonproprietary_name":"Alosetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65162-248-03)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":2.01861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"70756070230","name":"ALOSETRON HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-702-30","proprietary_name":"Alosetron","nonproprietary_name":"Alosetron","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-702-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":2.01861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"71930001030","name":"ALOSETRON HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-010-30","proprietary_name":"Alosetron Hydrochloride","nonproprietary_name":"Alosetron Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Eywa Pharma Inc","package_description":"30 TABLET in 1 BOTTLE (71930-010-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":2.01861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"53746024930","name":"ALOSETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-249-30","proprietary_name":"Alosetron Hydrochloride","nonproprietary_name":"Alosetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (53746-249-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":3.41983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"65162024903","name":"ALOSETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-249-03","proprietary_name":"Alosetron Hydrochloride","nonproprietary_name":"Alosetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65162-249-03)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":3.41983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"70756070130","name":"ALOSETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-701-30","proprietary_name":"Alosetron","nonproprietary_name":"Alosetron","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-701-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":3.41983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"71930001130","name":"ALOSETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-011-30","proprietary_name":"Alosetron Hydrochloride","nonproprietary_name":"Alosetron Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Eywa Pharma Inc","package_description":"30 TABLET in 1 BOTTLE (71930-011-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":3.41983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alosetron HCl|Alosetron HCl","basis":"generic"},"part_b":null}, {"ndc":"00023932105","name":"ALPHAGAN P 0.1% DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9321-05","proprietary_name":"ALPHAGAN P","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9321-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":37.35499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alphagan P|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00023932110","name":"ALPHAGAN P 0.1% DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9321-10","proprietary_name":"ALPHAGAN P","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9321-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":37.26824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alphagan P|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00023932115","name":"ALPHAGAN P 0.1% DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9321-15","proprietary_name":"ALPHAGAN P","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9321-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":37.25406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alphagan P|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00023917705","name":"ALPHAGAN P 0.15% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9177-05","proprietary_name":"ALPHAGAN P","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9177-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":39.74875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":9.74729,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alphagan P|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00023917710","name":"ALPHAGAN P 0.15% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9177-10","proprietary_name":"ALPHAGAN P","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9177-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":39.80818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":10.54168,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alphagan P|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00023917715","name":"ALPHAGAN P 0.15% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9177-15","proprietary_name":"ALPHAGAN P","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9177-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":39.84933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":11.65198,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alphagan P|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00228202710","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2027-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2027-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228202750","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2027-50","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0228-2027-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228202796","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2027-96","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0228-2027-96)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781106101","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1061-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0781-1061-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781106105","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1061-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0781-1061-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781106110","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1061-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET in 1 BOTTLE (0781-1061-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"50268003311","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"50268003315","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-033-15","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-033-15) / 1 TABLET in 1 BLISTER PACK (50268-033-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762371901","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3719-1","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-3719-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762371903","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3719-3","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59762-3719-3)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762371904","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3719-4","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-3719-4)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"60687037701","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-377-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-377-01) / 1 TABLET in 1 BLISTER PACK (60687-377-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"60687037711","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067601","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-676-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-676-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067605","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-676-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-676-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067699","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-676-99","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-676-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339019905","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-199-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Natco Pharma USA LLC","package_description":"500 TABLET in 1 BOTTLE (69339-199-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339019910","name":"ALPRAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-199-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Natco Pharma USA LLC","package_description":"1000 TABLET in 1 BOTTLE (69339-199-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228202910","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2029-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2029-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228202950","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2029-50","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0228-2029-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228202996","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2029-96","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0228-2029-96)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781107701","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1077-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0781-1077-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781107705","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1077-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0781-1077-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781107710","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1077-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET in 1 BOTTLE (0781-1077-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"50268003411","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"50268003415","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-034-15","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-034-15) / 1 TABLET in 1 BLISTER PACK (50268-034-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372001","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3720-1","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-3720-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372003","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3720-3","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59762-3720-3)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372004","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3720-4","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-3720-4)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"60687038801","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-388-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-388-01) / 1 TABLET in 1 BLISTER PACK (60687-388-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"60687038811","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067701","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-677-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-677-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067705","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-677-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-677-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067799","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-677-99","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-677-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339020005","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-200-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Natco Pharma USA LLC","package_description":"500 TABLET in 1 BOTTLE (69339-200-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339020010","name":"ALPRAZOLAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-200-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Natco Pharma USA LLC","package_description":"1000 TABLET in 1 BOTTLE (69339-200-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228203110","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2031-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2031-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228203150","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2031-50","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0228-2031-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228203196","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2031-96","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0228-2031-96)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781107901","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1079-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0781-1079-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781107905","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1079-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0781-1079-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781107910","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1079-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET in 1 BOTTLE (0781-1079-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"50268003511","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"50268003515","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-035-15","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-035-15) / 1 TABLET in 1 BLISTER PACK (50268-035-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372101","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3721-1","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-3721-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372103","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3721-3","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59762-3721-3)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372104","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3721-4","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-3721-4)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067801","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-678-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-678-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067805","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-678-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-678-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067899","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-678-99","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-678-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339020105","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-201-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Natco Pharma USA LLC","package_description":"500 TABLET in 1 BOTTLE (69339-201-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339020110","name":"ALPRAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-201-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Natco Pharma USA LLC","package_description":"1000 TABLET in 1 BOTTLE (69339-201-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228203910","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2039-10","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2039-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781108901","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1089-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0781-1089-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00781108905","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1089-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0781-1089-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372201","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3722-1","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-3722-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762372203","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3722-3","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59762-3722-3)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067901","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-679-01","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-679-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862067905","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-679-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-679-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"69339020205","name":"ALPRAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-202-05","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Natco Pharma USA LLC","package_description":"500 TABLET in 1 BOTTLE (69339-202-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862045460","name":"ALPRAZOLAM ER 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-454-60","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (65862-454-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ER|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862045560","name":"ALPRAZOLAM ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-455-60","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (65862-455-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ER|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862045660","name":"ALPRAZOLAM ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-456-60","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (65862-456-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.20607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ER|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"65862045760","name":"ALPRAZOLAM ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-457-60","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (65862-457-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.26176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ER|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00054306844","name":"ALPRAZOLAM INTENSOL 1 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0054-3068-44","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CONTAINER (0054-3068-44) / 30 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00228401911","name":"ALPRAZOLAM ODT 0.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-4019-11","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0228-4019-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.96967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"49884011052","name":"ALPRAZOLAM ODT 0.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"49884011074","name":"ALPRAZOLAM ODT 0.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-110-74","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".25 mg/1","labeler":"Par Health USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (49884-110-74) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.96967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228402211","name":"ALPRAZOLAM ODT 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-4022-11","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0228-4022-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.23092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"49884011152","name":"ALPRAZOLAM ODT 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.23092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"49884011174","name":"ALPRAZOLAM ODT 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-111-74","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (49884-111-74) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.23092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"00228402411","name":"ALPRAZOLAM ODT 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-4024-11","proprietary_name":"Alprazolam","nonproprietary_name":"Alprazolam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0228-4024-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.77,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"49884021352","name":"ALPRAZOLAM ODT 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.77,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"49884021374","name":"ALPRAZOLAM ODT 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-213-74","proprietary_name":"Alprazolam","nonproprietary_name":"alprazolam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (49884-213-74) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.77,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam ODT|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762005701","name":"ALPRAZOLAM XR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0057-1","proprietary_name":"Alprazolam XR","nonproprietary_name":"alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (59762-0057-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam XR|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762005901","name":"ALPRAZOLAM XR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0059-1","proprietary_name":"Alprazolam XR","nonproprietary_name":"alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (59762-0059-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam XR|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762006601","name":"ALPRAZOLAM XR 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0066-1","proprietary_name":"Alprazolam XR","nonproprietary_name":"alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (59762-0066-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.20607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam XR|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"59762006801","name":"ALPRAZOLAM XR 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0068-1","proprietary_name":"Alprazolam XR","nonproprietary_name":"alprazolam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (59762-0068-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.26176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alprazolam XR|Alprazolam","basis":"generic"},"part_b":null}, {"ndc":"24208035305","name":"ALREX 0.2% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-353-05","proprietary_name":"Alrex","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-353-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":58.04442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":30.71714,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alrex|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"24208035310","name":"ALREX 0.2% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-353-10","proprietary_name":"Alrex","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-353-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":58.01,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Alrex|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"70700011684","name":"ALTAVERA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Altavera|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700011685","name":"ALTAVERA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-116-85","proprietary_name":"ALTAVERA","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-116-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Altavera|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00536009185","name":"ALUMINUM HYDROXIDE GEL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0536-0091-85","proprietary_name":"Aluminum Hydroxide","nonproprietary_name":"aluminum hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"320 mg/5mL","labeler":"Rugby Laboratories","package_description":"473 mL in 1 BOTTLE (0536-0091-85)"},"nadac":{"value":0.01327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70515071201","name":"ALVESCO 160 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-712-01","proprietary_name":"Alvesco","nonproprietary_name":"ciclesonide","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1","labeler":"Covis Pharma US, Inc","package_description":"1 INHALER in 1 CARTON (70515-712-01) / 60 AEROSOL, METERED in 1 INHALER"},"nadac":{"value":42.97099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alvesco|Ciclesonide","basis":"brand"},"part_b":null}, {"ndc":"70515071101","name":"ALVESCO 80 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-711-01","proprietary_name":"Alvesco","nonproprietary_name":"ciclesonide","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1","labeler":"Covis Pharma US, Inc","package_description":"1 INHALER in 1 CARTON (70515-711-01) / 60 AEROSOL, METERED in 1 INHALER"},"nadac":{"value":42.95871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Alvesco|Ciclesonide","basis":"brand"},"part_b":null}, {"ndc":"68462039429","name":"ALYACEN 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-394-29","proprietary_name":"ALYACEN 1/35","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-394-29) / 1 KIT in 1 BLISTER PACK (68462-394-84)"},"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alyacen|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462039484","name":"ALYACEN 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alyacen|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462055629","name":"ALYACEN 7-7-7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-556-29","proprietary_name":"ALYACEN 7/7/7","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-556-29) / 1 KIT in 1 BLISTER PACK (68462-556-84)"},"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alyacen|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462055684","name":"ALYACEN 7-7-7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alyacen|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00480927706","name":"ALYQ 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9277-06","proprietary_name":"ALYQ","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0480-9277-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Alyq|Tadalafil","basis":"brand"},"part_b":null}, {"ndc":"00832101500","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1015-00","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0832-1015-00)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832101550","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1015-50","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 CAPSULE, GELATIN COATED in 1 BOTTLE (0832-1015-50)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904704206","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7042-06","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7042-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904704240","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7042-40","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 CAPSULE in 1 BOTTLE (0904-7042-40)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904704259","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7042-59","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (0904-7042-59)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904704261","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7042-61","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7042-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571083401","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-834-01","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-834-01)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571083450","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-834-50","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (16571-834-50)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155036201","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-362-01","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-362-01)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155036205","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-362-05","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-362-05)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006911","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006915","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-069-15","proprietary_name":"Amantadine HCl","nonproprietary_name":"AMANTADINE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-069-15) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (50268-069-11)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687042201","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-422-01","proprietary_name":"Amantadine","nonproprietary_name":"Amantadine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-422-01) / 1 CAPSULE in 1 BLISTER PACK (60687-422-11)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687042211","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135060990","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-609-90","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-609-90)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332024631","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-246-31","proprietary_name":"amantadine","nonproprietary_name":"amantadine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-246-31)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332024671","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-246-71","proprietary_name":"amantadine","nonproprietary_name":"amantadine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (62332-246-71)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382051201","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-512-01","proprietary_name":"amantadine hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-512-01)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382051205","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-512-05","proprietary_name":"amantadine hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 CAPSULE in 1 BOTTLE (68382-512-05)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452014220","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-142-20","proprietary_name":"Amantadine HCl","nonproprietary_name":"AMANTADINE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (69452-142-20)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888003301","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-033-01","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (72888-033-01)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888003305","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-033-05","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (72888-033-05)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888003330","name":"AMANTADINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-033-30","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (72888-033-30)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.14251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832011100","name":"AMANTADINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0111-00","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0111-00)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832011150","name":"AMANTADINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0111-50","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (0832-0111-50)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832011189","name":"AMANTADINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42543049701","name":"AMANTADINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-497-01","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (42543-497-01)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42543049705","name":"AMANTADINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-497-05","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Inc.","package_description":"500 TABLET in 1 BOTTLE (42543-497-05)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332058631","name":"AMANTADINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-586-31","proprietary_name":"Amantadine","nonproprietary_name":"Amantadine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-586-31)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00116401016","name":"AMANTADINE 50 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4010-16","proprietary_name":"Amantadine","nonproprietary_name":"Amantadine","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/5mL","labeler":"Xttrium Laboratories, Inc","package_description":"473 mL in 1 BOTTLE (0116-4010-16)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.04977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121064616","name":"AMANTADINE 50 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0646-16","proprietary_name":"AMANTADINE HYDROCHLORIDE","nonproprietary_name":"AMANTADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0646-16)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.04977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"39328053016","name":"AMANTADINE 50 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-530-16","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"amantadine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/5mL","labeler":"Patrin Pharma, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (39328-530-16)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.04977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135001047","name":"AMANTADINE 50 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-010-47","proprietary_name":"Amantadine Hydrochloride","nonproprietary_name":"Amantadine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-010-47)","pharm_classes":["Influenza A M2 Protein Inhibitor [EPC]","M2 Protein Inhibitors [MoA]"]},"nadac":{"value":0.04977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024542131","name":"AMBIEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.61381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambien|Zolpidem Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00713542101","name":"AMBIEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-5421-01","proprietary_name":"Ambien","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0713-5421-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":22.61381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambien|Zolpidem Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00024552131","name":"AMBIEN CR 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.57257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10925,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambien Cr|Zolpidem Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00713552101","name":"AMBIEN CR 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-5521-01","proprietary_name":"Ambien CR","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0713-5521-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":22.57257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10925,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambien Cr|Zolpidem Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00378427193","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4271-93","proprietary_name":"Ambrisentan","nonproprietary_name":"ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4271-93)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"00591240630","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2406-30","proprietary_name":"Ambrisentan","nonproprietary_name":"Ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0591-2406-30)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"42794005208","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-052-08","proprietary_name":"AMBRISENTAN","nonproprietary_name":"AMBRISENTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (42794-052-08)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"47335023783","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-237-83","proprietary_name":"ambrisentan","nonproprietary_name":"ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (47335-237-83)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"59651049530","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-495-30","proprietary_name":"ambrisentan","nonproprietary_name":"ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-495-30)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"60505455303","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4553-3","proprietary_name":"Ambrisentan","nonproprietary_name":"AMBRISENTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4553-3)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"69097038702","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-387-02","proprietary_name":"Ambrisentan","nonproprietary_name":"Ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69097-387-02)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"70710118003","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1180-3","proprietary_name":"Ambrisentan","nonproprietary_name":"Ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1180-3)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"82009014230","name":"AMBRISENTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-142-30","proprietary_name":"Ambrisentan","nonproprietary_name":"Ambrisentan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82009-142-30)","pharm_classes":["Endothelin Receptor Antagonist [EPC]","Endothelin Receptor Antagonists [MoA]"]},"nadac":{"value":8.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ambrisentan|Ambrisentan","basis":"generic"},"part_b":null}, {"ndc":"74157000660","name":"AMCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"74157-006-60","proprietary_name":"Amcinonide","nonproprietary_name":"Amcinonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"INA PHARMACEUTICS INC.","package_description":"1 TUBE in 1 CARTON (74157-006-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.90193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Amcinonide|Amcinonide","basis":"generic"},"part_b":null}, {"ndc":"82685034501","name":"AMERITHROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-345-01","proprietary_name":"Amerithroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-345-01)"},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82685034101","name":"AMERITHROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-341-01","proprietary_name":"Amerithroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-341-01)"},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82685034201","name":"AMERITHROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-342-01","proprietary_name":"Amerithroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-342-01)"},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82685034301","name":"AMERITHROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-343-01","proprietary_name":"Amerithroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-343-01)"},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82685034401","name":"AMERITHROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-344-01","proprietary_name":"Amerithroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-344-01)"},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480347224","name":"AMETHYST 90-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3472-24","proprietary_name":"Amethyst","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"90 ug/1; 20 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 POUCH in 1 CARTON (0480-3472-24) / 1 BLISTER PACK in 1 POUCH / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":1.13572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amethyst|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00641616710","name":"AMIKACIN SULF 500 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6167-10","proprietary_name":"Amikacin Sulfate","nonproprietary_name":"Amikacin Sulfate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0641-6167-10) / 2 mL in 1 VIAL, SINGLE-DOSE (0641-6167-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":2.3276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Amikacin Sulfate|Amikacin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J0278","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0278 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0641-6167-10) / 2 mL in 1 VIAL, SINGLE-DOSE (0641-6167-01)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155029041","name":"AMIKACIN SULF 500 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-290-41","proprietary_name":"Amikacin Sulfate","nonproprietary_name":"Amikacin Sulfate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 VIAL, GLASS in 1 CARTON (23155-290-41) / 2 mL in 1 VIAL, GLASS (23155-290-31)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":2.3276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Amikacin Sulfate|Amikacin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J0278","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0278 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (23155-290-41) / 2 mL in 1 VIAL, GLASS (23155-290-31)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155078541","name":"AMIKACIN SULF 500 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-785-41","proprietary_name":"Amikacin Sulfate","nonproprietary_name":"Amikacin Sulfate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/2mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 VIAL, GLASS in 1 CARTON (23155-785-41) / 2 mL in 1 VIAL, GLASS (23155-785-31)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":2.3276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Amikacin Sulfate|Amikacin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J0278","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0278 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (23155-785-41) / 2 mL in 1 VIAL, GLASS (23155-785-31)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021017302","name":"AMIKACIN SULF 500 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-173-02","proprietary_name":"amikacin sulfate","nonproprietary_name":"amikacin sulfate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-173-02) / 2 mL in 1 VIAL","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":2.3276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Amikacin Sulfate|Amikacin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J0278","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0278 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-173-02) / 2 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323081502","name":"AMIKACIN SULF 500 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-815-02","proprietary_name":"Amikacin Sulfate","nonproprietary_name":"Amikacin Sulfate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (63323-815-02) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-815-21)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":2.3276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Amikacin Sulfate|Amikacin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J0278","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0278 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (63323-815-02) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-815-21)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"83301002202","name":"AMIKACIN SULF 500 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0022-2","proprietary_name":"Amikacin Sulfate","nonproprietary_name":"Amikacin Sulfate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/mL","labeler":"Mullan Pharmaceutical Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (83301-0022-2) / 2 mL in 1 VIAL, SINGLE-DOSE (83301-0022-1)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":2.3276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Amikacin Sulfate|Amikacin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J0278","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0278 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (83301-0022-2) / 2 mL in 1 VIAL, SINGLE-DOSE (83301-0022-1)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00574029201","name":"AMILORIDE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0292-01","proprietary_name":"amiloride hydrochloride","nonproprietary_name":"amiloride hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET in 1 BOTTLE (0574-0292-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":0.1901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiloride HCl|Amiloride HCl","basis":"generic"},"part_b":null}, {"ndc":"42794000502","name":"AMILORIDE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-005-02","proprietary_name":"Amiloride Hydrochloride","nonproprietary_name":"Amiloride Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (42794-005-02)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":0.1901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiloride HCl|Amiloride HCl","basis":"generic"},"part_b":null}, {"ndc":"49884011701","name":"AMILORIDE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-117-01","proprietary_name":"Amiloride Hydrochloride","nonproprietary_name":"Amiloride Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-117-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":0.1901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiloride HCl|Amiloride HCl","basis":"generic"},"part_b":null}, {"ndc":"49884011710","name":"AMILORIDE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-117-10","proprietary_name":"Amiloride Hydrochloride","nonproprietary_name":"Amiloride Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (49884-117-10)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":0.1901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiloride HCl|Amiloride HCl","basis":"generic"},"part_b":null}, {"ndc":"00555048302","name":"AMILORIDE HCL-HYDROCHLOROTHIAZIDE 5-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0483-02","proprietary_name":"Amiloride Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Amiloride Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0483-02)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.44985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiloride-Hydrochlorothiazide|Amiloride/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00555048305","name":"AMILORIDE HCL-HYDROCHLOROTHIAZIDE 5-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0483-05","proprietary_name":"Amiloride Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Amiloride Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0555-0483-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.44985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiloride-Hydrochlorothiazide|Amiloride/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00054110058","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-1100-58","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"SYRUP","route":"ORAL","strength":".25 g/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"236.5 mL in 1 BOTTLE, PLASTIC (0054-1100-58)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722003523","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-035-23","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"aminocaproic acid","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"236.5 mL in 1 BOTTLE, PLASTIC (31722-035-23)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52817081508","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-815-08","proprietary_name":"Aminocaproic acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"TruPharma LLC","package_description":"236.5 mL in 1 BOTTLE, PLASTIC (52817-815-08)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651057308","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-573-08","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Aurobindo Pharma Limited","package_description":"236.5 mL in 1 BOTTLE (59651-573-08)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238159608","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1596-8","proprietary_name":"Aminocaproic acid","nonproprietary_name":"Aminocaproic acid","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"236.5 mL in 1 BOTTLE, PLASTIC (69238-1596-8)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69680011408","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-114-08","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Vitruvias Therapeutics","package_description":"236.5 mL in 1 BOTTLE (69680-114-08)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70377010411","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-104-11","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"AMINOCAPROIC ACID","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Biocon Pharma Inc.","package_description":"236.5 mL in 1 BOTTLE (70377-104-11)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71921017508","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-175-08","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"236.5 mL in 1 BOTTLE (71921-175-08)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"80005013022","name":"AMINOCAPROIC ACID 0.25 GRAM/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-130-22","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"AMINOCAPROIC ACID","dosage_form":"SOLUTION","route":"ORAL","strength":".25 g/mL","labeler":"Carnegie Pharmaceuticals, LLC","package_description":"236.5 mL in 1 BOTTLE (80005-130-22)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.57363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054111013","name":"AMINOCAPROIC ACID 1,000 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-1110-13","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-1110-13)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":8.31219,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658079930","name":"AMINOCAPROIC ACID 1,000 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-799-30","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"AMINOCAPROIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"30 TABLET in 1 BOTTLE (24658-799-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":8.31219,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680011630","name":"AMINOCAPROIC ACID 1,000 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-116-30","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Vitruvias Therapeutics","package_description":"30 TABLET in 1 BOTTLE (69680-116-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":8.31219,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377010311","name":"AMINOCAPROIC ACID 1,000 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-103-11","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"AMINOCAPROIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET in 1 BOTTLE (70377-103-11)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":8.31219,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904716507","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7165-07","proprietary_name":"Aminocaproic acid","nonproprietary_name":"Aminocaproic acid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7165-07) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658079830","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-798-30","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"AMINOCAPROIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"30 TABLET in 1 BOTTLE (24658-798-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073925","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-739-25","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-739-25) / 1 TABLET in 1 BLISTER PACK (60687-739-95)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073995","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559022530","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238163703","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1637-3","proprietary_name":"Aminocaproic acid","nonproprietary_name":"Aminocaproic acid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (69238-1637-3)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680011530","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-115-30","proprietary_name":"Aminocaproic Acid","nonproprietary_name":"Aminocaproic Acid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Vitruvias Therapeutics","package_description":"30 TABLET in 1 BOTTLE (69680-115-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377010211","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-102-11","proprietary_name":"AMINOCAPROIC ACID","nonproprietary_name":"AMINOCAPROIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET in 1 BOTTLE (70377-102-11)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205004930","name":"AMINOCAPROIC ACID 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-049-30","proprietary_name":"Aminocaproic acid","nonproprietary_name":"Aminocaproic acid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-049-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":2.52362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143987525","name":"AMIODARONE 150 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9875-25","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"50 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 BOX (0143-9875-25) / 3 mL in 1 VIAL (0143-9875-01)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.52115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0282","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0282 (30 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 BOX (0143-9875-25) / 3 mL in 1 VIAL (0143-9875-01)) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323061603","name":"AMIODARONE 150 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-616-03","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"AMIODARONE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"50 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-616-03) / 3 mL in 1 VIAL, SINGLE-DOSE (63323-616-01)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.52115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0282","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0282 (30 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (63323-616-03) / 3 mL in 1 VIAL, SINGLE-DOSE (63323-616-01)) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50268009711","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-097","inner_of":["50268-097-15"]},"part_b":null}, {"ndc":"50268009715","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-097-15","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-097-15) / 1 TABLET in 1 BLISTER PACK (50268-097-11)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"51672405506","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4055-6","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4055-6)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057630","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-576-30","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-576-30)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382029706","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-297-06","proprietary_name":"amiodarone hydrochloride","nonproprietary_name":"amiodarone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (68382-297-06)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006030","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-060-30","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (72888-060-30)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"75907000530","name":"AMIODARONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-005-30","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (75907-005-30)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904699361","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6993-61","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6993-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904757661","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7576-61","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7576-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300035905","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-359-05","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (29300-359-05)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300035916","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-359-16","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE (29300-359-16)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"51672402502","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4025-2","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE (51672-4025-2)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"51672402504","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4025-4","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET in 1 BOTTLE (51672-4025-4)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043701","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-437-01","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-437-01) / 1 TABLET in 1 BLISTER PACK (60687-437-11)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043711","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-437","inner_of":["60687-437-01"]},"part_b":null}, {"ndc":"62135057760","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-577-60","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-577-60)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862073205","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-732-05","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-732-05)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862073260","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-732-60","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-732-60)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382022705","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-227-05","proprietary_name":"amiodarone hydrochloride","nonproprietary_name":"amiodarone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-227-05)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382022714","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-227-14","proprietary_name":"amiodarone hydrochloride","nonproprietary_name":"amiodarone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (68382-227-14)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888003905","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-039-05","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-039-05)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888003960","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-039-60","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Advagen Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (72888-039-60)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"75907000660","name":"AMIODARONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-006-60","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (75907-006-60)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"51672405706","name":"AMIODARONE HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4057-6","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4057-6)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.49957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057830","name":"AMIODARONE HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-578-30","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-578-30)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.49957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382029806","name":"AMIODARONE HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-298-06","proprietary_name":"amiodarone hydrochloride","nonproprietary_name":"amiodarone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (68382-298-06)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.49957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006130","name":"AMIODARONE HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-061-30","proprietary_name":"Amiodarone Hydrochloride","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Advagen Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (72888-061-30)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.49957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amiodarone HCl*|Amiodarone HCl","basis":"generic"},"part_b":null}, {"ndc":"23635052460","name":"AMITIZA 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23635-524-60","proprietary_name":"Amitiza","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"SpecGx LLC","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (23635-524-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":6.44889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitiza|Lubiprostone","basis":"brand"},"part_b":null}, {"ndc":"23635050860","name":"AMITIZA 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23635-508-60","proprietary_name":"Amitiza","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"SpecGx LLC","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (23635-508-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":6.46774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitiza|Lubiprostone","basis":"brand"},"part_b":null}, {"ndc":"00781148601","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1486-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1486-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781148610","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1486-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0781-1486-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788007701","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-077-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-077-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788007710","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-077-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (11788-077-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010501","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-105-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-105-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010510","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-105-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-105-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714025701","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-257-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-257-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714025702","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-257-02","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-257-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041901","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-419-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-419-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041910","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-419-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (29300-419-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268003711","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268003715","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-037-15","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-037-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-037-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664068718","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-687-18","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-687-18)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664068788","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-687-88","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-687-88)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038801","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-388-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-388-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038810","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-388-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69367-388-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122500","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1225-0","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70710-1225-0)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122501","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1225-1","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1225-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020111","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-201-11","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70756-201-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020112","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-201-12","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70756-201-12)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006700","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-067-00","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-067-00)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006701","name":"AMITRIPTYLINE HCL 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-067-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-067-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.02998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781149001","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1490-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1490-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788008101","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-081-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-081-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010901","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-109-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-109-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714026101","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-261-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-261-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042301","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-423-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-423-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268004111","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268004115","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-041-15","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-041-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-041-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664069088","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-690-88","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-690-88)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367039201","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-392-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-392-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122901","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1229-1","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1229-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020511","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-205-11","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70756-205-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888007101","name":"AMITRIPTYLINE HCL 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-071-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-071-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781149101","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1491-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1491-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788008201","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-082-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-082-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011001","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-110-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-110-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714026201","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-262-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-262-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042401","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-424-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-424-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664069188","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-691-88","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-691-88)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367039301","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-393-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-393-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710123001","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1230-1","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1230-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020611","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-206-11","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70756-206-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888007201","name":"AMITRIPTYLINE HCL 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-072-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-072-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781148701","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1487-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1487-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781148710","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1487-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0781-1487-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00904741061","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7410-61","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7410-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788007801","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-078-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-078-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788007810","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-078-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (11788-078-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010601","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-106-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-106-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010610","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-106-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-106-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714025801","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-258-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-258-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714025802","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-258-02","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-258-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042001","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-420-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-420-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042010","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-420-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (29300-420-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268003811","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268003815","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-038-15","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-038-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-038-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664068818","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-688-18","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-688-18)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664068888","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-688-88","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-688-88)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043301","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-433-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-433-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-433-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043311","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038901","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-389-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-389-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038910","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-389-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69367-389-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122600","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1226-0","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70710-1226-0)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122601","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1226-1","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1226-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020211","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-202-11","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70756-202-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020212","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-202-12","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70756-202-12)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006800","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-068-00","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-068-00)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006801","name":"AMITRIPTYLINE HCL 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-068-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-068-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.05221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781148801","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1488-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1488-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781148810","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1488-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0781-1488-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00904741161","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7411-61","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7411-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788007901","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-079-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-079-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788007910","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-079-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (11788-079-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010701","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-107-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-107-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010710","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-107-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-107-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714025901","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-259-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-259-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714025902","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-259-02","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-259-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042101","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-421-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-421-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042110","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-421-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (29300-421-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268003911","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268003915","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-039-15","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-039-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-039-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664068918","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-689-18","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-689-18)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664068988","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-689-88","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-689-88)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044401","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-444-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-444-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-444-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044411","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367039001","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-390-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-390-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367039010","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-390-10","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69367-390-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122700","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1227-0","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70710-1227-0)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122701","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1227-1","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1227-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020311","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-203-11","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70756-203-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020312","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-203-12","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70756-203-12)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006900","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-069-00","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-069-00)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006901","name":"AMITRIPTYLINE HCL 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-069-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-069-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.09628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00781148901","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1489-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1489-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"11788008001","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-080-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-080-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571010801","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-108-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-108-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714026001","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-260-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-260-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"29300042201","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-422-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-422-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268004011","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268004015","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-040-15","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-040-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-040-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"57664069288","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-692-88","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-692-88)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367039101","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-391-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"75 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-391-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710122801","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1228-1","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1228-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"70756020411","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-204-11","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70756-204-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888007001","name":"AMITRIPTYLINE HCL 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-070-01","proprietary_name":"Amitriptyline Hydrochloride","nonproprietary_name":"Amitriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-070-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.1225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amitriptyline HCl|Amitriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00480716810","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7168-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-7168-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00480716898","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00904637161","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6371-61","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6371-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039805","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-398-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-398-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039810","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-398-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-398-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039819","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-398-19","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-398-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"42806005710","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-057-10","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (42806-057-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762213501","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2135-1","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-2135-1)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762213509","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2135-9","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59762-2135-9)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"60687049601","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-496-01","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-496-01) / 1 TABLET in 1 BLISTER PACK (60687-496-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"60687049611","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019905","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-199-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-199-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019910","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-199-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-199-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019990","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-199-90","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-199-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090205","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-902-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-902-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090210","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-902-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-902-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090290","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-902-90","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-902-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180072103","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-721-03","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-721-03)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180072109","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-721-09","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-721-09)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68382012305","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-123-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-123-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68382012316","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-123-16","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-123-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68645051654","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-516-54","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-516-54)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68645058054","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-580-54","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-580-54)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69097012805","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-128-05","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-128-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69097012815","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-128-15","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-128-15)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002309","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-023-09","proprietary_name":"AMLODIPINE BESYLATE 10 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (69584-023-09)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002350","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-023-50","proprietary_name":"AMLODIPINE BESYLATE 10 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-023-50)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002390","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-023-90","proprietary_name":"AMLODIPINE BESYLATE 10 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-023-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282023910","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-239-10","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-239-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282023990","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-239-90","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-239-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282050910","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-509-10","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-509-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282050990","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-509-90","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-509-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"82009002810","name":"AMLODIPINE BESYLATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-028-10","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-028-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00480008305","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-0083-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (0480-0083-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00480008398","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00904636961","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6369-61","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6369-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039605","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-396-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-396-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039610","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-396-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-396-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039619","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-396-19","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-396-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762224203","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2242-3","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"300 TABLET in 1 BOTTLE (59762-2242-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762224209","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2242-9","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59762-2242-9)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019705","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-197-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-197-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019710","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-197-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-197-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019790","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-197-90","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-197-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090005","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-900-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-900-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090010","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-900-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-900-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090090","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-900-90","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-900-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180023301","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-233-01","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-233-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180023302","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-233-02","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-233-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180071909","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68382012105","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-121-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-121-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68382012116","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-121-16","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-121-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69097012605","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-126-05","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-126-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69097012615","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-126-15","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-126-15)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002109","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-021-09","proprietary_name":"AMLODIPINE BESYLATE 2.5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (69584-021-09)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002150","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-021-50","proprietary_name":"AMLODIPINE BESYLATE 2.5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-021-50)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002190","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-021-90","proprietary_name":"AMLODIPINE BESYLATE 2.5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-021-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282050710","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-507-10","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-507-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282050790","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-507-90","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-507-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"82009002610","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-026-10","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-026-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"82009002690","name":"AMLODIPINE BESYLATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00480716710","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7167-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-7167-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00480716798","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00904637061","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6370-61","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6370-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039705","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-397-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-397-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039710","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-397-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-397-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"29300039719","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-397-19","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-397-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762201001","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2010-1","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-2010-1)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762201003","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2010-3","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"300 TABLET in 1 BOTTLE (59762-2010-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"59762201009","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2010-9","proprietary_name":"amlodipine besylate","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59762-2010-9)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"60687048801","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-488-01","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-488-01) / 1 TABLET in 1 BLISTER PACK (60687-488-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"60687048811","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019805","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-198-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-198-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019810","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-198-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-198-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877019890","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-198-90","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-198-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090105","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-901-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-901-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090110","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-901-10","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-901-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"67877090190","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-901-90","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-901-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180045501","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-455-01","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-455-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180045502","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-455-02","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-455-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180072003","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68180072009","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68382012205","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-122-05","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-122-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68382012216","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-122-16","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-122-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"68645051554","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-515-54","proprietary_name":"Amlodipine Besylate","nonproprietary_name":"Amlodipine Besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-515-54)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69097012705","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-127-05","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-127-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69097012715","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-127-15","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-127-15)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002209","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-022-09","proprietary_name":"AMLODIPINE BESYLATE 5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (69584-022-09)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002250","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-022-50","proprietary_name":"AMLODIPINE BESYLATE 5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-022-50)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002290","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-022-90","proprietary_name":"AMLODIPINE BESYLATE 5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-022-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"69584002295","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-022-95","proprietary_name":"AMLODIPINE BESYLATE 5 mg","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"5000 TABLET in 1 BOTTLE (69584-022-95)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282023810","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-238-10","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-238-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282023890","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-238-90","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-238-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282050810","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-508-10","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-508-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"76282050890","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-508-90","proprietary_name":"Amlodipine besylate","nonproprietary_name":"Amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-508-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"82009002710","name":"AMLODIPINE BESYLATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-027-10","proprietary_name":"AMLODIPINE BESYLATE","nonproprietary_name":"AMLODIPINE BESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-027-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate|Amlodipine Besylate","basis":"generic"},"part_b":null}, {"ndc":"00378451793","name":"AMLODIPINE-ATORVAST 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4517-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4517-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.97947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505347903","name":"AMLODIPINE-ATORVAST 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3479-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3479-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.97947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332076230","name":"AMLODIPINE-ATORVAST 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-762-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-762-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.97947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993027030","name":"AMLODIPINE-ATORVAST 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-270-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-270-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.97947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378451893","name":"AMLODIPINE-ATORVAST 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4518-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4518-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.79702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505348403","name":"AMLODIPINE-ATORVAST 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3484-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3484-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.79702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332076330","name":"AMLODIPINE-ATORVAST 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-763-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-763-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.79702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993027130","name":"AMLODIPINE-ATORVAST 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-271-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-271-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.79702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378451993","name":"AMLODIPINE-ATORVAST 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4519-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4519-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.33627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505348903","name":"AMLODIPINE-ATORVAST 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3489-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3489-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.33627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332076430","name":"AMLODIPINE-ATORVAST 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-764-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-764-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.33627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993027230","name":"AMLODIPINE-ATORVAST 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-272-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-272-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.33627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378452093","name":"AMLODIPINE-ATORVAST 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4520-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4520-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.56509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505349303","name":"AMLODIPINE-ATORVAST 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3493-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3493-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.56509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332076530","name":"AMLODIPINE-ATORVAST 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-765-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-765-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.56509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993027330","name":"AMLODIPINE-ATORVAST 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-273-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-273-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.56509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332075530","name":"AMLODIPINE-ATORVAST 2.5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-755-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-755-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":3.07993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026330","name":"AMLODIPINE-ATORVAST 2.5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66993-263-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-263-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":3.07993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332075630","name":"AMLODIPINE-ATORVAST 2.5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-756-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-756-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":4.49673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026430","name":"AMLODIPINE-ATORVAST 2.5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66993-264-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1; 20 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-264-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":4.49673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332075730","name":"AMLODIPINE-ATORVAST 2.5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-757-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-757-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":5.0363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026530","name":"AMLODIPINE-ATORVAST 2.5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-265-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1; 40 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-265-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":5.0363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378451393","name":"AMLODIPINE-ATORVAST 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4513-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4513-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.08105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505347803","name":"AMLODIPINE-ATORVAST 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3478-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3478-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.08105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332075830","name":"AMLODIPINE-ATORVAST 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-758-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-758-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.08105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026630","name":"AMLODIPINE-ATORVAST 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-266-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-266-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.08105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378451493","name":"AMLODIPINE-ATORVAST 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4514-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4514-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.88094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505348303","name":"AMLODIPINE-ATORVAST 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3483-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3483-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.88094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332075930","name":"AMLODIPINE-ATORVAST 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-759-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-759-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.88094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026730","name":"AMLODIPINE-ATORVAST 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-267-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-267-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.88094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378451593","name":"AMLODIPINE-ATORVAST 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4515-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4515-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.19146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505348803","name":"AMLODIPINE-ATORVAST 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3488-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3488-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.19146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332076030","name":"AMLODIPINE-ATORVAST 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-760-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-760-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.19146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026830","name":"AMLODIPINE-ATORVAST 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-268-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-268-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.19146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"00378451693","name":"AMLODIPINE-ATORVAST 5-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4516-93","proprietary_name":"Amlodipine and atorvastatin","nonproprietary_name":"Amlodipine and atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4516-93)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.55758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"60505349203","name":"AMLODIPINE-ATORVAST 5-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3492-3","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 80 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3492-3)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.55758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"62332076130","name":"AMLODIPINE-ATORVAST 5-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-761-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-761-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.55758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"66993026930","name":"AMLODIPINE-ATORVAST 5-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-269-30","proprietary_name":"Amlodipine and Atorvastatin","nonproprietary_name":"Amlodipine and Atorvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1; 80 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (66993-269-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.55758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Atorvastatin|Amlodipine/Atorvastatin","basis":"generic"},"part_b":null}, {"ndc":"23155092401","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-924-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-924-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111034101","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-341-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (55111-341-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111034105","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-341-05","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-341-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"57237014601","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-146-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-146-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058601","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-586-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-586-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058605","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-586-05","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-586-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68001013000","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-130-00","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-130-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68180047201","name":"AMLODIPINE-BENAZEPRIL 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-472-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-472-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"23155092501","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-925-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-925-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111058601","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-586-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (55111-586-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"57237014701","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-147-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-147-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058701","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-587-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-587-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058705","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-587-05","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-587-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68001013100","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-131-00","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-131-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68180047301","name":"AMLODIPINE-BENAZEPRIL 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-473-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-473-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"23155092001","name":"AMLODIPINE-BENAZEPRIL 2.5-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-920-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-920-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111033801","name":"AMLODIPINE-BENAZEPRIL 2.5-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-338-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (55111-338-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"57237014201","name":"AMLODIPINE-BENAZEPRIL 2.5-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-142-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-142-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058201","name":"AMLODIPINE-BENAZEPRIL 2.5-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-582-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-582-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68001013200","name":"AMLODIPINE-BENAZEPRIL 2.5-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-132-00","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-132-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68180075501","name":"AMLODIPINE-BENAZEPRIL 2.5-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-755-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-755-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"23155092101","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-921-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-921-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111033901","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-339-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (55111-339-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111033905","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-339-05","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-339-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"57237014301","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-143-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-143-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058301","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-583-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-583-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058305","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-583-05","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-583-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68001013300","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-133-00","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-133-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68180075601","name":"AMLODIPINE-BENAZEPRIL 5-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-756-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-756-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.09904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"23155092201","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-922-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-922-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111034001","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-340-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (55111-340-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111034005","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-340-05","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-340-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"57237014401","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-144-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-144-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058401","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-584-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-584-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058405","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-584-05","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-584-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68001013400","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-134-00","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-134-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68180045901","name":"AMLODIPINE-BENAZEPRIL 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-459-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-459-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.1035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"23155092301","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-923-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-923-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"55111058701","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-587-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (55111-587-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"57237014501","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-145-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-145-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058501","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-585-01","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-585-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"65862058505","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-585-05","proprietary_name":"Amlodipine and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-585-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68001013500","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-135-00","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-135-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"68180046301","name":"AMLODIPINE-BENAZEPRIL 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-463-01","proprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","nonproprietary_name":"Amlodipine Besylate and Benazepril Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-463-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.14392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine Besylate-Benazepril|Amlodipine Besylate/Benazepril","basis":"generic"},"part_b":null}, {"ndc":"27241008503","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-085-03","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-085-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008509","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-085-09","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-085-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044730","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-447-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-447-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044790","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-447-90","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-447-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019207","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-192-07","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-192-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019210","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-192-10","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-192-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023630","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-236-30","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-236-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023690","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-236-90","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Micro Labs Limited","package_description":"90 TABLET in 1 BOTTLE (42571-236-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"62332021430","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-214-30","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-214-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332021490","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-214-90","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-214-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862085630","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-856-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-856-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877050030","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-500-30","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-500-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877050090","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-500-90","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-500-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"69238267301","name":"AMLODIPINE-OLMESARTAN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2673-1","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69238-2673-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.24767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008603","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-086-03","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-086-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008609","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-086-09","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-086-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044830","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-448-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-448-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044890","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-448-90","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-448-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019307","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-193-07","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-193-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019310","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-193-10","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-193-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023830","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-238-30","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-238-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023890","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-238-90","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Micro Labs Limited","package_description":"90 TABLET in 1 BOTTLE (42571-238-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"62332021530","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-215-30","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-215-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332021590","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-215-90","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-215-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862085730","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-857-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-857-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877050230","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-502-30","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-502-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877050290","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-502-90","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-502-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"69238267401","name":"AMLODIPINE-OLMESARTAN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2674-1","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69238-2674-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008303","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-083-03","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-083-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008309","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-083-09","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-083-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044530","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-445-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-445-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044590","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-445-90","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-445-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019007","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-190-07","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-190-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019010","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-190-10","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-190-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023530","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-235-30","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-235-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023590","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-235-90","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Micro Labs Limited","package_description":"90 TABLET in 1 BOTTLE (42571-235-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"62332021230","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-212-30","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-212-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332021290","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-212-90","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-212-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862085430","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-854-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-854-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877049930","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-499-30","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-499-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877049990","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-499-90","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-499-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"69238267501","name":"AMLODIPINE-OLMESARTAN 5-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2675-1","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69238-2675-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008403","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-084-03","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-084-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"27241008409","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-084-09","proprietary_name":"Amlodipine besylate and Olmesartan medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-084-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"31722044630","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-446-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Aamlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-446-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722044690","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-446-90","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Aamlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-446-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342019107","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-191-07","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-191-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"33342019110","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-191-10","proprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","nonproprietary_name":"AMLODIPINE and OLMESARTAN medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-191-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023730","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-237-30","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-237-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"42571023790","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-237-90","proprietary_name":"AMLODIPINE AND OLMESARTAN MEDOXOMIL","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Micro Labs Limited","package_description":"90 TABLET in 1 BOTTLE (42571-237-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"62332021330","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-213-30","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-213-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332021390","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-213-90","proprietary_name":"Amlodipine besylate and Olmesartran medoxomil","nonproprietary_name":"Amlodipine besylate and Olmesartran medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-213-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862085530","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-855-30","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-855-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877050130","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-501-30","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-501-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"67877050190","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-501-90","proprietary_name":"Amlodipine and olmesartan Medoxomil","nonproprietary_name":"Amlodipine and olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-501-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"69238267601","name":"AMLODIPINE-OLMESARTAN 5-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2676-1","proprietary_name":"Amlodipine and Olmesartan Medoxomil","nonproprietary_name":"Amlodipine and Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69238-2676-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Olmesartan|Amlodipine Bes/Olmesartan Med","basis":"generic"},"part_b":null}, {"ndc":"00378172293","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1722-93","proprietary_name":"AMLODIPINE AND VALSARTAN","nonproprietary_name":"AMLODIPINE AND VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-1722-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084503","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-845-03","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (23155-845-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084509","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-845-09","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (23155-845-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028007","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-280-07","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-280-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028010","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-280-10","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-280-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020630","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-206-30","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-206-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020690","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-206-90","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-206-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862073930","name":"AMLODIPINE-VALSARTAN 10-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-739-30","proprietary_name":"Amlodipine and valsartan","nonproprietary_name":"Amlodipine and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-739-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.32969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378172493","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1724-93","proprietary_name":"AMLODIPINE AND VALSARTAN","nonproprietary_name":"AMLODIPINE AND VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-1724-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084703","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-847-03","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (23155-847-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084709","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-847-09","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (23155-847-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028207","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-282-07","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-282-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028210","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-282-10","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-282-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020830","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-208-30","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-208-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020890","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-208-90","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-208-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862074030","name":"AMLODIPINE-VALSARTAN 10-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-740-30","proprietary_name":"Amlodipine and valsartan","nonproprietary_name":"Amlodipine and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-740-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378172193","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1721-93","proprietary_name":"AMLODIPINE AND VALSARTAN","nonproprietary_name":"AMLODIPINE AND VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-1721-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084403","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-844-03","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (23155-844-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084409","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-844-09","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (23155-844-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342027907","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-279-07","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-279-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342027910","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-279-10","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-279-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020530","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-205-30","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-205-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020590","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-205-90","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-205-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862073730","name":"AMLODIPINE-VALSARTAN 5-160 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-737-30","proprietary_name":"Amlodipine and valsartan","nonproprietary_name":"Amlodipine and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-737-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378172393","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1723-93","proprietary_name":"AMLODIPINE AND VALSARTAN","nonproprietary_name":"AMLODIPINE AND VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-1723-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084603","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-846-03","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (23155-846-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"23155084609","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-846-09","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (23155-846-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028107","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-281-07","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-281-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028110","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-281-10","proprietary_name":"amlodipine and valsartan","nonproprietary_name":"amlodipine and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-281-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020730","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-207-30","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-207-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332020790","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-207-90","proprietary_name":"Amlodipine and Valsartan","nonproprietary_name":"Amlodipine and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-207-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862073830","name":"AMLODIPINE-VALSARTAN 5-320 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-738-30","proprietary_name":"Amlodipine and valsartan","nonproprietary_name":"Amlodipine and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 320 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-738-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.3511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amlodipine-Valsartan|Amlodipine Besylate/Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342028407","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-284-07","proprietary_name":"amlodipine,valsartan and hydrochlorothiazide","nonproprietary_name":"amlodipine,valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-284-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.9435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380019901","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-199-01","proprietary_name":"AMLODIPINE, VALSARTAN, HYDROCHLOROTHIAZIDE","nonproprietary_name":"amlodipine besylate valsartan hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1; 12.5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-199-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.9435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862083630","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-836-30","proprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","nonproprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-836-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.9435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342028607","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-286-07","proprietary_name":"amlodipine,valsartan and hydrochlorothiazide","nonproprietary_name":"amlodipine,valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-286-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.08879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380020001","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-200-01","proprietary_name":"AMLODIPINE, VALSARTAN, HYDROCHLOROTHIAZIDE","nonproprietary_name":"amlodipine besylate valsartan hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 25 mg/1; 160 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-200-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.08879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862083730","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-837-30","proprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","nonproprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 160 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-837-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.08879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342028707","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-287-07","proprietary_name":"amlodipine,valsartan and hydrochlorothiazide","nonproprietary_name":"amlodipine,valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-287-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":5.44347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380020101","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-201-01","proprietary_name":"AMLODIPINE, VALSARTAN, HYDROCHLOROTHIAZIDE","nonproprietary_name":"amlodipine besylate valsartan hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 25 mg/1; 320 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-201-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":5.44347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862083830","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 10-320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-838-30","proprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","nonproprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-838-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":5.44347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342028307","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 5-160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-283-07","proprietary_name":"amlodipine,valsartan and hydrochlorothiazide","nonproprietary_name":"amlodipine,valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-283-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.8615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380019701","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 5-160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-197-01","proprietary_name":"AMLODIPINE, VALSARTAN, HYDROCHLOROTHIAZIDE","nonproprietary_name":"amlodipine besylate valsartan hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1; 12.5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-197-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.8615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862083430","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 5-160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-834-30","proprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","nonproprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-834-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.8615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342028507","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 5-160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-285-07","proprietary_name":"amlodipine,valsartan and hydrochlorothiazide","nonproprietary_name":"amlodipine,valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-285-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.23865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380019801","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 5-160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-198-01","proprietary_name":"AMLODIPINE, VALSARTAN, HYDROCHLOROTHIAZIDE","nonproprietary_name":"amlodipine besylate valsartan hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1; 25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-198-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.23865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862083530","name":"AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE 5-160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-835-30","proprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","nonproprietary_name":"Amlodipine, Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-835-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.23865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802049326","name":"AMMONIUM LACTATE 12% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-493-26","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"CREAM","route":"TOPICAL","strength":"12 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"385 g in 1 BOTTLE, PUMP (45802-493-26)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.0668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"45802049338","name":"AMMONIUM LACTATE 12% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-493-38","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"CREAM","route":"TOPICAL","strength":"12 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"385 g in 1 BOTTLE (45802-493-38)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.0668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"45802049383","name":"AMMONIUM LACTATE 12% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"51672130100","name":"AMMONIUM LACTATE 12% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1301-0","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"CREAM","route":"TOPICAL","strength":"120 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"385 g in 1 BOTTLE, PLASTIC (51672-1301-0)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.0668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"51672130104","name":"AMMONIUM LACTATE 12% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1301-4","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"CREAM","route":"TOPICAL","strength":"120 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"2 TUBE in 1 CARTON (51672-1301-4) / 140 g in 1 TUBE","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"45802041926","name":"AMMONIUM LACTATE 12% LOTION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-419-26","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"LOTION","route":"TOPICAL","strength":"12 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"400 g in 1 BOTTLE, PLASTIC (45802-419-26)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.07241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"45802041954","name":"AMMONIUM LACTATE 12% LOTION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-419-54","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"LOTION","route":"TOPICAL","strength":"12 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"225 g in 1 BOTTLE, PLASTIC (45802-419-54)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.07324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"51672130005","name":"AMMONIUM LACTATE 12% LOTION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1300-5","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"LOTION","route":"TOPICAL","strength":"120 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"225 g in 1 BOTTLE, PLASTIC (51672-1300-5)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.07324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"51672130009","name":"AMMONIUM LACTATE 12% LOTION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1300-9","proprietary_name":"Ammonium Lactate","nonproprietary_name":"Ammonium Lactate","dosage_form":"LOTION","route":"TOPICAL","strength":"120 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"400 g in 1 BOTTLE, PLASTIC (51672-1300-9)","pharm_classes":["Acidifying Activity [MoA]"]},"nadac":{"value":0.07241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ammonium Lactate|Ammonium Lactate","basis":"generic"},"part_b":null}, {"ndc":"00378661185","name":"AMNESTEEM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661193","name":"AMNESTEEM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6611-93","proprietary_name":"Amnesteem","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0378-6611-93) / 10 CAPSULE in 1 BLISTER PACK (0378-6611-85)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661285","name":"AMNESTEEM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661293","name":"AMNESTEEM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6612-93","proprietary_name":"Amnesteem","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0378-6612-93) / 10 CAPSULE in 1 BLISTER PACK (0378-6612-85)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661385","name":"AMNESTEEM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661393","name":"AMNESTEEM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6613-93","proprietary_name":"Amnesteem","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0378-6613-93) / 10 CAPSULE in 1 BLISTER PACK (0378-6613-85)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661485","name":"AMNESTEEM 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00378661493","name":"AMNESTEEM 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6614-93","proprietary_name":"Amnesteem","nonproprietary_name":"isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0378-6614-93) / 10 CAPSULE in 1 BLISTER PACK (0378-6614-85)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amnesteem|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00093227773","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2277-73","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-2277-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.04807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143998101","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9981-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0143-9981-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.04807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143998150","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9981-50","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 mL in 1 BOTTLE (0143-9981-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143998175","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9981-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"75 mL in 1 BOTTLE (0143-9981-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781610246","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6102-46","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6102-46)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.04807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781610252","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6102-52","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Sandoz Inc","package_description":"50 mL in 1 BOTTLE (0781-6102-52)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781610257","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6102-57","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Sandoz Inc","package_description":"75 mL in 1 BOTTLE (0781-6102-57)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029201","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-292-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"50 mL in 1 BOTTLE (16714-292-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029202","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-292-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"75 mL in 1 BOTTLE (16714-292-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029203","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-292-03","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"100 mL in 1 BOTTLE (16714-292-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.04807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053301","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-533-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-533-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.04807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053350","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-533-50","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (65862-533-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053375","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-533-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 28.5 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (65862-533-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452033443","name":"AMOX-CLAV 200-28.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781187431","name":"AMOX-CLAV 250-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1874-31","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-1874-31)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":1.53115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029501","name":"AMOX-CLAV 250-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-295-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-295-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":1.53115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571016030","name":"AMOX-CLAV 250-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-160-30","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42571-160-30)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":1.53115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687078111","name":"AMOX-CLAV 250-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.53115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687078194","name":"AMOX-CLAV 250-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-781-94","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-781-94) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-781-11)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":1.53115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862050130","name":"AMOX-CLAV 250-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-501-30","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-501-30)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":1.53115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651002601","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-026-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (59651-026-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.45512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651002655","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-026-55","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"150 mL in 1 BOTTLE (59651-026-55)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.39204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651002675","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-026-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (59651-026-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.43537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69097009808","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-098-08","proprietary_name":"Amoxicillin and Clavulanate potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Cipla USA Inc.","package_description":"150 mL in 1 BOTTLE (69097-098-08)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.39204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69097009843","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-098-43","proprietary_name":"Amoxicillin and Clavulanate potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Cipla USA Inc.","package_description":"75 mL in 1 BOTTLE (69097-098-43)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.43537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69097009844","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-098-44","proprietary_name":"Amoxicillin and Clavulanate potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Cipla USA Inc.","package_description":"100 mL in 1 BOTTLE (69097-098-44)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.45512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043001001","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-010-01","proprietary_name":"amoxicillin and clavulanate potassium","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Devatis, Inc.","package_description":"75 mL in 1 BOTTLE (73043-010-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.43537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043001002","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-010-02","proprietary_name":"amoxicillin and clavulanate potassium","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Devatis, Inc.","package_description":"100 mL in 1 BOTTLE (73043-010-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.45512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043001003","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-010-03","proprietary_name":"amoxicillin and clavulanate potassium","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"Devatis, Inc.","package_description":"150 mL in 1 BOTTLE (73043-010-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.39204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020407","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-204-07","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"75 mL in 1 BOTTLE (81964-204-07)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.43537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020410","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-204-10","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"100 mL in 1 BOTTLE (81964-204-10)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.45512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020415","name":"AMOX-CLAV 250-62.5 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-204-15","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL; 62.5 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"150 mL in 1 BOTTLE (81964-204-15)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.39204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093227973","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2279-73","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-2279-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143998201","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9982-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0143-9982-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143998250","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9982-50","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 mL in 1 BOTTLE (0143-9982-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.08432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143998275","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9982-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"75 mL in 1 BOTTLE (0143-9982-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781610446","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6104-46","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6104-46)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781610452","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6104-52","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Sandoz Inc","package_description":"50 mL in 1 BOTTLE (0781-6104-52)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.08432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781610457","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6104-57","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Sandoz Inc","package_description":"75 mL in 1 BOTTLE (0781-6104-57)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029301","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-293-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"50 mL in 1 BOTTLE (16714-293-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.08432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029302","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-293-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"75 mL in 1 BOTTLE (16714-293-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029303","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-293-03","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"100 mL in 1 BOTTLE (16714-293-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053401","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-534-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-534-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053450","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-534-50","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (65862-534-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.08432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053475","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-534-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (65862-534-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452033543","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043000901","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-009-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Devatis, Inc.","package_description":"50 mL in 1 BOTTLE (73043-009-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.08432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043000902","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-009-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Devatis, Inc.","package_description":"75 mL in 1 BOTTLE (73043-009-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043000903","name":"AMOX-CLAV 400-57 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-009-03","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 57 mg/5mL","labeler":"Devatis, Inc.","package_description":"100 mL in 1 BOTTLE (73043-009-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.05616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093227434","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2274-34","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0093-2274-34)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781183101","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1831-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1831-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781183120","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1831-20","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"Sandoz Inc","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0781-1831-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029601","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-296-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"NorthStar Rx LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (16714-296-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571016101","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-161-01","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42571-161-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571016142","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-161-42","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"Micro Labs Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (42571-161-42)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687079201","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-792-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-792-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-792-11)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687079211","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135046220","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862050220","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-502-20","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (65862-502-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452033611","name":"AMOX-CLAV 500-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093867574","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8675-74","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"200 mL in 1 BOTTLE (0093-8675-74)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093867575","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8675-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"125 mL in 1 BOTTLE (0093-8675-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093867578","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8675-78","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"75 mL in 1 BOTTLE (0093-8675-78)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143985316","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9853-16","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"125 mL in 1 BOTTLE (0143-9853-16)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143985324","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9853-24","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"200 mL in 1 BOTTLE (0143-9853-24)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143985375","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9853-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"75 mL in 1 BOTTLE (0143-9853-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781613948","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6139-48","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Sandoz Inc","package_description":"200 mL in 1 BOTTLE, DISPENSING (0781-6139-48)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781613954","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6139-54","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Sandoz Inc","package_description":"125 mL in 1 BOTTLE, DISPENSING (0781-6139-54)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781613957","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6139-57","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Sandoz Inc","package_description":"75 mL in 1 BOTTLE, DISPENSING (0781-6139-57)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029401","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-294-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"75 mL in 1 BOTTLE (16714-294-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029402","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-294-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"125 mL in 1 BOTTLE (16714-294-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714029403","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-294-03","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"200 mL in 1 BOTTLE (16714-294-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053502","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-535-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"200 mL in 1 BOTTLE (65862-535-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053513","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-535-13","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"125 mL in 1 BOTTLE (65862-535-13)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862053575","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-535-75","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (65862-535-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043000801","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-008-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Devatis Inc.","package_description":"75 mL in 1 BOTTLE (73043-008-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043000802","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-008-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Devatis Inc.","package_description":"125 mL in 1 BOTTLE (73043-008-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73043000803","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-008-03","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"Devatis Inc.","package_description":"200 mL in 1 BOTTLE (73043-008-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020351","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-203-51","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"75 mL in 1 BOTTLE (81964-203-51)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020354","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-203-54","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"200 mL in 1 BOTTLE (81964-203-54)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.0693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020369","name":"AMOX-CLAV 600-42.9 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-203-69","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"600 mg/5mL; 42.9 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"125 mL in 1 BOTTLE (81964-203-69)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.06338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093227534","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2275-34","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0093-2275-34)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143924920","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9249-20","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"20 TABLET in 1 BOTTLE (0143-9249-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781185201","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1852-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-1852-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781185220","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1852-20","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Sandoz Inc","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0781-1852-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029701","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-297-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"NorthStar Rx LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (16714-297-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029702","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-297-02","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-297-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571016201","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-162-01","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42571-162-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571016242","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-162-42","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Micro Labs Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (42571-162-42)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687080301","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-803-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-803-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-803-11)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687080311","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135046320","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862050301","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-503-01","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-503-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862050320","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-503-20","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (65862-503-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452033711","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81964022101","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-221-01","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"USAntibiotics, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (81964-221-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81964022114","name":"AMOX-CLAV 875-125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-221-14","proprietary_name":"AMOXICILLIN AND CLAVULANATE POTASSIUM","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"875 mg/1; 125 mg/1","labeler":"USAntibiotics, LLC","package_description":"20 TABLET, COATED in 1 BOTTLE (81964-221-14)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":0.28385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781194339","name":"AMOX-CLAV ER 1,000-62.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1943-39","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"562.5 mg/1; 437.5 mg/1; 62.5 mg/1","labeler":"Sandoz Inc","package_description":"40 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE (0781-1943-39)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":5.81035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781194382","name":"AMOX-CLAV ER 1,000-62.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1943-82","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"Amoxicillin and Clavulanate Potassium","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"562.5 mg/1; 437.5 mg/1; 62.5 mg/1","labeler":"Sandoz Inc","package_description":"28 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE (0781-1943-82)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":5.81035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81964022028","name":"AMOX-CLAV ER 1,000-62.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-220-28","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"562.5 mg/1; 62.5 mg/1; 437.5 mg/1","labeler":"USAntibiotics, LLC","package_description":"28 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (81964-220-28)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":5.81035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81964022040","name":"AMOX-CLAV ER 1,000-62.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-220-40","proprietary_name":"Amoxicillin and Clavulanate Potassium","nonproprietary_name":"amoxicillin and clavulanate potassium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"562.5 mg/1; 62.5 mg/1; 437.5 mg/1","labeler":"USAntibiotics, LLC","package_description":"40 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (81964-220-40)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":5.81035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093226701","name":"AMOXICILLIN 125 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2267-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0093-2267-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.20766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143988801","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9888-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0143-9888-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988815","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9888-15","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"150 mL in 1 BOTTLE (0143-9888-15)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.01757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988880","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9888-80","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"80 mL in 1 BOTTLE (0143-9888-80)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781603946","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6039-46","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6039-46)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781603955","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6039-55","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Sandoz Inc","package_description":"150 mL in 1 BOTTLE (0781-6039-55)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.01757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781603958","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6039-58","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Sandoz Inc","package_description":"80 mL in 1 BOTTLE (0781-6039-58)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862070601","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-706-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-706-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862070655","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-706-55","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"150 mL in 1 BOTTLE (65862-706-55)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.01757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862070680","name":"AMOXICILLIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-706-80","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"80 mL in 1 BOTTLE (65862-706-80)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093416073","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4160-73","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4160-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093416076","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4160-76","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 mL in 1 BOTTLE (0093-4160-76)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093416078","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4160-78","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"75 mL in 1 BOTTLE (0093-4160-78)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988601","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9886-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0143-9886-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988650","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9886-50","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 mL in 1 BOTTLE (0143-9886-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988675","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9886-75","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"75 mL in 1 BOTTLE (0143-9886-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781615646","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6156-46","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6156-46)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781615652","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6156-52","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Sandoz Inc","package_description":"50 mL in 1 BOTTLE (0781-6156-52)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781615657","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6156-57","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Sandoz Inc","package_description":"75 mL in 1 BOTTLE (0781-6156-57)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862007001","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-070-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-070-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862007050","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-070-50","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (65862-070-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862007075","name":"AMOXICILLIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-070-75","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (65862-070-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093310701","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3107-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3107-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093310705","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3107-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-3107-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781202001","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2020-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2020-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781202005","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2020-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"500 CAPSULE in 1 BOTTLE (0781-2020-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029801","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-298-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-298-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029802","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-298-02","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-298-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237003001","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-030-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-030-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237003005","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-030-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-030-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687077601","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-776-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-776-01) / 1 CAPSULE in 1 BLISTER PACK (60687-776-11)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687077611","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001601","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-016-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-016-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001605","name":"AMOXICILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-016-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-016-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093226801","name":"AMOXICILLIN 250 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2268-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0093-2268-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.30445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093415573","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4155-73","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4155-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093415579","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4155-79","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"80 mL in 1 BOTTLE (0093-4155-79)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093415580","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4155-80","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"150 mL in 1 BOTTLE (0093-4155-80)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988901","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9889-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0143-9889-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988915","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9889-15","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"150 mL in 1 BOTTLE (0143-9889-15)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988980","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9889-80","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"80 mL in 1 BOTTLE (0143-9889-80)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781604146","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6041-46","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6041-46)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781604155","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6041-55","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Sandoz Inc","package_description":"150 mL in 1 BOTTLE (0781-6041-55)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781604158","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6041-58","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Sandoz Inc","package_description":"80 mL in 1 BOTTLE (0781-6041-58)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862070701","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-707-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-707-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862070755","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-707-55","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"150 mL in 1 BOTTLE (65862-707-55)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.02452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862070780","name":"AMOXICILLIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-707-80","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"80 mL in 1 BOTTLE (65862-707-80)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093416173","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4161-73","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4161-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093416176","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4161-76","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 mL in 1 BOTTLE (0093-4161-76)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093416178","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4161-78","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"75 mL in 1 BOTTLE (0093-4161-78)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988701","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9887-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0143-9887-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988750","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9887-50","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 mL in 1 BOTTLE (0143-9887-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143988775","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9887-75","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"75 mL in 1 BOTTLE (0143-9887-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781615746","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6157-46","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6157-46)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781615752","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6157-52","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Sandoz Inc","package_description":"50 mL in 1 BOTTLE (0781-6157-52)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781615757","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6157-57","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Sandoz Inc","package_description":"75 mL in 1 BOTTLE (0781-6157-57)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003301","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-033-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 BOTTLE (57237-033-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003350","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-033-50","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 mL in 1 BOTTLE (57237-033-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003375","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-033-75","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"75 mL in 1 BOTTLE (57237-033-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862007101","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-071-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-071-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862007150","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-071-50","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (65862-071-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862007175","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-071-75","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (65862-071-75)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020750","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-207-50","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"50 mL in 1 BOTTLE (81964-207-50)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020751","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-207-51","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"75 mL in 1 BOTTLE (81964-207-51)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81964020752","name":"AMOXICILLIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-207-52","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"USAntibiotics, LLC","package_description":"100 mL in 1 BOTTLE (81964-207-52)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.03383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093310905","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3109-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-3109-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093310953","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3109-53","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (0093-3109-53)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143993905","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9939-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (0143-9939-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143993928","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9939-28","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"480 CAPSULE in 1 BOTTLE, PLASTIC (0143-9939-28)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781261301","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2613-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2613-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781261305","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2613-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"500 CAPSULE in 1 BOTTLE (0781-2613-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029902","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-299-02","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"50 CAPSULE in 1 BOTTLE (16714-299-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029903","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-299-03","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-299-03)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714029904","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-299-04","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-299-04)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571023401","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-234-01","proprietary_name":"AMOXICILLIN","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-234-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571023405","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-234-05","proprietary_name":"AMOXICILLIN","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Micro Labs Limited","package_description":"500 CAPSULE in 1 BOTTLE (42571-234-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237003101","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-031-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-031-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237003105","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-031-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-031-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687078701","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-787-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-787-01) / 1 CAPSULE in 1 BLISTER PACK (60687-787-11)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687078711","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001701","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-017-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-017-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001705","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-017-05","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-017-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81964020501","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-205-01","proprietary_name":"AMOXICILLIN","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"USAntibiotics, LLC","package_description":"100 CAPSULE in 1 BOTTLE (81964-205-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81964020505","name":"AMOXICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81964-205-05","proprietary_name":"AMOXICILLIN","nonproprietary_name":"Amoxicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"USAntibiotics, LLC","package_description":"500 CAPSULE in 1 BOTTLE (81964-205-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093226301","name":"AMOXICILLIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2263-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-2263-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.08498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237002801","name":"AMOXICILLIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-028-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-028-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.08498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687079825","name":"AMOXICILLIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-798-25","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-798-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-798-95)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.08498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687079895","name":"AMOXICILLIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001401","name":"AMOXICILLIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-014-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-014-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.08498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093226401","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2264-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-2264-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143928501","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9285-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"875 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0143-9285-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143928520","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9285-20","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"875 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"20 TABLET, COATED in 1 BOTTLE (0143-9285-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781506101","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5061-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5061-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781506120","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5061-20","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"Sandoz Inc","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0781-5061-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237002901","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-029-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-029-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237002920","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-029-20","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (57237-029-20)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687080918","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687080928","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-809-28","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-809-28) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-809-18)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001501","name":"AMOXICILLIN 875 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-015-01","proprietary_name":"Amoxicillin","nonproprietary_name":"Amoxicillin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"875 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-015-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.15358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331819","name":"AMPHETAMINE ER 12.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.96228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331865","name":"AMPHETAMINE ER 12.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3318-65","proprietary_name":"Amphetamine","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"12.5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0480-3318-65) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.96228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62542002030","name":"AMPHETAMINE ER 12.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-020-30","proprietary_name":"Amphetamine Extended-Release","nonproprietary_name":"Amphetamine Extended-Release","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"12.5 mg/1","labeler":"Neos Therapeutics, LP","package_description":"30 BLISTER PACK in 1 CARTON (62542-020-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.96228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331919","name":"AMPHETAMINE ER 15.7 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.92901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331965","name":"AMPHETAMINE ER 15.7 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3319-65","proprietary_name":"Amphetamine","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15.7 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0480-3319-65) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.92901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62542002530","name":"AMPHETAMINE ER 15.7 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-025-30","proprietary_name":"Amphetamine Extended-Release","nonproprietary_name":"Amphetamine Extended-Release","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15.7 mg/1","labeler":"Neos Therapeutics, LP","package_description":"30 BLISTER PACK in 1 CARTON (62542-025-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.92901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480332019","name":"AMPHETAMINE ER 18.8 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.61431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480332065","name":"AMPHETAMINE ER 18.8 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3320-65","proprietary_name":"Amphetamine","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"18.8 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0480-3320-65) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.61431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62542003030","name":"AMPHETAMINE ER 18.8 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-030-30","proprietary_name":"Amphetamine Extended-Release","nonproprietary_name":"Amphetamine Extended-Release","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"18.8 mg/1","labeler":"Neos Therapeutics, LP","package_description":"30 BLISTER PACK in 1 CARTON (62542-030-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.61431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331519","name":"AMPHETAMINE ER 3.1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.84156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331565","name":"AMPHETAMINE ER 3.1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3315-65","proprietary_name":"Amphetamine","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"3.1 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0480-3315-65) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.84156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62542000530","name":"AMPHETAMINE ER 3.1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-005-30","proprietary_name":"Amphetamine Extended-Release","nonproprietary_name":"Amphetamine Extended-Release","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"3.1 mg/1","labeler":"Neos Therapeutics, LP","package_description":"30 BLISTER PACK in 1 CARTON (62542-005-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.84156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331619","name":"AMPHETAMINE ER 6.3 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.07321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331665","name":"AMPHETAMINE ER 6.3 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3316-65","proprietary_name":"Amphetamine","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"6.3 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0480-3316-65) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.07321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62542001030","name":"AMPHETAMINE ER 6.3 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-010-30","proprietary_name":"Amphetamine Extended-Release","nonproprietary_name":"Amphetamine Extended-Release","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"6.3 mg/1","labeler":"Neos Therapeutics, LP","package_description":"30 BLISTER PACK in 1 CARTON (62542-010-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.07321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331719","name":"AMPHETAMINE ER 9.4 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.21781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480331765","name":"AMPHETAMINE ER 9.4 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3317-65","proprietary_name":"Amphetamine","nonproprietary_name":"Amphetamine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"9.4 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0480-3317-65) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.21781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62542001530","name":"AMPHETAMINE ER 9.4 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-015-30","proprietary_name":"Amphetamine Extended-Release","nonproprietary_name":"Amphetamine Extended-Release","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"9.4 mg/1","labeler":"Neos Therapeutics, LP","package_description":"30 BLISTER PACK in 1 CARTON (62542-015-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.21781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527252537","name":"AMPHETAMINE SULFATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2525-37","proprietary_name":"AMPHETAMINE SULFATE","nonproprietary_name":"amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-2525-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.44899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43547045810","name":"AMPHETAMINE SULFATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-458-10","proprietary_name":"AMPHETAMINE SULFATE","nonproprietary_name":"amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-458-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.44899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43598089801","name":"AMPHETAMINE SULFATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-898-01","proprietary_name":"Amphetamine sulfate","nonproprietary_name":"Amphetamine Sulfate Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"DR. REDDY'S LABORATORIES INC","package_description":"100 TABLET in 1 BOTTLE (43598-898-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.44899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536005903","name":"AMPHETAMINE SULFATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-059-03","proprietary_name":"Amphetamine Sulfate","nonproprietary_name":"Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-059-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.44899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69238156401","name":"AMPHETAMINE SULFATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1564-1","proprietary_name":"Amphetamine Sulfate","nonproprietary_name":"Amphetamine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1564-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.44899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"70010004101","name":"AMPHETAMINE SULFATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-041-01","proprietary_name":"Amphetamine Sulfate","nonproprietary_name":"Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-041-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.44899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00527252437","name":"AMPHETAMINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2524-37","proprietary_name":"AMPHETAMINE SULFATE","nonproprietary_name":"amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-2524-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43547045710","name":"AMPHETAMINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-457-10","proprietary_name":"AMPHETAMINE SULFATE","nonproprietary_name":"amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-457-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43598089701","name":"AMPHETAMINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-897-01","proprietary_name":"Amphetamine sulfate","nonproprietary_name":"Amphetamine Sulfate Tablets","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"DR. REDDY'S LABORATORIES INC","package_description":"100 TABLET in 1 BOTTLE (43598-897-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536005703","name":"AMPHETAMINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-057-03","proprietary_name":"Amphetamine Sulfate","nonproprietary_name":"Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-057-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69238156301","name":"AMPHETAMINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1563-1","proprietary_name":"Amphetamine Sulfate","nonproprietary_name":"Amphetamine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1563-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"70010004001","name":"AMPHETAMINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-040-01","proprietary_name":"Amphetamine Sulfate","nonproprietary_name":"Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-040-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Amphetamine Sulfate|Amphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00781214501","name":"AMPICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2145-01","proprietary_name":"Ampicillin","nonproprietary_name":"Ampicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2145-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.44112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781214505","name":"AMPICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2145-05","proprietary_name":"Ampicillin","nonproprietary_name":"Ampicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"500 CAPSULE in 1 BOTTLE (0781-2145-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.44112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651055101","name":"AMPICILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-551-01","proprietary_name":"Ampicillin","nonproprietary_name":"Ampicillin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-551-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.44112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63459070060","name":"AMRIX ER 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63459-700-60","proprietary_name":"AMRIX","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Cephalon, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (63459-700-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":66.23256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.18556,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63459070160","name":"AMRIX ER 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63459-701-60","proprietary_name":"AMRIX","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Cephalon, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (63459-701-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":66.56709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.0822,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668045301","name":"ANAGRELIDE HCL 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-453-01","proprietary_name":"anagrelide","nonproprietary_name":"anagrelide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-453-01)","pharm_classes":["Decreased Platelet Production [PE]","Phosphodiesterase 3 Inhibitors [MoA]","Platelet-reducing Agent [EPC]"]},"nadac":{"value":0.72949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anagrelide HCl|Anagrelide HCl","basis":"generic"},"part_b":null}, {"ndc":"62135031212","name":"ANAGRELIDE HCL 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-312-12","proprietary_name":"Anagrelide","nonproprietary_name":"Anagrelide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE in 1 BOTTLE (62135-312-12)","pharm_classes":["Decreased Platelet Production [PE]","Phosphodiesterase 3 Inhibitors [MoA]","Platelet-reducing Agent [EPC]"]},"nadac":{"value":0.72949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anagrelide HCl|Anagrelide HCl","basis":"generic"},"part_b":null}, {"ndc":"70954087910","name":"ANAGRELIDE HCL 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-879-10","proprietary_name":"Anagrelide","nonproprietary_name":"Anagrelide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-879-10)","pharm_classes":["Decreased Platelet Production [PE]","Phosphodiesterase 3 Inhibitors [MoA]","Platelet-reducing Agent [EPC]"]},"nadac":{"value":0.72949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anagrelide HCl|Anagrelide HCl","basis":"generic"},"part_b":null}, {"ndc":"13668046201","name":"ANAGRELIDE HCL 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-462-01","proprietary_name":"anagrelide","nonproprietary_name":"anagrelide","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-462-01)","pharm_classes":["Decreased Platelet Production [PE]","Phosphodiesterase 3 Inhibitors [MoA]","Platelet-reducing Agent [EPC]"]},"nadac":{"value":1.41317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anagrelide HCl|Anagrelide HCl","basis":"generic"},"part_b":null}, {"ndc":"62135031360","name":"ANAGRELIDE HCL 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-313-60","proprietary_name":"Anagrelide","nonproprietary_name":"Anagrelide","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-313-60)","pharm_classes":["Decreased Platelet Production [PE]","Phosphodiesterase 3 Inhibitors [MoA]","Platelet-reducing Agent [EPC]"]},"nadac":{"value":1.41317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anagrelide HCl|Anagrelide HCl","basis":"generic"},"part_b":null}, {"ndc":"70954088110","name":"ANAGRELIDE HCL 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-881-10","proprietary_name":"Anagrelide","nonproprietary_name":"Anagrelide","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-881-10)","pharm_classes":["Decreased Platelet Production [PE]","Phosphodiesterase 3 Inhibitors [MoA]","Platelet-reducing Agent [EPC]"]},"nadac":{"value":1.41317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anagrelide HCl|Anagrelide HCl","basis":"generic"},"part_b":null}, {"ndc":"83107001801","name":"ANALPRAM HC 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83107-018-01","proprietary_name":"Analpram HC","nonproprietary_name":"hydrocortisone acetate and pramoxine hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; 10 mg/g","labeler":"Legacy Pharma USA Inc.","package_description":"28.4 g in 1 TUBE, WITH APPLICATOR (83107-018-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.88922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Analpram HC*|Hydrocortisone/Pramoxine","basis":"brand"},"part_b":null}, {"ndc":"83107001901","name":"ANALPRAM HC 2.5%-1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.58829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Analpram HC*|Hydrocortisone/Pramoxine","basis":"brand","route_from":"fda_product","route":"TOPICAL","product_ndc":"83107-019","inner_of":[]},"part_b":null}, {"ndc":"00093753656","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7536-56","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7536-56)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"16729003510","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-035-10","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (16729-035-10)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"16729003515","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-035-15","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (16729-035-15)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"16729003516","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-035-16","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (16729-035-16)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"23155085703","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-857-03","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole Tablets","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Avet Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (23155-857-03)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"23155085705","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-857-05","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole Tablets","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Avet Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (23155-857-05)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"23155085709","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-857-09","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole Tablets","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Avet Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (23155-857-09)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"50268007511","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"50268007515","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-075-15","proprietary_name":"ANASTROZOLE","nonproprietary_name":"ANASTROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-075-15) / 1 TABLET in 1 BLISTER PACK (50268-075-11)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"51991062010","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-620-10","proprietary_name":"ANASTROZOLE","nonproprietary_name":"ANASTROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51991-620-10)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"51991062033","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-620-33","proprietary_name":"ANASTROZOLE","nonproprietary_name":"ANASTROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (51991-620-33)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"51991062090","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-620-90","proprietary_name":"ANASTROZOLE","nonproprietary_name":"ANASTROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 TABLET in 1 BOTTLE (51991-620-90)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"59651023630","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-236-30","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-236-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"59651023690","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-236-90","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-236-90)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"60687011211","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"60687011221","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-112-21","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-112-21) / 1 TABLET, COATED in 1 BLISTER PACK (60687-112-11)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"62135049030","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-490-30","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-490-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"62135049090","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-490-90","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-490-90)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"68001015504","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-155-04","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, COATED in 1 BOTTLE (68001-155-04)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"68001015508","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-155-08","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, COATED in 1 BOTTLE (68001-155-08)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"68382020906","name":"ANASTROZOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-209-06","proprietary_name":"Anastrozole","nonproprietary_name":"Anastrozole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (68382-209-06)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anastrozole|Anastrozole","basis":"generic"},"part_b":null}, {"ndc":"50419048201","name":"ANGELIQ 0.25 MG-0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.36769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Angeliq|Drospirenone/Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419048203","name":"ANGELIQ 0.25 MG-0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-482-03","proprietary_name":"Angeliq","nonproprietary_name":"drospirenone and estradiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1; .25 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (50419-482-03) / 28 TABLET, FILM COATED in 1 BLISTER PACK (50419-482-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":6.36769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Angeliq|Drospirenone/Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419048301","name":"ANGELIQ 0.5 MG-1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.36667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Angeliq|Drospirenone/Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419048303","name":"ANGELIQ 0.5 MG-1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-483-03","proprietary_name":"Angeliq","nonproprietary_name":"drospirenone and estradiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (50419-483-03) / 28 TABLET, FILM COATED in 1 BLISTER PACK (50419-483-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":6.36667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Angeliq|Drospirenone/Estradiol","basis":"brand"},"part_b":null}, {"ndc":"82568004203","name":"ANLIDO 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568004204","name":"ANLIDO 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68308075201","name":"ANNOVERA VAGINAL RING","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-752-01","proprietary_name":"Annovera","nonproprietary_name":"segesterone acetate and ethinyl estradiol","dosage_form":"RING","route":"VAGINAL","strength":"103 mg/1; 17.4 mg/1","labeler":"Mayne Pharma","package_description":"1 POUCH in 1 CARTON (68308-752-01) / 30 RING in 1 POUCH","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":2315.28568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Annovera|Segesterone Ac/Ethin Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00173086906","name":"ANORO ELLIPTA 62.5-25 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0869-06","proprietary_name":"Anoro Ellipta","nonproprietary_name":"umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"62.5 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0869-06) / 1 INHALER in 1 TRAY / 7 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":8.02908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anoro Ellipta|Umeclidinium Brm/Vilanterol Tr","basis":"brand"},"part_b":null}, {"ndc":"00173086910","name":"ANORO ELLIPTA 62.5-25 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0869-10","proprietary_name":"Anoro Ellipta","nonproprietary_name":"umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"62.5 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0869-10) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":7.79706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.95495,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Anoro Ellipta|Umeclidinium Brm/Vilanterol Tr","basis":"brand"},"part_b":null}, {"ndc":"70000003401","name":"ANTACID 500 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0034-1","proprietary_name":"Regular Strength Antacid Assorted Fruit","nonproprietary_name":"Calcium Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"CARDINAL HEALTH","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (70000-0034-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385047847","name":"ANTACID 500 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-478-47","proprietary_name":"Regular Strength Antacid","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE (24385-478-47)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385048547","name":"ANTACID 500 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-485-47","proprietary_name":"Good Neighbor Pharmacy Antacid Regular Strength","nonproprietary_name":"Calcium Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"AmerisourceBergen Drug Corporation","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE (24385-485-47)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084098832","name":"ANTACID 500 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-988-32","proprietary_name":"Antacid Peppermint Flavour Regular Strength","nonproprietary_name":"Calcium Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-988-32) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (68084-988-33)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084098833","name":"ANTACID 500 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000046001","name":"ANTACID 750 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0460-1","proprietary_name":"Leader Extra Strength Sugar Free Antacid","nonproprietary_name":"Antacid","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Cardinal Health","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (70000-0460-1)"},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122043140","name":"ANTACID ANTI-GAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-431-40","proprietary_name":"ANTACID ANTIGAS NTA","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, simethicone","dosage_form":"LIQUID","route":"ORAL","strength":"800 mg/10mL; 800 mg/10mL; 80 mg/10mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-431-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122043240","name":"ANTACID ANTI-GAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-432-40","proprietary_name":"ANTACID ANTIGAS NTA","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, simethicone","dosage_form":"LIQUID","route":"ORAL","strength":"800 mg/10mL; 800 mg/10mL; 80 mg/10mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-432-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000006201","name":"ANTACID ANTI-GAS MAX STR LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0062-1","proprietary_name":"MAXIMUM STRENGTH ANTACID","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"800 mg/10mL; 800 mg/10mL; 80 mg/10mL","labeler":"CARDINAL HEALTH","package_description":"355 mL in 1 BOTTLE (70000-0062-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000042201","name":"ANTACID ANTI-GAS MAX STR LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0422-1","proprietary_name":"MAXIMUM STRENGTH ANTACID","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, simethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 400 mg/5mL; 40 mg/5mL","labeler":"CARDINAL HEALTH","package_description":"355 mL in 1 BOTTLE (70000-0422-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536122922","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1229-22","proprietary_name":"Rugby Extra Strength Antacid","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Rugby Laboratories","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (0536-1229-22)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122000741","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-007-41","proprietary_name":"Extra Strength sugar free Antacid","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Amerisource Bergen","package_description":"80 TABLET, CHEWABLE in 1 BOTTLE (46122-007-41)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000043002","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0430-2","proprietary_name":"Leader Extra Strength Antacid","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (70000-0430-2)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000043101","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0431-1","proprietary_name":"Leader Extra Strength Antacid","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (70000-0431-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000059201","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0592-1","proprietary_name":"CardinalExtra Strength Antacid Wintergreen flavor","nonproprietary_name":"Calcium Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"CARDINAL HEALTH","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (70000-0592-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000068101","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0681-1","proprietary_name":"ANTACID Extra Strength","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Cardinal Health 110, LLC.","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (70000-0681-1)"},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000068201","name":"ANTACID EX-STR 750 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0682-1","proprietary_name":"ANTACID Extra Strength","nonproprietary_name":"Calcium Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"CARDINAL HEALTH 110, LLC.","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (70000-0682-1)"},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000023401","name":"ANTACID EX-STR TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0234-1","proprietary_name":"Extra Strength Antacid Original Flavor","nonproprietary_name":"aluminum hydroxide and magnesium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1; 105 mg/1","labeler":"Cardinal Health","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (70000-0234-1)"},"nadac":{"value":0.04408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122015078","name":"ANTACID EXTRA STRENGTH CHW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-150-78","proprietary_name":"GOOD NEIGHBOR PHARMACY Antacid Extra Strength","nonproprietary_name":"aluminum hydroxide and magnesium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1; 105 mg/1","labeler":"Amerisource Bergen","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (46122-150-78)"},"nadac":{"value":0.04408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122043340","name":"ANTACID LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-433-40","proprietary_name":"REGULAR STRENGTH ANTACID","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"LIQUID","route":"ORAL","strength":"400 mg/10mL; 400 mg/10mL; 40 mg/10mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-433-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000045901","name":"ANTACID ULTRA STR 1,000 MG CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0459-1","proprietary_name":"LEADER Ultra Strength Peppermint Flavor","nonproprietary_name":"Chewable Antacid Tablets","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Cardinal Health","package_description":"72 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (70000-0459-1)"},"nadac":{"value":0.03701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000068301","name":"ANTACID ULTRA STR 1,000 MG CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0683-1","proprietary_name":"ANTACID Ultra Strength","nonproprietary_name":"calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"CARDINAL HEALTH 110, LLC.","package_description":"72 TABLET, CHEWABLE in 1 BOTTLE (70000-0683-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385059523","name":"ANTACID ULTRA TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-595-23","proprietary_name":"Ultra Strength Antacid Assorted Fruit","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Amerisource Bergen","package_description":"72 TABLET, CHEWABLE in 1 BOTTLE (24385-595-23)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385010680","name":"ANTACID XTRA STRENGTH CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-106-80","proprietary_name":"Good Neighbor Pharmacy Antacid Extra Strength","nonproprietary_name":"Calcium Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"AmerisourceBergen Drug Corporation","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (24385-106-80)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536129383","name":"ANTACID-ANTIGAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1293-83","proprietary_name":"Antacid","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, simethicone","dosage_form":"LIQUID","route":"ORAL","strength":"400 mg/10mL; 400 mg/10mL; 40 mg/10mL","labeler":"Rugby Laboratories","package_description":"355 mL in 1 BOTTLE (0536-1293-83)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536131783","name":"ANTACID-ANTIGAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1317-83","proprietary_name":"REGULAR STRENGTH ANTACID/ANTIGAS","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/10mL; 400 mg/10mL; 40 mg/10mL","labeler":"RUGBY LABORATORIES","package_description":"355 mL in 1 BOTTLE (0536-1317-83)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000006301","name":"ANTACID-ANTIGAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0063-1","proprietary_name":"ANTACID MINT","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/10mL; 400 mg/10mL; 40 mg/10mL","labeler":"CARDINAL HEALTH","package_description":"355 mL in 1 BOTTLE (70000-0063-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122043440","name":"ANTACID-ANTIGAS SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-434-40","proprietary_name":"REGULAR STRENGTH ANTACID","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"LIQUID","route":"ORAL","strength":"400 mg/10mL; 400 mg/10mL; 40 mg/10mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-434-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536199553","name":"ANTI-DANDRUFF 1% SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1995-53","proprietary_name":"Rugby Anti-Dandruff","nonproprietary_name":"Selenium Sulfide","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"10 mg/mL","labeler":"Rugby Laboratories","package_description":"207 mL in 1 BOTTLE, PLASTIC (0536-1995-53)"},"nadac":{"value":0.01409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000041701","name":"ANTI-DIARRHEAL 1 MG/7.5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0417-1","proprietary_name":"leader anti diarrheal","nonproprietary_name":"loperamide HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/7.5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"120 mL in 1 BOTTLE (70000-0417-1)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.02644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000041801","name":"ANTI-DIARRHEAL 1 MG/7.5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0418-1","proprietary_name":"leader anti diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 mg/7.5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"120 mL in 1 BOTTLE (70000-0418-1)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.02644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113222462","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2224-62","proprietary_name":"anti diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"24 BLISTER PACK in 1 CARTON (0113-2224-62) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113222468","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2224-68","proprietary_name":"anti diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"36 BLISTER PACK in 1 CARTON (0113-2224-68) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904772512","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7725-12","proprietary_name":"anti diarrheal","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"12 BLISTER PACK in 1 CARTON (0904-7725-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904772524","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7725-24","proprietary_name":"anti diarrheal","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"24 BLISTER PACK in 1 CARTON (0904-7725-24) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385055453","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385055462","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058901","name":"ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0589-1","proprietary_name":"leader anti diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"24 BLISTER PACK in 1 CARTON (70000-0589-1) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122058162","name":"ANTI-DIARRHEAL 2 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-581-62","proprietary_name":"Anti-Diarrheal","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"2 BLISTER PACK in 1 CARTON (46122-581-62) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000046101","name":"ANTI-DIARRHEAL 2 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0461-1","proprietary_name":"Anti-Diarrheal","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH","package_description":"2 BLISTER PACK in 1 CARTON (70000-0461-1) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076964","name":"ANTI-GAS 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-769-64","proprietary_name":"Gas Relief","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"180 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE in 1 BOX (46122-769-64) / 60 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536126812","name":"ANTI-ITCH 0.5%-0.5% LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1268-12","proprietary_name":"Rugby Anti-Itch","nonproprietary_name":"Camphor, Menthol","dosage_form":"LOTION","route":"TOPICAL","strength":".5 g/100g; .5 g/100g","labeler":"RUGBY LABORATORIES","package_description":"212 g in 1 BOTTLE, PUMP (0536-1268-12)"},"nadac":{"value":0.02212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122057310","name":"ANTI-ITCH 0.5%-0.5% LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-573-10","proprietary_name":"GNP Anti Itch","nonproprietary_name":"Camphor, Menthol","dosage_form":"LOTION","route":"TOPICAL","strength":".5 g/100g; .5 g/100g","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"212 g in 1 BOTTLE, PUMP (46122-573-10)"},"nadac":{"value":0.02212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000054601","name":"ANTI-ITCH 0.5%-0.5% LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0546-1","proprietary_name":"Leader Anti-Itch","nonproprietary_name":"Camphor, Menthol","dosage_form":"LOTION","route":"TOPICAL","strength":".5 g/100g; .5 g/100g","labeler":"LEADER/Cardinal Helath 110, Inc.","package_description":"212 g in 1 BOTTLE, PUMP (70000-0546-1)"},"nadac":{"value":0.02212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000038801","name":"ANTI-ITCH 2%-0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0388-1","proprietary_name":"leader anti itch","nonproprietary_name":"Diphenhydramine Hydrochloride, Zinc Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g; .1 g/100g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 TUBE in 1 CARTON (70000-0388-1) / 28 g in 1 TUBE","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536130297","name":"ANTI-NAUSEA LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1302-97","proprietary_name":"Anti Nausea","nonproprietary_name":"dextrose(glucose),Levulose(fructose),Phosphoric acid","dosage_form":"LIQUID","route":"ORAL","strength":"1.87 g/5mL; 1.87 g/5mL; 21.5 mg/5mL","labeler":"RUGBY LABORATORIES","package_description":"1 BOTTLE in 1 CARTON (0536-1302-97) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536127222","name":"ANTIFUNGAL 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1272-22","proprietary_name":"RUGBY ANTIFUNGAL CLOTRIMAZOLE","nonproprietary_name":"CLOTRIMAZOLE","dosage_form":"CREAM","route":"TOPICAL","strength":".01 g/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1272-22) / 28 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.06293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001047545","name":"ANTIFUNGAL 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-475-45","proprietary_name":"Antifungal Cream","nonproprietary_name":"antifungal","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-475-45) / 14.2 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001047547","name":"ANTIFUNGAL 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-475-47","proprietary_name":"Antifungal Cream","nonproprietary_name":"antifungal","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-475-47) / 28.4 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000032301","name":"ANTIFUNGAL 2% POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.05789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000067901","name":"ANTIFUNGAL 2% POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0679-1","proprietary_name":"Antifungal Powder","nonproprietary_name":"Miconazole Nitrate","dosage_form":"POWDER","route":"TOPICAL","strength":"20 mg/g","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"71 g in 1 BOTTLE, PLASTIC (70000-0679-1)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.05789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922009506","name":"ANTIFUNGAL 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-095-06","proprietary_name":"Antifungal Cream","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-095-06) / 42.5 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.07945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000071801","name":"ANTIFUNGAL 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0718-1","proprietary_name":"MICONAZOLE Nitrate 2% Cream ANTIFUNGAL","nonproprietary_name":"MICONAZOLE NITRATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Cardinal Health 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0718-1) / 28 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.07821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122013734","name":"ANTISEPTIC SKIN CLEANSER 4%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-137-34","proprietary_name":"Antiseptic Skin Cleanser","nonproprietary_name":"Chlorhexidine Gluconate 4%","dosage_form":"LIQUID","route":"TOPICAL","strength":"4 mg/100mL","labeler":"AmerisourceBergen Drug Corporation","package_description":"237 mL in 1 BOTTLE, PLASTIC (46122-137-34)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68599540102","name":"ANTISEPTIC SKIN CLEANSER 4%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.03992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68599540103","name":"ANTISEPTIC SKIN CLEANSER 4%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.03664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68599540104","name":"ANTISEPTIC SKIN CLEANSER 4%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.01776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00088250033","name":"APIDRA 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0088-2500-33","proprietary_name":"Apidra","nonproprietary_name":"insulin glulisine","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"sanofi-aventis U.S. LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0088-2500-33) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":8.16233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Apidra|Insulin Glulisine","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0088-2500-33) / 10 mL in 1 VIAL, GLASS) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00088250205","name":"APIDRA SOLOSTAR 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0088-2502-05","proprietary_name":"Apidra SoloStar","nonproprietary_name":"insulin glulisine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"sanofi-aventis U.S. LLC","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0088-2502-05) / 3 mL in 1 SYRINGE, PLASTIC (0088-2502-00)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.50102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Apidra Solostar|Insulin Glulisine","basis":"brand"},"part_b":null}, {"ndc":"42023010401","name":"APLISOL 5T UNIT/0.1 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":120.4534,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42023010405","name":"APLISOL 5T UNIT/0.1 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":94.86867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314066505","name":"APRACLONIDINE HCL 0.5% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-665-05","proprietary_name":"Apraclonidine","nonproprietary_name":"Apraclonidine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5.75 mg/mL","labeler":"Sandoz Inc","package_description":"5 mL in 1 BOTTLE (61314-665-05)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.15612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Apraclonidine HCl|Apraclonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"61314066510","name":"APRACLONIDINE HCL 0.5% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-665-10","proprietary_name":"Apraclonidine","nonproprietary_name":"Apraclonidine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5.75 mg/mL","labeler":"Sandoz Inc","package_description":"10 mL in 1 BOTTLE (61314-665-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Apraclonidine HCl|Apraclonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00781232306","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"00781232368","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2323-68","proprietary_name":"Aprepitant","nonproprietary_name":"aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Sandoz Inc","package_description":"1 BLISTER PACK in 1 CARTON (0781-2323-68) / 6 CAPSULE in 1 BLISTER PACK (0781-2323-06)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0781-2323-68) / 6 CAPSULE in 1 BLISTER PACK (0781-2323-06)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"13668059380","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"13668059386","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-593-86","proprietary_name":"APREPITANT","nonproprietary_name":"APREPITANT","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"6 BLISTER PACK in 1 CARTON (13668-593-86) / 1 CAPSULE in 1 BLISTER PACK (13668-593-80)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (13668-593-86) / 1 CAPSULE in 1 BLISTER PACK (13668-593-80)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066819","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-668-19","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (68001-668-19) / 6 CAPSULE in 1 BLISTER PACK (68001-668-44)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68001-668-19) / 6 CAPSULE in 1 BLISTER PACK (68001-668-44)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066844","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"68462058540","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"68462058576","name":"APREPITANT 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-585-76","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-585-76) / 6 CAPSULE in 1 BLISTER PACK (68462-585-40)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":114.04399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68462-585-76) / 6 CAPSULE in 1 BLISTER PACK (68462-585-40)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781406336","name":"APREPITANT 125-80-80 MG PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-4063-36","proprietary_name":"Aprepitant","nonproprietary_name":"aprepitant","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sandoz Inc","package_description":"1 KIT in 1 DOSE PACK (0781-4063-36) * 1 CAPSULE in 1 BLISTER PACK * 2 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":85.017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":57,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (57 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 DOSE PACK (0781-4063-36) * 1 CAPSULE in 1 BLISTER PACK * 2 CAPSULE in 1 BLISTER PACK) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, but package size x quantity is 3 here, so the crosswalk counts something other than the kit NADAC prices and package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"13668059487","name":"APREPITANT 125-80-80 MG PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-594-87","proprietary_name":"APREPITANT","nonproprietary_name":"APREPITANT","dosage_form":"KIT","route":null,"strength":null,"labeler":"Torrent Pharmaceuticals Limited","package_description":"1 KIT in 1 DOSE PACK (13668-594-87) * 2 CAPSULE in 1 BLISTER PACK * 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":85.017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":57,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (57 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 DOSE PACK (13668-594-87) * 2 CAPSULE in 1 BLISTER PACK * 1 CAPSULE in 1 BLISTER PACK) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, but package size x quantity is 3 here, so the crosswalk counts something other than the kit NADAC prices and package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"68001066915","name":"APREPITANT 125-80-80 MG PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-669-15","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"KIT","route":null,"strength":null,"labeler":"BluePoint Laboratories","package_description":"1 KIT in 1 DOSE PACK (68001-669-15) * 2 CAPSULE in 1 BLISTER PACK * 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":85.017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":57,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (57 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 DOSE PACK (68001-669-15) * 2 CAPSULE in 1 BLISTER PACK * 1 CAPSULE in 1 BLISTER PACK) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, but package size x quantity is 3 here, so the crosswalk counts something other than the kit NADAC prices and package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"68462011233","name":"APREPITANT 125-80-80 MG PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-112-33","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 KIT in 1 DOSE PACK (68462-112-33) * 2 CAPSULE in 1 BLISTER PACK * 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":85.017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":57,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (57 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 DOSE PACK (68462-112-33) * 2 CAPSULE in 1 BLISTER PACK * 1 CAPSULE in 1 BLISTER PACK) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, but package size x quantity is 3 here, so the crosswalk counts something other than the kit NADAC prices and package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00781232106","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2321-06","proprietary_name":"Aprepitant","nonproprietary_name":"aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"1 BLISTER PACK in 1 CARTON (0781-2321-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":8,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0781-2321-06) / 1 CAPSULE in 1 BLISTER PACK) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781232151","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2321-51","proprietary_name":"Aprepitant","nonproprietary_name":"aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"5 BLISTER PACK in 1 CARTON (0781-2321-51) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (0781-2321-51) / 1 CAPSULE in 1 BLISTER PACK) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"13668059180","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"13668059181","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-591-81","proprietary_name":"APREPITANT","nonproprietary_name":"APREPITANT","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (13668-591-81) / 1 CAPSULE in 1 BLISTER PACK (13668-591-80)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":8,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (13668-591-81) / 1 CAPSULE in 1 BLISTER PACK (13668-591-80)) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"13668059182","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-591-82","proprietary_name":"APREPITANT","nonproprietary_name":"APREPITANT","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"5 BLISTER PACK in 1 CARTON (13668-591-82) / 1 CAPSULE in 1 BLISTER PACK (13668-591-80)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (13668-591-82) / 1 CAPSULE in 1 BLISTER PACK (13668-591-80)) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066601","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-666-01","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (68001-666-01) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":8,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68001-666-01) / 1 CAPSULE in 1 BLISTER PACK) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066617","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-666-17","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"5 BLISTER PACK in 1 CARTON (68001-666-17) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (68001-666-17) / 1 CAPSULE in 1 BLISTER PACK) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462058340","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-583-40","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-583-40) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":8,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68462-583-40) / 1 CAPSULE in 1 BLISTER PACK) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462058385","name":"APREPITANT 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-583-85","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"5 BLISTER PACK in 1 CARTON (68462-583-85) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":46.42062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (68462-583-85) / 1 CAPSULE in 1 BLISTER PACK) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781232206","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"00781232246","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2322-46","proprietary_name":"Aprepitant","nonproprietary_name":"aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Sandoz Inc","package_description":"2 CAPSULE in 1 DOSE PACK (0781-2322-46)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (32 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 CAPSULE in 1 DOSE PACK (0781-2322-46)) gives 2 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781232268","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2322-68","proprietary_name":"Aprepitant","nonproprietary_name":"aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Sandoz Inc","package_description":"1 BLISTER PACK in 1 CARTON (0781-2322-68) / 6 CAPSULE in 1 BLISTER PACK (0781-2322-06)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":96,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (96 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0781-2322-68) / 6 CAPSULE in 1 BLISTER PACK (0781-2322-06)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"13668059283","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"13668059284","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-592-84","proprietary_name":"APREPITANT","nonproprietary_name":"APREPITANT","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"2 BLISTER PACK in 1 CARTON (13668-592-84) / 1 CAPSULE in 1 BLISTER PACK (13668-592-85)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (32 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 BLISTER PACK in 1 CARTON (13668-592-84) / 1 CAPSULE in 1 BLISTER PACK (13668-592-85)) gives 2 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"13668059285","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"13668059286","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-592-86","proprietary_name":"APREPITANT","nonproprietary_name":"APREPITANT","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"3 BLISTER PACK in 1 CARTON (13668-592-86) / 2 CAPSULE in 1 BLISTER PACK (13668-592-83)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":96,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (96 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 BLISTER PACK in 1 CARTON (13668-592-86) / 2 CAPSULE in 1 BLISTER PACK (13668-592-83)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066701","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-667-01","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"BluePoint Laboratories","package_description":"2 CAPSULE in 1 DOSE PACK (68001-667-01)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (32 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 CAPSULE in 1 DOSE PACK (68001-667-01)) gives 2 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066719","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-667-19","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (68001-667-19) / 6 CAPSULE in 1 BLISTER PACK (68001-667-44)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":96,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (96 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68001-667-19) / 6 CAPSULE in 1 BLISTER PACK (68001-667-44)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001066744","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"68462058440","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":null}, {"ndc":"68462058458","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-584-58","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"2 CAPSULE in 1 DOSE PACK (68462-584-58)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (32 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 CAPSULE in 1 DOSE PACK (68462-584-58)) gives 2 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462058476","name":"APREPITANT 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-584-76","proprietary_name":"Aprepitant","nonproprietary_name":"Aprepitant","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-584-76) / 6 CAPSULE in 1 BLISTER PACK (68462-584-40)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":76.35243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aprepitant|Aprepitant","basis":"generic"},"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":96,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (96 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68462-584-76) / 6 CAPSULE in 1 BLISTER PACK (68462-584-40)) gives 6 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00555904358","name":"APRI 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9043-58","proprietary_name":"Apri 28 Day","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9043-58) / 1 BLISTER PACK in 1 POUCH (0555-9043-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Apri|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555904379","name":"APRI 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Apri|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00904730224","name":"APRODINE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7302-24","proprietary_name":"Aprodine","nonproprietary_name":"Pseudoephedrine HCl, Triprolidine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1; 2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (0904-7302-24) / 24 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904730260","name":"APRODINE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7302-60","proprietary_name":"Aprodine","nonproprietary_name":"Pseudoephedrine HCl, Triprolidine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1; 2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-7302-60) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63402020230","name":"APTIOM 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63402-202-30","proprietary_name":"Aptiom","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET in 1 BOTTLE (63402-202-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":44.24295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aptiom|Eslicarbazepine Acetate","basis":"brand"},"part_b":null}, {"ndc":"63402020430","name":"APTIOM 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-204-30","proprietary_name":"Aptiom","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET in 1 BOTTLE (63402-204-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":44.00708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aptiom|Eslicarbazepine Acetate","basis":"brand"},"part_b":null}, {"ndc":"63402020660","name":"APTIOM 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-206-60","proprietary_name":"Aptiom","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"60 TABLET in 1 BOTTLE (63402-206-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":44.42614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aptiom|Eslicarbazepine Acetate","basis":"brand"},"part_b":null}, {"ndc":"63402020830","name":"APTIOM 800 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-208-30","proprietary_name":"Aptiom","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET in 1 BOTTLE (63402-208-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":44.16672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aptiom|Eslicarbazepine Acetate","basis":"brand"},"part_b":null}, {"ndc":"00555906667","name":"ARANELLE 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9066-67","proprietary_name":"Aranelle","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9066-67) / 1 BLISTER PACK in 1 POUCH (0555-9066-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.63013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aranelle|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555906679","name":"ARANELLE 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.63013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aranelle|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"55513005704","name":"ARANESP 25 MCG/0.42 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-057-04","proprietary_name":"ARANESP","nonproprietary_name":"darbepoetin alfa","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"25 ug/.42mL","labeler":"Amgen, Inc","package_description":"1 BLISTER PACK in 1 PACKAGE (55513-057-04) / 4 SYRINGE in 1 BLISTER PACK / .42 mL in 1 SYRINGE (55513-057-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":446.57738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Aranesp|Darbepoetin Alfa In Polysorbat","basis":"brand"},"part_b":null}, {"ndc":"55513002104","name":"ARANESP 40 MCG/0.4 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-021-04","proprietary_name":"ARANESP","nonproprietary_name":"darbepoetin alfa","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"40 ug/.4mL","labeler":"Amgen, Inc","package_description":"1 BLISTER PACK in 1 PACKAGE (55513-021-04) / 4 SYRINGE in 1 BLISTER PACK / .4 mL in 1 SYRINGE (55513-021-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":752.43625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Aranesp|Darbepoetin Alfa In Polysorbat","basis":"brand"},"part_b":null}, {"ndc":"55513002304","name":"ARANESP 60 MCG/0.3 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-023-04","proprietary_name":"ARANESP","nonproprietary_name":"darbepoetin alfa","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"60 ug/.3mL","labeler":"Amgen, Inc","package_description":"1 BLISTER PACK in 1 PACKAGE (55513-023-04) / 4 SYRINGE in 1 BLISTER PACK / .3 mL in 1 SYRINGE (55513-023-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":1500.14688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Aranesp|Darbepoetin Alfa In Polysorbat","basis":"brand"},"part_b":null}, {"ndc":"42571046473","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-464-73","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Micro Labs Limited","package_description":"30 POUCH in 1 CARTON (42571-464-73) / 1 VIAL in 1 POUCH (42571-464-75) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (42571-464-73) / 1 VIAL in 1 POUCH (42571-464-75) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598077730","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-777-30","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"30 POUCH in 1 CARTON (43598-777-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH (43598-777-11) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (43598-777-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH (43598-777-11) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598077760","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-777-60","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"15 POUCH in 1 CARTON (43598-777-60) / 4 VIAL, SINGLE-DOSE in 1 POUCH (43598-777-48) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (15 POUCH in 1 CARTON (43598-777-60) / 4 VIAL, SINGLE-DOSE in 1 POUCH (43598-777-48) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50742039530","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-395-30","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"6 POUCH in 1 CARTON (50742-395-30) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (50742-395-30) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50742039560","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-395-60","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"12 POUCH in 1 CARTON (50742-395-60) / 5 VIAL, SINGLE-DOSE in 1 POUCH (50742-395-05) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (50742-395-60) / 5 VIAL, SINGLE-DOSE in 1 POUCH (50742-395-05) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60687077083","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-770-83","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-770-83) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE (60687-770-79)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (60687-770-83) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE (60687-770-79)) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60687077084","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-770-84","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"American Health Packaging","package_description":"60 POUCH in 1 CARTON (60687-770-84) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE (60687-770-79)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (60687-770-84) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE (60687-770-79)) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62332063330","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-633-30","proprietary_name":"Arformoterol tartrate","nonproprietary_name":"Arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (62332-633-30) / 1 VIAL in 1 POUCH (62332-633-01) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (62332-633-30) / 1 VIAL in 1 POUCH (62332-633-01) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62332063360","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-633-60","proprietary_name":"Arformoterol tartrate","nonproprietary_name":"Arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 POUCH in 1 CARTON (62332-633-60) / 4 VIAL in 1 POUCH (62332-633-04) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"62756027702","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-277-02","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 CARTON (62756-277-02) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62756027703","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-277-03","proprietary_name":"Arformoterol Tartrate","nonproprietary_name":"Arformoterol Tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"12 POUCH in 1 CARTON (62756-277-03) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"69097016853","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-168-53","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Cipla USA Inc.","package_description":"30 POUCH in 1 CARTON (69097-168-53) / 1 VIAL, SINGLE-DOSE in 1 POUCH (69097-168-32) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (69097-168-53) / 1 VIAL, SINGLE-DOSE in 1 POUCH (69097-168-32) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097016864","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-168-64","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Cipla USA Inc.","package_description":"12 POUCH in 1 CARTON (69097-168-64) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (69097-168-64) / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097016887","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-168-87","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Cipla USA Inc.","package_description":"6 POUCH in 1 CARTON (69097-168-87) / 5 VIAL, SINGLE-DOSE in 1 POUCH (69097-168-48) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (69097-168-87) / 5 VIAL, SINGLE-DOSE in 1 POUCH (69097-168-48) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70436015157","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-151-57","proprietary_name":"Arformoterol Tartrate Inhalation","nonproprietary_name":"Arformoterol Tartrate Inhalation","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Slate Run Pharmaceuticals","package_description":"30 POUCH in 1 CARTON (70436-151-57) / 1 VIAL in 1 POUCH (70436-151-19) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (70436-151-57) / 1 VIAL in 1 POUCH (70436-151-19) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70436015158","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-151-58","proprietary_name":"Arformoterol Tartrate Inhalation","nonproprietary_name":"Arformoterol Tartrate Inhalation","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Slate Run Pharmaceuticals","package_description":"15 POUCH in 1 CARTON (70436-151-58) / 4 VIAL in 1 POUCH (70436-151-20) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (15 POUCH in 1 CARTON (70436-151-58) / 4 VIAL in 1 POUCH (70436-151-20) / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70748017530","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-175-30","proprietary_name":"Arformoterol tartrate","nonproprietary_name":"Arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 POUCH in 1 CARTON (70748-175-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (70748-175-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70748017560","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-175-60","proprietary_name":"Arformoterol tartrate","nonproprietary_name":"Arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 POUCH in 1 CARTON (70748-175-60) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (70748-175-60) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756061260","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-612-60","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Lifestar Pharma LLC","package_description":"60 POUCH in 1 CARTON (70756-612-60) / 4 VIAL in 1 POUCH (70756-612-44) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"70756061270","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-612-70","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Lifestar Pharma LLC","package_description":"30 POUCH in 1 CARTON (70756-612-70) / 1 VIAL in 1 POUCH (70756-612-12) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (70756-612-70) / 1 VIAL in 1 POUCH (70756-612-12) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266025930","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-259-30","proprietary_name":"Arformoterol tartrate","nonproprietary_name":"Arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Fosun Pharma USA Inc.","package_description":"30 POUCH in 1 CARTON (72266-259-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH (72266-259-01) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (72266-259-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH (72266-259-01) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266025960","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-259-60","proprietary_name":"Arformoterol tartrate","nonproprietary_name":"Arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Fosun Pharma USA Inc.","package_description":"15 POUCH in 1 CARTON (72266-259-60) / 4 VIAL, SINGLE-DOSE in 1 POUCH (72266-259-04) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (15 POUCH in 1 CARTON (72266-259-60) / 4 VIAL, SINGLE-DOSE in 1 POUCH (72266-259-04) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603020830","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-208-30","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"NorthStar RxLLC","package_description":"30 POUCH in 1 CARTON (72603-208-30) / 1 VIAL in 1 POUCH (72603-208-01) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (72603-208-30) / 1 VIAL in 1 POUCH (72603-208-01) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603020860","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-208-60","proprietary_name":"arformoterol tartrate","nonproprietary_name":"arformoterol tartrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"NorthStar RxLLC","package_description":"60 POUCH in 1 CARTON (72603-208-60) / 4 VIAL in 1 POUCH (72603-208-04) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"73043005260","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-052-60","proprietary_name":"Arformoterol Tartrate Inhalation","nonproprietary_name":"Arformoterol Tartrate Inhalation","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Devatis, Inc.","package_description":"60 POUCH in 1 CARTON (73043-052-60) / 4 VIAL in 1 POUCH (73043-052-04) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"73043005293","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-052-93","proprietary_name":"Arformoterol Tartrate Inhalation","nonproprietary_name":"Arformoterol Tartrate Inhalation","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Devatis, Inc.","package_description":"30 POUCH in 1 CARTON (73043-052-93) / 1 VIAL in 1 POUCH (73043-052-01) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76204002602","name":"ARFORMOTEROL 15 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-026-02","proprietary_name":"Arformoterol Tartrate Inhalation Solution","nonproprietary_name":"Arformoterol Tartrate Inhalation Solution","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"15 ug/2mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"60 POUCH in 1 CARTON (76204-026-02) / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Arformoterol Tartrate|Arformoterol Tartrate","basis":"generic"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (76204-026-02) / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62559067030","name":"ARIMIDEX 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-670-30","proprietary_name":"ARIMIDEX","nonproprietary_name":"Anastrozole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-670-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":52.86163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14163,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Arimidex|Anastrozole","basis":"brand"},"part_b":null}, {"ndc":"31722068415","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-684-15","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole oral","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-684-15) / 150 mL in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838057059","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-570-59","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Lannett Company, Inc.","package_description":"150 mL in 1 BOTTLE, PLASTIC (54838-570-59)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505040405","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0404-5","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-0404-5) / 150 mL in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162089374","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-893-74","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-893-74) / 150 mL in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66689073505","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-735-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"VistaPharm, LLC","package_description":"1 BOTTLE in 1 CARTON (66689-735-05) / 150 mL in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603044501","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-445-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole oral","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-445-01) / 150 mL in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888010020","name":"ARIPIPRAZOLE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-100-20","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-100-20) / 150 mL in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.33119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904736806","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7368-06","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7368-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904736861","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7368-61","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7368-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021805","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-218-05","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-218-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021830","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-218-30","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-218-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021890","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-218-90","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-218-90)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"16714014301","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-143-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-143-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005303","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-053-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-053-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005308","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-053-08","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-053-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"29300017713","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-177-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-177-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"31722082730","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-827-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-827-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"33342012407","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-124-07","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-124-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547030403","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-304-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-304-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088603","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-886-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-886-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088650","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-886-50","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-886-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598055630","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-556-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-556-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598096730","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-967-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-967-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268008911","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268008915","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-089-15","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-089-15) / 1 TABLET in 1 BLISTER PACK (50268-089-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687017901","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-179-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-179-01) / 1 TABLET in 1 BLISTER PACK (60687-179-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687017911","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687017965","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-179-65","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-179-65) / 1 TABLET in 1 BLISTER PACK (60687-179-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009930","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-099-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-099-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009931","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-099-31","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-099-31)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009971","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-099-71","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-099-71)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089803","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-898-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-898-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089809","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-898-09","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-898-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066305","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-663-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-663-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066330","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-663-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-663-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043203","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-432-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-432-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043205","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-432-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-432-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"82009009005","name":"ARIPIPRAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-090-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-090-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904736904","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7369-04","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7369-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021905","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-219-05","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-219-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021930","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-219-30","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-219-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021990","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-219-90","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-219-90)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"16714014401","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-144-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-144-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005403","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-054-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-054-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005408","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-054-08","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-054-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"29300017813","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-178-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-178-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"31722082830","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-828-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-828-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"33342012507","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-125-07","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-125-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547030503","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-305-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-305-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088703","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-887-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-887-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088750","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-887-50","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-887-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598055730","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-557-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-557-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598096830","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-968-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-968-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268009011","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268009012","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-090-12","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-090-12) / 1 TABLET in 1 BLISTER PACK (50268-090-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687019111","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687019121","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-191-21","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-191-21) / 1 TABLET in 1 BLISTER PACK (60687-191-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687019194","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-191-94","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-191-94) / 1 TABLET in 1 BLISTER PACK (60687-191-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010030","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-100-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-100-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010031","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-100-31","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-100-31)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010071","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-100-71","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-100-71)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089903","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-899-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-899-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089909","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-899-09","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-899-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066405","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-664-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-664-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066430","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-664-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-664-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043303","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-433-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-433-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043305","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-433-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-433-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"82009009105","name":"ARIPIPRAZOLE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-091-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-091-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904736604","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7366-04","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7366-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021605","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-216-05","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-216-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021630","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-216-30","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-216-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021690","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-216-90","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-216-90)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"16714014101","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-141-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-141-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005103","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-051-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-051-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005108","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-051-08","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-051-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"29300017513","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-175-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-175-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"31722081930","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-819-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-819-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"33342012207","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-122-07","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-122-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547030203","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-302-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-302-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088403","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-884-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-884-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088450","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-884-50","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-884-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598055430","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-554-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-554-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598096530","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-965-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-965-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268008711","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268008712","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-087-12","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-087-12) / 1 TABLET in 1 BLISTER PACK (50268-087-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687015711","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687015721","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-157-21","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-157-21) / 1 TABLET in 1 BLISTER PACK (60687-157-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687015794","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-157-94","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-157-94) / 1 TABLET in 1 BLISTER PACK (60687-157-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009730","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-097-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-097-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009731","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-097-31","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-097-31)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009771","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-097-71","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-097-71)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089603","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-896-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-896-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089609","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-896-09","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-896-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066105","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-661-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-661-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066130","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-661-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-661-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043003","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-430-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-430-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043005","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-430-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-430-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"82009008805","name":"ARIPIPRAZOLE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-088-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-088-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904737004","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7370-04","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7370-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668022005","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-220-05","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-220-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668022030","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-220-30","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-220-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668022090","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-220-90","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-220-90)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"16714014501","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-145-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-145-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005503","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-055-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-055-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005508","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-055-08","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-055-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"29300017913","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-179-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-179-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"31722082930","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-829-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-829-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547030603","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-306-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-306-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088803","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-888-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-888-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088850","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-888-50","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-888-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598055830","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-558-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-558-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598096930","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-969-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-969-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268009111","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268009112","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-091-12","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-091-12) / 1 TABLET in 1 BLISTER PACK (50268-091-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687020211","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687020221","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-202-21","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-202-21) / 1 TABLET in 1 BLISTER PACK (60687-202-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687020294","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-202-94","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-202-94) / 1 TABLET in 1 BLISTER PACK (60687-202-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010130","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-101-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-101-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010131","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-101-31","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-101-31)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162090103","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-901-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-901-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162090109","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-901-09","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-901-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066505","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-665-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-665-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066530","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-665-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-665-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043403","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-434-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-434-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043405","name":"ARIPIPRAZOLE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-434-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-434-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904737104","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7371-04","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7371-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668022105","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-221-05","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-221-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668022130","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-221-30","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-221-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668022190","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-221-90","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-221-90)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"16714014601","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-146-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-146-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005603","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-056-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-056-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005608","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-056-08","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-056-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"29300018013","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-180-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-180-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"31722083030","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-830-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-830-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547030703","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-307-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-307-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088903","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-889-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-889-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088950","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-889-50","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-889-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598055930","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-559-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-559-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598097030","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-970-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-970-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268009211","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268009212","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-092-12","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-092-12) / 1 TABLET in 1 BLISTER PACK (50268-092-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687021311","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687021321","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-213-21","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-213-21) / 1 TABLET in 1 BLISTER PACK (60687-213-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687021394","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-213-94","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-213-94) / 1 TABLET in 1 BLISTER PACK (60687-213-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010230","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-102-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-102-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010231","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-102-31","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-102-31)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162090203","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-902-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-902-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162090209","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-902-09","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-902-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066605","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-666-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-666-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066630","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-666-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-666-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043503","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-435-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-435-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043505","name":"ARIPIPRAZOLE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-435-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-435-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.17347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904665640","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6656-40","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-6656-40)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904736706","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7367-06","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7367-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"00904736761","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7367-61","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7367-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021705","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-217-05","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-217-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021730","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-217-30","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-217-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"13668021790","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-217-90","proprietary_name":"aripiprazole","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-217-90)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"16714014201","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-142-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-142-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005203","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-052-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-052-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"27241005208","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-052-08","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-052-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"29300017613","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-176-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-176-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"31722082030","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-820-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-820-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"33342012307","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-123-07","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-123-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547030303","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-303-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-303-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088503","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-885-03","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-885-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43547088550","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-885-50","proprietary_name":"ARIPIPRAZOLE","nonproprietary_name":"aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-885-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598055530","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-555-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-555-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598096630","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-966-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-966-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268008811","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"50268008815","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-088-15","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-088-15) / 1 TABLET in 1 BLISTER PACK (50268-088-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687016801","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-168-01","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-168-01) / 1 TABLET in 1 BLISTER PACK (60687-168-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687016811","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"60687016865","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-168-65","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-168-65) / 1 TABLET in 1 BLISTER PACK (60687-168-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009830","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-098-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-098-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009831","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-098-31","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-098-31)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332009871","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-098-71","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-098-71)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089703","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-897-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-897-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65162089709","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-897-09","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-897-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066205","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-662-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-662-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65862066230","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-662-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-662-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043103","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-431-03","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-431-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"67877043105","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-431-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-431-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"82009008905","name":"ARIPIPRAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-089-05","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-089-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598073330","name":"ARIPIPRAZOLE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-733-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole orally disintegrating","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-733-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.47005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010330","name":"ARIPIPRAZOLE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-103-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 CARTON (62332-103-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.47005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"69452033813","name":"ARIPIPRAZOLE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-338-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (69452-338-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.47005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"72578010606","name":"ARIPIPRAZOLE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-106-06","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (72578-106-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.47005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"72578010630","name":"ARIPIPRAZOLE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.47005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"72578010678","name":"ARIPIPRAZOLE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-106-78","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (72578-106-78) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (72578-106-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.47005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"43598073430","name":"ARIPIPRAZOLE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-734-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole orally disintegrating","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-734-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.22394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"62332010430","name":"ARIPIPRAZOLE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-104-30","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 CARTON (62332-104-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.22394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"69452033913","name":"ARIPIPRAZOLE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-339-13","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (69452-339-13)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.22394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"72578010706","name":"ARIPIPRAZOLE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-107-06","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (72578-107-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.22394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"72578010730","name":"ARIPIPRAZOLE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.22394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"72578010778","name":"ARIPIPRAZOLE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-107-78","proprietary_name":"Aripiprazole","nonproprietary_name":"Aripiprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (72578-107-78) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (72578-107-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.22394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aripiprazole ODT|Aripiprazole","basis":"generic"},"part_b":null}, {"ndc":"65757040403","name":"ARISTADA ER 1,064 MG/3.9 ML SYR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-404-03","proprietary_name":"ARISTADA","nonproprietary_name":"aripiprazole lauroxil","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"1064 mg/3.9mL","labeler":"Alkermes, Inc.","package_description":"1 SYRINGE in 1 CARTON (65757-404-03) / 3.9 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":993.60013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1944","bill_units_per_package":{"value":1064,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1944 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1064 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3.9,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (65757-404-03) / 3.9 mL in 1 SYRINGE) gives 3.9 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65757040103","name":"ARISTADA ER 441 MG/1.6 ML SYRN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-401-03","proprietary_name":"ARISTADA","nonproprietary_name":"aripiprazole lauroxil","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"441 mg/1.6mL","labeler":"Alkermes, Inc.","package_description":"1 SYRINGE in 1 CARTON (65757-401-03) / 1.6 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1007.58949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1944","bill_units_per_package":{"value":441,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1944 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (441 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (65757-401-03) / 1.6 mL in 1 SYRINGE) gives 1.6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65757040203","name":"ARISTADA ER 662 MG/2.4 ML SYRN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-402-03","proprietary_name":"ARISTADA","nonproprietary_name":"aripiprazole lauroxil","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"662 mg/2.4mL","labeler":"Alkermes, Inc.","package_description":"1 SYRINGE in 1 CARTON (65757-402-03) / 2.4 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1006.57422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1944","bill_units_per_package":{"value":662,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1944 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (662 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (65757-402-03) / 2.4 mL in 1 SYRINGE) gives 2.4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65757040303","name":"ARISTADA ER 882 MG/3.2 ML SYRN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-403-03","proprietary_name":"ARISTADA","nonproprietary_name":"aripiprazole lauroxil","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"882 mg/3.2mL","labeler":"Alkermes, Inc.","package_description":"1 SYRINGE in 1 CARTON (65757-403-03) / 3.2 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1004.17967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1944","bill_units_per_package":{"value":882,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1944 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (882 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3.2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (65757-403-03) / 3.2 mL in 1 SYRINGE) gives 3.2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65757050003","name":"ARISTADA INITIO ER 675 MG/2.4","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65757-500-03","proprietary_name":"ARISTADA INITIO","nonproprietary_name":"aripiprazole lauroxil","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"675 mg/2.4mL","labeler":"Alkermes, Inc.","package_description":"1 SYRINGE in 1 CARTON (65757-500-03) / 2.4 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1026.91122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1943","bill_units_per_package":{"value":675,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1943 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (675 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (65757-500-03) / 2.4 mL in 1 SYRINGE) gives 2.4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093309256","name":"ARMODAFINIL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3092-56","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-3092-56)"},"nadac":{"value":0.78762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00378343293","name":"ARMODAFINIL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3432-93","proprietary_name":"Armodafinil","nonproprietary_name":"armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3432-93)"},"nadac":{"value":0.78762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00781803731","name":"ARMODAFINIL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8037-31","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET in 1 BOTTLE (0781-8037-31)"},"nadac":{"value":0.78762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"65862080630","name":"ARMODAFINIL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-806-30","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-806-30)"},"nadac":{"value":0.78762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00781804531","name":"ARMODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8045-31","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET in 1 BOTTLE (0781-8045-31)"},"nadac":{"value":0.8028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"65862099830","name":"ARMODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-998-30","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-998-30)"},"nadac":{"value":0.8028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"69339017903","name":"ARMODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-179-03","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Natco Pharma USA LLC","package_description":"30 TABLET in 1 BOTTLE (69339-179-03)"},"nadac":{"value":0.8028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00093309456","name":"ARMODAFINIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3094-56","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-3094-56)"},"nadac":{"value":0.90818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00378343393","name":"ARMODAFINIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3433-93","proprietary_name":"Armodafinil","nonproprietary_name":"armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3433-93)"},"nadac":{"value":0.90818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00781805331","name":"ARMODAFINIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8053-31","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET in 1 BOTTLE (0781-8053-31)"},"nadac":{"value":0.90818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"65862080730","name":"ARMODAFINIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-807-30","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-807-30)"},"nadac":{"value":0.90818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00093309056","name":"ARMODAFINIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3090-56","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-3090-56)"},"nadac":{"value":0.30558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00378343193","name":"ARMODAFINIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3431-93","proprietary_name":"Armodafinil","nonproprietary_name":"armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3431-93)"},"nadac":{"value":0.30558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00781802931","name":"ARMODAFINIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8029-31","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET in 1 BOTTLE (0781-8029-31)"},"nadac":{"value":0.30558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"65862080530","name":"ARMODAFINIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-805-30","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-805-30)"},"nadac":{"value":0.30558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"69339017703","name":"ARMODAFINIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-177-03","proprietary_name":"Armodafinil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Natco Pharma USA LLC","package_description":"30 TABLET in 1 BOTTLE (69339-177-03)"},"nadac":{"value":0.30558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armodafinil|Armodafinil","basis":"generic"},"part_b":null}, {"ndc":"00456046101","name":"ARMOUR THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0461-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0461-01)"},"nadac":{"value":2.06571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456104501","name":"ARMOUR THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1045-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-1045-01)"},"nadac":{"value":0.86404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456046201","name":"ARMOUR THYROID 180 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0462-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0462-01)"},"nadac":{"value":1.54334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456046301","name":"ARMOUR THYROID 240 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0463-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0463-01)"},"nadac":{"value":1.87912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456045801","name":"ARMOUR THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0458-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0458-01)"},"nadac":{"value":1.01458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456046401","name":"ARMOUR THYROID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0464-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0464-01)"},"nadac":{"value":2.20504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456045901","name":"ARMOUR THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0459-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0459-01)"},"nadac":{"value":1.12737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00456046001","name":"ARMOUR THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-0460-01","proprietary_name":"Armour Thyroid","nonproprietary_name":"THYROID, PORCINE","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (0456-0460-01)"},"nadac":{"value":1.76457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Armour Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00173087410","name":"ARNUITY ELLIPTA 100 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0874-10","proprietary_name":"Arnuity Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0874-10) / 30 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.64675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.28421,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Arnuity Ellipta|Fluticasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"00173087414","name":"ARNUITY ELLIPTA 100 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0874-14","proprietary_name":"Arnuity Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0874-14) / 14 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.64902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Arnuity Ellipta|Fluticasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"00173087610","name":"ARNUITY ELLIPTA 200 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0876-10","proprietary_name":"Arnuity Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0876-10) / 30 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.90364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.71401,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Arnuity Ellipta|Fluticasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"00173087614","name":"ARNUITY ELLIPTA 200 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0876-14","proprietary_name":"Arnuity Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0876-14) / 14 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.90107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Arnuity Ellipta|Fluticasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"00173088810","name":"ARNUITY ELLIPTA 50 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0888-10","proprietary_name":"Arnuity Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0888-10) / 30 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.22058,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Arnuity Ellipta|Fluticasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"00009766304","name":"AROMASIN 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-7663-04","proprietary_name":"Aromasin","nonproprietary_name":"exemestane","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"30 TABLET in 1 BOTTLE (0009-7663-04)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":38.97921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aromasin|Exemestane","basis":"brand"},"part_b":null}, {"ndc":"70000055501","name":"ARTHRITIS PAIN RELIEVER 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0555-1","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"1 TUBE in 1 CARTON (70000-0555-1) / 50 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000055502","name":"ARTHRITIS PAIN RELIEVER 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0555-2","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"1 TUBE in 1 CARTON (70000-0555-2) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000055503","name":"ARTHRITIS PAIN RELIEVER 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0555-3","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"1 TUBE in 1 CARTON (70000-0555-3) / 150 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536111825","name":"ARTHRITIS PAIN RLF 0.075% CRM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1118-25","proprietary_name":"Rugby Arthritis Pain Relieving Topical Analgesic","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".75 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1118-25) / 57 g in 1 TUBE"},"nadac":{"value":0.07134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00025141160","name":"ARTHROTEC 50 MG-200 MCG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0025-1411-60","proprietary_name":"ARTHROTEC","nonproprietary_name":"diclofenac sodium and misoprostol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0025-1411-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":8.54949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00025141190","name":"ARTHROTEC 50 MG-200 MCG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0025-1411-90","proprietary_name":"ARTHROTEC","nonproprietary_name":"diclofenac sodium and misoprostol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0025-1411-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":8.54949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00025142160","name":"ARTHROTEC 75 MG-200 MCG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0025-1421-60","proprietary_name":"ARTHROTEC","nonproprietary_name":"diclofenac sodium and misoprostol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0025-1421-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":8.47483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268004315","name":"ARTIFICIAL TEARS 0.1-0.2-0.3%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50268-043-15","proprietary_name":"Artificial Tears","nonproprietary_name":"Artificial Tears","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL; 2 mg/mL; 3 mg/mL","labeler":"AvPAK","package_description":"15 mL in 1 BOTTLE (50268-043-15)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Increased Intravascular Volume [PE]","Non-Standardized Chemical Allergen [EPC]","Osmotic Activity [MoA]","Plasma Volume Expander [EPC]"]},"nadac":{"value":0.40378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385000605","name":"ARTIFICIAL TEARS DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-006-05","proprietary_name":"GOOD NEIGHBOR PHARMACY ARTIFICAL TEARS LUBRICANT EYE DROPS","nonproprietary_name":"polyvinyl alcohol, povidone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL; .6 g/100mL","labeler":"AmerisourceBergen","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24385-006-05) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.11327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000001101","name":"ARTIFICIAL TEARS DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0011-1","proprietary_name":"Leader Artificial Tears 15 mL","nonproprietary_name":"Polyvinyl Alcohol, Povidone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL; .6 g/100mL","labeler":"Cardinal Health","package_description":"1 BOTTLE, DROPPER in 1 BOX (70000-0011-1) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.11327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238199301","name":"ASA-BUTALB-CAFF-COD #3 CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1993-1","proprietary_name":"BUTALBITAL, ASPIRIN, CAFFEINE and CODEINE PHOSPHATE","nonproprietary_name":"BUTALBITAL, ASPIRIN, CAFFEINE and CODEINE PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1; 30 mg/1","labeler":"Amneal Pharmaceuticals of New York, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69238-1993-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":1.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991007401","name":"ASCOMP WITH CODEINE CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-074-01","proprietary_name":"Ascomp with Codeine","nonproprietary_name":"Butalbital, Aspirin, Caffeine and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1; 30 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (51991-074-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":1.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ascomp With Codeine|Codeine/Butalbital/Asa/Caffein","basis":"brand"},"part_b":null}, {"ndc":"51991007405","name":"ASCOMP WITH CODEINE CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-074-05","proprietary_name":"Ascomp with Codeine","nonproprietary_name":"Butalbital, Aspirin, Caffeine and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1; 30 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (51991-074-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":1.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ascomp With Codeine|Codeine/Butalbital/Asa/Caffein","basis":"brand"},"part_b":null}, {"ndc":"42794001710","name":"ASENAPINE 10 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-017-10","proprietary_name":"ASENAPINE","nonproprietary_name":"ASENAPINE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"10 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (42794-017-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"51991036060","name":"ASENAPINE 10 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-360-60","proprietary_name":"Asenapine","nonproprietary_name":"ASENAPINE MALEATE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"10 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"6 BLISTER PACK in 1 BOX (51991-360-60) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332019910","name":"ASENAPINE 10 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332019931","name":"ASENAPINE 10 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-199-31","proprietary_name":"Asenapine","nonproprietary_name":"Asenapine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 BLISTER PACK in 1 CARTON (62332-199-31) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332019960","name":"ASENAPINE 10 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-199-60","proprietary_name":"Asenapine","nonproprietary_name":"Asenapine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-199-60) / 10 TABLET in 1 BLISTER PACK (62332-199-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"51991092860","name":"ASENAPINE 2.5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-928-60","proprietary_name":"Asenapine","nonproprietary_name":"ASENAPINE MALEATE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"6 BLISTER PACK in 1 BOX (51991-928-60) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":3.08807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332054410","name":"ASENAPINE 2.5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.08807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332054460","name":"ASENAPINE 2.5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-544-60","proprietary_name":"Asenapine","nonproprietary_name":"Asenapine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-544-60) / 10 TABLET in 1 BLISTER PACK (62332-544-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":3.08807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"42794001610","name":"ASENAPINE 5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-016-10","proprietary_name":"ASENAPINE","nonproprietary_name":"ASENAPINE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"5 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (42794-016-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"51991035860","name":"ASENAPINE 5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-358-60","proprietary_name":"Asenapine","nonproprietary_name":"ASENAPINE MALEATE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"6 BLISTER PACK in 1 BOX (51991-358-60) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332019810","name":"ASENAPINE 5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332019831","name":"ASENAPINE 5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-198-31","proprietary_name":"Asenapine","nonproprietary_name":"Asenapine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 BLISTER PACK in 1 CARTON (62332-198-31) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332019860","name":"ASENAPINE 5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-198-60","proprietary_name":"Asenapine","nonproprietary_name":"Asenapine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-198-60) / 10 TABLET in 1 BLISTER PACK (62332-198-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asenapine Maleate|Asenapine Maleate","basis":"generic"},"part_b":null}, {"ndc":"68462064691","name":"ASHLYNA 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ashlyna|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"68462064693","name":"ASHLYNA 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-646-93","proprietary_name":"Ashlyna","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"2 POUCH in 1 CARTON (68462-646-93) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK (68462-646-91)"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ashlyna|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"78206011201","name":"ASMANEX HFA 100 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-112-01","proprietary_name":"ASMANEX HFA","nonproprietary_name":"MOMETASONE FUROATE","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-112-01) / 120 AEROSOL in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.37626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Asmanex HFA|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011301","name":"ASMANEX HFA 200 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-113-01","proprietary_name":"ASMANEX HFA","nonproprietary_name":"MOMETASONE FUROATE","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-113-01) / 120 AEROSOL in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.66783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Asmanex HFA|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011101","name":"ASMANEX HFA 50 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-111-01","proprietary_name":"ASMANEX HFA","nonproprietary_name":"MOMETASONE FUROATE","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-111-01) / 120 AEROSOL in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.83925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Asmanex HFA|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011501","name":"ASMANEX TWISTHALER 110 MCG #30","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-115-01","proprietary_name":"ASMANEX","nonproprietary_name":"Mometasone Furoate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"110 ug/1","labeler":"Organon LLC","package_description":"1 POUCH in 1 CARTON (78206-115-01) / 1 INHALER in 1 POUCH / 30 INHALANT in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":88.83058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asmanex|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011403","name":"ASMANEX TWISTHALER 220 MCG #14","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-114-03","proprietary_name":"ASMANEX","nonproprietary_name":"Mometasone Furoate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"220 ug/1","labeler":"Organon LLC","package_description":"1 POUCH in 1 CARTON (78206-114-03) / 1 INHALER in 1 POUCH / 14 INHALANT in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":36.98,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asmanex|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011404","name":"ASMANEX TWISTHALER 220 MCG #30","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-114-04","proprietary_name":"ASMANEX","nonproprietary_name":"Mometasone Furoate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"220 ug/1","labeler":"Organon LLC","package_description":"1 POUCH in 1 CARTON (78206-114-04) / 1 INHALER in 1 POUCH / 30 INHALANT in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":96.04106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asmanex|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011402","name":"ASMANEX TWISTHALER 220 MCG #60","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-114-02","proprietary_name":"ASMANEX","nonproprietary_name":"Mometasone Furoate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"220 ug/1","labeler":"Organon LLC","package_description":"1 POUCH in 1 CARTON (78206-114-02) / 1 INHALER in 1 POUCH / 60 INHALANT in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":112.64988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asmanex|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"78206011401","name":"ASMANEX TWISTHALR 220 MCG #120","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-114-01","proprietary_name":"ASMANEX","nonproprietary_name":"Mometasone Furoate","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"220 ug/1","labeler":"Organon LLC","package_description":"1 POUCH in 1 CARTON (78206-114-01) / 1 INHALER in 1 POUCH / 120 INHALANT in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":161.43234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Asmanex|Mometasone Furoate","basis":"brand"},"part_b":null}, {"ndc":"00536105429","name":"ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1054-29","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0536-1054-29) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483001101","name":"ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-011-01","proprietary_name":"ASPIRIN","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1","labeler":"TIME CAP LABS INC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-011-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483001110","name":"ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-011-10","proprietary_name":"ASPIRIN","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1","labeler":"TIME CAP LABS INC","package_description":"1000 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-011-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599131103","name":"ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-1311-3","proprietary_name":"McKesson Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"McKesson Medical-Surgical","package_description":"250 PACKET in 1 BOX (68599-1311-3) / 2 TABLET, FILM COATED in 1 PACKET","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000025302","name":"ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0253-2","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70000-0253-2)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536100836","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1008-36","proprietary_name":"Rugby Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1008-36) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904404073","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-4040-73","proprietary_name":"aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-4040-73) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904679480","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6794-80","proprietary_name":"Aspirin Low Dose Chewable Orange","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"1000 TABLET, CHEWABLE in 1 PACKAGE (0904-6794-80)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904679489","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6794-89","proprietary_name":"Aspirin Low Dose Chewable Orange","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (0904-6794-89)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904750930","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7509-30","proprietary_name":"Aspirin Low Dose Chewable Orange","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Major Pharmaceuticals","package_description":"300 BLISTER PACK in 1 CARTON (0904-7509-30) / 1 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385002868","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-028-68","proprietary_name":"Good Neighbor Pharmacy Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-028-68) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385027868","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-278-68","proprietary_name":"good neighbor pharmacy aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-278-68) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483033463","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-334-63","proprietary_name":"aspirin low dose chewable","nonproprietary_name":"aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Time-Cap Labs, Inc","package_description":"36 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (49483-334-63)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000041901","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0419-1","proprietary_name":"leader aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0419-1) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000042001","name":"ASPIRIN 81 MG CHEWABLE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0420-1","proprietary_name":"leader aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0420-1) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536123201","name":"ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1232-01","proprietary_name":"Aspirin Regular Strength","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0536-1232-01) / 100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122059602","name":"ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-596-02","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-596-02) / 125 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483033101","name":"ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-331-01","proprietary_name":"Enteric Coated Aspirin Regular Strength","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/3251","labeler":"Time-Cap Labs, Inc","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (49483-331-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483033110","name":"ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-331-10","proprietary_name":"Enteric Coated Aspirin Regular Strength","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/3251","labeler":"Time-Cap Labs, Inc","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (49483-331-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000001401","name":"ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0014-1","proprietary_name":"Regular Strength Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1","labeler":"CARDINAL HEALTH, INC.","package_description":"300 TABLET, COATED in 1 BOTTLE (70000-0014-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000003501","name":"ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0035-1","proprietary_name":"Aspirin Regular Strength","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0035-1) / 125 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536123441","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1234-41","proprietary_name":"Aspirin Low Dose","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0536-1234-41) / 120 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904675180","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6751-80","proprietary_name":"Aspirin Low Dose","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0904-6751-80)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904678370","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6783-70","proprietary_name":"ASPIRIN LOW DOSE","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"250 TABLET, COATED in 1 BOTTLE (0904-6783-70)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483038710","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-387-10","proprietary_name":"aspirin low dose enteric coated","nonproprietary_name":"aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"Time-Cap Labs, Inc","package_description":"1000 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-387-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483038712","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-387-12","proprietary_name":"aspirin low dose enteric coated","nonproprietary_name":"aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"Time-Cap Labs, Inc","package_description":"120 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-387-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483048110","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-481-10","proprietary_name":"LOW DOSE ASPIRIN","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-481-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483048112","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-481-12","proprietary_name":"LOW DOSE ASPIRIN","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"120 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-481-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237030210","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-302-10","proprietary_name":"Aspirin 81","nonproprietary_name":"Aspirin","dosage_form":"TABLET","route":"ORAL","strength":"81 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (57237-302-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237030212","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-302-12","proprietary_name":"Aspirin 81","nonproprietary_name":"Aspirin","dosage_form":"TABLET","route":"ORAL","strength":"81 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET in 1 BOTTLE (57237-302-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237034910","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-349-10","proprietary_name":"Adult Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-349-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237034912","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-349-12","proprietary_name":"Adult Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-349-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000301","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0003-1","proprietary_name":"ASPIRIN LOW DOSE","nonproprietary_name":"ASPIRIN LOW DOSE","dosage_form":"TABLET","route":"ORAL","strength":"81 mg/1","labeler":"AARNA USA INC.","package_description":"120 TABLET in 1 BOTTLE (82568-0003-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000302","name":"ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0003-2","proprietary_name":"ASPIRIN LOW DOSE","nonproprietary_name":"ASPIRIN LOW DOSE","dosage_form":"TABLET","route":"ORAL","strength":"81 mg/1","labeler":"AARNA USA INC.","package_description":"1000 TABLET in 1 BOTTLE (82568-0003-2)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060301","name":"ASPIRIN REGIMEN 81 MG EC TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0603-1","proprietary_name":"Aspirin Regimen","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0603-1) / 32 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060302","name":"ASPIRIN REGIMEN 81 MG EC TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0603-2","proprietary_name":"Aspirin Regimen","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0603-2) / 120 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060303","name":"ASPIRIN REGIMEN 81 MG EC TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0603-3","proprietary_name":"Aspirin Regimen","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"300 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (70000-0603-3)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060401","name":"ASPIRIN REGIMEN 81 MG EC TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0604-1","proprietary_name":"Aspirin Regimen","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0604-1) / 36 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060402","name":"ASPIRIN REGIMEN 81 MG EC TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0604-2","proprietary_name":"Aspirin Regimen","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0604-2) / 120 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237034801","name":"ASPIRIN-ACETAMINOPHEN-CAFFEINE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-348-01","proprietary_name":"Acetaminophen, Aspirin and Caffeine","nonproprietary_name":"Acetaminophen, Aspirin and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-348-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904705699","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7056-99","proprietary_name":"Aspirin and Extended - Release Dipyridamole Capsules, 25 mg / 200 mg","nonproprietary_name":"Aspirin and Extended - Release Dipyridamole","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7056-99) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aspirin-Dipyridamole ER|Aspirin/Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"16714096401","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-964-01","proprietary_name":"Aspirin and Dipyridamole","nonproprietary_name":"Aspirin and Dipyridamole","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-964-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aspirin-Dipyridamole ER|Aspirin/Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"42571027460","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-274-60","proprietary_name":"ASPIRIN AND EXTENDED-RELEASE DIPYRIDAMOLE","nonproprietary_name":"ASPIRIN and Extended-Release DIPYRIDAMOLE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"Micro Labs Limited","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42571-274-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aspirin-Dipyridamole ER|Aspirin/Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"43598033960","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-339-60","proprietary_name":"Aspirin and Dipyridamole","nonproprietary_name":"Aspirin and Dipyridamole","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-339-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aspirin-Dipyridamole ER|Aspirin/Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"49884000702","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-007-02","proprietary_name":"Aspirin and Extended - Release Dipyridamole Capsules, 25 mg / 200 mg","nonproprietary_name":"Aspirin and Extended - Release Dipyridamole","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"Par Health USA, LLC","package_description":"60 CAPSULE in 1 BOTTLE (49884-007-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aspirin-Dipyridamole ER|Aspirin/Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"65162059606","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-596-06","proprietary_name":"Aspirin and Extended-Release Dipyridamole","nonproprietary_name":"Aspirin and Extended-Release Dipyridamole","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (65162-596-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aspirin-Dipyridamole ER|Aspirin/Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"68462040560","name":"ASPIRIN-DIPYRIDAM ER 25-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-405-60","proprietary_name":"ASPRIN AND EXTENDED-RELEASE DIPYRIDAMOLE","nonproprietary_name":"ASPRIN AND EXTENDED-RELEASE DIPYRIDAMOLE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE in 1 BOTTLE (68462-405-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.55859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00469064773","name":"ASTAGRAF XL 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-0647-73","proprietary_name":"ASTAGRAF XL","nonproprietary_name":"tacrolimus extended-release capsules","dosage_form":"CAPSULE, COATED, EXTENDED RELEASE","route":"ORAL","strength":".5 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-0647-73) / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":2.88173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Astagraf XL|Tacrolimus","basis":"brand"},"part_b":{"hcpcs":"J7508","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7508 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (0469-0647-73) / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00469067773","name":"ASTAGRAF XL 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-0677-73","proprietary_name":"ASTAGRAF XL","nonproprietary_name":"tacrolimus extended-release capsules","dosage_form":"CAPSULE, COATED, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-0677-73) / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":5.70907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Astagraf XL|Tacrolimus","basis":"brand"},"part_b":{"hcpcs":"J7508","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7508 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (0469-0677-73) / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62559064230","name":"ATACAND 16 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62559-642-30","proprietary_name":"ATACAND","nonproprietary_name":"Candesartan Cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-642-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":7.85024,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atacand|Candesartan Cilexetil","basis":"brand"},"part_b":null}, {"ndc":"62559064290","name":"ATACAND 16 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62559-642-90","proprietary_name":"ATACAND","nonproprietary_name":"Candesartan Cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-642-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":7.85024,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atacand|Candesartan Cilexetil","basis":"brand"},"part_b":null}, {"ndc":"62559064330","name":"ATACAND 32 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-643-30","proprietary_name":"ATACAND","nonproprietary_name":"Candesartan Cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-643-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":9.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atacand|Candesartan Cilexetil","basis":"brand"},"part_b":null}, {"ndc":"62559064390","name":"ATACAND 32 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-643-90","proprietary_name":"ATACAND","nonproprietary_name":"Candesartan Cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-643-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":9.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atacand|Candesartan Cilexetil","basis":"brand"},"part_b":null}, {"ndc":"00093552706","name":"ATAZANAVIR SULFATE 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-5527-06","proprietary_name":"Atazanavir Sulfate","nonproprietary_name":"Atazanavir Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (0093-5527-06)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":1.10873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"31722065460","name":"ATAZANAVIR SULFATE 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-654-60","proprietary_name":"Atazanavir","nonproprietary_name":"Atazanavir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (31722-654-60)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":1.10873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42385092160","name":"ATAZANAVIR SULFATE 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42385-921-60","proprietary_name":"Atazanavir","nonproprietary_name":"Atazanavir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Laurus Labs Limited","package_description":"60 CAPSULE in 1 BOTTLE (42385-921-60)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":1.10873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"65862071260","name":"ATAZANAVIR SULFATE 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65862-712-60","proprietary_name":"Atazanavir Sulfate","nonproprietary_name":"Atazanavir","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-712-60)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":1.10873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00093552856","name":"ATAZANAVIR SULFATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5528-56","proprietary_name":"Atazanavir Sulfate","nonproprietary_name":"Atazanavir Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-5528-56)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":2.22639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"31722065530","name":"ATAZANAVIR SULFATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-655-30","proprietary_name":"Atazanavir","nonproprietary_name":"Atazanavir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-655-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":2.22639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42385092230","name":"ATAZANAVIR SULFATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-922-30","proprietary_name":"Atazanavir","nonproprietary_name":"Atazanavir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Laurus Labs Limited","package_description":"30 CAPSULE in 1 BOTTLE (42385-922-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":2.22639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"65862071330","name":"ATAZANAVIR SULFATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-713-30","proprietary_name":"Atazanavir Sulfate","nonproprietary_name":"Atazanavir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (65862-713-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":2.22639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atazanavir Sulfate|Atazanavir Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00430097903","name":"ATELVIA DR 35 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0430-0979-03","proprietary_name":"Atelvia","nonproprietary_name":"risedronate sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"30.1 mg/1; 4.9 mg/1","labeler":"Allergan, Inc.","package_description":"4 TABLET, DELAYED RELEASE in 1 DOSE PACK (0430-0979-03)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":63.80786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":30.67721,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093075301","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0753-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-0753-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00093075305","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0753-05","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-0753-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00378075701","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0757-01","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0757-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00378075710","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0757-10","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0757-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041201","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-412-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-412-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041205","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-412-05","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (29300-412-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041210","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-412-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-412-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"51079068501","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"51079068520","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-685-20","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-685-20) / 1 TABLET in 1 BLISTER PACK (51079-685-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"64980043901","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-439-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-439-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"64980043910","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-439-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-439-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"65862017001","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-170-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-170-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"65862017099","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-170-99","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-170-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"68382002401","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-024-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-024-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"68382002410","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-024-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-024-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"75834028300","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"83980002401","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-024-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-024-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"83980002410","name":"ATENOLOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-024-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-024-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00093078701","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0787-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-0787-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00093078710","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0787-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-0787-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00378021801","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0218-01","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0218-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00378021810","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0218-10","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0218-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00904718761","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7187-61","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7187-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041001","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-410-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-410-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041005","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-410-05","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (29300-410-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041010","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-410-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-410-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"51079075901","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"51079075920","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-759-20","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-759-20) / 1 TABLET in 1 BLISTER PACK (51079-759-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"60687060501","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-605-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-605-01) / 1 TABLET in 1 BLISTER PACK (60687-605-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"60687060511","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"64980043701","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-437-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-437-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"64980043710","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-437-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-437-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"65862016801","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-168-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-168-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"65862016899","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-168-99","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-168-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"68382002201","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-022-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-022-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"68382002210","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-022-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-022-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"75834028100","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"83980002201","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-022-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-022-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"83980002210","name":"ATENOLOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-022-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-022-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00093075201","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0752-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-0752-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00093075210","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0752-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-0752-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00378023101","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0231-01","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0231-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00378023110","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0231-10","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0231-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041101","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-411-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-411-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041105","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-411-05","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (29300-411-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"29300041110","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-411-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-411-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"51079068401","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"51079068420","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-684-20","proprietary_name":"Atenolol","nonproprietary_name":"atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-684-20) / 1 TABLET in 1 BLISTER PACK (51079-684-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"64980043801","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-438-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-438-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"64980043810","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-438-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-438-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"65862016901","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-169-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-169-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"65862016999","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-169-99","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-169-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"68382002301","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-023-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-023-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"68382002310","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-023-10","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-023-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"75834028200","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"83980002301","name":"ATENOLOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-023-01","proprietary_name":"Atenolol","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-023-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol|Atenolol","basis":"generic"},"part_b":null}, {"ndc":"00591578301","name":"ATENOLOL-CHLORTHALIDONE 100-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5783-01","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-5783-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.33513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"16714093701","name":"ATENOLOL-CHLORTHALIDONE 100-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-937-01","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET in 1 BOTTLE (16714-937-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.33513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"29300040101","name":"ATENOLOL-CHLORTHALIDONE 100-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-401-01","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-401-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.33513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70710116801","name":"ATENOLOL-CHLORTHALIDONE 100-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1168-1","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1168-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.33513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70954039110","name":"ATENOLOL-CHLORTHALIDONE 100-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-391-10","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-391-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.33513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00591578201","name":"ATENOLOL-CHLORTHALIDONE 50-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5782-01","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-5782-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"16714093601","name":"ATENOLOL-CHLORTHALIDONE 50-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-936-01","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET in 1 BOTTLE (16714-936-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"29300040001","name":"ATENOLOL-CHLORTHALIDONE 50-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-400-01","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-400-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70710116701","name":"ATENOLOL-CHLORTHALIDONE 50-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1167-1","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1167-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70954039010","name":"ATENOLOL-CHLORTHALIDONE 50-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-390-10","proprietary_name":"Atenolol and Chlorthalidone","nonproprietary_name":"Atenolol and Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-390-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atenolol-Chlorthalidone|Atenolol/Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70000033801","name":"ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0338-1","proprietary_name":"Terbinafine Hydrochloride","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"1 TUBE in 1 CARTON (70000-0338-1) / 15 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.39833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000066701","name":"ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0667-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Cardinal Health 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0667-1) / 28 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.06293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536148101","name":"ATHLETE'S FOOT 1% POWDER SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1481-01","proprietary_name":"Athletes Foot","nonproprietary_name":"Tolnaftate","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":"10 mg/g","labeler":"Rugby Laboratories","package_description":"130 g in 1 CAN (0536-1481-01)"},"nadac":{"value":0.03283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000032201","name":"ATHLETE'S FOOT 1% POWDER SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0322-1","proprietary_name":"Tolnafate","nonproprietary_name":"Tolnaftate Powder Spray - Talc Free","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":"1.3 g/130g","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"130 g in 1 CAN (70000-0322-1)"},"nadac":{"value":0.03283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672215801","name":"ATHLETE'S FOOT 1% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2158-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 g/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-2158-1) / 10 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.01789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000032101","name":"ATHLETE'S FOOT 2% POWDER SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0321-1","proprietary_name":"Miconazole Nitrate","nonproprietary_name":"Anti-fungal Powder Miconazole Nitrate Talc Free","dosage_form":"POWDER","route":"TOPICAL","strength":"2.6 g/130g","labeler":"Cardinal Health","package_description":"130 g in 1 CAN (70000-0321-1)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.03613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093354256","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3542-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3542-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714075501","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-755-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-755-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722071430","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-714-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-714-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111051930","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-519-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-519-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283003","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2830-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2830-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047201","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-472-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-472-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037303","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-373-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-373-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026530","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-265-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-265-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603043501","name":"ATOMOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-435-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-435-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.32216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093354856","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3548-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3548-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714076101","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-761-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-761-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722072030","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-720-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-720-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111056430","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-564-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-564-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283603","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2836-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2836-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047801","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-478-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-478-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037903","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-379-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-379-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462027130","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-271-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-271-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603044101","name":"ATOMOXETINE HCL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-441-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-441-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.51448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093354356","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3543-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3543-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714075601","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-756-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-756-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722071530","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-715-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-715-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111052030","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-520-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-520-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283103","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2831-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2831-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047301","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-473-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-473-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037403","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-374-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-374-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026630","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-266-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-266-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603043601","name":"ATOMOXETINE HCL 18 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-436-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"18 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-436-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093354456","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3544-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3544-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714075701","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-757-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-757-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722071630","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-716-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-716-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005711","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005713","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-057-13","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-057-13) / 1 CAPSULE in 1 BLISTER PACK (50268-057-11)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111052830","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-528-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-528-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283203","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2832-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2832-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687056711","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687056721","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-567-21","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-567-21) / 1 CAPSULE in 1 BLISTER PACK (60687-567-11)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047401","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-474-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-474-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037503","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-375-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-375-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026730","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-267-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-267-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603043701","name":"ATOMOXETINE HCL 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-437-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-437-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093354556","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3545-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3545-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904690804","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6908-04","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6908-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714075801","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-758-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-758-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722071730","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-717-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-717-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005811","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005813","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-058-13","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-058-13) / 1 CAPSULE in 1 BLISTER PACK (50268-058-11)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111052130","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-521-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-521-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283303","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2833-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2833-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687032625","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-326-25","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-326-25) / 1 CAPSULE in 1 BLISTER PACK (60687-326-95)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687032695","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047501","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-475-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-475-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037603","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-376-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-376-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026830","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-268-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-268-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603043801","name":"ATOMOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-438-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-438-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.44218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093354656","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3546-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3546-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714075901","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-759-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-759-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722071830","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-718-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-718-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005911","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268005913","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-059-13","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-059-13) / 1 CAPSULE in 1 BLISTER PACK (50268-059-11)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111052230","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-522-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-522-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283403","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2834-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2834-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047601","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-476-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-476-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037703","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-377-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-377-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026930","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-269-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-269-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603043901","name":"ATOMOXETINE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-439-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-439-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.50934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093354756","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3547-56","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3547-56)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714076001","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-760-01","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Northstar Rx LLC","package_description":"30 CAPSULE in 1 BOTTLE (16714-760-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722071930","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-719-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-719-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111056330","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-563-30","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE in 1 BOTTLE (55111-563-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505283503","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2835-3","proprietary_name":"Atomoxetine Hydrochloride","nonproprietary_name":"atomoxetine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-2835-3)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380047701","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-477-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (64380-477-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980037803","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-378-03","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-378-03)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462027030","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-270-30","proprietary_name":"atomoxetine","nonproprietary_name":"atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-270-30)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603044001","name":"ATOMOXETINE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-440-01","proprietary_name":"Atomoxetine","nonproprietary_name":"Atomoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE in 1 BOTTLE (72603-440-01)","pharm_classes":["Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atomoxetine HCl|Atomoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"46287003001","name":"ATORVALIQ 20 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["3","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-030-01","proprietary_name":"ATORVALIQ","nonproprietary_name":"ATORVALIQ","dosage_form":"SUSPENSION","route":"ORAL","strength":"20 mg/5mL","labeler":"CMP Pharma, Inc.","package_description":"150 mL in 1 BOTTLE (46287-030-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.23479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093505610","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5056-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-5056-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505698","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5056-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-5056-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395005","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3950-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3950-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395077","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3950-77","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3950-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358510","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3585-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0480-3585-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358598","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3585-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3585-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629006","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6290-06","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6290-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629061","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6290-61","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6290-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013609","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-136-09","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-136-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013610","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-136-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-136-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013650","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-136-50","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-136-50)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714017303","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-173-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-173-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042405","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-424-05","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-424-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042410","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-424-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-424-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042490","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-424-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-424-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031510","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-315-10","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-315-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031515","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-315-15","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-315-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031544","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-315-44","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-315-44)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094001","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-940-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-940-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094005","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-940-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-940-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094011","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-940-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-940-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094090","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-940-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Laurus Labs Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42385-940-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017210","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017290","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598009805","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-098-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-098-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598009887","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-098-87","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (43598-098-87)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598009890","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-098-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-098-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083005","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-830-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-830-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083090","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-830-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-830-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045110","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-451-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-451-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045190","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-451-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-451-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009311","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009315","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-093-15","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-093-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-093-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079020801","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079020820","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-208-20","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-208-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-208-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012105","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-121-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-121-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012190","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-121-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-121-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060690","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-606-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-606-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060699","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-606-99","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-606-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60290003902","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-039-02","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (60290-039-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505257808","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2578-8","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-2578-8)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505257809","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2578-9","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (60505-2578-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051105","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-511-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-511-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051110","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-511-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-511-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051190","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-511-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-511-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084009701","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-097-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-097-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-097-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084009711","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382024910","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382024916","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377002711","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377002713","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377007711","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-077-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-077-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377007713","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-077-13","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-077-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177700","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1777-0","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1777-0)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177709","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1777-9","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (70710-1777-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024712","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-247-12","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70756-247-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024751","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-247-51","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70756-247-51)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024790","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-247-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70756-247-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002205","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-022-05","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-022-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002290","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-022-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-022-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002299","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-022-99","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-022-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028201","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-282-01","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-282-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028202","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-282-02","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-282-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028203","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-282-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-282-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040301","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040302","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-403-02","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-403-02) / 100 TABLET, FILM COATED in 1 BLISTER PACK (72603-403-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"75834025501","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-255-01","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-255-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009000110","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-001-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-001-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009000190","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-001-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-001-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009017610","name":"ATORVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-176-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-176-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505910","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5059-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-5059-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505998","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5059-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-5059-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395105","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3951-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3951-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395177","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3951-77","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3951-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358610","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3586-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0480-3586-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358698","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3586-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3586-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629106","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6291-06","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6291-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629161","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6291-61","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6291-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013709","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-137-09","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-137-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013710","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-137-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-137-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013750","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-137-50","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-137-50)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714017403","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042505","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-425-05","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-425-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042510","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-425-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-425-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042590","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-425-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-425-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031610","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-316-10","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-316-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031615","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-316-15","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-316-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031644","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-316-44","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-316-44)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094101","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-941-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-941-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094105","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-941-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-941-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094111","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-941-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-941-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094190","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-941-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Laurus Labs Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42385-941-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017310","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017390","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598009905","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-099-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-099-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598009987","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-099-87","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (43598-099-87)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598009990","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-099-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-099-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083105","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-831-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-831-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083190","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-831-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-831-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045205","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-452-05","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-452-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045290","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-452-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-452-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009411","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009415","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-094-15","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-094-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-094-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079020901","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079020920","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-209-20","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-209-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-209-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012205","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-122-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-122-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012290","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-122-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-122-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060790","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-607-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-607-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060799","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-607-99","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-607-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60290004002","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-040-02","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (60290-040-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505257908","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2579-8","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-2579-8)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505257909","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2579-9","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (60505-2579-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051205","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-512-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-512-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051210","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-512-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-512-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051290","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-512-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-512-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084009801","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-098-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-098-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-098-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084009811","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382025010","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382025016","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377002811","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377002813","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377007811","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-078-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-078-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377007813","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-078-13","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-078-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177500","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1775-0","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1775-0)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177509","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1775-9","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (70710-1775-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024812","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-248-12","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70756-248-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024851","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-248-51","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70756-248-51)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024890","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-248-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70756-248-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002305","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-023-05","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-023-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002390","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-023-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-023-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002399","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-023-99","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-023-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028301","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-283-01","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-283-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028302","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-283-02","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-283-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028303","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-283-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-283-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040401","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040402","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-404-02","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-404-02) / 100 TABLET, FILM COATED in 1 BLISTER PACK (72603-404-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"75834025601","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-256-01","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-256-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009000210","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-002-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Quallent","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-002-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009017710","name":"ATORVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-177-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-177-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505810","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5058-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-5058-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505898","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5058-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-5058-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395205","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3952-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3952-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395277","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3952-77","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3952-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358710","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3587-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0480-3587-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358798","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3587-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3587-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629206","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6292-06","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6292-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629261","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6292-61","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6292-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013809","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-138-09","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-138-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013810","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-138-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-138-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013850","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-138-50","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-138-50)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714017501","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-175-01","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-175-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714017503","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-175-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-175-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042605","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-426-05","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-426-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042610","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-426-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-426-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042690","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-426-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-426-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031710","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-317-10","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-317-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031715","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-317-15","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-317-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031744","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-317-44","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-317-44)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094201","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-942-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-942-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094205","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-942-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-942-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094211","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-942-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-942-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094290","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-942-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Laurus Labs Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42385-942-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017410","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017490","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598010105","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-101-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-101-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598010187","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-101-87","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (43598-101-87)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598010190","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-101-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-101-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083205","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-832-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-832-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083290","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-832-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-832-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045310","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-453-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-453-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045390","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-453-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-453-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009511","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009515","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-095-15","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-095-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-095-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079021001","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079021020","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-210-20","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-210-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-210-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012305","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-123-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-123-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012390","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-123-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-123-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060890","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-608-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-608-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060899","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-608-99","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-608-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505258008","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2580-8","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-2580-8)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505258009","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2580-9","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (60505-2580-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051305","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-513-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-513-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051310","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-513-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-513-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051390","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-513-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-513-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084009901","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-099-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-099-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-099-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084009911","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382025110","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382025116","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377002911","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377002913","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377007911","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-079-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-079-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377007913","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-079-13","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-079-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177200","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1772-0","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1772-0)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177209","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1772-9","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (70710-1772-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024912","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-249-12","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70756-249-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024951","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-249-51","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70756-249-51)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756024990","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-249-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70756-249-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002405","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-024-05","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-024-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002490","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-024-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-024-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002499","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-024-99","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-024-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028401","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-284-01","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-284-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028402","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-284-02","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-284-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028403","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-284-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-284-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040501","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040502","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-405-02","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-405-02) / 100 TABLET, FILM COATED in 1 BLISTER PACK (72603-405-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"75834025701","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-257-01","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-257-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009000310","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-003-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Quallent","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-003-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009017810","name":"ATORVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-178-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-178-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505705","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5057-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-5057-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00093505798","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5057-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-5057-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395305","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3953-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3953-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378395377","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3953-77","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3953-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358810","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3588-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0480-3588-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480358898","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3588-98","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3588-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904629304","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6293-04","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6293-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013909","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-139-09","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-139-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013910","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-139-10","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-139-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16571013950","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-139-50","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-139-50)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714017601","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-176-01","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-176-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714017603","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-176-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-176-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042705","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-427-05","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-427-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042710","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-427-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-427-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722042790","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-427-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-427-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031810","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-318-10","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-318-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031815","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-318-15","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-318-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"33342031844","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-318-44","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-318-44)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094301","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-943-01","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-943-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094305","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-943-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-943-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094311","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-943-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-943-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42385094390","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-943-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Laurus Labs Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42385-943-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017510","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42571017590","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598010305","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-103-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-103-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598010387","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-103-87","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (43598-103-87)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598010390","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-103-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-103-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083305","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-833-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-833-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43598083390","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-833-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-833-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045405","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-454-05","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-454-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228045490","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-454-90","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-454-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009611","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268009612","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-096-12","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-096-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-096-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079021101","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"51079021103","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-211-03","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Institutional Inc.","package_description":"30 BLISTER PACK in 1 CARTON (51079-211-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-211-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012405","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-124-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-124-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"55111012490","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-124-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-124-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060990","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-609-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-609-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"59651060999","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-609-99","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-609-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60290004204","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-042-04","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (60290-042-04)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505267108","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2671-8","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-2671-8)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60505267109","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2671-9","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (60505-2671-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051405","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-514-05","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-514-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877051490","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-514-90","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-514-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084059025","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-590-25","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"Atorvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-590-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-590-95)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68084059095","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382025210","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382025216","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377003012","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377003014","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377008011","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-080-11","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-080-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377008013","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-080-13","proprietary_name":"Atorvastatin Calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-080-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177000","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1770-0","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1770-0)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70710177009","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1770-9","proprietary_name":"atorvastatin calcium","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (70710-1770-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756025051","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-250-51","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70756-250-51)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70756025090","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-250-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70756-250-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002505","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-025-05","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-025-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002590","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-025-90","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-025-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002599","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-025-99","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-025-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028501","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-285-01","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-285-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028502","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-285-02","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-285-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603028503","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-285-03","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-285-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040601","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603040602","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-406-02","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-406-02) / 100 TABLET, FILM COATED in 1 BLISTER PACK (72603-406-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"75834025801","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-258-01","proprietary_name":"Atorvastatin calcium","nonproprietary_name":"Atorvastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-258-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009000410","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-004-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Quallent","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-004-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009017910","name":"ATORVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-179-10","proprietary_name":"ATORVASTATIN CALCIUM","nonproprietary_name":"ATORVASTATIN CALCIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-179-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atorvastatin Calcium|Atorvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00121095608","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0956-08","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"1 BOTTLE in 1 CARTON (0121-0956-08) / 210 mL in 1 BOTTLE","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"10702022321","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-223-21","proprietary_name":"Atovaquone Oral Suspension","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"KVK-Tech, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (10702-223-21) / 210 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"31722062921","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-629-21","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-629-21) / 210 mL in 1 BOTTLE","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"62135052809","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-528-09","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"210 mL in 1 BOTTLE (62135-528-09)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"65162069388","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-693-88","proprietary_name":"ATOVAQUONE","nonproprietary_name":"ATOVAQUONE","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-693-88) / 210 mL in 1 BOTTLE","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"68462042121","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-421-21","proprietary_name":"atovaquone","nonproprietary_name":"atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"210 mL in 1 BOTTLE (68462-421-21)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"68462042169","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-421-69","proprietary_name":"atovaquone","nonproprietary_name":"atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"42 POUCH in 1 CARTON (68462-421-69) / 5 mL in 1 POUCH","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"69452025287","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-252-87","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Bionpharma Inc.","package_description":"1 BOTTLE in 1 CARTON (69452-252-87) / 210 mL in 1 BOTTLE","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"72603024801","name":"ATOVAQUONE 750 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-248-01","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-248-01) / 210 mL in 1 BOTTLE","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"00904745953","name":"ATOVAQUONE 750 MG/5 ML SUSP CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7459-53","proprietary_name":"ATOVAQUONE","nonproprietary_name":"Atovaquone Oral Suspension","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"7 TRAY in 1 CASE (0904-7459-53) / 6 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE (0904-7459-41)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"81033010442","name":"ATOVAQUONE 750 MG/5 ML SUSP CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-104-42","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Kesin Pharma","package_description":"42 CUP, UNIT-DOSE in 1 CARTON (81033-104-42) / 5 mL in 1 CUP, UNIT-DOSE (81033-104-05)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"81033010542","name":"ATOVAQUONE 750 MG/5 ML SUSP CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-105-42","proprietary_name":"Atovaquone Oral Suspension","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"Kesin Pharma Corporation","package_description":"42 CUP, UNIT-DOSE in 1 CARTON (81033-105-42) / 5 mL in 1 CUP, UNIT-DOSE (81033-105-05)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"00121101642","name":"ATOVAQUONE 750 MG/5 ML SUSPENSION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1016-42","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"7 TRAY in 1 CASE (0121-1016-42) / 6 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE (0121-1016-05)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"60687053478","name":"ATOVAQUONE 750 MG/5 ML SUSPENSION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-534-78","proprietary_name":"Atovaquone","nonproprietary_name":"Atovaquone","dosage_form":"SUSPENSION","route":"ORAL","strength":"750 mg/5mL","labeler":"American Health Packaging","package_description":"7 TRAY in 1 CASE (60687-534-78) / 6 CUP, UNIT-DOSE in 1 TRAY (60687-534-52) / 5 mL in 1 CUP, UNIT-DOSE (60687-534-40)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]"]},"nadac":{"value":0.76684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atovaquone|Atovaquone","basis":"generic"},"part_b":null}, {"ndc":"00378416201","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4162-01","proprietary_name":"Atovaquone and Proguanil Hydrochloride","nonproprietary_name":"atovaquone and proguanil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4162-01)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"66993006002","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-060-02","proprietary_name":"Atovaquone and Proguanil HCl","nonproprietary_name":"atovaquone and proguanil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-060-02)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"66993006027","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-060-27","proprietary_name":"Atovaquone and Proguanil HCl","nonproprietary_name":"atovaquone and proguanil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"Prasco Laboratories","package_description":"24 TABLET, FILM COATED in 1 DOSE PACK (66993-060-27)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68001024500","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-245-00","proprietary_name":"Atovaquone and Proguanil Hydrochloride","nonproprietary_name":"Atovaquone and Proguanil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-245-00)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68001024514","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68001024515","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-245-15","proprietary_name":"Atovaquone and Proguanil Hydrochloride","nonproprietary_name":"Atovaquone and Proguanil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"BluePoint Laboratories","package_description":"2 BLISTER PACK in 1 CARTON (68001-245-15) / 12 TABLET, FILM COATED in 1 BLISTER PACK (68001-245-14)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462040401","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-404-01","proprietary_name":"Atovaquone and Proguanil Hydrochloride","nonproprietary_name":"Atovaquone and Proguanil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-404-01)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462040444","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462040467","name":"ATOVAQUONE-PROGUANIL 250-100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-404-67","proprietary_name":"Atovaquone and Proguanil Hydrochloride","nonproprietary_name":"Atovaquone and Proguanil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 100 mg/1","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"2 BLISTER PACK in 1 CARTON (68462-404-67) / 12 TABLET, FILM COATED in 1 BLISTER PACK (68462-404-44)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":1.48584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"00378416001","name":"ATOVAQUONE-PROGUANIL 62.5-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4160-01","proprietary_name":"Atovaquone and Proguanil Hydrochloride","nonproprietary_name":"atovaquone and proguanil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"62.5 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4160-01)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":0.92749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462040201","name":"ATOVAQUONE-PROGUANIL 62.5-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-402-01","proprietary_name":"Atovaquone and Proguanil Hydrochloride Pediatric","nonproprietary_name":"Atovaquone and Proguanil Hydrochloride Pediatric","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"62.5 mg/1; 25 mg/1","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-402-01)","pharm_classes":["Antimalarial [EPC]","Antiprotozoal [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":0.92749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Atovaquone-Proguanil HCl|Atovaquone/Proguanil HCl","basis":"generic"},"part_b":null}, {"ndc":"42799082601","name":"ATROPINE 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-826-01","proprietary_name":"Atropine sulfate","nonproprietary_name":"Atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"1 BOTTLE in 1 CARTON (42799-826-01) / 2 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":11.51489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42799082602","name":"ATROPINE 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-826-02","proprietary_name":"Atropine sulfate","nonproprietary_name":"Atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"1 BOTTLE in 1 CARTON (42799-826-02) / 5 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":5.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42799082603","name":"ATROPINE 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-826-03","proprietary_name":"Atropine sulfate","nonproprietary_name":"Atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"1 BOTTLE in 1 CARTON (42799-826-03) / 15 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":4.16186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069058301","name":"ATROPINE 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-583-01","proprietary_name":"Atropine sulfate","nonproprietary_name":"Atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-583-01) / 15 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":4.16186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065081701","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0817-01","proprietary_name":"atropine sulfate","nonproprietary_name":"atropine sulfate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0817-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":10.34502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065081702","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0817-02","proprietary_name":"atropine sulfate","nonproprietary_name":"atropine sulfate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0817-02) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":19.98626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219174802","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1748-2","proprietary_name":"Atropine","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-1748-2) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":11.51489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atropine Sulfate*|Atropine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"60219174903","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1749-3","proprietary_name":"Atropine","nonproprietary_name":"atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-1749-3) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":5.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atropine Sulfate*|Atropine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"60219175008","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1750-8","proprietary_name":"Atropine","nonproprietary_name":"atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-1750-8) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":4.16186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atropine Sulfate*|Atropine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"60505622600","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6226-0","proprietary_name":"Atropine","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-6226-0) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":11.51489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atropine Sulfate*|Atropine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"60505622601","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6226-1","proprietary_name":"Atropine","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-6226-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":5.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atropine Sulfate*|Atropine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"60505622602","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6226-2","proprietary_name":"Atropine","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-6226-2) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":4.16186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Atropine Sulfate*|Atropine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"70069058101","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-581-01","proprietary_name":"Atropine sulfate","nonproprietary_name":"Atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-581-01) / 2 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":11.51489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069058201","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-582-01","proprietary_name":"Atropine sulfate","nonproprietary_name":"Atropine sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-582-01) / 5 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":5.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069071601","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-716-01","proprietary_name":"Atropine Sulfate","nonproprietary_name":"Atropine Sulfate Monohydrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-716-01) / 5 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":10.34502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065125","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-651-25","proprietary_name":"Atropine Sulfate","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-651-25) / 2 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":11.51489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065225","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-652-25","proprietary_name":"Atropine Sulfate","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-652-25) / 5 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":5.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065335","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-653-35","proprietary_name":"Atropine Sulfate","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-653-35) / 15 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":4.16186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603026401","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-264-01","proprietary_name":"Atropine Sulfate","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-264-01) / 2 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":11.51489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603026402","name":"ATROPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-264-02","proprietary_name":"Atropine Sulfate","nonproprietary_name":"Atropine Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-264-02) / 5 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":5.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00597008717","name":"ATROVENT 17 MCG HFA INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0087-17","proprietary_name":"Atrovent HFA","nonproprietary_name":"ipratropium bromide","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"17 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 CANISTER in 1 CARTON (0597-0087-17) / 200 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":22.76435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":22.10952,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Atrovent HFA|Ipratropium Bromide","basis":"brand"},"part_b":null}, {"ndc":"50102022021","name":"AUBRA EQ-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aubra Eq|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102022023","name":"AUBRA EQ-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-220-23","proprietary_name":"Aubra EQ","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 POUCH in 1 CARTON (50102-220-23) / 1 BLISTER PACK in 1 POUCH (50102-220-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aubra Eq|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862093921","name":"AUROVELA 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862093988","name":"AUROVELA 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-939-88","proprietary_name":"Aurovela 1/20","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; 20 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-939-88) / 1 BLISTER PACK in 1 POUCH / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862093521","name":"AUROVELA 21 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862093574","name":"AUROVELA 21 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-935-74","proprietary_name":"Aurovela 1.5/30","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1; 30 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-935-74) / 1 BLISTER PACK in 1 POUCH / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862093487","name":"AUROVELA 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-934-87","proprietary_name":"Aurovela 24 Fe","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"1 POUCH in 1 CARTON (65862-934-87) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862093488","name":"AUROVELA 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-934-88","proprietary_name":"Aurovela 24 Fe","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-934-88) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862094087","name":"AUROVELA FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aurovela Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"65862094088","name":"AUROVELA FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-940-88","proprietary_name":"Aurovela Fe 1/20","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-940-88) / 1 BLISTER PACK in 1 POUCH (65862-940-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aurovela Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"65862094187","name":"AUROVELA FE 1.5 MG-30 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aurovela Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"65862094188","name":"AUROVELA FE 1.5 MG-30 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-941-88","proprietary_name":"AUROVELA Fe","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-941-88) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aurovela Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"59922063101","name":"AURYXIA 210 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59922-631-01","proprietary_name":"Auryxia","nonproprietary_name":"ferric citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"210 mg/1","labeler":"Akebia Therapeutics, Inc.","package_description":"200 TABLET, FILM COATED in 1 BOTTLE (59922-631-01)","pharm_classes":["Iron [CS]","Parenteral Iron Replacement [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":7.48095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.27508,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auryxia|Ferric Citrate","basis":"brand"},"part_b":null}, {"ndc":"68546017260","name":"AUSTEDO 12 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-172-60","proprietary_name":"Austedo","nonproprietary_name":"Deutetrabenazine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"12 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (68546-172-60)"},"nadac":{"value":125.02961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546017060","name":"AUSTEDO 6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-170-60","proprietary_name":"Austedo","nonproprietary_name":"Deutetrabenazine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"6 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (68546-170-60)"},"nadac":{"value":83.20001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546017160","name":"AUSTEDO 9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-171-60","proprietary_name":"Austedo","nonproprietary_name":"Deutetrabenazine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"9 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (68546-171-60)"},"nadac":{"value":93.97081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047156","name":"AUSTEDO XR 12 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-471-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-471-56)"},"nadac":{"value":166.76453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047956","name":"AUSTEDO XR 18 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-479-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-479-56)"},"nadac":{"value":251.16057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047256","name":"AUSTEDO XR 24 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-472-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"24 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-472-56)"},"nadac":{"value":250.63121,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047356","name":"AUSTEDO XR 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-473-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-473-56)"},"nadac":{"value":332.33999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047456","name":"AUSTEDO XR 36 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-474-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-474-56)"},"nadac":{"value":416.75609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047556","name":"AUSTEDO XR 42 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-475-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"42 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-475-56)"},"nadac":{"value":498.13485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047656","name":"AUSTEDO XR 48 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-476-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"48 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-476-56)"},"nadac":{"value":500.84367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047056","name":"AUSTEDO XR 6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-470-56","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68546-470-56)"},"nadac":{"value":83.0345,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047728","name":"AUSTEDO XR TITR(12-18-24-30 MG)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68546-477-28","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Neuroscience, Inc.","package_description":"1 KIT in 1 BLISTER PACK (68546-477-28) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-192-07) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-190-07) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-193-07) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-191-07)"},"nadac":{"value":249.323,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-29","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"68546047729","name":"AUSTEDO XR TITR(12-18-24-30 MG)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68546-477-29","proprietary_name":"AUSTEDO XR","nonproprietary_name":"deutetrabenazine","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Neuroscience, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68546-477-29) / 1 KIT in 1 BLISTER PACK * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-192-07) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-190-07) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-193-07) * 7 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68546-191-07)"},"nadac":{"value":249.323,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Austedo XR|Deutetrabenazine","basis":"brand"},"part_b":null}, {"ndc":"81968004530","name":"AUVELITY ER 45-105 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81968-045-30","proprietary_name":"AUVELITY","nonproprietary_name":"dextromethorphan hydrobromide, bupropion hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"45 mg/1; 105 mg/1","labeler":"Axsome Therapeutics, Inc.","package_description":"30 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE (81968-045-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":19.89769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81968004560","name":"AUVELITY ER 45-105 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81968-045-60","proprietary_name":"AUVELITY","nonproprietary_name":"dextromethorphan hydrobromide, bupropion hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"45 mg/1; 105 mg/1","labeler":"Axsome Therapeutics, Inc.","package_description":"60 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE (81968-045-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":19.89769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60842002101","name":"AUVI-Q 0.1 MG AUTO-INJECTOR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":309.55227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auvi-Q|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"60842002102","name":"AUVI-Q 0.1 MG AUTO-INJECTOR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60842-021-02","proprietary_name":"Auvi-Q","nonproprietary_name":"epinephrine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":".1 mg/.1mL","labeler":"kaleo, Inc","package_description":"2 DOSE PACK in 1 CARTON (60842-021-02) / .1 mL in 1 DOSE PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":309.55227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auvi-Q|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"60842002201","name":"AUVI-Q 0.15 MG AUTO-INJECTOR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":309.85103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auvi-Q|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"60842002202","name":"AUVI-Q 0.15 MG AUTO-INJECTOR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60842-022-02","proprietary_name":"Auvi-Q","nonproprietary_name":"epinephrine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":".15 mg/.15mL","labeler":"kaleo, Inc","package_description":"2 DOSE PACK in 1 CARTON (60842-022-02) / .15 mL in 1 DOSE PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":309.85103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auvi-Q|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"60842002301","name":"AUVI-Q 0.3 MG AUTO-INJECTOR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":309.37573,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auvi-Q|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"60842002302","name":"AUVI-Q 0.3 MG AUTO-INJECTOR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60842-023-02","proprietary_name":"Auvi-Q","nonproprietary_name":"epinephrine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":".3 mg/.3mL","labeler":"kaleo, Inc","package_description":"2 DOSE PACK in 1 CARTON (60842-023-02) / .3 mL in 1 DOSE PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":309.37573,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Auvi-Q|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"00024585530","name":"AVALIDE 150-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0024-5855-30","proprietary_name":"Avalide","nonproprietary_name":"irbesartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Sanofi-Aventis U.S. LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0024-5855-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":8.91093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Avalide|Irbesartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"31722044230","name":"AVANAFIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-442-30","proprietary_name":"Avanafil","nonproprietary_name":"Avanafil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-442-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":49.99744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00024585130","name":"AVAPRO 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5851-30","proprietary_name":"Avapro","nonproprietary_name":"irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Sanofi-Aventis U.S. LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0024-5851-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":7.3449,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Avapro|Irbesartan","basis":"brand"},"part_b":null}, {"ndc":"00024585230","name":"AVAPRO 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5852-30","proprietary_name":"Avapro","nonproprietary_name":"irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Sanofi-Aventis U.S. LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0024-5852-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":8.79188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Avapro|Irbesartan","basis":"brand"},"part_b":null}, {"ndc":"00555904558","name":"AVIANE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9045-58","proprietary_name":"Aviane","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9045-58) / 1 BLISTER PACK in 1 POUCH (0555-9045-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aviane|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555904579","name":"AVIANE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Aviane|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"59627022205","name":"AVONEX 30 MCG/0.5 ML SYRINGE KIT (4 PACK)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59627-222-05","proprietary_name":"AVONEX","nonproprietary_name":"interferon beta-1a","dosage_form":"KIT","route":"INTRAMUSCULAR","strength":null,"labeler":"Biogen Inc.","package_description":"1 KIT in 1 CARTON (59627-222-05) * 1 SYRINGE in 1 TRAY / .5 mL in 1 SYRINGE * 4 POUCH in 1 POUCH / .4 mL in 1 POUCH"},"nadac":{"value":8776.25231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59627033304","name":"AVONEX PEN 30 MCG/0.5 ML KIT (4 PACK)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59627-333-04","proprietary_name":"AVONEX","nonproprietary_name":"interferon beta-1a","dosage_form":"KIT","route":"INTRAMUSCULAR","strength":null,"labeler":"Biogen Inc.","package_description":"1 KIT in 1 CARTON (59627-333-04) * 1 SYRINGE in 1 BOX / .5 mL in 1 SYRINGE * 4 POUCH in 1 POUCH / .4 mL in 1 POUCH"},"nadac":{"value":8772.025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862084828","name":"AYUNA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ayuna|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862084888","name":"AYUNA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-848-88","proprietary_name":"Ayuna","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-848-88) / 1 BLISTER PACK in 1 POUCH (65862-848-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ayuna|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"82584030703","name":"AZASITE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82584-307-03","proprietary_name":"AZASITE","nonproprietary_name":"azithromycin monohydrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Thea Pharma Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82584-307-03) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":98.5088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azasite|Azithromycin","basis":"brand"},"part_b":null}, {"ndc":"60219203701","name":"AZATHIOPRINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2037-1","proprietary_name":"AZATHIOPRINE","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (60219-2037-1)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":3.31459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"68382012001","name":"AZATHIOPRINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-120-01","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-120-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":3.31459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"16571083501","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-835-01","proprietary_name":"AZATHIOPRINE","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-835-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"60219107601","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1076-1","proprietary_name":"AZATHIOPRINE","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (60219-1076-1)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":{"hcpcs":"J7500","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7500 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60219-1076-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877049301","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-493-01","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-493-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":{"hcpcs":"J7500","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7500 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (67877-493-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877049305","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-493-05","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-493-05)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":{"hcpcs":"J7500","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7500 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET in 1 BOTTLE (67877-493-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084022901","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-229-01","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-229-01) / 1 TABLET in 1 BLISTER PACK (68084-229-11)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":{"hcpcs":"J7500","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7500 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (68084-229-01) / 1 TABLET in 1 BLISTER PACK (68084-229-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084022911","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"68382000301","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-003-01","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-003-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"68382000305","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-003-05","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-003-05)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"68462050201","name":"AZATHIOPRINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-502-01","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (68462-502-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":0.12428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":{"hcpcs":"J7500","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7500 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (68462-502-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60219203601","name":"AZATHIOPRINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2036-1","proprietary_name":"AZATHIOPRINE","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (60219-2036-1)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":7.65661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"68382011901","name":"AZATHIOPRINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-119-01","proprietary_name":"Azathioprine","nonproprietary_name":"Azathioprine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-119-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleosides [CS]","Purine Antimetabolite [EPC]","Purines [CS]"]},"nadac":{"value":7.65661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azathioprine|Azathioprine","basis":"generic"},"part_b":null}, {"ndc":"00591213155","name":"AZELAIC ACID 15% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2131-55","proprietary_name":"azelaic acid","nonproprietary_name":"azelaic acid","dosage_form":"GEL","route":"TOPICAL","strength":".15 g/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0591-2131-55) / 50 g in 1 TUBE","pharm_classes":["Decreased Protein Synthesis [PE]","Decreased Sebaceous Gland Activity [PE]"]},"nadac":{"value":0.44069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Azelaic Acid|Azelaic Acid","basis":"generic"},"part_b":null}, {"ndc":"00781717250","name":"AZELAIC ACID 15% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7172-50","proprietary_name":"Azelaic Acid Gel","nonproprietary_name":"azelaic acid","dosage_form":"GEL","route":"TOPICAL","strength":".15 g/g","labeler":"Sandoz Inc.","package_description":"1 TUBE in 1 CARTON (0781-7172-50) / 50 g in 1 TUBE","pharm_classes":["Decreased Protein Synthesis [PE]","Decreased Sebaceous Gland Activity [PE]"]},"nadac":{"value":0.44069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Azelaic Acid|Azelaic Acid","basis":"generic"},"part_b":null}, {"ndc":"21922003814","name":"AZELAIC ACID 15% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-038-14","proprietary_name":"Azelaic Acid Gel","nonproprietary_name":"Azelaic Acid","dosage_form":"GEL","route":"TOPICAL","strength":".15 g/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-038-14) / 50 g in 1 TUBE","pharm_classes":["Decreased Protein Synthesis [PE]","Decreased Sebaceous Gland Activity [PE]"]},"nadac":{"value":0.44069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Azelaic Acid|Azelaic Acid","basis":"generic"},"part_b":null}, {"ndc":"51672138903","name":"AZELAIC ACID 15% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1389-3","proprietary_name":"Azelaic Acid","nonproprietary_name":"Azelaic Acid","dosage_form":"GEL","route":"TOPICAL","strength":".15 g/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1389-3) / 50 g in 1 TUBE","pharm_classes":["Decreased Protein Synthesis [PE]","Decreased Sebaceous Gland Activity [PE]"]},"nadac":{"value":0.44069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Azelaic Acid|Azelaic Acid","basis":"generic"},"part_b":null}, {"ndc":"68462062652","name":"AZELAIC ACID 15% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-626-52","proprietary_name":"azelaic acid","nonproprietary_name":"azelaic acid","dosage_form":"GEL","route":"TOPICAL","strength":".15 g/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-626-52) / 50 g in 1 TUBE","pharm_classes":["Decreased Protein Synthesis [PE]","Decreased Sebaceous Gland Activity [PE]"]},"nadac":{"value":0.44069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Azelaic Acid|Azelaic Acid","basis":"generic"},"part_b":null}, {"ndc":"00378345823","name":"AZELASTIN-FLUTIC 137-50 MCG SPR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3458-23","proprietary_name":"Azelastine Hydrochloride and Fluticasone Propionate","nonproprietary_name":"Azelastine Hydrochloride and Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1; 50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 BOX (0378-3458-23) / 120 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":2.021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00480215757","name":"AZELASTIN-FLUTIC 137-50 MCG SPR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2157-57","proprietary_name":"Azelastine Hydrochloride and Fluticasone Propionate","nonproprietary_name":"Azelastine Hydrochloride and Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1; 50 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0480-2157-57) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":2.021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006601","name":"AZELASTIN-FLUTIC 137-50 MCG SPR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-066-01","proprietary_name":"AZELASTINE HYDROCHLORIDE AND FLUTICASONE PROPIONATE","nonproprietary_name":"azelastine hydrochloride, fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1; 50 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-066-01) / 120 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":2.021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"60505095303","name":"AZELASTIN-FLUTIC 137-50 MCG SPR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0953-3","proprietary_name":"Azelastine hydrochloride and Fluticasone propionate","nonproprietary_name":"Azelastine hydrochloride and Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1; 50 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-0953-3) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":2.021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651021430","name":"AZELASTINE 0.1% (137 MCG) SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-214-30","proprietary_name":"AZELASTINE HYDROCHLORIDE","nonproprietary_name":"AZELASTINE HYDROCHLORIDE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE, SPRAY in 1 CARTON (59651-214-30) / 200 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.27283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azelastine HCl*|Azelastine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505083305","name":"AZELASTINE 0.1% (137 MCG) SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0833-5","proprietary_name":"Azelastine Hydrochloride","nonproprietary_name":"azelastine hydrochloride","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-0833-5) / 200 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.27283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azelastine HCl*|Azelastine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162067684","name":"AZELASTINE 0.1% (137 MCG) SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-676-84","proprietary_name":"Azelastine Hydrochloride","nonproprietary_name":"Azelastine","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (65162-676-84) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.27283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azelastine HCl*|Azelastine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877047750","name":"AZELASTINE 0.1% (137 MCG) SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-477-50","proprietary_name":"Azelastine","nonproprietary_name":"Azelastine","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1","labeler":"Ascend Laboratories, LLC","package_description":"1 SPRAY, METERED in 1 BOTTLE (67877-477-50)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.27283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azelastine HCl*|Azelastine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603061101","name":"AZELASTINE 0.1% (137 MCG) SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-611-01","proprietary_name":"AZELASTINE HYDROCHLORIDE","nonproprietary_name":"AZELASTINE HYDROCHLORIDE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (72603-611-01) / 200 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.27283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azelastine HCl*|Azelastine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505057804","name":"AZELASTINE HCL 0.05% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0578-4","proprietary_name":"AZELASTINE HYDROCHLORIDE","nonproprietary_name":"AZELASTINE HYDROCHLORIDE","dosage_form":"SOLUTION/ DROPS","route":"INTRAOCULAR","strength":".5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60505-0578-4) / 6 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.01239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314030802","name":"AZELASTINE HCL 0.05% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-308-02","proprietary_name":"Azelastine Hydrochloride","nonproprietary_name":"azelastine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"INTRAOCULAR","strength":".5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-308-02) / 6 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.01239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332050606","name":"AZELASTINE HCL 0.05% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-506-06","proprietary_name":"Azelastine Hydrochloride Ophthalmic Solution 0.05%","nonproprietary_name":"Azelastine Hydrochloride Ophthalmic Solution 0.05%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-506-06) / 6 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.01239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069009101","name":"AZELASTINE HCL 0.05% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-091-01","proprietary_name":"Azelastine Hydrochloride","nonproprietary_name":"Azelastine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-091-01) / 6 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.01239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72266014101","name":"AZELASTINE HCL 0.05% DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-141-01","proprietary_name":"Azelastine Hydrochloride","nonproprietary_name":"Azelastine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"INTRAOCULAR","strength":".5 mg/mL","labeler":"Fosun Pharma USA Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (72266-141-01) / 6 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.01239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68546014256","name":"AZILECT 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68546-142-56","proprietary_name":"Azilect","nonproprietary_name":"Rasagiline mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Neuroscience, Inc.","package_description":"30 TABLET in 1 BOTTLE (68546-142-56)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":44.04633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azilect|Rasagiline Mesylate","basis":"brand"},"part_b":null}, {"ndc":"52536000403","name":"AZILSARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-004-03","proprietary_name":"Azilsartan Medoxomil","nonproprietary_name":"Azilsartan kamedoxomil","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-004-03)","pharm_classes":["Angiotensin 2 Receptor Blocker [EPC]","Angiotensin 2 Type 1 Receptor Antagonists [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":5.46667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536000803","name":"AZILSARTAN MEDOXOMIL 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-008-03","proprietary_name":"Azilsartan Medoxomil","nonproprietary_name":"Azilsartan kamedoxomil","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-008-03)","pharm_classes":["Angiotensin 2 Receptor Blocker [EPC]","Angiotensin 2 Type 1 Receptor Antagonists [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":5.81043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093202723","name":"AZITHROMYCIN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2027-23","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"15 mL in 1 BOTTLE (0093-2027-23)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.37021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11788012813","name":"AZITHROMYCIN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-128-13","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (11788-128-13) / 15 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.37021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42806014731","name":"AZITHROMYCIN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-147-31","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Epic Pharma, LLC","package_description":"15 mL in 1 BOTTLE, PLASTIC (42806-147-31)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.37021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651000715","name":"AZITHROMYCIN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-007-15","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-007-15) / 15 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.37021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710145701","name":"AZITHROMYCIN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1457-1","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1457-1) / 15 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.37021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093202623","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2026-23","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"15 mL in 1 BOTTLE (0093-2026-23)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.28536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093202631","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2026-31","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 mL in 1 BOTTLE (0093-2026-31)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093202694","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2026-94","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"22.5 mL in 1 BOTTLE (0093-2026-94)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.23793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11788012913","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-129-13","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (11788-129-13) / 15 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.28536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11788012914","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-129-14","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (11788-129-14) / 22.5 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.23793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11788012915","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-129-15","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (11788-129-15) / 30 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24658070632","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-706-32","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"AZITHROMYCIN","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"15 mL in 1 BOTTLE, PLASTIC (24658-706-32)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.28536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24658070733","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-707-33","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"AZITHROMYCIN","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"22.5 mL in 1 BOTTLE, PLASTIC (24658-707-33)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.23793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24658070834","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-708-34","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"AZITHROMYCIN","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"30 mL in 1 BOTTLE, PLASTIC (24658-708-34)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42806014932","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-149-32","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Epic Pharma, LLC","package_description":"15 mL in 1 BOTTLE, PLASTIC (42806-149-32)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.28536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42806015033","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-150-33","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Epic Pharma, LLC","package_description":"22.5 mL in 1 BOTTLE, PLASTIC (42806-150-33)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.23793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42806015134","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-151-34","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Epic Pharma, LLC","package_description":"30 mL in 1 BOTTLE, PLASTIC (42806-151-34)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651000815","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-008-15","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-008-15) / 15 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.28536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651000823","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-008-23","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-008-23) / 22.5 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.23793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651000830","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-008-30","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-008-30) / 30 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135070543","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-705-43","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"30 mL in 1 BOTTLE (62135-705-43)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710145802","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1458-2","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1458-2) / 15 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.28536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710145902","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1459-2","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1459-2) / 22.5 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.23793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710146002","name":"AZITHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1460-2","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1460-2) / 30 mL in 1 BOTTLE","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.20465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527237020","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2370-20","proprietary_name":"azithromycin","nonproprietary_name":"AZITHROMYCIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lannett Company, Inc.","package_description":"6 TABLET, FILM COATED in 1 BLISTER PACK (0527-2370-20)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527237032","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2370-32","proprietary_name":"azithromycin","nonproprietary_name":"AZITHROMYCIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0527-2370-32)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781808926","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8089-26","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"6 DOSE PACK in 1 CARTON (0781-8089-26) / 1 TABLET, FILM COATED in 1 DOSE PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781808931","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8089-31","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-8089-31)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904735006","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7350-06","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7350-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904735061","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7350-61","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7350-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078710","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-787-10","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50111-787-10)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078751","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-787-51","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (50111-787-51) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078766","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-787-66","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 CARTON in 1 PACKAGE (50111-787-66) / 1 BLISTER PACK in 1 CARTON / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268007411","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268007415","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-074-15","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin Dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-074-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-074-11)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687074201","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-742-01","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-742-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-742-11)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687074211","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687074265","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-742-65","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-742-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-742-11)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332025118","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-251-18","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"18 BLISTER PACK in 1 CARTON (62332-251-18) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332025130","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-251-30","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-251-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064130","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-641-30","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-641-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064163","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-641-63","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-641-63) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064169","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-641-69","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-641-69) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094090006","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-900-06","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin Dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Precision Dose, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68094-900-06) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094090018","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-900-18","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin Dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Precision Dose, Inc.","package_description":"3 CARTON in 1 BOX (68094-900-18) / 1 BLISTER PACK in 1 CARTON / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094090030","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-900-30","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin Dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Precision Dose, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68094-900-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094090050","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-900-50","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin Dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68094-900-50)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180086106","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-861-06","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 CONTAINER (68180-861-06)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180086111","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-861-11","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"6 TABLET, FILM COATED in 1 BLISTER PACK (68180-861-11)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017104","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-171-04","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-171-04) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017113","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-171-13","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69452-171-13)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017173","name":"AZITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-171-73","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"3 BLISTER PACK in 1 CARTON (69452-171-73) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.26557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527239519","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2395-19","proprietary_name":"azithromycin","nonproprietary_name":"AZITHROMYCIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0527-2395-19) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527239532","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2395-32","proprietary_name":"azithromycin","nonproprietary_name":"AZITHROMYCIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0527-2395-32)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781809003","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8090-03","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"1 DOSE PACK in 1 CARTON (0781-8090-03) / 3 TABLET, FILM COATED in 1 DOSE PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781809031","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8090-31","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-8090-31)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904735104","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7351-04","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7351-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078810","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-788-10","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50111-788-10)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078855","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-788-55","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (50111-788-55) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078867","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-788-67","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 CARTON in 1 PACKAGE (50111-788-67) / 1 BLISTER PACK in 1 CARTON / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687075311","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687075321","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-753-21","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-753-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-753-11)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332025209","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-252-09","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (62332-252-09) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332025230","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-252-30","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-252-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064230","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-642-30","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-642-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064264","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-642-64","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-642-64) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064290","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-642-90","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-642-90) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094079903","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-799-03","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68094-799-03) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094079909","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-799-09","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"3 CARTON in 1 BOX (68094-799-09) / 1 BLISTER PACK in 1 CARTON / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094079930","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-799-30","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68094-799-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094079950","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-799-50","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68094-799-50)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180086206","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-862-06","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 CONTAINER (68180-862-06)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180086211","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-862-11","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-862-11) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017213","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-172-13","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69452-172-13)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017272","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-172-72","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Bionpharma Inc.","package_description":"3 BLISTER PACK in 1 CARTON (69452-172-72) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017274","name":"AZITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-172-74","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-172-74) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.54094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781809131","name":"AZITHROMYCIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8091-31","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-8091-31)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.71481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111078910","name":"AZITHROMYCIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-789-10","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50111-789-10)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.71481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332025330","name":"AZITHROMYCIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-253-30","proprietary_name":"AZITHROMYCIN","nonproprietary_name":"AZITHROMYCIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-253-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.71481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094069030","name":"AZITHROMYCIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-690-30","proprietary_name":"Azithromycin Dihydrate","nonproprietary_name":"Azithromycin dihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Precision Dose, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68094-690-30)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.71481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180086306","name":"AZITHROMYCIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-863-06","proprietary_name":"azithromycin","nonproprietary_name":"azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 CONTAINER (68180-863-06)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.71481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452017313","name":"AZITHROMYCIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-173-13","proprietary_name":"Azithromycin","nonproprietary_name":"Azithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69452-173-13)","pharm_classes":["Macrolide Antimicrobial [EPC]","Macrolides [CS]"]},"nadac":{"value":0.71481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66758008570","name":"AZOPT 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-085-70","proprietary_name":"Azopt","nonproprietary_name":"brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (66758-085-70) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":35.06272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":8.52641,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azopt|Brinzolamide","basis":"brand"},"part_b":null}, {"ndc":"66758008585","name":"AZOPT 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-085-85","proprietary_name":"Azopt","nonproprietary_name":"brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (66758-085-85) / 15 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":35.29803,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":9.474,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Azopt|Brinzolamide","basis":"brand"},"part_b":null}, {"ndc":"00713087330","name":"AZOR 10-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0873-30","proprietary_name":"Azor","nonproprietary_name":"amlodipine besylate and olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0873-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":19.53822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.29874,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azor|Amlodipine Bes/Olmesartan Med","basis":"brand"},"part_b":null}, {"ndc":"00713087030","name":"AZOR 5-20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0870-30","proprietary_name":"Azor","nonproprietary_name":"amlodipine besylate and olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 20 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0870-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":15.32433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.21854,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azor|Amlodipine Bes/Olmesartan Med","basis":"brand"},"part_b":null}, {"ndc":"00713087230","name":"AZOR 5-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0872-30","proprietary_name":"Azor","nonproprietary_name":"amlodipine besylate and olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 40 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0872-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":19.63458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31873,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azor|Amlodipine Bes/Olmesartan Med","basis":"brand"},"part_b":null}, {"ndc":"65038028699","name":"AZSTARYS 26.1 MG-5.2 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65038-286-99","proprietary_name":"AZSTARYS","nonproprietary_name":"Serdexmethylphenidate and Dexmethylphenidate","dosage_form":"CAPSULE","route":"ORAL","strength":"26.1 mg/1; 5.2 mg/1","labeler":"Commave Sub, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (65038-286-99)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.40113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65038042999","name":"AZSTARYS 39.2 MG-7.8 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65038-429-99","proprietary_name":"AZSTARYS","nonproprietary_name":"Serdexmethylphenidate and Dexmethylphenidate","dosage_form":"CAPSULE","route":"ORAL","strength":"39.2 mg/1; 7.8 mg/1","labeler":"Commave Sub, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (65038-429-99)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.41843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65038056199","name":"AZSTARYS 52.3 MG-10.4 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65038-561-99","proprietary_name":"AZSTARYS","nonproprietary_name":"Serdexmethylphenidate and Dexmethylphenidate","dosage_form":"CAPSULE","route":"ORAL","strength":"52.3 mg/1; 10.4 mg/1","labeler":"Commave Sub, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (65038-561-99)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.41261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907009128","name":"AZURETTE 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-091-28","proprietary_name":"Azurette","nonproprietary_name":"desogestrel/ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-091-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azurette|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907009162","name":"AZURETTE 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-091-62","proprietary_name":"Azurette","nonproprietary_name":"desogestrel/ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"6 BLISTER PACK in 1 CARTON (75907-091-62) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Azurette|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70000007901","name":"BABY SKIN PROTECTANT 41% OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0079-1","proprietary_name":"Leader Baby Skin Protectant","nonproprietary_name":"Baby Skin Protectant","dosage_form":"OINTMENT","route":"TOPICAL","strength":"41 g/100g","labeler":"Cardinal Health","package_description":"85 g in 1 TUBE (70000-0079-1)"},"nadac":{"value":0.05424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536125628","name":"BACITRACIN 500 UNIT/GM OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1256-28","proprietary_name":"Bacitracin","nonproprietary_name":"BACITRACIN","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 U/g","labeler":"RUGBY LABORATORIES","package_description":"30 g in 1 BOX (0536-1256-28)","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.05506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713028031","name":"BACITRACIN 500 UNIT/GM OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0280-31","proprietary_name":"Bacitracin","nonproprietary_name":"Bacitracin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"28.4 g in 1 TUBE (0713-0280-31)","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.07349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006001","name":"BACITRACIN 500 UNIT/GM OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-060-01","proprietary_name":"Bacitracin","nonproprietary_name":"Bacitracin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-060-01) / 14 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.11735,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006003","name":"BACITRACIN 500 UNIT/GM OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-060-03","proprietary_name":"Bacitracin","nonproprietary_name":"Bacitracin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-060-03) / 28 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.0787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001047746","name":"BACITRACIN 500 UNIT/GM OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-477-46","proprietary_name":"Bacitracin","nonproprietary_name":"Bacitracin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [iU]/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-477-46) / 14.2 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.09366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001047747","name":"BACITRACIN 500 UNIT/GM OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-477-47","proprietary_name":"Bacitracin","nonproprietary_name":"Bacitracin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [iU]/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-477-47) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.07349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536126328","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1263-28","proprietary_name":"Bacitracin Zinc","nonproprietary_name":"Bacitracin Zinc","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1263-28) / 28 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.0742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922009105","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-091-05","proprietary_name":"BACITRACIN ZINC","nonproprietary_name":"first aid antibiotic","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-091-05) / 28 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.0742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385006003","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-060-03","proprietary_name":"Good Neighbor Pharmacy Bacitracin Zinc","nonproprietary_name":"Bacitracin Zinc","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [iU]/g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-060-03) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672207501","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2075-1","proprietary_name":"Bacitracin Zinc","nonproprietary_name":"Bacitracin Zinc","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2075-1) / 15 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.18628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672207502","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2075-2","proprietary_name":"Bacitracin Zinc","nonproprietary_name":"Bacitracin Zinc","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2075-2) / 30 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001053145","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-531-45","proprietary_name":"Bacitracin Zinc","nonproprietary_name":"First Aid Antibiotic","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-531-45) / 14.2 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.18628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001053146","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-531-46","proprietary_name":"Bacitracin Zinc","nonproprietary_name":"First Aid Antibiotic","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-531-46) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000054701","name":"BACITRACIN ZN 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0547-1","proprietary_name":"Leader Bacitracin Zinc","nonproprietary_name":"Bacitracin Zinc","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"Cardinal Health 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0547-1) / 28 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.0742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208055555","name":"BACITRACIN-POLYMYXIN EYE OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-555-55","proprietary_name":"Bacitracin Zinc and Polymyxin B Sulfate","nonproprietary_name":"Bacitracin Zinc and Polymyxin B Sulfate","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"500 [USP'U]/g; 10000 [USP'U]/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-555-55) / 3.5 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":2.77554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000012702","name":"BACK-BODY PAIN 500-32.5 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0127-2","proprietary_name":"Back and Body Extra Strength","nonproprietary_name":"Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 32.5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0127-2) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.04217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00172409660","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-4096-60","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-4096-60)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00172409680","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-4096-80","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-4096-80)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00527133001","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1330-01","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0527-1330-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00527133010","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1330-10","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0527-1330-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00603240621","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2406-21","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2406-21)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00603240628","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2406-28","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0603-2406-28)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00603240632","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2406-32","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-2406-32)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00832105410","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1054-10","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1054-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00832105411","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1054-11","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1054-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00832105415","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1054-15","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (0832-1054-15)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00904647561","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6475-61","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6475-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00904755261","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7552-61","proprietary_name":"BACLOFEN","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-7552-61) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571017101","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-171-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-171-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571017110","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-171-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-171-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571017150","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-171-50","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-171-50)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16714007104","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-071-04","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-071-04)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16714007106","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-071-06","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (16714-071-06)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"29300034301","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-343-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-343-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"29300034310","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-343-10","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-343-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"31722099801","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722099810","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268010611","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-106","inner_of":["50268-106-15"]},"part_b":null}, {"ndc":"50268010615","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-106-15","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-106-15) / 1 TABLET in 1 BLISTER PACK (50268-106-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817032000","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-320-00","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-320-00)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817032010","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-320-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET in 1 BOTTLE (52817-320-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817032050","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-320-50","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma LLC","package_description":"500 TABLET in 1 BOTTLE (52817-320-50)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657073101","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-731-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-731-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657073110","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-731-10","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-731-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093101","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-931-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"10 BLISTER PACK in 1 CARTON (58657-931-01) / 10 TABLET in 1 BLISTER PACK (58657-931-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093105","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-931-05","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"5 BLISTER PACK in 1 CARTON (58657-931-05) / 10 TABLET in 1 BLISTER PACK (58657-931-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093110","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"58657-931","inner_of":["58657-931-01","58657-931-05"]},"part_b":null}, {"ndc":"59651039401","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-394-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-394-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"59651039405","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-394-05","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-394-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"59651039499","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-394-99","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-394-99)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"60687081501","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-815-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-815-01) / 1 TABLET in 1 BLISTER PACK (60687-815-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"60687081511","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-815","inner_of":["60687-815-01","60687-815-65"]},"part_b":null}, {"ndc":"60687081565","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-815-65","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-815-65) / 1 TABLET in 1 BLISTER PACK (60687-815-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"62135047305","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-473-05","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-473-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"62135047390","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-473-90","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-473-90)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70512078210","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-782-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70512-782-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710128500","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1285-0","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1285-0)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710128501","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1285-1","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1285-1)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710128505","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1285-5","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (70710-1285-5)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70756028811","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-288-11","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-288-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70756028812","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-288-12","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-288-12)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"71930000612","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-006-12","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-006-12)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"71930000613","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-006-13","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Eywa Pharma Inc","package_description":"1000 TABLET in 1 BOTTLE (71930-006-13)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888001000","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-010-00","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (72888-010-00)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888001001","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-010-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-010-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888001005","name":"BACLOFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-010-05","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-010-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817062008","name":"BACLOFEN 10 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-620-08","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"TRUPHARMA, LLC","package_description":"237 mL in 1 BOTTLE (52817-620-08)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":2.04441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888046602","name":"BACLOFEN 10 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-466-02","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Advagen Pharma Ltd.,","package_description":"237 mL in 1 BOTTLE (72888-466-02)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":2.04441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52817031810","name":"BACLOFEN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-318-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET in 1 BOTTLE (52817-318-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":1.66662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710166601","name":"BACLOFEN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1666-1","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1666-1)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":1.66662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00172409760","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-4097-60","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-4097-60)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00172409780","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-4097-80","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-4097-80)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00527133701","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1337-01","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0527-1337-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00527133705","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1337-05","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0527-1337-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00527133710","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1337-10","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0527-1337-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00603240721","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2407-21","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2407-21)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00603240728","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2407-28","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0603-2407-28)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00904647661","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6476-61","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6476-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00904755361","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7553-61","proprietary_name":"BACLOFEN","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-7553-61) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571017201","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-172-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-172-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571017210","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-172-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-172-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571017250","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-172-50","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-172-50)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16714007204","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-072-04","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-072-04)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16714007205","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-072-05","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Northstar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-072-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"29300034401","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-344-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-344-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"29300034410","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-344-10","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-344-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"31722099901","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722099905","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722099910","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268010711","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-107","inner_of":["50268-107-15"]},"part_b":null}, {"ndc":"50268010715","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-107-15","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-107-15) / 1 TABLET in 1 BLISTER PACK (50268-107-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817032100","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-321-00","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"TruPharma LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-321-00)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817032110","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-321-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET in 1 BOTTLE (52817-321-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817032150","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-321-50","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"TruPharma LLC","package_description":"500 TABLET in 1 BOTTLE (52817-321-50)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657073201","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-732-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-732-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657073210","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-732-10","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-732-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093201","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-932-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"10 BLISTER PACK in 1 CARTON (58657-932-01) / 10 TABLET in 1 BLISTER PACK (58657-932-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093205","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-932-05","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"5 BLISTER PACK in 1 CARTON (58657-932-05) / 10 TABLET in 1 BLISTER PACK (58657-932-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093210","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"58657-932","inner_of":["58657-932-01","58657-932-05"]},"part_b":null}, {"ndc":"59651039501","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-395-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-395-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"59651039505","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-395-05","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-395-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"59651039599","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-395-99","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-395-99)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"60687082601","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-826-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-826-01) / 1 TABLET in 1 BLISTER PACK (60687-826-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"60687082611","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-826","inner_of":["60687-826-01"]},"part_b":null}, {"ndc":"62135047405","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-474-05","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-474-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"62135047490","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-474-90","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-474-90)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710128600","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1286-0","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1286-0)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710128601","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1286-1","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1286-1)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710128605","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1286-5","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (70710-1286-5)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70756028911","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-289-11","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-289-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70756028912","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-289-12","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-289-12)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70756028951","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-289-51","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70756-289-51)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"71930000712","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-007-12","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-007-12)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"71930000713","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-007-13","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Eywa Pharma Inc","package_description":"1000 TABLET in 1 BOTTLE (71930-007-13)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888001100","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-011-00","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (72888-011-00)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888001101","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-011-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-011-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888001105","name":"BACLOFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-011-05","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-011-05)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.05185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52536060011","name":"BACLOFEN 25 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-600-11","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"5 mg/mL","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52536-600-11) / 120 mL in 1 BOTTLE","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":3.76436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536060012","name":"BACLOFEN 25 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-600-12","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"5 mg/mL","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52536-600-12) / 300 mL in 1 BOTTLE","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":3.78853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559020403","name":"BACLOFEN 25 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-204-03","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"5 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (62559-204-03) / 300 mL in 1 BOTTLE","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":3.78853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559020412","name":"BACLOFEN 25 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-204-12","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"5 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (62559-204-12) / 120 mL in 1 BOTTLE","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":3.76436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527133301","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1333-01","proprietary_name":"Baclofen","nonproprietary_name":"baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0527-1333-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"00904755806","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7558-06","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7558-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"16571016901","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-169-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-169-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"29300047401","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-474-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-474-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"31722013801","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268010511","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-105","inner_of":["50268-105-15"]},"part_b":null}, {"ndc":"50268010515","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-105-15","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-105-15) / 1 TABLET in 1 BLISTER PACK (50268-105-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"52817031910","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-319-10","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET in 1 BOTTLE (52817-319-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657073001","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-730-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-730-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093001","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-930-01","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"10 BLISTER PACK in 1 CARTON (58657-930-01) / 10 TABLET in 1 BLISTER PACK (58657-930-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093005","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-930-05","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"5 BLISTER PACK in 1 CARTON (58657-930-05) / 10 TABLET in 1 BLISTER PACK (58657-930-10)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"58657093010","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"58657-930","inner_of":["58657-930-01","58657-930-05"]},"part_b":null}, {"ndc":"60687080411","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-804","inner_of":["60687-804-65"]},"part_b":null}, {"ndc":"60687080465","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-804-65","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-804-65) / 1 TABLET in 1 BLISTER PACK (60687-804-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"62135047290","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-472-90","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-472-90)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70710160901","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1609-1","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1609-1)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"70756008511","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-085-11","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-085-11)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"71930006612","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-066-12","proprietary_name":"Baclofen","nonproprietary_name":"Baclofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-066-12)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888000901","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-009-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-009-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"84386003501","name":"BACLOFEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-035-01","proprietary_name":"BACLOFEN","nonproprietary_name":"BACLOFEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (84386-035-01)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.06798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baclofen*|Baclofen","basis":"generic"},"part_b":null}, {"ndc":"72888010324","name":"BACLOFEN 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-103-24","proprietary_name":"BACLOFEN","nonproprietary_name":"Baclofen","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Advagen Pharma Ltd","package_description":"473 mL in 1 BOTTLE (72888-103-24)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":1.07017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73352010316","name":"BACLOFEN 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-103-16","proprietary_name":"BACLOFEN","nonproprietary_name":"Baclofen","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Trifluent Pharma, LLC","package_description":"473 mL in 1 BOTTLE (73352-103-16)","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":1.07017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409196605","name":"BACTERIOSTATIC SALINE VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-1966-05","proprietary_name":"BACTERIOSTATIC SODIUM CHLORIDE","nonproprietary_name":"SODIUM CHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"9 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0409-1966-05) / 20 mL in 1 VIAL, MULTI-DOSE (0409-1966-01)"},"nadac":{"value":0.06728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409397703","name":"BACTERIOSTATIC WATER VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3977-03","proprietary_name":"Bacteriostatic Water","nonproprietary_name":"Bacteriostatic Water","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mL/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0409-3977-03) / 30 mL in 1 VIAL, MULTI-DOSE (0409-3977-01)"},"nadac":{"value":0.19238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75854060203","name":"BALCOLTRA TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"75854-602-03","proprietary_name":"Balcoltra","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Avion Pharmaceuticals","package_description":"3 BLISTER PACK in 1 CARTON (75854-602-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":10.03814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balcoltra|Levonorgest/Eth.Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"75854060228","name":"BALCOLTRA TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"75854-602-28","proprietary_name":"Balcoltra","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Avion Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (75854-602-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":10.03814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balcoltra|Levonorgest/Eth.Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"00054007928","name":"BALSALAZIDE DISODIUM 750 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0079-28","proprietary_name":"Balsalazide Disodium","nonproprietary_name":"Balsalazide Disodium","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"280 CAPSULE in 1 BOTTLE (0054-0079-28)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.34426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balsalazide Disodium|Balsalazide Disodium","basis":"generic"},"part_b":null}, {"ndc":"50268010211","name":"BALSALAZIDE DISODIUM 750 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balsalazide Disodium|Balsalazide Disodium","basis":"generic"},"part_b":null}, {"ndc":"50268010213","name":"BALSALAZIDE DISODIUM 750 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-102-13","proprietary_name":"Balsalazide Disodium","nonproprietary_name":"Balsalazide Disodium","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-102-13) / 1 CAPSULE in 1 BLISTER PACK (50268-102-11)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.34426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balsalazide Disodium|Balsalazide Disodium","basis":"generic"},"part_b":null}, {"ndc":"60505257507","name":"BALSALAZIDE DISODIUM 750 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2575-7","proprietary_name":"Balsalazide Disodium","nonproprietary_name":"Balsalazide Disodium","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Apotex Corp.","package_description":"280 CAPSULE in 1 BOTTLE (60505-2575-7)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.34426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balsalazide Disodium|Balsalazide Disodium","basis":"generic"},"part_b":null}, {"ndc":"70710162601","name":"BALSALAZIDE DISODIUM 750 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1626-1","proprietary_name":"balsalazide disodium","nonproprietary_name":"balsalazide disodium","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"280 CAPSULE in 1 BOTTLE (70710-1626-1)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.34426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balsalazide Disodium|Balsalazide Disodium","basis":"generic"},"part_b":null}, {"ndc":"80005012625","name":"BALSALAZIDE DISODIUM 750 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-126-25","proprietary_name":"balsalazide disodium","nonproprietary_name":"balsalazide disodium","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Carnegie Pharmaceuticals, LLC","package_description":"280 CAPSULE in 1 BOTTLE (80005-126-25)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.34426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balsalazide Disodium|Balsalazide Disodium","basis":"generic"},"part_b":null}, {"ndc":"00555903458","name":"BALZIVA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9034-58","proprietary_name":"Balziva","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9034-58) / 1 BLISTER PACK in 1 POUCH (0555-9034-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balziva|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555903479","name":"BALZIVA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Balziva|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00904723724","name":"BANOPHEN 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7237-24","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-7237-24) / 12 CAPSULE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904723760","name":"BANOPHEN 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7237-60","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (0904-7237-60)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904723761","name":"BANOPHEN 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7237-61","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-7237-61) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904723780","name":"BANOPHEN 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7237-80","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 CAPSULE in 1 BOTTLE (0904-7237-80)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904555124","name":"BANOPHEN 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5551-24","proprietary_name":"Banophen","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-5551-24) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904555159","name":"BANOPHEN 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5551-59","proprietary_name":"Banophen","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-5551-59) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904530760","name":"BANOPHEN 50 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5307-60","proprietary_name":"Banophen","nonproprietary_name":"diphenhydramine hcl","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (0904-5307-60)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904530780","name":"BANOPHEN 50 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5307-80","proprietary_name":"Banophen","nonproprietary_name":"diphenhydramine hcl","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 CAPSULE in 1 BOTTLE (0904-5307-80)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904535431","name":"BANOPHEN ANTI-ITCH 2% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5354-31","proprietary_name":"Banophen","nonproprietary_name":"Diphenhydramine Hydrochloride, Zinc Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g; .1 g/100g","labeler":"Major Pharmaceuticals","package_description":"1 TUBE in 1 CARTON (0904-5354-31) / 28 g in 1 TUBE","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62856058252","name":"BANZEL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-582-52","proprietary_name":"Banzel","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Eisai Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62856-582-52)"},"nadac":{"value":12.61034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62856058446","name":"BANZEL 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-584-46","proprietary_name":"Banzel","nonproprietary_name":"rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Eisai Inc.","package_description":"1 BOTTLE in 1 CARTON (62856-584-46) / 460 mL in 1 BOTTLE"},"nadac":{"value":3.64872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62856058352","name":"BANZEL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-583-52","proprietary_name":"Banzel","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Eisai Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62856-583-52)"},"nadac":{"value":25.18264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00548835112","name":"BAQSIMI 3 MG SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":292.98014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baqsimi|Glucagon","basis":"brand"},"part_b":null}, {"ndc":"00548835101","name":"BAQSIMI 3 MG SPRAY ONE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-8351-01","proprietary_name":"Baqsimi","nonproprietary_name":"glucagon","dosage_form":"POWDER","route":"NASAL","strength":"3 mg/1","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0548-8351-01) / 1 BOTTLE, UNIT-DOSE in 1 TUBE / 1 POWDER in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":292.98014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baqsimi|Glucagon","basis":"brand"},"part_b":null}, {"ndc":"00548835202","name":"BAQSIMI 3 MG SPRAY TWO PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-8352-02","proprietary_name":"Baqsimi","nonproprietary_name":"glucagon","dosage_form":"POWDER","route":"NASAL","strength":"3 mg/1","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"2 TUBE in 1 CARTON (0548-8352-02) / 1 BOTTLE, UNIT-DOSE in 1 TUBE / 1 POWDER in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":293.03517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baqsimi|Glucagon","basis":"brand"},"part_b":null}, {"ndc":"00003161112","name":"BARACLUDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0003-1611-12","proprietary_name":"BARACLUDE","nonproprietary_name":"entecavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 BOTTLE in 1 CARTON (0003-1611-12) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":44.18654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Baraclude|Entecavir","basis":"brand"},"part_b":null}, {"ndc":"00002771559","name":"BASAGLAR 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7715-59","proprietary_name":"BASAGLAR KwikPen","nonproprietary_name":"Insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-7715-59) / 3 mL in 1 SYRINGE (0002-7715-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":20.93507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00052060201","name":"BCG (TICE STRAIN) VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","5"],"carried_forward":false,"identity":null,"nadac":{"value":187.77376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-26","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00052060202","name":"BCG (TICE STRAIN) VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0052-0602-02","proprietary_name":"TICE BCG","nonproprietary_name":"BACILLUS CALMETTE-GUERIN","dosage_form":"POWDER, FOR SUSPENSION","route":"INTRAVESICAL","strength":"50 mg/50mL","labeler":"Merck Sharp & Dohme LLC","package_description":"1 VIAL in 1 CARTON (0052-0602-02) / 50 mL in 1 VIAL (0052-0602-01)","pharm_classes":["Actively Acquired Immunity [PE]","BCG Vaccine [CS]","Increased Immunologically Active Molecule Activity [PE]","Increased Macrophage Proliferation [PE]","Live Attenuated Bacillus Calmette-Guerin Immunotherapy [EPC]","Live Attenuated Bacillus Calmette-Guerin Vaccine [EPC]","Vaccines, Attenuated [CS]"]},"nadac":{"value":187.77376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-26","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J9030","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9030 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0052-0602-02) / 50 mL in 1 VIAL (0052-0602-01)) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59385002201","name":"BELBUCA 150 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.55761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002260","name":"BELBUCA 150 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-022-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"150 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-022-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-022-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":7.55761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002301","name":"BELBUCA 300 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.85628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002360","name":"BELBUCA 300 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-023-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"300 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-023-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-023-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":11.85628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002401","name":"BELBUCA 450 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.1142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002460","name":"BELBUCA 450 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-024-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"450 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-024-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-024-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":16.1142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002501","name":"BELBUCA 600 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":17.19033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002560","name":"BELBUCA 600 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-025-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"600 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-025-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-025-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":17.19033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002101","name":"BELBUCA 75 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.54173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002160","name":"BELBUCA 75 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-021-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"75 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-021-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-021-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":7.54173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002601","name":"BELBUCA 750 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.09899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002660","name":"BELBUCA 750 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-026-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"750 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-026-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-026-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":18.09899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002701","name":"BELBUCA 900 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.59055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"59385002760","name":"BELBUCA 900 MCG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-027-60","proprietary_name":"BELBUCA","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL","strength":"900 ug/1","labeler":"BioDelivery Sciences International Inc","package_description":"60 POUCH in 1 CARTON (59385-027-60) / 1 FILM, SOLUBLE in 1 POUCH (59385-027-01)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":18.59055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belbuca|Buprenorphine HCl","basis":"brand"},"part_b":null}, {"ndc":"00006003310","name":"BELSOMRA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.21275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006003330","name":"BELSOMRA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0033-30","proprietary_name":"BELSOMRA","nonproprietary_name":"suvorexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"3 CASE in 1 CARTON (0006-0033-30) / 1 BLISTER PACK in 1 CASE (0006-0033-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":15.21275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006032510","name":"BELSOMRA 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.19058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006032530","name":"BELSOMRA 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0325-30","proprietary_name":"BELSOMRA","nonproprietary_name":"suvorexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"3 CASE in 1 CARTON (0006-0325-30) / 1 BLISTER PACK in 1 CASE (0006-0325-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":15.19058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006033510","name":"BELSOMRA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.20528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006033530","name":"BELSOMRA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0335-30","proprietary_name":"BELSOMRA","nonproprietary_name":"suvorexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"3 CASE in 1 CARTON (0006-0335-30) / 1 BLISTER PACK in 1 CASE (0006-0335-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":15.20528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006000510","name":"BELSOMRA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.20133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"00006000530","name":"BELSOMRA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0005-30","proprietary_name":"BELSOMRA","nonproprietary_name":"suvorexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"3 CASE in 1 CARTON (0006-0005-30) / 1 BLISTER PACK in 1 CASE (0006-0005-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":15.20133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Belsomra|Suvorexant","basis":"brand"},"part_b":null}, {"ndc":"23155075001","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-750-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-750-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075005","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-750-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-750-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033610","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-336-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (43547-336-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033650","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-336-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (43547-336-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268011011","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268011015","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-110-15","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-110-15) / 1 TABLET in 1 BLISTER PACK (50268-110-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075201","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-752-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-752-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075205","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-752-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-752-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072090","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-720-90","proprietary_name":"Benazepril hydrochloride","nonproprietary_name":"Benazepril hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-720-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075210","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-752-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-752-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075250","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-752-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-752-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65862011601","name":"BENAZEPRIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075101","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-751-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-751-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075105","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-751-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-751-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033703","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-337-03","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (43547-337-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033710","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-337-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (43547-337-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033750","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-337-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (43547-337-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268011111","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268011115","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-111-15","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-111-15) / 1 TABLET in 1 BLISTER PACK (50268-111-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075301","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-753-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-753-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075305","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-753-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-753-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072190","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-721-90","proprietary_name":"Benazepril hydrochloride","nonproprietary_name":"Benazepril hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-721-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075310","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-753-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-753-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075350","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-753-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-753-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65862011701","name":"BENAZEPRIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-117-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-117-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.07888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075201","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-752-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-752-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075205","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-752-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-752-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033803","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-338-03","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (43547-338-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033810","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-338-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (43547-338-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033850","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-338-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (43547-338-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268011211","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268011215","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-112-15","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-112-15) / 1 TABLET in 1 BLISTER PACK (50268-112-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075401","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-754-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-754-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075405","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-754-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-754-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072290","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-722-90","proprietary_name":"Benazepril hydrochloride","nonproprietary_name":"Benazepril hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-722-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075410","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-754-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-754-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075450","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-754-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-754-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65862011801","name":"BENAZEPRIL HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-118-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-118-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.10107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155074901","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-749-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-749-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"23155074905","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-749-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-749-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"43547033510","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-335-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (43547-335-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268010911","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"50268010915","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-109-15","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-109-15) / 1 TABLET in 1 BLISTER PACK (50268-109-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075101","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-751-01","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-751-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"53746075105","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-751-05","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-751-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"62135071990","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-719-90","proprietary_name":"Benazepril hydrochloride","nonproprietary_name":"Benazepril hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-719-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075110","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-751-10","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-751-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"65162075150","name":"BENAZEPRIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-751-50","proprietary_name":"Benazepril Hydrochloride","nonproprietary_name":"Benazepril Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-751-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.04842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril HCl|Benazepril HCl","basis":"generic"},"part_b":null}, {"ndc":"00185032501","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0325-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0185-0325-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62559041501","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-415-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-415-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462057701","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-577-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-577-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72888022001","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-220-01","proprietary_name":"benazepril hydrochloride and hydrochlorothiazide","nonproprietary_name":"benazepril hydrochloride and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-220-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00185021101","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0211-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0185-0211-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00574022901","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0229-01","proprietary_name":"benazepril hydrochloride and hydrochlorothiazide","nonproprietary_name":"benazepril hydrochloride and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET in 1 BOTTLE (0574-0229-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62559041601","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-416-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-416-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462057801","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-578-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-578-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72888022101","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-221-01","proprietary_name":"benazepril hydrochloride and hydrochlorothiazide","nonproprietary_name":"benazepril hydrochloride and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-221-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.22162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00185027701","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0277-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0185-0277-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.25257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00574022801","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0228-01","proprietary_name":"benazepril hydrochloride and hydrochlorothiazide","nonproprietary_name":"benazepril hydrochloride and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET in 1 BOTTLE (0574-0228-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.25257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62559041701","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-417-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-417-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.25257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462057901","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-579-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-579-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.25257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72888022201","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-222-01","proprietary_name":"benazepril hydrochloride and hydrochlorothiazide","nonproprietary_name":"benazepril hydrochloride and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-222-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.25257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00185023601","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0236-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0185-0236-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.50927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62559041401","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-414-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-414-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.50927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462057601","name":"BENAZEPRIL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-576-01","proprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","nonproprietary_name":"Benazepril Hydrochloride and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-576-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.50927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benazepril-Hydrochlorothiazide|Benazepril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00713094130","name":"BENICAR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0941-30","proprietary_name":"Benicar","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0941-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":12.31644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benicar|Olmesartan Medoxomil","basis":"brand"},"part_b":null}, {"ndc":"00713094230","name":"BENICAR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0942-30","proprietary_name":"Benicar","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0942-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":17.24162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benicar|Olmesartan Medoxomil","basis":"brand"},"part_b":null}, {"ndc":"00713094030","name":"BENICAR 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0940-30","proprietary_name":"Benicar","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0940-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":10.1271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benicar|Olmesartan Medoxomil","basis":"brand"},"part_b":null}, {"ndc":"00713094430","name":"BENICAR HCT 40-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0944-30","proprietary_name":"Benicar HCT","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0713-0944-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":17.20133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benicar HCT|Olmesartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"00904656460","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6564-60","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (0904-6564-60)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"00904715361","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7153-61","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7153-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"23155089801","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-898-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (23155-898-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"23155089805","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-898-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE, LIQUID FILLED in 1 BOTTLE (23155-898-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"31722095601","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-956-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-956-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"31722095605","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-956-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-956-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"42806071401","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-714-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-714-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"42806071405","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-714-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma LLC","package_description":"500 CAPSULE in 1 BOTTLE (42806-714-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"49483094601","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-946-01","proprietary_name":"Benzonatate 100 mg","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (49483-946-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"49483094650","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-946-50","proprietary_name":"Benzonatate 100 mg","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 CAPSULE, LIQUID FILLED in 1 BOTTLE (49483-946-50)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"62135044031","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-440-31","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 CAPSULE in 1 BOTTLE (62135-440-31)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"62135044090","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-440-90","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-440-90)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64380071206","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-712-06","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-712-06)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64380071207","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-712-07","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE (64380-712-07)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64980063401","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-634-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-634-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64980063450","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-634-50","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (64980-634-50)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"67877057301","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-573-01","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-573-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"67877057305","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-573-05","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-573-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"68084021401","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-214-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"10 BLISTER PACK in 1 CARTON (68084-214-01) / 10 CAPSULE in 1 BLISTER PACK (68084-214-11)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"68084021411","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"68382024701","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-247-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (68382-247-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"68382024705","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-247-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 CAPSULE, LIQUID FILLED in 1 BOTTLE (68382-247-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"69452014320","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-143-20","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (69452-143-20)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"69452014330","name":"BENZONATATE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-143-30","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69452-143-30)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.0656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"23155089901","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-899-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (23155-899-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"23155089905","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-899-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE, LIQUID FILLED in 1 BOTTLE (23155-899-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"31722095801","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-958-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-958-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"31722095805","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-958-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-958-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"42806071501","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-715-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-715-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"42806071505","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-715-05","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma LLC","package_description":"500 CAPSULE in 1 BOTTLE (42806-715-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"49483094701","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-947-01","proprietary_name":"Benzonatate 200 mg","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (49483-947-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"49483094750","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-947-50","proprietary_name":"Benzonatate 200 mg","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 CAPSULE, LIQUID FILLED in 1 BOTTLE (49483-947-50)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"62135044131","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-441-31","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 CAPSULE in 1 BOTTLE (62135-441-31)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"62135044160","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-441-60","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-441-60)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64380071306","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-713-06","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-713-06)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64380071307","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-713-07","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE (64380-713-07)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64980063501","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-635-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-635-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"64980063550","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-635-50","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (64980-635-50)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"67877057501","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-575-01","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-575-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"67877057505","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-575-05","proprietary_name":"BENZONATATE","nonproprietary_name":"BENZONATATE","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-575-05)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"68382009101","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-091-01","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (68382-091-01)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"69452014420","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-144-20","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (69452-144-20)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"69452014430","name":"BENZONATATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-144-30","proprietary_name":"Benzonatate","nonproprietary_name":"Benzonatate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69452-144-30)","pharm_classes":["Decreased Tracheobronchial Stretch Receptor Activity [PE]","Non-narcotic Antitussive [EPC]"]},"nadac":{"value":0.10129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benzonatate|Benzonatate","basis":"generic"},"part_b":null}, {"ndc":"00536145925","name":"BENZOYL PEROXIDE 10% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1459-25","proprietary_name":"Rugby Benzoyl Peroxide Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"100 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1459-25) / 60 g in 1 TUBE"},"nadac":{"value":0.23145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802030801","name":"BENZOYL PEROXIDE 10% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-308-01","proprietary_name":"benzoyl peroxide","nonproprietary_name":"BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"10 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-308-01) / 90 g in 1 TUBE"},"nadac":{"value":0.18096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802030896","name":"BENZOYL PEROXIDE 10% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-308-96","proprietary_name":"benzoyl peroxide","nonproprietary_name":"BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"10 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-308-96) / 60 g in 1 TUBE"},"nadac":{"value":0.23145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536126163","name":"BENZOYL PEROXIDE 10% WASH","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0536-1261-63","proprietary_name":"Rugby Benzoyl Peroxide Wash Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"LOTION","route":"TOPICAL","strength":"100 mg/mL","labeler":"Rugby Laboratories","package_description":"148 mL in 1 BOTTLE, DISPENSING (0536-1261-63)"},"nadac":{"value":0.04701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536135142","name":"BENZOYL PEROXIDE 10% WASH","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536147442","name":"BENZOYL PEROXIDE 10% WASH","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1474-42","proprietary_name":"Rugby Benzoyl Peroxide Wash Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"LOTION","route":"TOPICAL","strength":"100 mg/g","labeler":"Rugby Laboratories","package_description":"237 g in 1 BOTTLE (0536-1474-42)"},"nadac":{"value":0.04672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"35573045408","name":"BENZOYL PEROXIDE 10% WASH","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-454-08","proprietary_name":"Benzoyl Peroxide","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"237 mL in 1 BOTTLE (35573-454-08)"},"nadac":{"value":0.04672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"35573045491","name":"BENZOYL PEROXIDE 10% WASH","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-454-91","proprietary_name":"Benzoyl Peroxide","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"148 mL in 1 BOTTLE (35573-454-91)"},"nadac":{"value":0.05026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536146625","name":"BENZOYL PEROXIDE 2.5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1466-25","proprietary_name":"Rugby Benzoyl Peroxide Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"25 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1466-25) / 60 g in 1 TUBE"},"nadac":{"value":0.20089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802010196","name":"BENZOYL PEROXIDE 2.5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-101-96","proprietary_name":"benzoyl peroxide","nonproprietary_name":"Benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"2.5 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-101-96) / 60 g in 1 TUBE"},"nadac":{"value":0.20089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536146725","name":"BENZOYL PEROXIDE 5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1467-25","proprietary_name":"Rugby Benzoyl Peroxide Acne Medication","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1467-25) / 60 g in 1 TUBE"},"nadac":{"value":0.2175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802021601","name":"BENZOYL PEROXIDE 5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-216-01","proprietary_name":"benzoyl peroxide","nonproprietary_name":"BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"5 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-216-01) / 90 g in 1 TUBE"},"nadac":{"value":0.17795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802021696","name":"BENZOYL PEROXIDE 5% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-216-96","proprietary_name":"benzoyl peroxide","nonproprietary_name":"BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"5 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-216-96) / 60 g in 1 TUBE"},"nadac":{"value":0.2175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536125919","name":"BENZOYL PEROXIDE 5% WASH","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0536-1259-19","proprietary_name":"Rugby Benzoyl Peroxide Wash Acne Medication","nonproprietary_name":"BENZOYL PEROXIDE","dosage_form":"LOTION","route":"TOPICAL","strength":"50 mg/mL","labeler":"Rugby Laboratories","package_description":"236 mL in 1 BOTTLE, DISPENSING (0536-1259-19)"},"nadac":{"value":0.02831,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536125963","name":"BENZOYL PEROXIDE 5% WASH","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0536-1259-63","proprietary_name":"Rugby Benzoyl Peroxide Wash Acne Medication","nonproprietary_name":"BENZOYL PEROXIDE","dosage_form":"LOTION","route":"TOPICAL","strength":"50 mg/mL","labeler":"Rugby Laboratories","package_description":"148 mL in 1 BOTTLE, DISPENSING (0536-1259-63)"},"nadac":{"value":0.03551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"35573045308","name":"BENZOYL PEROXIDE 5% WASH","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-453-08","proprietary_name":"Benzoyl Peroxide","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"50 mg/mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"237 mL in 1 BOTTLE (35573-453-08)"},"nadac":{"value":0.04513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"35573045391","name":"BENZOYL PEROXIDE 5% WASH","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-453-91","proprietary_name":"Benzoyl Peroxide","nonproprietary_name":"Benzoyl Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"50 mg/mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"148 mL in 1 BOTTLE (35573-453-91)"},"nadac":{"value":0.04944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00603243321","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2433-21","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2433-21)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00603243332","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2433-32","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-2433-32)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904728861","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7288-61","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7288-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"11534016709","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-167-09","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"100 TABLET in 1 BOTTLE (11534-167-09)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"11534016710","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-167-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"1000 TABLET in 1 BOTTLE (11534-167-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50228022501","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-225-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-225-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50228022510","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-225-10","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-225-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014118","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-141-18","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"180 TABLET in 1 BOTTLE (62135-141-18)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014157","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-141-57","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"540 TABLET in 1 BOTTLE (62135-141-57)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084038101","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-381-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-381-01) / 1 TABLET in 1 BLISTER PACK (68084-381-11)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084038111","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-381","inner_of":["68084-381-01"]},"part_b":null}, {"ndc":"69097082607","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-826-07","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-826-07)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69315013601","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-136-01","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-136-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69315013610","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-136-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-136-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70752012310","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-123-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-123-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70752012311","name":"BENZTROPINE MES 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-123-11","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (70752-123-11)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00603243421","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2434-21","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2434-21)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00603243432","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2434-32","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-2434-32)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904728961","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7289-61","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7289-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"11534016809","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-168-09","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"100 TABLET in 1 BOTTLE (11534-168-09)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"11534016810","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-168-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"1000 TABLET in 1 BOTTLE (11534-168-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50228022601","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-226-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-226-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50228022610","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-226-10","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-226-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014401","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-144-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (62135-144-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014410","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-144-10","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (62135-144-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014418","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-144-18","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"180 TABLET in 1 BOTTLE, PLASTIC (62135-144-18)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014457","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-144-57","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"540 TABLET in 1 BOTTLE, PLASTIC (62135-144-57)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084038801","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-388-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-388-01) / 1 TABLET in 1 BLISTER PACK (68084-388-11)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084038811","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-388","inner_of":["68084-388-01"]},"part_b":null}, {"ndc":"69097082707","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-827-07","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-827-07)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69315013701","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-137-01","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-137-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69315013710","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-137-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-137-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70752012410","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-124-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-124-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70752012411","name":"BENZTROPINE MES 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-124-11","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (70752-124-11)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.0753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00603243521","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2435-21","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-2435-21)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00603243532","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2435-32","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-2435-32)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904729061","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7290-61","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7290-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"11534016909","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-169-09","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"100 TABLET in 1 BOTTLE (11534-169-09)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"11534016910","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-169-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"1000 TABLET in 1 BOTTLE (11534-169-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50228022701","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-227-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-227-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50228022710","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-227-10","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-227-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014201","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-142-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (62135-142-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014210","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-142-10","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (62135-142-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014218","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-142-18","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC.","package_description":"180 TABLET in 1 BOTTLE, PLASTIC (62135-142-18)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135014257","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-142-57","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC.","package_description":"540 TABLET in 1 BOTTLE, PLASTIC (62135-142-57)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084038901","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-389-01","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-389-01) / 1 TABLET in 1 BLISTER PACK (68084-389-11)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084038911","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-389","inner_of":["68084-389-01"]},"part_b":null}, {"ndc":"69097083207","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-832-07","proprietary_name":"Benztropine Mesylate","nonproprietary_name":"Benztropine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-832-07)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69315013801","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-138-01","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-138-01)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69315013810","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-138-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-138-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70752012510","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-125-10","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-125-10)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70752012511","name":"BENZTROPINE MES 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-125-11","proprietary_name":"BENZTROPINE MESYLATE","nonproprietary_name":"BENZTROPINE MESYLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (70752-125-11)","pharm_classes":["Anticholinergic [EPC]","Antihistamine [EPC]","Cholinergic Antagonists [MoA]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.09059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Benztropine Mesylate*|Benztropine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378705535","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7055-35","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"Bepotastine Besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0378-7055-35) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":10.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"00378705567","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7055-67","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"Bepotastine Besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0378-7055-67) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":8.28568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"24208063005","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-630-05","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"bepotastine besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-630-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":10.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"24208063010","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-630-10","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"bepotastine besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-630-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":8.28568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"62332059805","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-598-05","proprietary_name":"Bepotastine Besilate Ophthalmic Solution 1.5%","nonproprietary_name":"Bepotastine Besilate Ophthalmic Solution 1.5%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-598-05) / 5 mL in 1 BOTTLE","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":10.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"62332059810","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-598-10","proprietary_name":"Bepotastine Besilate Ophthalmic Solution 1.5%","nonproprietary_name":"Bepotastine Besilate Ophthalmic Solution 1.5%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-598-10) / 10 mL in 1 BOTTLE","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":8.28568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"70069071101","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-711-01","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"Bepotastine Besilate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-711-01) / 5 mL in 1 BOTTLE","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":10.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"70069071201","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-712-01","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"Bepotastine Besilate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-712-01) / 10 mL in 1 BOTTLE","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":8.28568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"82260063005","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-630-05","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"bepotastine besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-630-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":10.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"82260063010","name":"BEPOTASTINE 1.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-630-10","proprietary_name":"Bepotastine Besilate","nonproprietary_name":"bepotastine besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-630-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":8.28568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepotastine Besilate|Bepotastine Besilate","basis":"generic"},"part_b":null}, {"ndc":"24208062902","name":"BEPREVE 1.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-629-02","proprietary_name":"Bepreve","nonproprietary_name":"bepotastine besilate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"15 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-629-02) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":55.93567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":10.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bepreve|Bepotastine Besilate","basis":"brand"},"part_b":null}, {"ndc":"24208044605","name":"BESIVANCE 0.6% SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-446-05","proprietary_name":"Besivance","nonproprietary_name":"Besifloxacin","dosage_form":"SUSPENSION","route":"OPHTHALMIC","strength":"6 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-446-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":44.09023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Besivance|Besifloxacin HCl","basis":"brand"},"part_b":null}, {"ndc":"67618015004","name":"BETADINE 10% SOLUTION","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67618-150-04","proprietary_name":"Betadine Solution","nonproprietary_name":"POVIDONE-IODINE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"118 mL in 1 BOTTLE (67618-150-04)"},"nadac":{"value":0.01532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67618015009","name":"BETADINE 10% SOLUTION","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67618-150-09","proprietary_name":"Betadine Solution","nonproprietary_name":"POVIDONE-IODINE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"237 mL in 1 BOTTLE (67618-150-09)"},"nadac":{"value":0.01302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.02034,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67618015017","name":"BETADINE 10% SOLUTION","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67618-150-17","proprietary_name":"Betadine Solution","nonproprietary_name":"POVIDONE-IODINE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"473 mL in 1 BOTTLE (67618-150-17)"},"nadac":{"value":0.01037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67618016003","name":"BETADINE 5% SPRAY","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.07048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Betadine|Povidone-Iodine","basis":"brand"},"part_b":null}, {"ndc":"00168005515","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0055-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0055-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168005546","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0055-46","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0055-46) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472038015","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0380-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0380-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472038045","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0380-45","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0380-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065915","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0659-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0659-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065937","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0659-37","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0659-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714099601","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-996-01","proprietary_name":"Betamethasone dipropionate","nonproprietary_name":"Betamethasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC.","package_description":"1 TUBE in 1 CARTON (16714-996-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714099602","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-996-02","proprietary_name":"Betamethasone dipropionate","nonproprietary_name":"Betamethasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC.","package_description":"1 TUBE in 1 CARTON (16714-996-02) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127401","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1274-1","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1274-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127406","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1274-6","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1274-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70710123301","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1233-1","proprietary_name":"Betamethasone dipropionate","nonproprietary_name":"Betamethasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 TUBE in 1 CARTON (70710-1233-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70710123304","name":"BETAMETHASONE DP 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1233-4","proprietary_name":"Betamethasone dipropionate","nonproprietary_name":"Betamethasone dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 TUBE in 1 CARTON (70710-1233-4) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168005760","name":"BETAMETHASONE DP 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0057-60","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (0168-0057-60) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713080753","name":"BETAMETHASONE DP 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0807-53","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (0713-0807-53) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802002146","name":"BETAMETHASONE DP 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-021-46","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"56.2 g in 1 BOTTLE, PLASTIC (45802-021-46)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168005615","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0056-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0056-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.45991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168005646","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0056-46","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0056-46) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472038115","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0381-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0381-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.45991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472038145","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0381-45","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0381-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802050514","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-505-14","proprietary_name":"BETAMETHASONE DIPROPIONATE","nonproprietary_name":"betamethasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-505-14) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.45991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802050584","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-505-84","proprietary_name":"BETAMETHASONE DIPROPIONATE","nonproprietary_name":"betamethasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-505-84) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817082415","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-824-15","proprietary_name":"Betamethasone Dipropionate USP, 0.05%","nonproprietary_name":"Betamethasone Dipropionate USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"TruPharma LLC","package_description":"1 TUBE in 1 CARTON (52817-824-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.45991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817082445","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-824-45","proprietary_name":"Betamethasone Dipropionate USP, 0.05%","nonproprietary_name":"Betamethasone Dipropionate USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"TruPharma LLC","package_description":"1 TUBE in 1 CARTON (52817-824-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578009301","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-093-01","proprietary_name":"betamethasone dipropionate","nonproprietary_name":"betamethasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-093-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.45991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578009306","name":"BETAMETHASONE DP 0.05% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-093-06","proprietary_name":"betamethasone dipropionate","nonproprietary_name":"betamethasone dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-093-06) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802037632","name":"BETAMETHASONE DP AUG 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-376-32","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-376-32) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802037635","name":"BETAMETHASONE DP AUG 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-376-35","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-376-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131001","name":"BETAMETHASONE DP AUG 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1310-1","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1310-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131003","name":"BETAMETHASONE DP AUG 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1310-3","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"CREAM, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1310-3) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672130901","name":"BETAMETHASONE DP AUG 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1309-1","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1309-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.73958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672130903","name":"BETAMETHASONE DP AUG 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1309-3","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1309-3) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.09456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168026730","name":"BETAMETHASONE DP AUG 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0267-30","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION, AUGMENTED","route":"TOPICAL","strength":".5 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"30 mL in 1 BOTTLE (0168-0267-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168026760","name":"BETAMETHASONE DP AUG 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0267-60","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION, AUGMENTED","route":"TOPICAL","strength":".5 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"60 mL in 1 BOTTLE (0168-0267-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.51026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922010401","name":"BETAMETHASONE DP AUG 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-104-01","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"BETAMETHASONE DIPROPIONATE","dosage_form":"LOTION, AUGMENTED","route":"TOPICAL","strength":".5 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (21922-104-01) / 60 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.51026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922010421","name":"BETAMETHASONE DP AUG 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-104-21","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"BETAMETHASONE DIPROPIONATE","dosage_form":"LOTION, AUGMENTED","route":"TOPICAL","strength":".5 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (21922-104-21) / 30 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672134003","name":"BETAMETHASONE DP AUG 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1340-3","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION, AUGMENTED","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1340-3) / 30 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672134004","name":"BETAMETHASONE DP AUG 0.05% LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1340-4","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"LOTION, AUGMENTED","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1340-4) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.51026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168026815","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0268-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"betamethasone dipropionate","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"15 g in 1 TUBE (0168-0268-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168026850","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0268-50","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"betamethasone dipropionate","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"50 g in 1 TUBE (0168-0268-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.53451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472038215","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0382-15","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0382-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472038245","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0382-45","proprietary_name":"Betamethasone Dipropionate","nonproprietary_name":"Betamethasone Dipropionate","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0382-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.47045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"35573010715","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-107-15","proprietary_name":"BETAMETHASONE DIPROPIONATE","nonproprietary_name":"BETAMETHASONE DIPROPIONATE","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Burel Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (35573-107-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"35573010749","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-107-49","proprietary_name":"BETAMETHASONE DIPROPIONATE","nonproprietary_name":"BETAMETHASONE DIPROPIONATE","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Burel Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (35573-107-49) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.53451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180094701","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-947-01","proprietary_name":"Betamethasone dipropionate","nonproprietary_name":"Betamethasone dipropionate","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-947-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180094702","name":"BETAMETHASONE DP AUG 0.05% OIN","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-947-02","proprietary_name":"Betamethasone dipropionate","nonproprietary_name":"Betamethasone dipropionate","dosage_form":"OINTMENT, AUGMENTED","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-947-02) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.53451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00517072001","name":"BETAMETHASONE SP-AC 30 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0720-01","proprietary_name":"Betamethasone Sodium Phosphate and Betamethasone Acetate","nonproprietary_name":"Betamethasone Sodium Phosphate and Betamethasone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR","strength":"3 mg/mL; 3 mg/mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0517-0720-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.13831,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0702","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0702 (3 MG & 3 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0517-0720-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517079101","name":"BETAMETHASONE SP-AC 30 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0791-01","proprietary_name":"Betamethasone Sodium Phosphate and Betamethasone Acetate","nonproprietary_name":"Betamethasone Sodium Phosphate and Betamethasone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR","strength":"3 mg/mL; 3 mg/mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0517-0791-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.13831,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0702","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0702 (3 MG & 3 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0517-0791-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517079901","name":"BETAMETHASONE SP-AC 30 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0799-01","proprietary_name":"Betamethasone Sodium Phosphate and Betamethasone Acetate","nonproprietary_name":"Betamethasone Sodium Phosphate and Betamethasone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR","strength":"3 mg/mL; 3 mg/mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0517-0799-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.13831,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0702","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0702 (3 MG & 3 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0517-0799-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00168004015","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0040-15","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"betamethasone valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"15 g in 1 TUBE (0168-0040-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.41536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00168004046","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0040-46","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"betamethasone valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"45 g in 1 TUBE (0168-0040-46)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00472037015","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.41536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472037045","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.34759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713032615","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0326-15","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0326-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.41536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713032637","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0326-37","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0326-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672126901","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1269-1","proprietary_name":"BETAMETHASONE VALERATE","nonproprietary_name":"Betamethasone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1269-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.41536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672126906","name":"BETAMETHASONE VA 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1269-6","proprietary_name":"BETAMETHASONE VALERATE","nonproprietary_name":"Betamethasone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1269-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.34759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00168004160","name":"BETAMETHASONE VA 0.1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0041-60","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"betamethasone valerate","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"60 mL in 1 BOTTLE (0168-0041-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.45228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168003315","name":"BETAMETHASONE VALER 0.1% OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0033-15","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"betamethasone valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"15 g in 1 TUBE (0168-0033-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00168003346","name":"BETAMETHASONE VALER 0.1% OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0033-46","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"betamethasone valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"45 g in 1 TUBE (0168-0033-46)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00472037115","name":"BETAMETHASONE VALER 0.1% OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.61436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472037145","name":"BETAMETHASONE VALER 0.1% OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713032715","name":"BETAMETHASONE VALER 0.1% OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0327-15","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0327-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713032737","name":"BETAMETHASONE VALER 0.1% OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0327-37","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0327-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"45802005301","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-053-01","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-053-01) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.63156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"45802005302","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-053-02","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-053-02) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672418803","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4188-3","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 CARTON (51672-4188-3) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.63156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672418807","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4188-7","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 CARTON (51672-4188-7) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"62332070831","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-708-31","proprietary_name":"Betamethasone valerate","nonproprietary_name":"Betamethasone valerate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CAN in 1 CARTON (62332-708-31) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"62332070850","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-708-50","proprietary_name":"Betamethasone valerate","nonproprietary_name":"Betamethasone valerate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CAN in 1 CARTON (62332-708-50) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.63156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Betamethasone Valerate|Betamethasone Valerate","basis":"generic"},"part_b":null}, {"ndc":"70700014119","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-141-19","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate Foam","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Xiromed, LLC.","package_description":"1 CANISTER in 1 CARTON (70700-141-19) / 50 g in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.63156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700014120","name":"BETAMETHASONE VALER 0.12% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-141-20","proprietary_name":"Betamethasone Valerate","nonproprietary_name":"Betamethasone Valerate Foam","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1.2 mg/g","labeler":"Xiromed, LLC.","package_description":"1 CANISTER in 1 CARTON (70700-141-20) / 100 g in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67618020004","name":"BETASEPT 4% SURGICAL SCRUB","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-200-04","proprietary_name":"BETASEPT","nonproprietary_name":"Antiseptic Surgical Scrub","dosage_form":"SOLUTION","route":"TOPICAL","strength":".04 mg/mL","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"118 mL in 1 BOTTLE (67618-200-04)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67618020008","name":"BETASEPT 4% SURGICAL SCRUB","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-200-08","proprietary_name":"BETASEPT","nonproprietary_name":"Antiseptic Surgical Scrub","dosage_form":"SOLUTION","route":"TOPICAL","strength":".04 mg/mL","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"237 mL in 1 BOTTLE (67618-200-08)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67618020016","name":"BETASEPT 4% SURGICAL SCRUB","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-200-16","proprietary_name":"BETASEPT","nonproprietary_name":"Antiseptic Surgical Scrub","dosage_form":"SOLUTION","route":"TOPICAL","strength":".04 mg/mL","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"473 mL in 1 BOTTLE (67618-200-16)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.01776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50419052401","name":"BETASERON 0.3 MG KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":725.97471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Betaseron|Interferon Beta-1b","basis":"brand"},"part_b":null}, {"ndc":"50419052435","name":"BETASERON 0.3 MG KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-524-35","proprietary_name":"Betaseron","nonproprietary_name":"interferon beta-1b","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"14 CARTON in 1 BOX (50419-524-35) / 1 KIT in 1 CARTON (50419-524-01) * 1 mL in 1 VIAL, SINGLE-USE * 1.2 mL in 1 SYRINGE"},"nadac":{"value":725.97471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Betaseron|Interferon Beta-1b","basis":"brand"},"part_b":null}, {"ndc":"10702001301","name":"BETAXOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-013-01","proprietary_name":"BETAXOLOL HYDROCHLORIDE","nonproprietary_name":"betaxolol hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 TABLET, COATED in 1 BOTTLE (10702-013-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.59124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702001401","name":"BETAXOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10702-014-01","proprietary_name":"BETAXOLOL HYDROCHLORIDE","nonproprietary_name":"betaxolol hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 TABLET, COATED in 1 BOTTLE (10702-014-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.79502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61314024501","name":"BETAXOLOL HCL 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-245-01","proprietary_name":"Betaxolol Hydrochloride","nonproprietary_name":"Betaxolol Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5.6 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-245-01) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.96243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314024503","name":"BETAXOLOL HCL 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-245-03","proprietary_name":"Betaxolol Hydrochloride","nonproprietary_name":"Betaxolol Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5.6 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-245-03) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.98694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832051100","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0511-00","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0511-00)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051101","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0511-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-0511-01) / 1 TABLET in 1 BLISTER PACK (0832-0511-89)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051189","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155093501","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-935-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-935-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"53746057201","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-572-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-572-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"60687068901","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-689-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-689-01) / 1 TABLET in 1 BLISTER PACK (60687-689-11)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"60687068911","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135075612","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-756-12","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-756-12)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"65162057210","name":"BETHANECHOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-572-10","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-572-10)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051200","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0512-00","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0512-00)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051201","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0512-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-0512-01) / 1 TABLET in 1 BLISTER PACK (0832-0512-89)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051289","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155093601","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-936-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-936-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"53746057301","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-573-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-573-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"60687070001","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-700-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-700-01) / 1 TABLET in 1 BLISTER PACK (60687-700-11)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"60687070011","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135075712","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-757-12","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-757-12)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"65162057310","name":"BETHANECHOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-573-10","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-573-10)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.18782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051000","name":"BETHANECHOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0510-00","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0510-00)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.12208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155093401","name":"BETHANECHOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-934-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-934-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.12208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"53746057101","name":"BETHANECHOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-571-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-571-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.12208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135075590","name":"BETHANECHOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-755-90","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-755-90)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.12208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"65162057110","name":"BETHANECHOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-571-10","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-571-10)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.12208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832051300","name":"BETHANECHOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0513-00","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0513-00)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.27036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155093701","name":"BETHANECHOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-937-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-937-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.27036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"53746057401","name":"BETHANECHOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-574-01","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-574-01)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.27036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135075812","name":"BETHANECHOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-758-12","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-758-12)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.27036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"65162057410","name":"BETHANECHOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-574-10","proprietary_name":"Bethanechol Chloride","nonproprietary_name":"Bethanechol Chloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-574-10)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]"]},"nadac":{"value":0.27036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bethanechol Chloride|Bethanechol Chloride","basis":"generic"},"part_b":null}, {"ndc":"82584000205","name":"BETIMOL 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82584-002-05","proprietary_name":"BETIMOL","nonproprietary_name":"timolol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5.12 mg/mL","labeler":"Thea Pharma Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82584-002-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":31.12233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":21.6742,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Betimol|Timolol","basis":"brand"},"part_b":null}, {"ndc":"00078072910","name":"BETOPTIC S 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0729-10","proprietary_name":"Betoptic S","nonproprietary_name":"betaxolol hydrochloride","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2.8 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 BOTTLE in 1 CARTON (0078-0729-10) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":42.62424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Betoptic S|Betaxolol HCl","basis":"brand"},"part_b":null}, {"ndc":"00078072915","name":"BETOPTIC S 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0729-15","proprietary_name":"Betoptic S","nonproprietary_name":"betaxolol hydrochloride","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2.8 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 BOTTLE in 1 CARTON (0078-0729-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":42.87902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Betoptic S|Betaxolol HCl","basis":"brand"},"part_b":null}, {"ndc":"00310460012","name":"BEVESPI AEROSPHERE INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-4600-12","proprietary_name":"BEVESPI AEROSPHERE","nonproprietary_name":"Glycopyrrolate and formoterol fumarate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"9 ug/1; 4.8 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"120 AEROSOL, METERED in 1 INHALER (0310-4600-12)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":40.85993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Bevespi Aerosphere|Glycopyrrolate/Formoterol Fum","basis":"brand"},"part_b":null}, {"ndc":"50419040701","name":"BEYAZ 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.29785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.38228,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50419040703","name":"BEYAZ 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-407-03","proprietary_name":"Beyaz","nonproprietary_name":"Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 PACKAGE (50419-407-03) / 1 KIT in 1 BLISTER PACK (50419-407-01)"},"nadac":{"value":8.29785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.38228,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729002301","name":"BICALUTAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-023-01","proprietary_name":"Bicalutamide","nonproprietary_name":"Bicalutamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-023-01)","pharm_classes":["Androgen Receptor Antagonists [MoA]","Androgen Receptor Inhibitor [EPC]"]},"nadac":{"value":0.40441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bicalutamide|Bicalutamide","basis":"generic"},"part_b":null}, {"ndc":"16729002310","name":"BICALUTAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-023-10","proprietary_name":"Bicalutamide","nonproprietary_name":"Bicalutamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET in 1 BOTTLE (16729-023-10)","pharm_classes":["Androgen Receptor Antagonists [MoA]","Androgen Receptor Inhibitor [EPC]"]},"nadac":{"value":0.40441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bicalutamide|Bicalutamide","basis":"generic"},"part_b":null}, {"ndc":"47335048583","name":"BICALUTAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-485-83","proprietary_name":"bicalutamide","nonproprietary_name":"bicalutamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (47335-485-83)","pharm_classes":["Androgen Receptor Antagonists [MoA]","Androgen Receptor Inhibitor [EPC]"]},"nadac":{"value":0.40441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bicalutamide|Bicalutamide","basis":"generic"},"part_b":null}, {"ndc":"47335048588","name":"BICALUTAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-485-88","proprietary_name":"bicalutamide","nonproprietary_name":"bicalutamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (47335-485-88)","pharm_classes":["Androgen Receptor Antagonists [MoA]","Androgen Receptor Inhibitor [EPC]"]},"nadac":{"value":0.40441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bicalutamide|Bicalutamide","basis":"generic"},"part_b":null}, {"ndc":"72578021506","name":"BICALUTAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-215-06","proprietary_name":"Bicalutamide","nonproprietary_name":"Bicalutamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (72578-215-06)","pharm_classes":["Androgen Receptor Antagonists [MoA]","Androgen Receptor Inhibitor [EPC]"]},"nadac":{"value":0.40441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bicalutamide|Bicalutamide","basis":"generic"},"part_b":null}, {"ndc":"24338001009","name":"BIDIL 20 MG-37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24338-010-09","proprietary_name":"BiDil","nonproprietary_name":"Hydralazine hydrochloride and Isosorbide dinitrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 20 mg/1","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (24338-010-09)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]","Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":4.34518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.7138,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bidil|Isosorbide Dinit/Hydralazine","basis":"brand"},"part_b":null}, {"ndc":"68308075130","name":"BIJUVA 0.5 MG-100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":8.84931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bijuva|Estradiol/Progesterone","basis":"brand"},"part_b":null}, {"ndc":"68308075030","name":"BIJUVA 1 MG-100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":8.53176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bijuva|Estradiol/Progesterone","basis":"brand"},"part_b":null}, {"ndc":"61958250501","name":"BIKTARVY 30-120-15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2505-1","proprietary_name":"Biktarvy","nonproprietary_name":"bictegravir sodium, emtricitabine, and tenofovir alafenamide fumarate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1; 120 mg/1; 15 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2505-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":136.65502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61958250601","name":"BIKTARVY 30-120-15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2506-1","proprietary_name":"Biktarvy","nonproprietary_name":"bictegravir sodium, emtricitabine, and tenofovir alafenamide fumarate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1; 120 mg/1; 15 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2506-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":136.65502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61958250101","name":"BIKTARVY 50-200-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2501-1","proprietary_name":"Biktarvy","nonproprietary_name":"bictegravir sodium, emtricitabine, and tenofovir alafenamide fumarate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 200 mg/1; 25 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2501-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":136.7284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61958250103","name":"BIKTARVY 50-200-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2501-3","proprietary_name":"Biktarvy","nonproprietary_name":"bictegravir sodium, emtricitabine, and tenofovir alafenamide fumarate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 200 mg/1; 25 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BLISTER PACK (61958-2501-3)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":136.7284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"78206019301","name":"BILDYOS 60 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-193-01","proprietary_name":"BILDYOS","nonproprietary_name":"Denosumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"60 mg/mL","labeler":"Organon LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (78206-193-01) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":814.13419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5162","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (78206-193-01) / 1 mL in 1 SYRINGE, GLASS) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60219214901","name":"BIMATOPROST 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2149-1","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (60219-2149-1) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":42.51553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"60219214902","name":"BIMATOPROST 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2149-2","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (60219-2149-2) / 7.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":43.41341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"60219214904","name":"BIMATOPROST 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2149-4","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (60219-2149-4) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":42.752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"70756062630","name":"BIMATOPROST 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-626-30","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-626-30) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":42.51553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"70756062730","name":"BIMATOPROST 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-627-30","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-627-30) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":42.752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"70756062830","name":"BIMATOPROST 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-628-30","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-628-30) / 7.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":43.41341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"42571012821","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-128-21","proprietary_name":"BIMATOPROST","nonproprietary_name":"BIMATOPROST","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-128-21) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.85194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"42571012828","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-128-28","proprietary_name":"BIMATOPROST","nonproprietary_name":"BIMATOPROST","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-128-28) / 7.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":4.20713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"42571012835","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-128-35","proprietary_name":"BIMATOPROST","nonproprietary_name":"BIMATOPROST","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-128-35) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":6.96893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"60505058301","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0583-1","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0583-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.85194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"60505058304","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0583-4","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0583-4) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":6.96893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"62332050705","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-507-05","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-507-05) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.85194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"62332050725","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-507-25","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-507-25) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":6.96893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"65862080205","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-802-05","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-802-05) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.85194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"65862080210","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-802-10","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-802-10) / 7.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":4.20713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"65862080244","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-802-44","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-802-44) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":6.96893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"70069040101","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-401-01","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-401-01) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":6.96893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"70069040201","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-402-01","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-402-01) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.85194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"70069040301","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-403-01","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-403-01) / 7.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":4.20713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"72266013901","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-139-01","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 BOTTLE in 1 CARTON (72266-139-01) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":6.96893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"72266014001","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-140-01","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 BOTTLE in 1 CARTON (72266-140-01) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.85194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"72266024101","name":"BIMATOPROST 0.03% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-241-01","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 BOTTLE in 1 CARTON (72266-241-01) / 7.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":4.20713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"00781620675","name":"BIMATOPROST 0.03% EYELASH SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6206-75","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (0781-6206-75) / 5 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":20.64928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"00781620693","name":"BIMATOPROST 0.03% EYELASH SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6206-93","proprietary_name":"Bimatoprost","nonproprietary_name":"Bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (0781-6206-93) / 3 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":26.27422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"62332051103","name":"BIMATOPROST 0.03% EYELASH SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-511-03","proprietary_name":"bimatoprost","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-511-03) / 3 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":26.27422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"62332051105","name":"BIMATOPROST 0.03% EYELASH SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-511-05","proprietary_name":"bimatoprost","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-511-05) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":20.64928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimatoprost*|Bimatoprost","basis":"generic"},"part_b":null}, {"ndc":"50474078184","name":"BIMZELX 160 MG/ML AUTOINJECTOR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-781-84","proprietary_name":"Bimzelx","nonproprietary_name":"bimekizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"160 mg/mL","labeler":"UCB, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (50474-781-84) / 1 mL in 1 SYRINGE, GLASS"},"nadac":{"value":8035.07333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimzelx Autoinjector|Bimekizumab-Bkzx","basis":"brand"},"part_b":null}, {"ndc":"50474078185","name":"BIMZELX 160 MG/ML AUTOINJECTOR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50474-781-85","proprietary_name":"Bimzelx","nonproprietary_name":"bimekizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"160 mg/mL","labeler":"UCB, Inc.","package_description":"2 SYRINGE, GLASS in 1 CARTON (50474-781-85) / 1 mL in 1 SYRINGE, GLASS"},"nadac":{"value":8112.5853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimzelx Autoinjector|Bimekizumab-Bkzx","basis":"brand"},"part_b":null}, {"ndc":"50474078284","name":"BIMZELX 320 MG/2 ML AUTOINJECT","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-782-84","proprietary_name":"Bimzelx","nonproprietary_name":"bimekizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"320 mg/2mL","labeler":"UCB, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (50474-782-84) / 2 mL in 1 SYRINGE, GLASS"},"nadac":{"value":8016.03643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bimzelx Autoinjector|Bimekizumab-Bkzx","basis":"brand"},"part_b":null}, {"ndc":"70539040000","name":"BINOSTO 70 MG EFFERVESCENT TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":71.226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Binosto|Alendronate Sodium","basis":"brand"},"part_b":null}, {"ndc":"70539040004","name":"BINOSTO 70 MG EFFERVESCENT TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70539-400-04","proprietary_name":"Binosto","nonproprietary_name":"alendronate sodium","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"91.37 mg/1","labeler":"Radius Health, Inc.","package_description":"4 BLISTER PACK in 1 BOX (70539-400-04) / 1 TABLET, EFFERVESCENT in 1 BLISTER PACK (70539-400-00)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":71.226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Binosto|Alendronate Sodium","basis":"brand"},"part_b":null}, {"ndc":"00574705012","name":"BISACODYL 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-7050-12","proprietary_name":"Bisacodyl","nonproprietary_name":"bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Padagis US LLC","package_description":"12 BLISTER PACK in 1 CARTON (0574-7050-12) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574705050","name":"BISACODYL 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-7050-50","proprietary_name":"Bisacodyl","nonproprietary_name":"bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Padagis US LLC","package_description":"50 BLISTER PACK in 1 CARTON (0574-7050-50) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904714212","name":"BISACODYL 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7142-12","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-7142-12) / 6 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032703","name":"BISACODYL 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-327-03","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (57237-327-03) / 5 SUPPOSITORY in 1 BLISTER PACK (57237-327-51)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032721","name":"BISACODYL 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-327-21","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-327-21) / 4 SUPPOSITORY in 1 BLISTER PACK (57237-327-04)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904640761","name":"BISACODYL EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6407-61","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX (0904-6407-61) / 10 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674817","name":"BISACODYL EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6748-17","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (0904-6748-17) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674860","name":"BISACODYL EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6748-60","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0904-6748-60)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674880","name":"BISACODYL EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6748-80","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0904-6748-80)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483000355","name":"BISACODYL EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904720546","name":"BISMUTH 262 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7205-46","proprietary_name":"Major Bismuth Subsalicylate","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"262 mg/1","labeler":"Major Pharmaceuticals","package_description":"5 BLISTER PACK in 1 BOX (0904-7205-46) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.08166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599474407","name":"BISMUTH 262 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-4744-7","proprietary_name":"McKesson Bismuth","nonproprietary_name":"bismuth subsalicylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"262 mg/1","labeler":"McKesson Medical-Surgical","package_description":"100 PACKET in 1 BOX (68599-4744-7) / 2 TABLET, CHEWABLE in 1 PACKET"},"nadac":{"value":0.08166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884015124","name":"BISMUTH-METRONIDAZOLE-TETRACYCLINE 140-125-125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.40281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884015154","name":"BISMUTH-METRONIDAZOLE-TETRACYCLINE 140-125-125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-151-54","proprietary_name":"Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride","nonproprietary_name":"Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"140 mg/1; 125 mg/1; 125 mg/1","labeler":"Par Health USA, LLC","package_description":"120 CAPSULE in 1 CARTON (49884-151-54)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]","Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]","Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.40281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742028313","name":"BISMUTH-METRONIDAZOLE-TETRACYCLINE 140-125-125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-283-13","proprietary_name":"Bismuth subcitrate potassium, Metronidazole, Tetracycline hydrochloride","nonproprietary_name":"Bismuth subcitrate potassium, Metronidazole, Tetracycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"140 mg/1; 125 mg/1; 125 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"120 CAPSULE in 1 CARTON (50742-283-13)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]","Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]","Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.40281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61269038512","name":"BISMUTH-METRONIDAZOLE-TETRACYCLINE 140-125-125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":2.40281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714053001","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-530-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-530-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714053002","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-530-02","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-530-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300012701","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-127-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-127-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300012713","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-127-13","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-127-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547061703","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-617-03","proprietary_name":"Bisoprolol fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-617-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547061710","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-617-10","proprietary_name":"Bisoprolol fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-617-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"52817027110","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-271-10","proprietary_name":"Bisoprolol","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-271-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"52817027130","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-271-30","proprietary_name":"Bisoprolol","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (52817-271-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62332060430","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-604-30","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62332-604-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62332060431","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-604-31","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62332-604-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"64980071001","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-710-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-710-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"64980071003","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-710-03","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64980-710-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862008701","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-087-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-087-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70095001901","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-019-01","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, UNIT-DOSE (70095-019-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70095001902","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-019-02","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70095-019-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70954045610","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-456-10","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novitium Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70954-456-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70954045620","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-456-20","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-456-20)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72578011201","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-112-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72578-112-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72578011206","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-112-06","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-112-06)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72888009301","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-093-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-093-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72888009330","name":"BISOPROLOL FUMARATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-093-30","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72888-093-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.16028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"52817026830","name":"BISOPROLOL FUMARATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-268-30","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"TruPharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (52817-268-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.51999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714052901","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-529-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-529-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714052902","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-529-02","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-529-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300012601","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-126-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-126-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300012613","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-126-13","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-126-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547061603","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-616-03","proprietary_name":"Bisoprolol fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-616-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547061610","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-616-10","proprietary_name":"Bisoprolol fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-616-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268012711","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268012715","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-127-15","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-127-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-127-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"52817027010","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-270-10","proprietary_name":"Bisoprolol","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-270-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"52817027030","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-270-30","proprietary_name":"Bisoprolol","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (52817-270-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687067911","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687067921","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-679-21","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-679-21) / 1 TABLET in 1 BLISTER PACK (60687-679-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62332060330","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-603-30","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62332-603-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62332060331","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-603-31","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62332-603-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"64980070901","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-709-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-709-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"64980070903","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-709-03","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64980-709-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862008601","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-086-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-086-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70095002001","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-020-01","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, UNIT-DOSE (70095-020-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70095002002","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-020-02","proprietary_name":"BISOPROLOL FUMARATE","nonproprietary_name":"BISOPROLOL FUMARATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70095-020-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70954045510","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-455-10","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novitium Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70954-455-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70954045520","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-455-20","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-455-20)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72578011101","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-111-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72578-111-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72578011106","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-111-06","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-111-06)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72888009201","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-092-01","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-092-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72888009230","name":"BISOPROLOL FUMARATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-092-30","proprietary_name":"Bisoprolol Fumarate","nonproprietary_name":"Bisoprolol Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72888-092-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol Fumarate|Bisoprolol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093324356","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3243-56","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-3243-56)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378050501","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0505-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0505-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018901","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-189-01","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-189-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018905","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-189-05","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-189-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018913","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-189-13","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-189-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092201","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-922-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42799-922-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092202","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-922-02","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42799-922-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092230","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-922-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42799-922-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462088001","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-880-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-880-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462088005","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-880-05","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-880-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462088030","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-880-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-880-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70954041410","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-414-10","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-414-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70954041430","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-414-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-414-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011501","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-115-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72578-115-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011505","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-115-05","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72578-115-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011506","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-115-06","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-115-06)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.20936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093324101","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3241-01","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-3241-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378050101","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0501-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0501-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018701","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-187-01","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-187-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018705","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-187-05","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-187-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018713","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-187-13","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-187-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092001","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-920-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42799-920-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092002","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-920-02","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42799-920-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092030","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-920-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42799-920-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462087801","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-878-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-878-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462087805","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-878-05","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-878-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462087830","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-878-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-878-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70954041230","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-412-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-412-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011301","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-113-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72578-113-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011305","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-113-05","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72578-113-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011306","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-113-06","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-113-06)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093324201","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3242-01","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-3242-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378050301","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0503-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0503-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018801","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-188-01","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-188-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018805","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-188-05","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-188-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300018813","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-188-13","proprietary_name":"bisoprolol fumarate and hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"6.25 mg/1; 5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-188-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092101","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-921-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42799-921-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092102","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-921-02","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42799-921-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"42799092130","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-921-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42799-921-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462087901","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-879-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-879-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462087905","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-879-05","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-879-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68462087930","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-879-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-879-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70954041330","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-413-30","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-413-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011401","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-114-01","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72578-114-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011405","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-114-05","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72578-114-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72578011406","name":"BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-114-06","proprietary_name":"Bisoprolol Fumarate and Hydrochlorothiazide","nonproprietary_name":"bisoprolol fumarate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 6.25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-114-06)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.22026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bisoprolol-Hydrochlorothiazide|Bisoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00143924001","name":"BLEOMYCIN SULFATE 15 UNIT VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9240-01","proprietary_name":"Bleomycin","nonproprietary_name":"Bleomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAPLEURAL; INTRAVENOUS; SUBCUTANEOUS","strength":"15 [USP'U]/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 BOX, UNIT-DOSE (0143-9240-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL","pharm_classes":["Cytoprotective Agent [EPC]"]},"nadac":{"value":26.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bleomycin Sulfate|Bleomycin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J9040","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9040 (15 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX, UNIT-DOSE (0143-9240-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409033220","name":"BLEOMYCIN SULFATE 15 UNIT VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-0332-20","proprietary_name":"Bleomycin","nonproprietary_name":"BLEOMYCIN","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAPLEURAL; INTRAVENOUS; SUBCUTANEOUS","strength":"15 [USP'U]/1","labeler":"Hospira, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0409-0332-20) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Cytoprotective Agent [EPC]"]},"nadac":{"value":26.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bleomycin Sulfate|Bleomycin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J9040","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9040 (15 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0409-0332-20) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16714088601","name":"BLEOMYCIN SULFATE 15 UNIT VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"16714-886-01","proprietary_name":"Bleomycin","nonproprietary_name":"Bleomycin","dosage_form":"POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAPLEURAL; INTRAVENOUS; SUBCUTANEOUS","strength":"15 [USP'U]/1","labeler":"NorthStar Rx LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (16714-886-01) / 15 POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Cytoprotective Agent [EPC]"]},"nadac":{"value":26.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bleomycin Sulfate|Bleomycin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J9040","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9040 (15 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (16714-886-01) / 15 POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"61703033218","name":"BLEOMYCIN SULFATE 15 UNIT VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61703-332-18","proprietary_name":"Bleomycin","nonproprietary_name":"BLEOMYCIN","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAPLEURAL; INTRAVENOUS; SUBCUTANEOUS","strength":"15 [USP'U]/1","labeler":"Hospira, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (61703-332-18) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Cytoprotective Agent [EPC]"]},"nadac":{"value":26.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bleomycin Sulfate|Bleomycin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J9040","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9040 (15 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (61703-332-18) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323013610","name":"BLEOMYCIN SULFATE 15 UNIT VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-136-10","proprietary_name":"Bleomycin","nonproprietary_name":"BLEOMYCIN SULFATE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAPLEURAL; INTRAVENOUS; SUBCUTANEOUS","strength":"15 [USP'U]/1","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL in 1 CARTON (63323-136-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL","pharm_classes":["Cytoprotective Agent [EPC]"]},"nadac":{"value":26.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bleomycin Sulfate|Bleomycin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J9040","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9040 (15 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (63323-136-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"71288010610","name":"BLEOMYCIN SULFATE 15 UNIT VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-106-10","proprietary_name":"Bleomycin","nonproprietary_name":"Bleomycin Sulfate","dosage_form":"POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAPLEURAL; INTRAVENOUS; SUBCUTANEOUS","strength":"15 [USP'U]/1","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (71288-106-10) / 15 POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Cytoprotective Agent [EPC]"]},"nadac":{"value":26.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bleomycin Sulfate|Bleomycin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J9040","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9040 (15 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (71288-106-10) / 15 POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68180086471","name":"BLISOVI 24 FE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086473","name":"BLISOVI 24 FE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-864-73","proprietary_name":"Blisovi 24 Fe","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-864-73) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086571","name":"BLISOVI FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086573","name":"BLISOVI FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-865-73","proprietary_name":"Blisovi Fe 1/20","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-865-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086671","name":"BLISOVI FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086673","name":"BLISOVI FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-866-73","proprietary_name":"BLISOVI FE 1.5/30","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-866-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086911","name":"BLISOVI FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180086913","name":"BLISOVI FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-869-13","proprietary_name":"BLISOVI FE 1.5/30","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-869-13) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Blisovi Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"00536106139","name":"BLUE 2% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1061-39","proprietary_name":"Rugby Ice Blue External Analgesic","nonproprietary_name":"MENTHOL, UNSPECIFIED FORM","dosage_form":"GEL","route":"TOPICAL","strength":"20 mg/g","labeler":"Rugby Laboratories","package_description":"226.8 g in 1 JAR (0536-1061-39)"},"nadac":{"value":0.01005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00173092238","name":"BLUJEPA 750 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0922-38","proprietary_name":"Blujepa","nonproprietary_name":"gepotidacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"8 TABLET, FILM COATED in 1 BOTTLE (0173-0922-38)","pharm_classes":["Cholinesterase Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Topoisomerase 2 Inhibitors [MoA]","Topoisomerase 4 Inhibitors [MoA]","Triazaacenaphthylene Bacterial Type II Topoisomerase Inhibitor [EPC]"]},"nadac":{"value":91.40209,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00173092245","name":"BLUJEPA 750 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0922-45","proprietary_name":"Blujepa","nonproprietary_name":"gepotidacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0173-0922-45)","pharm_classes":["Cholinesterase Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Topoisomerase 2 Inhibitors [MoA]","Topoisomerase 4 Inhibitors [MoA]","Triazaacenaphthylene Bacterial Type II Topoisomerase Inhibitor [EPC]"]},"nadac":{"value":91.40209,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55494012060","name":"BONJESTA ER 20-20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55494-120-60","proprietary_name":"BONJESTA","nonproprietary_name":"doxylamine succinate and pyridoxine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1; 20 mg/1","labeler":"Duchesnay USA, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (55494-120-60)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]"]},"nadac":{"value":11.11533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781085289","name":"BONSITY 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-852-89","proprietary_name":"Bonsity","nonproprietary_name":"teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Alvogen Inc.","package_description":"1 SYRINGE in 1 CARTON (47781-852-89) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"00173085910","name":"BREO ELLIPTA 100-25 MCG INHALR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0859-10","proprietary_name":"Breo Ellipta","nonproprietary_name":"fluticasone furoate and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0859-10) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.49895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.8971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Breo Ellipta|Fluticasone/Vilanterol","basis":"brand"},"part_b":null}, {"ndc":"00173085914","name":"BREO ELLIPTA 100-25 MCG INHALR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0859-14","proprietary_name":"Breo Ellipta","nonproprietary_name":"fluticasone furoate and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0859-14) / 1 INHALER in 1 TRAY / 14 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":5.36105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Breo Ellipta|Fluticasone/Vilanterol","basis":"brand"},"part_b":null}, {"ndc":"00173088210","name":"BREO ELLIPTA 200-25 MCG INHALR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0882-10","proprietary_name":"Breo Ellipta","nonproprietary_name":"fluticasone furoate and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0882-10) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.91371,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Breo Ellipta|Fluticasone/Vilanterol","basis":"brand"},"part_b":null}, {"ndc":"00173088214","name":"BREO ELLIPTA 200-25 MCG INHALR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0882-14","proprietary_name":"Breo Ellipta","nonproprietary_name":"fluticasone furoate and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0882-14) / 1 INHALER in 1 TRAY / 14 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":5.36203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Breo Ellipta|Fluticasone/Vilanterol","basis":"brand"},"part_b":null}, {"ndc":"00173091610","name":"BREO ELLIPTA 50-25 MCG INHALER","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0916-10","proprietary_name":"Breo Ellipta","nonproprietary_name":"fluticasone furoate and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0916-10) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.48203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Breo Ellipta|Fluticasone/Vilanterol","basis":"brand"},"part_b":null}, {"ndc":"00378750332","name":"BREYNA 160-4.5 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7503-32","proprietary_name":"BREYNA","nonproprietary_name":"Budesonide and Formoterol Fumarate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 4.5 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-7503-32) / 1 CANISTER in 1 POUCH / 120 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":21.61843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Breyna|Budesonide/Formoterol Fumarate","basis":"brand"},"part_b":null}, {"ndc":"00378750232","name":"BREYNA 80-4.5 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7502-32","proprietary_name":"BREYNA","nonproprietary_name":"Budesonide and Formoterol Fumarate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1; 4.5 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-7502-32) / 1 CANISTER in 1 POUCH / 120 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":18.53679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Breyna|Budesonide/Formoterol Fumarate","basis":"brand"},"part_b":null}, {"ndc":"00310461612","name":"BREZTRI AEROSPHERE 160-9-4.8 MCG","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-4616-12","proprietary_name":"BREZTRI","nonproprietary_name":"budesonide, glycopyrrolate, and formoterol fumarate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 9 ug/1; 4.8 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"120 AEROSOL, METERED in 1 INHALER (0310-4616-12)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":61.30387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Breztri Aerosphere|Budesonide/Glycopyr/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"00310461639","name":"BREZTRI AEROSPHERE 160-9-4.8 MCG","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-4616-39","proprietary_name":"BREZTRI","nonproprietary_name":"budesonide, glycopyrrolate, and formoterol fumarate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 9 ug/1; 4.8 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"28 AEROSOL, METERED in 1 INHALER (0310-4616-39)","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":61.52481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Breztri Aerosphere|Budesonide/Glycopyr/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"68462031629","name":"BRIELLYN 0.4 MG-0.035 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-316-29","proprietary_name":"BRIELLYN","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-316-29) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Briellyn|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462031684","name":"BRIELLYN 0.4 MG-0.035 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Briellyn|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00186077660","name":"BRILINTA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0776-60","proprietary_name":"BRILINTA","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"60 TABLET in 1 BOTTLE (0186-0776-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":7.41915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Brilinta|Ticagrelor","basis":"brand"},"part_b":null}, {"ndc":"00186077739","name":"BRILINTA 90 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0777-39","proprietary_name":"BRILINTA","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0186-0777-39) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":7.42045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Brilinta|Ticagrelor","basis":"brand"},"part_b":null}, {"ndc":"00186077760","name":"BRILINTA 90 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0777-60","proprietary_name":"BRILINTA","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"60 TABLET in 1 BOTTLE (0186-0777-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":7.42045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Brilinta|Ticagrelor","basis":"brand"},"part_b":null}, {"ndc":"24208041105","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-411-05","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-411-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.85299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"24208041110","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-411-10","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-411-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.57862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"24208041115","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-411-15","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-411-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.50116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"42571041992","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-419-92","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"Brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (42571-419-92) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.85299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"61314014305","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-143-05","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-143-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.85299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"61314014310","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-143-10","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-143-10) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.57862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"61314014315","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-143-15","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-143-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.50116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70069023101","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-231-01","proprietary_name":"BRIMONIDINE TARTRATE","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-231-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.85299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70069023201","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-232-01","proprietary_name":"BRIMONIDINE TARTRATE","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-232-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.57862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70069023301","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-233-01","proprietary_name":"BRIMONIDINE TARTRATE","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-233-01) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.50116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71921018505","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-185-05","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mg","labeler":"Florida Pharmaceutical Products, LLC","package_description":"5 mg in 1 BOTTLE, PLASTIC (71921-185-05)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.85299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71921018510","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-185-10","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mg","labeler":"Florida Pharmaceutical Products, LLC","package_description":"10 mg in 1 BOTTLE, PLASTIC (71921-185-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.57862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71921018515","name":"BRIMONIDINE 0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-185-15","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mg","labeler":"Florida Pharmaceutical Products, LLC","package_description":"15 mg in 1 BOTTLE, PLASTIC (71921-185-15)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.50116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"45802007830","name":"BRIMONIDINE 0.33% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-078-30","proprietary_name":"BRIMONIDINE","nonproprietary_name":"brimonidine","dosage_form":"GEL","route":"TOPICAL","strength":"5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, PUMP in 1 CARTON (45802-078-30) / 30 g in 1 BOTTLE, PUMP","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":13.92613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00781717770","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7177-70","proprietary_name":"Brimonidine","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0781-7177-70) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781717775","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7177-75","proprietary_name":"Brimonidine","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0781-7177-75) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781717785","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7177-85","proprietary_name":"Brimonidine","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0781-7177-85) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505057701","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0577-1","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0577-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505057702","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0577-2","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0577-2) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505057703","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0577-3","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0577-3) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332074905","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-749-05","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-749-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332074910","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-749-10","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-749-10) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332074915","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-749-15","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-749-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70069056601","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-566-01","proprietary_name":"BRIMONIDINE TARTRATE","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-566-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70069056701","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-567-01","proprietary_name":"BRIMONIDINE TARTRATE","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-567-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70069056801","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-568-01","proprietary_name":"BRIMONIDINE TARTRATE","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-568-01) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70756067730","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-677-30","proprietary_name":"Brimonidine Tartrate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-677-30) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70756067830","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-678-30","proprietary_name":"Brimonidine Tartrate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-678-30) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70756067935","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-679-35","proprietary_name":"Brimonidine Tartrate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-679-35) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"82182032105","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-321-05","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82182-321-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.05936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"82182032110","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-321-10","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82182-321-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.51982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"82182032115","name":"BRIMONIDINE TARTRATE 0.1% DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-321-15","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82182-321-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.5539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505056401","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0564-1","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0564-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.74729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505056402","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0564-2","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0564-2) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.54168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505056403","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0564-3","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0564-3) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.65198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"61314014405","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-144-05","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-144-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.74729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"61314014410","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-144-10","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-144-10) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.54168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"61314014415","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-144-15","proprietary_name":"Brimonidine Tartrate","nonproprietary_name":"Brimonidine Tartrate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-144-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.65198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332066105","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-661-05","proprietary_name":"Brimonidine Tartrate ophthalmic solution, 0.15%","nonproprietary_name":"Brimonidine Tartrate ophthalmic solution, 0.15%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-661-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.74729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332066110","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-661-10","proprietary_name":"Brimonidine Tartrate ophthalmic solution, 0.15%","nonproprietary_name":"Brimonidine Tartrate ophthalmic solution, 0.15%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-661-10) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.54168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332066115","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-661-15","proprietary_name":"Brimonidine Tartrate ophthalmic solution, 0.15%","nonproprietary_name":"Brimonidine Tartrate ophthalmic solution, 0.15%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-661-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.65198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"82182077305","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-773-05","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82182-773-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.74729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"82182077310","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-773-10","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82182-773-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.54168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"82182077315","name":"BRIMONIDINE TARTRATE 0.15% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-773-15","proprietary_name":"Brimonidine tartrate","nonproprietary_name":"brimonidine tartrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82182-773-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.65198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate*|Brimonidine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781718670","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7186-70","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (0781-7186-70) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"00781718675","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7186-75","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (0781-7186-75) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"00781718685","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7186-85","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (0781-7186-85) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"00832142505","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1425-05","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0832-1425-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"00832142510","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1425-10","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0832-1425-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"00832142515","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1425-15","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0832-1425-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"60505058901","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0589-1","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0589-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"60505058902","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0589-2","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0589-2) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"62332070605","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-706-05","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (62332-706-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"62332070610","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-706-10","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (62332-706-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"62332070615","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-706-15","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (62332-706-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"65145016201","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-162-01","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-162-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"65145016301","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-163-01","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-163-01) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"65145016401","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-164-01","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-164-01) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"68462028132","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-281-32","proprietary_name":"Brimonidine Tartrate/Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE, DROPPER in 1 CARTON (68462-281-32) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"68462028169","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-281-69","proprietary_name":"Brimonidine Tartrate/Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE, DROPPER in 1 CARTON (68462-281-69) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"69315033005","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-330-05","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-330-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"69315033010","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-330-10","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-330-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"69315033015","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-330-15","proprietary_name":"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-330-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"70069065101","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-651-01","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-651-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"70069065201","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-652-01","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-652-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"70069065301","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-653-01","proprietary_name":"Brimonidine Tartrate and Timolol Maleate","nonproprietary_name":"Brimonidine Tartrate and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-653-01) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"71921018805","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-188-05","proprietary_name":"BRIMONIDINE TARTRATE AND TIMOLOL MALEATE","nonproprietary_name":"Brimonidine tartrate and Timolol maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (71921-188-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"71921018810","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-188-10","proprietary_name":"BRIMONIDINE TARTRATE AND TIMOLOL MALEATE","nonproprietary_name":"Brimonidine tartrate and Timolol maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (71921-188-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"71921018815","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-188-15","proprietary_name":"BRIMONIDINE TARTRATE AND TIMOLOL MALEATE","nonproprietary_name":"Brimonidine tartrate and Timolol maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (71921-188-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"72603093105","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-931-05","proprietary_name":"Brimonidine tartrate and Timolol maleate","nonproprietary_name":"Brimonidine tartrate and Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72603-931-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"72603093110","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-931-10","proprietary_name":"Brimonidine tartrate and Timolol maleate","nonproprietary_name":"Brimonidine tartrate and Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72603-931-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"82182045505","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"82182045510","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"82182045515","name":"BRIMONIDINE-TIMOLOL 0.2%-0.5%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brimonidine Tartrate-Timolol|Brimonidine Tartrate/Timolol","basis":"generic"},"part_b":null}, {"ndc":"00574401210","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4012-10","proprietary_name":"BRINZOLAMIDE","nonproprietary_name":"brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE in 1 CARTON (0574-4012-10) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":8.52641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"00574401215","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4012-15","proprietary_name":"BRINZOLAMIDE","nonproprietary_name":"brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE in 1 CARTON (0574-4012-15) / 15 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":9.474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"00591212712","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":9.474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"00591212779","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":8.52641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"00781601470","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6014-70","proprietary_name":"Brinzolamide","nonproprietary_name":"Brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0781-6014-70) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":8.52641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"00781601485","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6014-85","proprietary_name":"Brinzolamide","nonproprietary_name":"Brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0781-6014-85) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":9.474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"24208046410","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-464-10","proprietary_name":"BRINZOLAMIDE","nonproprietary_name":"brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (24208-464-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":8.52641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"24208046415","name":"BRINZOLAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-464-15","proprietary_name":"BRINZOLAMIDE","nonproprietary_name":"brinzolamide","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (24208-464-15) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":9.474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brinzolamide|Brinzolamide","basis":"generic"},"part_b":null}, {"ndc":"00121107410","name":"BRIVARACETAM 10 MG/ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1074-10","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"1 BOTTLE in 1 CARTON (0121-1074-10) / 300 mL in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.26682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877090458","name":"BRIVARACETAM 10 MG/ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-904-58","proprietary_name":"Brivaracetam Oral Solution","nonproprietary_name":"Brivaracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (67877-904-58) / 300 mL in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.26682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748041101","name":"BRIVARACETAM 10 MG/ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-411-01","proprietary_name":"BRIVARACETAM","nonproprietary_name":"brivaracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-411-01) / 300 mL in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.26682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71921041072","name":"BRIVARACETAM 10 MG/ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-410-72","proprietary_name":"Brivaracetam oral Solution","nonproprietary_name":"Brivaracetam oral","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE in 1 CARTON (71921-410-72) / 300 mL in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.26682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205003373","name":"BRIVARACETAM 10 MG/ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-033-73","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-033-73) / 300 mL in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.26682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505472706","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4727-6","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4727-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710158806","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1588-6","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1588-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205027101","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205027106","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-271-06","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (72205-271-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205027160","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-271-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-271-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73473090860","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-908-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (73473-908-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282082660","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-826-60","proprietary_name":"BRIVARACETAM","nonproprietary_name":"BRIVARACETAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-826-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"84386007260","name":"BRIVARACETAM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-072-60","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (84386-072-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505472406","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4724-6","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4724-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710158506","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1585-6","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1585-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205026801","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205026806","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-268-06","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (72205-268-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205026860","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-268-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-268-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73473090560","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-905-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (73473-905-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282082360","name":"BRIVARACETAM 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-823-60","proprietary_name":"BRIVARACETAM","nonproprietary_name":"BRIVARACETAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-823-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505472506","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4725-6","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4725-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710158606","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1586-6","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1586-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205026901","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205026906","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-269-06","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (72205-269-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205026960","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-269-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-269-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73473090660","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-906-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (73473-906-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282082460","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-824-60","proprietary_name":"BRIVARACETAM","nonproprietary_name":"BRIVARACETAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-824-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"84386007060","name":"BRIVARACETAM 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-070-60","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (84386-070-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505472606","name":"BRIVARACETAM 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4726-6","proprietary_name":"Brivaracetam","nonproprietary_name":"Brivaracetam","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4726-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710158706","name":"BRIVARACETAM 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1587-6","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1587-6)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205027060","name":"BRIVARACETAM 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-270-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-270-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73473090760","name":"BRIVARACETAM 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-907-60","proprietary_name":"brivaracetam","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (73473-907-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282082560","name":"BRIVARACETAM 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-825-60","proprietary_name":"BRIVARACETAM","nonproprietary_name":"BRIVARACETAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-825-60)","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":0.266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474037066","name":"BRIVIACT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-370-66","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"UCB, Inc.","package_description":"1 BOTTLE in 1 CARTON (50474-370-66) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":23.98643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474087015","name":"BRIVIACT 10 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-870-15","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"UCB, Inc.","package_description":"1 BOTTLE in 1 CARTON (50474-870-15) / 300 mL in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":4.8099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.26682,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50474077009","name":"BRIVIACT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-770-09","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"UCB, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (50474-770-09) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.06984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474077066","name":"BRIVIACT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-770-66","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"UCB, Inc.","package_description":"1 BOTTLE in 1 CARTON (50474-770-66) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.06984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.25862,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474047009","name":"BRIVIACT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-470-09","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"UCB, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (50474-470-09) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.06598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474047066","name":"BRIVIACT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-470-66","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"UCB, Inc.","package_description":"1 BOTTLE in 1 CARTON (50474-470-66) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.06598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22236,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474057009","name":"BRIVIACT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-570-09","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"UCB, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (50474-570-09) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.07445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474057066","name":"BRIVIACT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-570-66","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"UCB, Inc.","package_description":"1 BOTTLE in 1 CARTON (50474-570-66) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.07445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18877,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474067066","name":"BRIVIACT 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-670-66","proprietary_name":"Briviact","nonproprietary_name":"brivaracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"UCB, Inc.","package_description":"1 BOTTLE in 1 CARTON (50474-670-66) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Epoxide Hydrolase Inhibitors [MoA]"]},"nadac":{"value":24.05799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.266,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49708075541","name":"BROMFENAC SOD 0.075% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49708-755-41","proprietary_name":"bromfenac 0.075%","nonproprietary_name":"bromfenac","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".76 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 POUCH in 1 CARTON (49708-755-41) / 1 BOTTLE, DROPPER in 1 POUCH / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":24.38477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180043401","name":"BROMFENAC SOD 0.075% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-434-01","proprietary_name":"BROMFENAC","nonproprietary_name":"BROMFENAC","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".75 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-434-01) / 5 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":24.38477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505100602","name":"BROMFENAC SODIUM 0.07% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1006-2","proprietary_name":"Bromfenac Ophthalmic Solution, 0.07%","nonproprietary_name":"Bromfenac Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".7 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-1006-2) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":13.24968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"62332058303","name":"BROMFENAC SODIUM 0.07% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-583-03","proprietary_name":"BROMFENAC SODIUM","nonproprietary_name":"BROMFENAC SODIUM","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".805 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-583-03) / 3 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":13.24968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180043302","name":"BROMFENAC SODIUM 0.07% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-433-02","proprietary_name":"bromfenac sodium","nonproprietary_name":"bromfenac sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".805 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (68180-433-02) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":13.24968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"75907009303","name":"BROMFENAC SODIUM 0.07% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-093-03","proprietary_name":"bromfenac ophthalmic solution","nonproprietary_name":"Bromfenac Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".7 mg/mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (75907-093-03) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":13.24968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"82260060203","name":"BROMFENAC SODIUM 0.07% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-602-03","proprietary_name":"bromfenac ophthalmic solution","nonproprietary_name":"Bromfenac Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".7 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-602-03) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":13.24968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"62332050817","name":"BROMFENAC SODIUM 0.09% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-508-17","proprietary_name":"Bromfenac Ophthalmic Solution 0.09%","nonproprietary_name":"Bromfenac Ophthalmic Solution 0.09%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.035 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-508-17) / 1.7 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.63411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862078917","name":"BROMFENAC SODIUM 0.09% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-789-17","proprietary_name":"Bromfenac","nonproprietary_name":"Bromfenac","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".9 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-789-17) / 1.7 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.63411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180043601","name":"BROMFENAC SODIUM 0.09% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-436-01","proprietary_name":"Bromfenac","nonproprietary_name":"Bromfenac","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".9 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-436-01) / 1.7 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.63411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"72266014201","name":"BROMFENAC SODIUM 0.09% EYE DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-142-01","proprietary_name":"BROMFENAC","nonproprietary_name":"Bromfenac","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".9 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72266-142-01) / 1.7 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.63411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromfenac Sodium|Bromfenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"00574010601","name":"BROMOCRIPTINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0106-01","proprietary_name":"Bromocriptine mesylate","nonproprietary_name":"Bromocriptine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0574-0106-01)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.60949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00574010603","name":"BROMOCRIPTINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0106-03","proprietary_name":"Bromocriptine mesylate","nonproprietary_name":"Bromocriptine mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Padagis US LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0574-0106-03)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.60949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687093111","name":"BROMOCRIPTINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.60949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687093121","name":"BROMOCRIPTINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-931-21","proprietary_name":"Bromocriptine Mesylate","nonproprietary_name":"Bromocriptine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-931-21) / 1 TABLET in 1 BLISTER PACK (60687-931-11)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.60949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70954097810","name":"BROMOCRIPTINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-978-10","proprietary_name":"Bromocriptine Mesylate","nonproprietary_name":"Bromocriptine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-978-10)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.60949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"70954097820","name":"BROMOCRIPTINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-978-20","proprietary_name":"Bromocriptine Mesylate","nonproprietary_name":"Bromocriptine Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-978-20)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.60949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378709601","name":"BROMOCRIPTINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-7096-01","proprietary_name":"Bromocriptine Mesylate","nonproprietary_name":"bromocriptine mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, UNIT-DOSE (0378-7096-01)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.11666,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378709693","name":"BROMOCRIPTINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-7096-93","proprietary_name":"Bromocriptine Mesylate","nonproprietary_name":"bromocriptine mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE, UNIT-DOSE (0378-7096-93)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.11666,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382011006","name":"BROMOCRIPTINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68382-110-06","proprietary_name":"Bromocriptine mesylate","nonproprietary_name":"Bromocriptine mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68382-110-06)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.11666,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bromocriptine Mesylate|Bromocriptine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00121093304","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0933-04","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"118 mL in 1 BOTTLE (0121-0933-04)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121093316","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0933-16","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0933-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574110404","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-1104-04","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Padagis US LLC","package_description":"118 mL in 1 BOTTLE, PLASTIC (0574-1104-04)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574110416","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-1104-16","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Padagis US LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (0574-1104-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192060704","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-607-04","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"118 mL in 1 BOTTLE, PLASTIC (42192-607-04)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192060716","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-607-16","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (42192-607-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192063004","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-630-04","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"118 mL in 1 BOTTLE, PLASTIC (42192-630-04)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192063016","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-630-16","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (42192-630-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135030247","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-302-47","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-302-47)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135030248","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-302-48","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"118 mL in 1 BOTTLE (62135-302-48)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877055816","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-558-16","proprietary_name":"Brompheniramine, Pseudoephedrine, Dextromethorphan","nonproprietary_name":"Brompheniramine, Pseudoephedrine, Dextromethorphan","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"473 mL in 1 BOTTLE (67877-558-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877055817","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-558-17","proprietary_name":"Brompheniramine, Pseudoephedrine, Dextromethorphan","nonproprietary_name":"Brompheniramine, Pseudoephedrine, Dextromethorphan","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"118 mL in 1 BOTTLE (67877-558-17)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452047855","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-478-55","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","nonproprietary_name":"BROMPHENIRAMINE MALEATE, PSEUDOEPHEDRINE HYDROCHLORIDE, and DEXTROMETHORPHAN HYDROBROMIDE","dosage_form":"SYRUP","route":"ORAL","strength":"10 mg/5mL; 30 mg/5mL; 2 mg/5mL","labeler":"BIONPHARMA INC.","package_description":"118 mL in 1 BOTTLE (69452-478-55)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452047888","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-478-88","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","nonproprietary_name":"BROMPHENIRAMINE MALEATE, PSEUDOEPHEDRINE HYDROCHLORIDE, and DEXTROMETHORPHAN HYDROBROMIDE","dosage_form":"SYRUP","route":"ORAL","strength":"10 mg/5mL; 30 mg/5mL; 2 mg/5mL","labeler":"BIONPHARMA INC.","package_description":"473 mL in 1 BOTTLE (69452-478-88)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71930002643","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-026-43","proprietary_name":"Brompheniramine maleate, pseudoephedrine hydrochloride,","nonproprietary_name":"Brompheniramine maleate, pseudoephedrine hydrochloride,","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Eywa Pharma Inc","package_description":"473 mL in 1 BOTTLE (71930-026-43)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75907020704","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-207-04","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Dr. Reddy's Labratories Inc.","package_description":"118 mL in 1 BOTTLE, PLASTIC (75907-207-04)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75907020716","name":"BROMPHEN-PSE-DM 2-30-10 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-207-16","proprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","nonproprietary_name":"Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL; 30 mg/5mL; 10 mg/5mL","labeler":"Dr. Reddy's Labratories Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (75907-207-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49708075441","name":"BROMSITE 0.075% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49708-754-41","proprietary_name":"BROMSITE 0.075%","nonproprietary_name":"bromfenac","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".76 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 POUCH in 1 CARTON (49708-754-41) / 1 BOTTLE, DROPPER in 1 POUCH / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":49.55344,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":24.38477,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Bromsite|Bromfenac Sodium","basis":"brand"},"part_b":null}, {"ndc":"27437006030","name":"BROVANA 15 MCG/2 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":9.67343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.63275,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brovana|Arformoterol Tartrate","basis":"brand"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"27437006060","name":"BROVANA 15 MCG/2 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":9.74999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.6202,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Brovana|Arformoterol Tartrate","basis":"brand"},"part_b":{"hcpcs":"J7605","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7605 (15 mcg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00093681555","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6815-55","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 POUCH in 1 CARTON (0093-6815-55) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0093-6815-55) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093681573","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6815-73","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-6815-73) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-6815-45) / 2 mL in 1 VIAL, SINGLE-DOSE (0093-6815-19)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0093-6815-73) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-6815-45) / 2 mL in 1 VIAL, SINGLE-DOSE (0093-6815-19)) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00115168774","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1687-74","proprietary_name":"Budesonide Inhalation","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"6 POUCH in 1 CARTON (0115-1687-74) / 5 VIAL in 1 POUCH (0115-1687-76) / 2 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0115-1687-74) / 5 VIAL in 1 POUCH (0115-1687-76) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487960101","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9601-01","proprietary_name":"Budesonide","nonproprietary_name":"BUDESONIDE","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"6 POUCH in 1 CARTON (0487-9601-01) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0487-9601-01) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487960130","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9601-30","proprietary_name":"Budesonide","nonproprietary_name":"BUDESONIDE","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-9601-30) / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-9601-30) / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335063149","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-631-49","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 CARTON (47335-631-49) / 5 AMPULE in 1 POUCH (47335-631-48) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (47335-631-49) / 5 AMPULE in 1 POUCH (47335-631-48) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60687088983","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-889-83","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-889-83) / 1 AMPULE in 1 POUCH (60687-889-79) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"62135082284","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-822-84","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Chartwell RX, LLC","package_description":"6 POUCH in 1 CARTON (62135-822-84) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (62135-822-84) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64980063803","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-638-03","proprietary_name":"Budesonide","nonproprietary_name":"BUDESONIDE","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":".25 mg/2mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 POUCH in 1 CARTON (64980-638-03) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"69097031853","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-318-53","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":".25 mg/2mL","labeler":"Cipla USA Inc.","package_description":"30 POUCH in 1 CARTON (69097-318-53) / 1 AMPULE in 1 POUCH (69097-318-32) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (69097-318-53) / 1 AMPULE in 1 POUCH (69097-318-32) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097031887","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-318-87","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":".25 mg/2mL","labeler":"Cipla USA Inc.","package_description":"6 POUCH in 1 CARTON (69097-318-87) / 5 AMPULE in 1 POUCH (69097-318-86) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (69097-318-87) / 5 AMPULE in 1 POUCH (69097-318-86) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76282064038","name":"BUDESONIDE 0.25 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-640-38","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":".25 mg/2mL","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"6 POUCH in 1 CARTON (76282-640-38) / 5 AMPULE in 1 POUCH (76282-640-37) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.6974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (76282-640-38) / 5 AMPULE in 1 POUCH (76282-640-37) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093681655","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6816-55","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 POUCH in 1 CARTON (0093-6816-55) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0093-6816-55) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093681673","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6816-73","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-6816-73) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-6816-45) / 2 mL in 1 VIAL, SINGLE-DOSE (0093-6816-19)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0093-6816-73) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-6816-45) / 2 mL in 1 VIAL, SINGLE-DOSE (0093-6816-19)) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00115168974","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1689-74","proprietary_name":"Budesonide Inhalation","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"6 POUCH in 1 CARTON (0115-1689-74) / 5 VIAL in 1 POUCH (0115-1689-76) / 2 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0115-1689-74) / 5 VIAL in 1 POUCH (0115-1689-76) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487970101","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9701-01","proprietary_name":"Budesonide","nonproprietary_name":"BUDESONIDE","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"6 POUCH in 1 CARTON (0487-9701-01) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0487-9701-01) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487970130","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9701-30","proprietary_name":"Budesonide","nonproprietary_name":"BUDESONIDE","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-9701-30) / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-9701-30) / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335063249","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-632-49","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 CARTON (47335-632-49) / 5 AMPULE in 1 POUCH (47335-632-48) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (47335-632-49) / 5 AMPULE in 1 POUCH (47335-632-48) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59651058530","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-585-30","proprietary_name":"BUDESONIDE","nonproprietary_name":"BUDESONIDE","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Aurobindo Pharma Limited","package_description":"6 POUCH in 1 CARTON (59651-585-30) / 5 AMPULE in 1 POUCH (59651-585-05) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"60687052483","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-524-83","proprietary_name":"Budesonide Inhalation","nonproprietary_name":"Budesonide Inhalation","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-524-83) / 1 AMPULE in 1 POUCH (60687-524-79) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (60687-524-83) / 1 AMPULE in 1 POUCH (60687-524-79) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62135082384","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-823-84","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Chartwell RX, LLC","package_description":"6 POUCH in 1 CARTON (62135-823-84) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (62135-823-84) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64980063903","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-639-03","proprietary_name":"Budesonide","nonproprietary_name":"BUDESONIDE","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 POUCH in 1 CARTON (64980-639-03) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"68180098430","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-984-30","proprietary_name":"budesonide inhalation","nonproprietary_name":"budesonide inhalation","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"6 POUCH in 1 CARTON (68180-984-30) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (68180-984-30) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097031953","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-319-53","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":".5 mg/2mL","labeler":"Cipla USA Inc.","package_description":"30 POUCH in 1 CARTON (69097-319-53) / 1 AMPULE in 1 POUCH (69097-319-32) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (69097-319-53) / 1 AMPULE in 1 POUCH (69097-319-32) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097031987","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-319-87","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":".5 mg/2mL","labeler":"Cipla USA Inc.","package_description":"6 POUCH in 1 CARTON (69097-319-87) / 5 AMPULE in 1 POUCH (69097-319-86) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (69097-319-87) / 5 AMPULE in 1 POUCH (69097-319-86) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204001801","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"76282064138","name":"BUDESONIDE 0.5 MG/2 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-641-38","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":".5 mg/2mL","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"6 POUCH in 1 CARTON (76282-641-38) / 5 AMPULE in 1 POUCH (76282-641-37) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (76282-641-38) / 5 AMPULE in 1 POUCH (76282-641-37) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093681773","name":"BUDESONIDE 1 MG/2 ML INH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6817-73","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":"1 mg/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-6817-73) / 5 AMPULE in 1 POUCH (0093-6817-45) / 2 mL in 1 AMPULE (0093-6817-19)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.42737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0093-6817-73) / 5 AMPULE in 1 POUCH (0093-6817-45) / 2 mL in 1 AMPULE (0093-6817-19)) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335063349","name":"BUDESONIDE 1 MG/2 ML INH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-633-49","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":"1 mg/2mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 CARTON (47335-633-49) / 5 AMPULE in 1 POUCH (47335-633-48) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.42737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Budesonide*|Budesonide","basis":"generic"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (47335-633-49) / 5 AMPULE in 1 POUCH (47335-633-48) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097032153","name":"BUDESONIDE 1 MG/2 ML INH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-321-53","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":"1 mg/2mL","labeler":"Cipla USA Inc.","package_description":"30 POUCH in 1 CARTON (69097-321-53) / 1 AMPULE in 1 POUCH (69097-321-32) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.42737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (69097-321-53) / 1 AMPULE in 1 POUCH (69097-321-32) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097032187","name":"BUDESONIDE 1 MG/2 ML INH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-321-87","proprietary_name":"Budesonide Inhalation Suspension","nonproprietary_name":"Budesonide","dosage_form":"INHALANT","route":"ORAL","strength":"1 mg/2mL","labeler":"Cipla USA Inc.","package_description":"6 POUCH in 1 CARTON (69097-321-87) / 5 AMPULE in 1 POUCH (69097-321-86) / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.42737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (69097-321-87) / 5 AMPULE in 1 POUCH (69097-321-86) / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"45802062786","name":"BUDESONIDE 2 MG RECTAL FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-627-86","proprietary_name":"BUDESONIDE","nonproprietary_name":"budesonide","dosage_form":"AEROSOL, FOAM","route":"RECTAL","strength":"2 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"2 CANISTER in 1 CARTON (45802-627-86) / 1 AEROSOL, FOAM in 1 CANISTER (45802-627-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.56406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536145684","name":"BUDESONIDE 32 MCG NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1456-84","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"32 ug/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0536-1456-84) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.41168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122038976","name":"BUDESONIDE 32 MCG NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.41168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505612902","name":"BUDESONIDE 32 MCG NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6129-2","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"32 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 BOTTLE, SPRAY (60505-6129-2) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.41168,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574985510","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-9855-10","proprietary_name":"budesonide","nonproprietary_name":"budesonide","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Padagis US LLC","package_description":"1 BOTTLE in 1 CARTON (0574-9855-10) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"00904731310","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7313-10","proprietary_name":"budesonide","nonproprietary_name":"budesonide","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"3 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7313-10) / 1 CAPSULE, COATED PELLETS in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"16714082901","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-829-01","proprietary_name":"budesonide","nonproprietary_name":"budesonide","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"3 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 CAPSULE, COATED PELLETS in 1 BOTTLE (16714-829-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"53746077810","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-778-10","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (53746-778-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"60687059632","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-596-32","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"3 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-596-32) / 1 CAPSULE, COATED PELLETS in 1 BLISTER PACK (60687-596-33)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"60687059633","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"68382072001","name":"BUDESONIDE DR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-720-01","proprietary_name":"budesonide","nonproprietary_name":"budesonide","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"3 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, COATED PELLETS in 1 BOTTLE (68382-720-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide Dr|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"65162077810","name":"BUDESONIDE EC 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-778-10","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (65162-778-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.49753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide EC|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"00378450093","name":"BUDESONIDE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4500-93","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-4500-93)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":15.54905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide ER|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"00591251030","name":"BUDESONIDE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2510-30","proprietary_name":"Budesonide","nonproprietary_name":"Budesonide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0591-2510-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":15.54905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Budesonide ER|Budesonide","basis":"generic"},"part_b":null}, {"ndc":"00310737020","name":"BUDESONIDE-FORMOTEROL 160-4.5","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-7370-20","proprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","nonproprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 4.5 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 POUCH in 1 CARTON (0310-7370-20) / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":17.26446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Budesonide-Formoterol Fumarate|Budesonide/Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00480308131","name":"BUDESONIDE-FORMOTEROL 160-4.5","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3081-31","proprietary_name":"Budesonide and formoterol fumarate dihydrate","nonproprietary_name":"Budesonide and formoterol fumarate dihydrate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 4.5 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 POUCH in 1 CARTON (0480-3081-31) / 1 CANISTER in 1 POUCH / 120 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":17.26446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Budesonide-Formoterol Fumarate|Budesonide/Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00310737220","name":"BUDESONIDE-FORMOTEROL 80-4.5","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-7372-20","proprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","nonproprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1; 4.5 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 POUCH in 1 CARTON (0310-7372-20) / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":15.66845,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Budesonide-Formoterol Fumarate|Budesonide/Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00480308031","name":"BUDESONIDE-FORMOTEROL 80-4.5","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3080-31","proprietary_name":"Budesonide and formoterol fumarate dihydrate","nonproprietary_name":"Budesonide and formoterol fumarate dihydrate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1; 4.5 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 POUCH in 1 CARTON (0480-3080-31) / 1 CANISTER in 1 POUCH / 120 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":15.66845,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Budesonide-Formoterol Fumarate|Budesonide/Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"70000014701","name":"BUFFERED ASPIRIN 325 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0147-1","proprietary_name":"Buffered Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0147-1) / 130 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185012801","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0128-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-0128-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00185012805","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0128-05","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0185-0128-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"14539070001","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"14539070005","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571067901","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-679-01","proprietary_name":"Bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc","package_description":"100 TABLET in 1 BOTTLE (16571-679-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"42799011901","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-119-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-119-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"43547089610","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-896-10","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-896-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"50268013011","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-130","inner_of":["50268-130-15"]},"part_b":null}, {"ndc":"50268013015","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-130-15","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-130-15) / 1 TABLET in 1 BLISTER PACK (50268-130-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"51672422301","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4223-1","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4223-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"69238148901","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1489-1","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1489-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"70756007911","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-079-11","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-079-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72603088901","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-889-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-889-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72888001901","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-019-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-019-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"76282079701","name":"BUMETANIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-797-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-797-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.12883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00185012901","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0129-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-0129-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00185012905","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0129-05","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0185-0129-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00904701604","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7016-04","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7016-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00904701606","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7016-06","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7016-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00904701661","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7016-61","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7016-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"14539070101","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"14539070105","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571067801","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-678-01","proprietary_name":"Bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc","package_description":"100 TABLET in 1 BOTTLE (16571-678-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"23155090101","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-901-01","proprietary_name":"bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-901-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"23155090105","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-901-05","proprietary_name":"bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-901-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"42799012001","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-120-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-120-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"42799012002","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-120-02","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET in 1 BOTTLE (42799-120-02)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"43547089710","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-897-10","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-897-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"43547089750","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-897-50","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-897-50)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"50268013111","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-131","inner_of":["50268-131-15"]},"part_b":null}, {"ndc":"50268013115","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-131-15","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-131-15) / 1 TABLET in 1 BLISTER PACK (50268-131-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"51672422401","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4224-1","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4224-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"60687038401","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-384-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-384-01) / 1 TABLET in 1 BLISTER PACK (60687-384-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"60687038411","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-384","inner_of":["60687-384-01","60687-384-65"]},"part_b":null}, {"ndc":"60687038465","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-384-65","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-384-65) / 1 TABLET in 1 BLISTER PACK (60687-384-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"69238149001","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1490-1","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1490-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"69238149005","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1490-5","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET in 1 BOTTLE (69238-1490-5)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"70756008011","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-080-11","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-080-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"70756008051","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-080-51","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70756-080-51)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72603090001","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-900-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-900-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72888002001","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-020-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-020-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"76282079801","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-798-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-798-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"76282079805","name":"BUMETANIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-798-05","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-798-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.10789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00185013001","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0130-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-0130-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"00185013005","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0130-05","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET in 1 BOTTLE (0185-0130-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"14539070201","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"14539070205","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571067701","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-677-01","proprietary_name":"Bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc","package_description":"100 TABLET in 1 BOTTLE (16571-677-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"23155090201","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-902-01","proprietary_name":"bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-902-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"23155090205","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-902-05","proprietary_name":"bumetanide","nonproprietary_name":"bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-902-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"42799012101","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-121-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-121-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"42799012102","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-121-02","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET in 1 BOTTLE (42799-121-02)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"43547089810","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-898-10","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-898-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"43547089850","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-898-50","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-898-50)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"50268013211","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-132","inner_of":["50268-132-15"]},"part_b":null}, {"ndc":"50268013215","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-132-15","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-132-15) / 1 TABLET in 1 BLISTER PACK (50268-132-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"51672422501","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4225-1","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4225-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"60687053511","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-535","inner_of":["60687-535-65"]},"part_b":null}, {"ndc":"60687053565","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-535-65","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-535-65) / 1 TABLET in 1 BLISTER PACK (60687-535-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"69238149101","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1491-1","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1491-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"69238149105","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1491-5","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET in 1 BOTTLE (69238-1491-5)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"70756008111","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-081-11","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-081-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"70756008151","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-081-51","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70756-081-51)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72603090101","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-901-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-901-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72888002101","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-021-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-021-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"76282079901","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-799-01","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-799-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"76282079905","name":"BUMETANIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-799-05","proprietary_name":"Bumetanide","nonproprietary_name":"Bumetanide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-799-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.1819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bumetanide*|Bumetanide","basis":"generic"},"part_b":null}, {"ndc":"72603027901","name":"BUPIVACAINE 0.25% 125 MG/50 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143932801","name":"BUPIVACAINE 0.25% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409116018","name":"BUPIVACAINE 0.25% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069075201","name":"BUPIVACAINE 0.25% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70069-752-01","proprietary_name":"Bupivacaine hydrochloride","nonproprietary_name":"Bupivacaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"2.5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 VIAL in 1 CARTON (70069-752-01) / 50 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Local Anesthesia [PE]"]},"nadac":{"value":0.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70594011601","name":"BUPIVACAINE 0.25% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70594-116-01","proprietary_name":"Bupivacaine HCl","nonproprietary_name":"Bupivacaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"PERINEURAL","strength":"2.5 mg/mL","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"50 mL in 1 VIAL, MULTI-DOSE (70594-116-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Local Anesthesia [PE]"]},"nadac":{"value":0.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0665","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0665 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 mL in 1 VIAL, MULTI-DOSE (70594-116-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288072352","name":"BUPIVACAINE 0.25% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-723-52","proprietary_name":"bupivacaine hydrochloride","nonproprietary_name":"bupivacaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"2.5 mg/mL","labeler":"Meitheal Pharmaceuticals Inc","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (71288-723-52) / 50 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Local Anesthesia [PE]"]},"nadac":{"value":0.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0665","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0665 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (71288-723-52) / 50 mL in 1 VIAL, MULTI-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603028701","name":"BUPIVACAINE 0.5% 250 MG/50 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.08596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143932901","name":"BUPIVACAINE 0.5% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.08596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409116318","name":"BUPIVACAINE 0.5% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.08596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069075301","name":"BUPIVACAINE 0.5% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70069-753-01","proprietary_name":"Bupivacaine hydrochloride","nonproprietary_name":"Bupivacaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 VIAL in 1 CARTON (70069-753-01) / 50 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Local Anesthesia [PE]"]},"nadac":{"value":0.08596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70594011901","name":"BUPIVACAINE 0.5% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70594-119-01","proprietary_name":"Bupivacaine HCl","nonproprietary_name":"Bupivacaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"PERINEURAL","strength":"5 mg/mL","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"50 mL in 1 VIAL, MULTI-DOSE (70594-119-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Local Anesthesia [PE]"]},"nadac":{"value":0.08596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0665","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0665 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 mL in 1 VIAL, MULTI-DOSE (70594-119-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288072652","name":"BUPIVACAINE 0.5% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-726-52","proprietary_name":"bupivacaine hydrochloride","nonproprietary_name":"bupivacaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"PERINEURAL","strength":"5 mg/mL","labeler":"Meitheal Pharmaceuticals Inc","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (71288-726-52) / 50 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Local Anesthesia [PE]"]},"nadac":{"value":0.08596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0665","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0665 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (71288-726-52) / 50 mL in 1 VIAL, MULTI-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093365721","name":"BUPRENORPHINE 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365740","name":"BUPRENORPHINE 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3657-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"10 ug/h","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"4 POUCH in 1 CARTON (0093-3657-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858049340","name":"BUPRENORPHINE 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-493-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"10 ug/h","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 POUCH in 1 CARTON (42858-493-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine|Buprenorphine","basis":"generic"},"part_b":null}, {"ndc":"50742037401","name":"BUPRENORPHINE 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742037404","name":"BUPRENORPHINE 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-374-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"10 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"4 POUCH in 1 CARTON (50742-374-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238120302","name":"BUPRENORPHINE 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1203-2","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"10 ug/h","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"4 POUCH in 1 CARTON (69238-1203-2) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365821","name":"BUPRENORPHINE 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365840","name":"BUPRENORPHINE 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3658-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"15 ug/h","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"4 POUCH in 1 CARTON (0093-3658-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858058640","name":"BUPRENORPHINE 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-586-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"15 ug/h","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 POUCH in 1 CARTON (42858-586-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine|Buprenorphine","basis":"generic"},"part_b":null}, {"ndc":"50742037501","name":"BUPRENORPHINE 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742037504","name":"BUPRENORPHINE 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-375-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"15 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"4 POUCH in 1 CARTON (50742-375-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238120402","name":"BUPRENORPHINE 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1204-2","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"15 ug/h","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"4 POUCH in 1 CARTON (69238-1204-2) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054017613","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0176-13","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0176-13)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121101930","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1019-30","proprietary_name":"buprenorphine hydrochloride","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"30 TABLET in 1 BOTTLE (0121-1019-30)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228315603","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3156-03","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (0228-3156-03)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406701203","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-7012-03","proprietary_name":"Buprenorphine HCl","nonproprietary_name":"Buprenorphine HCl","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET in 1 BOTTLE (0406-7012-03)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904715404","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7154-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7154-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722087030","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-870-30","proprietary_name":"Buprenorphine HCl","nonproprietary_name":"Buprenorphine HCl","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-870-30)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858050103","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-501-03","proprietary_name":"BUPRENORPHINE","nonproprietary_name":"BUPRENORPHINE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (42858-501-03)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268012811","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268012815","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-128-15","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-128-15) / 1 TABLET in 1 BLISTER PACK (50268-128-11)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687048111","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687048121","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-481-21","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-481-21) / 1 TABLET in 1 BLISTER PACK (60687-481-11)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756045983","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-459-83","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (62756-459-83)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888018230","name":"BUPRENORPHINE 2 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-182-30","proprietary_name":"buprenorphine hydrochloride","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET in 1 BOTTLE (72888-182-30)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.27676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365921","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365940","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3659-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"20 ug/h","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"4 POUCH in 1 CARTON (0093-3659-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858083940","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-839-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"20 ug/h","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 POUCH in 1 CARTON (42858-839-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine|Buprenorphine","basis":"generic"},"part_b":null}, {"ndc":"47781040804","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-408-04","proprietary_name":"buprenorphine transdermal system","nonproprietary_name":"buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"20 ug/h","labeler":"Alvogen Inc.","package_description":"4 POUCH in 1 CARTON (47781-408-04) / 1 PATCH in 1 POUCH (47781-408-11) / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742037601","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742037604","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-376-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"20 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"4 POUCH in 1 CARTON (50742-376-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238120502","name":"BUPRENORPHINE 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1205-2","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"20 ug/h","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"4 POUCH in 1 CARTON (69238-1205-2) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365621","name":"BUPRENORPHINE 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365640","name":"BUPRENORPHINE 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3656-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"5 ug/h","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"4 POUCH in 1 CARTON (0093-3656-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858075040","name":"BUPRENORPHINE 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-750-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"5 ug/h","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 POUCH in 1 CARTON (42858-750-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine|Buprenorphine","basis":"generic"},"part_b":null}, {"ndc":"50742037201","name":"BUPRENORPHINE 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742037204","name":"BUPRENORPHINE 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-372-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"5 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"4 POUCH in 1 CARTON (50742-372-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238120202","name":"BUPRENORPHINE 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1202-2","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"5 ug/h","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"4 POUCH in 1 CARTON (69238-1202-2) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093323921","name":"BUPRENORPHINE 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093323940","name":"BUPRENORPHINE 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3239-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7.5 ug/h","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"4 POUCH in 1 CARTON (0093-3239-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858035340","name":"BUPRENORPHINE 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-353-40","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"7.5 ug/h","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 POUCH in 1 CARTON (42858-353-40) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine|Buprenorphine","basis":"generic"},"part_b":null}, {"ndc":"50742037301","name":"BUPRENORPHINE 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742037304","name":"BUPRENORPHINE 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-373-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7.5 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"4 POUCH in 1 CARTON (50742-373-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238150502","name":"BUPRENORPHINE 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1505-2","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7.5 ug/h","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"4 POUCH in 1 CARTON (69238-1505-2) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054017713","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0177-13","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0177-13)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121203830","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-2038-30","proprietary_name":"buprenorphine hydrochloride","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"30 TABLET in 1 BOTTLE (0121-2038-30)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228315303","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3153-03","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (0228-3153-03)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406701803","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-7018-03","proprietary_name":"Buprenorphine HCl","nonproprietary_name":"Buprenorphine HCl","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET in 1 BOTTLE (0406-7018-03)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904715504","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7155-04","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7155-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722087130","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-871-30","proprietary_name":"Buprenorphine HCl","nonproprietary_name":"Buprenorphine HCl","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-871-30)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858050203","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-502-03","proprietary_name":"BUPRENORPHINE","nonproprietary_name":"BUPRENORPHINE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (42858-502-03)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268012911","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268012915","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-129-15","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-129-15) / 1 TABLET in 1 BLISTER PACK (50268-129-11)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687049211","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687049221","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-492-21","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-492-21) / 1 TABLET in 1 BLISTER PACK (60687-492-11)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756046083","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-460-83","proprietary_name":"Buprenorphine","nonproprietary_name":"Buprenorphine","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (62756-460-83)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888018330","name":"BUPRENORPHINE 8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-183-30","proprietary_name":"buprenorphine hydrochloride","nonproprietary_name":"buprenorphine hydrochloride","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET in 1 BOTTLE (72888-183-30)","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.57141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378876816","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876893","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8768-93","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"12 mg/1; 3 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8768-93) / 1 FILM in 1 POUCH (0378-8768-16)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598058101","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598058130","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-581-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"12 mg/1; 3 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 POUCH in 1 CARTON (43598-581-30) / 1 FILM, SOLUBLE in 1 POUCH (43598-581-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035803","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-358-03","proprietary_name":"Buprenorphine and Naloxone Sublingual Film","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"12 mg/1; 3 mg/1","labeler":"Alvogen Inc.","package_description":"30 POUCH in 1 CARTON (47781-358-03) / 1 FILM in 1 POUCH (47781-358-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035811","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742036501","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742036530","name":"BUPRENORPHINE-NALOXONE 12-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-365-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"buprenorphine and naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"12 mg/1; 3 mg/1","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"30 POUCH in 1 CARTON (50742-365-30) / 1 FILM in 1 POUCH (50742-365-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876516","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876593","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8765-93","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8765-93) / 1 FILM in 1 POUCH (0378-8765-16)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598057901","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598057930","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-579-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 POUCH in 1 CARTON (43598-579-30) / 1 FILM, SOLUBLE in 1 POUCH (43598-579-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035503","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-355-03","proprietary_name":"Buprenorphine and Naloxone Sublingual Film","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Alvogen Inc.","package_description":"30 POUCH in 1 CARTON (47781-355-03) / 1 FILM in 1 POUCH (47781-355-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035511","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742039701","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742039730","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-397-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"buprenorphine and naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"30 POUCH in 1 CARTON (50742-397-30) / 1 FILM in 1 POUCH (50742-397-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00054018813","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0188-13","proprietary_name":"buprenorphine and naloxone","nonproprietary_name":"buprenorphine and naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0188-13)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00121101830","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1018-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0121-1018-30)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00228315403","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3154-03","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (0228-3154-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406800503","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8005-03","proprietary_name":"Buprenorphine Hydrochloride and Naloxone Hydrochloride Dihydrate","nonproprietary_name":"Buprenorphine Hydrochloride and Naloxone Hydrochloride Dihydrate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0406-8005-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904700906","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7009-06","proprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride dihydrate","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride dihydrate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7009-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"16729054910","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-549-10","proprietary_name":"BUPRENORPHINE HYDROCHLORIDE and NALOXONE HYDROCHLORIDE DIHYDRATE","nonproprietary_name":"BUPRENORPHINE HYDROCHLORIDE and NALOXONE HYDROCHLORIDE DIHYDRATE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Accord Healthcare, Inc","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (16729-549-10)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"42858060103","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-601-03","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (42858-601-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014411","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014415","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-144-15","proprietary_name":"Buprenorphine HCl and Naloxone HCl","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-144-15) / 1 TABLET in 1 BLISTER PACK (50268-144-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687062611","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687062665","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-626-65","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-626-65) / 1 TABLET in 1 BLISTER PACK (60687-626-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"62175045232","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-452-32","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (62175-452-32)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"62756096983","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-969-83","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (62756-969-83)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"65162041603","name":"BUPRENORPHINE-NALOXONE 2-0.5 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-416-03","proprietary_name":"Buprenorphine HCl and Naloxone HCl","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-416-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.52138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876616","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876693","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8766-93","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"4 mg/1; 1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8766-93) / 1 FILM in 1 POUCH (0378-8766-16)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598058001","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598058030","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-580-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"4 mg/1; 1 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 POUCH in 1 CARTON (43598-580-30) / 1 FILM, SOLUBLE in 1 POUCH (43598-580-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035603","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-356-03","proprietary_name":"Buprenorphine and Naloxone Sublingual Film","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"4 mg/1; 1 mg/1","labeler":"Alvogen Inc.","package_description":"30 POUCH in 1 CARTON (47781-356-03) / 1 FILM in 1 POUCH (47781-356-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035611","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742039801","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742039830","name":"BUPRENORPHINE-NALOXONE 4-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-398-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"buprenorphine and naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"4 mg/1; 1 mg/1","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"30 POUCH in 1 CARTON (50742-398-30) / 1 FILM in 1 POUCH (50742-398-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876716","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378876793","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8767-93","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8767-93) / 1 FILM in 1 POUCH (0378-8767-16)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598058201","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598058230","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-582-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 POUCH in 1 CARTON (43598-582-30) / 1 FILM, SOLUBLE in 1 POUCH (43598-582-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035703","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-357-03","proprietary_name":"Buprenorphine and Naloxone Sublingual Film","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Alvogen Inc.","package_description":"30 POUCH in 1 CARTON (47781-357-03) / 1 FILM in 1 POUCH (47781-357-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"47781035711","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742036401","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50742036430","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-364-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"buprenorphine and naloxone","dosage_form":"FILM","route":"BUCCAL; SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"30 POUCH in 1 CARTON (50742-364-30) / 1 FILM in 1 POUCH (50742-364-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00054018913","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0189-13","proprietary_name":"buprenorphine and naloxone","nonproprietary_name":"buprenorphine and naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0189-13)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00121203630","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-2036-30","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0121-2036-30)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00228315503","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3155-03","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (0228-3155-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406802003","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8020-03","proprietary_name":"Buprenorphine Hydrochloride and Naloxone Hydrochloride Dihydrate","nonproprietary_name":"Buprenorphine Hydrochloride and Naloxone Hydrochloride Dihydrate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0406-8020-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904701006","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7010-06","proprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride dihydrate","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride dihydrate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7010-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"16729055010","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-550-10","proprietary_name":"BUPRENORPHINE HYDROCHLORIDE and NALOXONE HYDROCHLORIDE DIHYDRATE","nonproprietary_name":"BUPRENORPHINE HYDROCHLORIDE and NALOXONE HYDROCHLORIDE DIHYDRATE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Accord Healthcare, Inc","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (16729-550-10)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"42858060203","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-602-03","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (42858-602-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014511","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014515","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-145-15","proprietary_name":"Buprenorphine HCl and Naloxone HCl","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-145-15) / 1 TABLET in 1 BLISTER PACK (50268-145-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687063711","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687063765","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-637-65","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-637-65) / 1 TABLET in 1 BLISTER PACK (60687-637-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"62175045832","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-458-32","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (62175-458-32)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"62756097083","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-970-83","proprietary_name":"Buprenorphine and Naloxone","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (62756-970-83)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"65162041503","name":"BUPRENORPHINE-NALOXONE 8-2 MG SL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-415-03","proprietary_name":"Buprenorphine HCl and Naloxone HCl","nonproprietary_name":"Buprenorphine and Naloxone","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-415-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":0.66282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buprenorphine-Naloxone|Buprenorphine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904663661","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6636-61","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6636-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904753060","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7530-60","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"100 TABLET in 1 BOTTLE (0904-7530-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"23155019201","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-192-01","proprietary_name":"bupropion Hydrochloride","nonproprietary_name":"bupropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-192-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"24689012001","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014311","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014315","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-143-15","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-143-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-143-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651087501","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-875-01","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-875-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60505015701","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0157-1","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0157-1)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687035101","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-351-01","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-351-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-351-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687035111","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072490","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-724-90","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-724-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"62332012731","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-127-31","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-127-31)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001030900","name":"BUPROPION HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-309-00","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-309-00)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.11295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904663561","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6635-61","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6635-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904752960","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7529-60","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"100 TABLET in 1 BOTTLE (0904-7529-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"23155019101","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-191-01","proprietary_name":"bupropion Hydrochloride","nonproprietary_name":"bupropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-191-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"24689011901","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014211","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268014215","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-142-15","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-142-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-142-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651087401","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-874-01","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-874-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60505015801","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0158-1","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0158-1)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687034001","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-340-01","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-340-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-340-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687034011","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072390","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-723-90","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-723-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"62332011831","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-118-31","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-118-31)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001030800","name":"BUPROPION HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-308-00","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-308-00)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354005","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3540-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3540-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354060","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3540-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3540-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904709961","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7099-61","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7099-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006601","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-066-01","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-066-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006605","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-066-05","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-066-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006660","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-066-60","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-066-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806042401","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-424-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-424-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806042460","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-424-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-424-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547028809","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-288-09","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-288-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547028810","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-288-10","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-288-10)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547028850","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-288-50","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-288-50)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075101","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-751-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-751-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075105","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-751-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-751-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075160","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-751-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-751-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017401","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-174-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-174-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017405","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-174-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-174-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017460","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-174-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-174-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084601","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-846-01","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-846-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084605","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-846-05","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-846-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68084069701","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-697-01","proprietary_name":"BuPROPion Hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-697-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-697-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68084069711","name":"BUPROPION HCL SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354105","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3541-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3541-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354125","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3541-25","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"250 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3541-25)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354160","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3541-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3541-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354360","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3543-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3543-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.25221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354376","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3543-76","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0591-3543-76) / 60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.25221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904746561","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7465-61","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7465-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006701","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-067-01","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-067-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006705","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-067-05","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-067-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006760","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-067-60","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-067-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041360","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-413-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-413-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.25221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806042501","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-425-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-425-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806042505","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-425-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-425-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547028909","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-289-09","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare US LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-289-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547028910","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-289-10","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare US LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-289-10)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547028950","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-289-50","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare US LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-289-50)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075201","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-752-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-752-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075205","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-752-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-752-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075260","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-752-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-752-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598086360","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-863-60","proprietary_name":"BUPROPION HYDROCHLORIDE (SR)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-863-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.25221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017501","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-175-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-175-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017505","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-175-05","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-175-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017560","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-175-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-175-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084701","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-847-01","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-847-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084705","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-847-05","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-847-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68084070825","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-708-25","proprietary_name":"BuPROPion Hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-708-25) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-708-95)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68084070895","name":"BUPROPION HCL SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591354260","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3542-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3542-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006801","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-068-01","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-068-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722006860","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-068-60","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-068-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806042660","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-426-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-426-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547029009","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-290-09","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare US LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-290-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43547029010","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-290-10","proprietary_name":"bupropion hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare US LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-290-10)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598075360","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-753-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-753-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017601","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-176-01","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-176-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228017660","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-176-60","proprietary_name":"Bupropion Hydrochloride SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-176-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084801","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-848-01","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-848-01)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084860","name":"BUPROPION HCL SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-848-60","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-848-60)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion HCl SR|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591333105","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3331-05","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3331-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591333119","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3331-19","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3331-19)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00591333130","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3331-30","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3331-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904750504","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7505-04","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7505-04) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904750561","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7505-61","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7505-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086203","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-862-03","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-862-03)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086209","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-862-09","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-862-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086212","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-862-12","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-862-12)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086250","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-862-50","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-862-50)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16729044310","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-443-10","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-443-10)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16729044315","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-443-15","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-443-15)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16729044316","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-443-16","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-443-16)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722048705","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-487-05","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-487-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041405","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-414-05","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42806-414-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041409","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-414-09","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42806-414-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041430","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-414-30","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42806-414-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598065530","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-655-30","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-655-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228014405","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-144-05","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals,Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-144-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228014430","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-144-30","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals,Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-144-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228014490","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-144-90","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals,Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-144-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268013311","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268013313","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-133-13","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-133-13) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-133-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687078201","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-782-01","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-782-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-782-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687078211","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"62135087530","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-875-30","proprietary_name":"BUPROPION HYDROCHLORIDE (XL)","nonproprietary_name":"BUPROPION HYDROCHLORIDE (XL)","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 PACKAGE (62135-875-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001051904","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-519-04","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-519-04)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001051905","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-519-05","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-519-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001061303","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-613-03","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-613-03)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001061304","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-613-04","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET in 1 BOTTLE (68001-613-04)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001061305","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-613-05","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"90 TABLET in 1 BOTTLE (68001-613-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68180031902","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-319-02","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-319-02)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68180031906","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-319-06","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-319-06)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68180031909","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-319-09","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-319-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68382035305","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-353-05","proprietary_name":"bupropion","nonproprietary_name":"bupropion","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68382035306","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-353-06","proprietary_name":"bupropion","nonproprietary_name":"bupropion","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-06)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68382035316","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-353-16","proprietary_name":"bupropion","nonproprietary_name":"bupropion","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-16)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69097007112","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-071-12","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Cipla USA., Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69097-071-12)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69097087505","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-875-05","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"CIPLA USA INC.,","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69097-875-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69367028805","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69367028809","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69680015790","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-157-90","proprietary_name":"Bupropion hydrochloride (XL)","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Vitruvias Therapeutics","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69680-157-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69680015792","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-157-92","proprietary_name":"Bupropion hydrochloride (XL)","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Vitruvias Therapeutics","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (69680-157-92)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70010078403","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-784-03","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-784-03)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70010078405","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-784-05","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-784-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70010078409","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-784-09","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-784-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"72516003550","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-035-50","proprietary_name":"buPropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Oryza pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-035-50)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"82009005105","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-051-05","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (82009-051-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002401","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0024-1","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0024-1)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002402","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0024-2","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0024-2)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002403","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0024-3","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0024-3)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002404","name":"BUPROPION HCL XL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0024-4","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0024-4)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.07846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"00904746904","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7469-04","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7469-04) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086303","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-863-03","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-863-03)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086309","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-863-09","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-863-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16571086350","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-863-50","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-863-50)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16729044410","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-444-10","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-444-10)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"16729044416","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-444-16","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-444-16)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722048805","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-488-05","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-488-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"31722048890","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-488-90","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-488-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041605","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-416-05","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42806-416-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041609","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-416-09","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42806-416-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"42806041630","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-416-30","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Epic Pharma, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42806-416-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598065605","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-656-05","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Dr Reddys Laboratories Inc","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-656-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"43598065630","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-656-30","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Dr Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (43598-656-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"45963014205","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-142-05","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (45963-142-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"45963014230","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-142-30","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (45963-142-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"45963014290","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-142-90","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (45963-142-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228014505","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-145-05","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals,Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-145-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228014530","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-145-30","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals,Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-145-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50228014590","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-145-90","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals,Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-145-90)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268013411","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"50268013413","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-134-13","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-134-13) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-134-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687079311","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"60687079321","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-793-21","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-793-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-793-11)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001052004","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-520-04","proprietary_name":"BUPROPION HYDROCHLORIDE","nonproprietary_name":"BUPROPION HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-520-04)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001061403","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-614-03","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-614-03)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001061404","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-614-04","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET in 1 BOTTLE (68001-614-04)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68001061405","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-614-05","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"90 TABLET in 1 BOTTLE (68001-614-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68180032002","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-320-02","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-320-02)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68180032006","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-320-06","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-320-06)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"68180032009","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-320-09","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-320-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69097007212","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-072-12","proprietary_name":"Bupropion Hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA., Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69097-072-12)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69097087602","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-876-02","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"CIPLA USA INC.,","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69097-876-02)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69097087612","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-876-12","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"CIPLA USA INC.,","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69097-876-12)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69367028905","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69367028909","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"69680015892","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-158-92","proprietary_name":"Bupropion hydrochloride (XL)","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Vitruvias Therapeutics","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (69680-158-92)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70010078503","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-785-03","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-785-03)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70010078505","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-785-05","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-785-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70010078509","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-785-09","proprietary_name":"Bupropion hydrochloride","nonproprietary_name":"Bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-785-09)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"72516003650","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-036-50","proprietary_name":"buPropion Hydrochloride XL","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Oryza pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-036-50)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"76282048130","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-481-30","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (76282-481-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"82009005205","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-052-05","proprietary_name":"Bupropion Hydrochloride XL","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (82009-052-05)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002501","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0025-1","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0025-1)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002502","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0025-2","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0025-2)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002503","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0025-3","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0025-3)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"83301002504","name":"BUPROPION HCL XL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0025-4","proprietary_name":"Bupropion Hydrochloride (XL)","nonproprietary_name":"Bupropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (83301-0025-4)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":0.10041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"24979024806","name":"BUPROPION HCL XL 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-248-06","proprietary_name":"bupropion hydrochloride","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (24979-248-06)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":7.99556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bupropion XL|Bupropion HCl","basis":"generic"},"part_b":null}, {"ndc":"70756083030","name":"BUPROPION HCL XL 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-830-30","proprietary_name":"BUPROPION HCl ER (XL)","nonproprietary_name":"BUPROPION HCl ER","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70756-830-30)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":7.99556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122055528","name":"BURN RELIEF 0.5% SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-555-28","proprietary_name":"Burn Relief","nonproprietary_name":"Lidocaine","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":".64 g/127g","labeler":"AmerisourceBergen Drug Corporation","package_description":"127 g in 1 CAN (46122-555-28)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.02802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000062401","name":"BURN RELIEF 0.5% SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0624-1","proprietary_name":"Leader Burn Relief","nonproprietary_name":"Lidocaine","dosage_form":"SPRAY","route":"TOPICAL","strength":".5 g/100g","labeler":"Cardinal Health","package_description":"128 g in 1 BOTTLE, PLASTIC (70000-0624-1)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.02758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093005401","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0054-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-0054-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093005405","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0054-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-0054-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904712161","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7121-61","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7121-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005901","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-059-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-059-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005905","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-059-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET in 1 BOTTLE (11788-059-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002401","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-024-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-024-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002405","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-024-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-024-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689090701","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-907-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-907-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689090705","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-907-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"APNAR PHARMA LP","package_description":"500 TABLET in 1 BOTTLE (24689-907-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024501","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-245-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-245-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024505","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-245-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-245-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"42543074207","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-742-07","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Inc.","package_description":"500 TABLET in 1 BOTTLE (42543-742-07)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079098601","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079098620","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-986-20","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-986-20) / 1 TABLET in 1 BLISTER PACK (51079-986-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651039101","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-391-01","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-391-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651039105","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-391-05","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-391-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687081201","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-812-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-812-01) / 1 TABLET in 1 BLISTER PACK (60687-812-11)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687081211","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074206","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-742-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-742-06)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074207","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-742-07","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE (64380-742-07)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074208","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-742-08","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-742-08)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065250","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-652-50","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-652-50)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018101","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-181-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-181-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018105","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-181-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-181-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009210","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-092-10","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-092-10)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009250","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-092-50","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-092-50)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006401","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-064-01","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-064-01)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006405","name":"BUSPIRONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-064-05","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-064-05)"},"nadac":{"value":0.02795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093100301","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1003-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1003-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093100305","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1003-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-1003-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378116505","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1165-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-1165-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904689961","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6899-61","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6899-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788006001","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-060-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-060-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788006003","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-060-03","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"180 TABLET in 1 BOTTLE (11788-060-03)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788006005","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-060-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET in 1 BOTTLE (11788-060-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002501","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-025-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-025-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002505","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-025-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-025-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002506","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-025-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (23155-025-06)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002508","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-025-08","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"180 TABLET in 1 BOTTLE (23155-025-08)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689092101","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-921-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-921-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689092105","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-921-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"APNAR PHARMA LP","package_description":"500 TABLET in 1 BOTTLE (24689-921-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689092106","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-921-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"APNAR PHARMA LP","package_description":"60 TABLET in 1 BOTTLE (24689-921-06)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024601","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-246-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-246-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024605","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-246-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-246-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024616","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-246-16","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-246-16)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024618","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-246-18","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"180 TABLET in 1 BOTTLE, PLASTIC (29300-246-18)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300047701","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-477-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-477-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300047705","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-477-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-477-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300047716","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-477-16","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-477-16)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300047718","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-477-18","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"180 TABLET in 1 BOTTLE, PLASTIC (29300-477-18)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"42543074318","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-743-18","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Strides Pharma Inc.","package_description":"180 TABLET in 1 BOTTLE (42543-743-18)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268013511","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268013515","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-135-15","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-135-15) / 1 TABLET in 1 BLISTER PACK (50268-135-11)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079096001","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079096020","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-960-20","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-960-20) / 1 TABLET in 1 BLISTER PACK (51079-960-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651039201","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-392-01","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-392-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651039205","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-392-05","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-392-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687082301","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-823-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-823-01) / 1 TABLET in 1 BLISTER PACK (60687-823-11)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687082311","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074303","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-743-03","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET in 1 BOTTLE (64380-743-03)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074318","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-743-18","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Strides Pharma Science Limited","package_description":"180 TABLET in 1 BOTTLE (64380-743-18)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018201","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-182-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-182-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018205","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-182-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-182-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009306","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-093-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (69584-093-06)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009310","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-093-10","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-093-10)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009350","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-093-50","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-093-50)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006501","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-065-01","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-065-01)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006505","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-065-05","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-065-05)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006560","name":"BUSPIRONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-065-60","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Advagen Pharma Ltd","package_description":"60 TABLET in 1 BOTTLE (72888-065-60)"},"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093520005","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5200-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-5200-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093520006","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5200-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-5200-06)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788006105","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-061-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET in 1 BOTTLE (11788-061-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788006160","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-061-60","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (11788-061-60)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155009705","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-097-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-097-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155009706","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-097-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (23155-097-06)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689093306","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-933-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"APNAR PHARMA LP","package_description":"60 TABLET in 1 BOTTLE (24689-933-06)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024705","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-247-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-247-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024716","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-247-16","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-247-16)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300047805","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-478-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-478-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300047816","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-478-16","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-478-16)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"42543074403","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-744-03","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Strides Pharma Inc.","package_description":"60 TABLET in 1 BOTTLE (42543-744-03)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079099401","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079099420","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-994-20","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-994-20) / 1 TABLET in 1 BLISTER PACK (51079-994-01)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651039360","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-393-60","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (59651-393-60)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074403","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-744-03","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET in 1 BOTTLE (64380-744-03)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018305","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-183-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-183-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018314","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-183-14","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (68382-183-14)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009406","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-094-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (69584-094-06)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009450","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-094-50","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-094-50)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006605","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-066-05","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-066-05)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006660","name":"BUSPIRONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-066-60","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Advagen Pharma Ltd","package_description":"60 TABLET in 1 BOTTLE (72888-066-60)"},"nadac":{"value":0.11985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093005301","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0053-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-0053-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093005305","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0053-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-0053-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00378114005","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1140-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-1140-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904712261","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7122-61","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7122-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005701","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-057-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-057-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005705","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-057-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET in 1 BOTTLE (11788-057-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002301","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-023-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-023-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002305","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-023-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-023-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689078101","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-781-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-781-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689078105","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-781-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"APNAR PHARMA LP","package_description":"500 TABLET in 1 BOTTLE (24689-781-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024401","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-244-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-244-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"29300024405","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-244-05","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-244-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"42543074107","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-741-07","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Inc.","package_description":"500 TABLET in 1 BOTTLE (42543-741-07)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079098501","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"51079098520","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-985-20","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-985-20) / 1 TABLET in 1 BLISTER PACK (51079-985-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038901","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-389-01","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-389-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038905","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-389-05","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-389-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074106","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-741-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-741-06)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074107","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-741-07","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE (64380-741-07)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074108","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-741-08","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-741-08)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065050","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-650-50","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-650-50)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018001","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-180-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-180-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018005","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-180-05","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-180-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009110","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-091-10","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-091-10)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"69584009150","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-091-50","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-091-50)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006201","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-062-01","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-062-01)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006205","name":"BUSPIRONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-062-05","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-062-05)"},"nadac":{"value":0.02195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005801","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-058-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-058-01)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"24689078501","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-785-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-785-01)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"42543078706","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-787-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Strides Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (42543-787-06)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651039001","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-390-01","proprietary_name":"BUSPIRONE HYDROCHLORIDE","nonproprietary_name":"BUSPIRONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-390-01)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687080111","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687080121","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-801-21","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-801-21) / 1 TABLET in 1 BLISTER PACK (60687-801-11)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380078706","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-787-06","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-787-06)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065101","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-651-01","proprietary_name":"Buspirone Hydrochloride","nonproprietary_name":"Buspirone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-651-01)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382062301","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-623-01","proprietary_name":"Buspirone hydrochloride","nonproprietary_name":"Buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-623-01)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006301","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-063-01","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-063-01)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"72888006305","name":"BUSPIRONE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-063-05","proprietary_name":"busPIRone HCl","nonproprietary_name":"buspirone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-063-05)"},"nadac":{"value":0.1003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Buspirone HCl|Buspirone HCl","basis":"generic"},"part_b":null}, {"ndc":"35573045502","name":"BUTALBITAL-ACETAMINOPHEN 50-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-455-02","proprietary_name":"BUTALBITAL AND ACETAMINOPHEN","nonproprietary_name":"butalbital and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 300 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (35573-455-02)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.87462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70752014710","name":"BUTALBITAL-ACETAMINOPHEN 50-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-147-10","proprietary_name":"BUTALBITAL and ACETAMINOPHEN","nonproprietary_name":"BUTALBITAL and ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 300 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-147-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.87462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00603254021","name":"BUTALBITAL-ACETAMINOPHEN 50-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-2540-21","proprietary_name":"butalbital and acetaminophen","nonproprietary_name":"butalbital and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1","labeler":"Par Health","package_description":"100 TABLET in 1 BOTTLE (0603-2540-21)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.57087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"35573045602","name":"BUTALBITAL-ACETAMINOPHEN 50-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-456-02","proprietary_name":"BUTALBITAL AND ACETAMINOPHEN","nonproprietary_name":"butalbital and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (35573-456-02)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.57087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"68047072101","name":"BUTALBITAL-ACETAMINOPHEN 50-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-721-01","proprietary_name":"Butalbital And Acetaminophen","nonproprietary_name":"butalbital and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1","labeler":"Larken Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (68047-721-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.57087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"69292030201","name":"BUTALBITAL-ACETAMINOPHEN 50-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-302-01","proprietary_name":"BUTALBITAL AND ACETAMINOPHEN","nonproprietary_name":"butalbital and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1; 50 mg/1","labeler":"Amici Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (69292-302-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.57087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70752014810","name":"BUTALBITAL-ACETAMINOPHEN 50-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-148-10","proprietary_name":"BUTALBITAL and ACETAMINOPHEN","nonproprietary_name":"BUTALBITAL and ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (70752-148-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]"]},"nadac":{"value":0.57087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Acetaminophen|Butalbital/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00527409537","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4095-37","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine Capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0527-4095-37)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591264001","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2640-01","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0591-2640-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591264005","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2640-05","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0591-2640-05)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534018701","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-187-01","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"butalbital, acetaminophen and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1; 40 mg/1; 50 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"100 CAPSULE in 1 BOTTLE (11534-187-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547068610","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-686-10","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"butalbital, acetaminophen and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-686-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672422201","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4222-1","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"butalbital, acetaminophen, and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (51672-4222-1)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010004401","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-044-01","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen and Caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-044-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752014410","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-144-10","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (70752-144-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527409437","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4094-37","proprietary_name":"butalbital, acetaminophen and caffeine","nonproprietary_name":"butalbital, acetaminophen and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0527-4094-37)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.93118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107007501","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-075-01","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen and Caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (13107-075-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.93118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752014110","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-141-10","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (70752-141-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.93118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907000901","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-009-01","proprietary_name":"butalbital, acetaminophen and caffeine","nonproprietary_name":"butalbital, acetaminophen and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (75907-009-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.93118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527169501","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1695-01","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0527-1695-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527169505","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1695-05","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0527-1695-05)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591336901","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3369-01","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-3369-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591336905","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3369-05","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0591-3369-05)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904693806","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6938-06","proprietary_name":"Butalbital, Acetaminophen, and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6938-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702025301","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-253-01","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-253-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702025350","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-253-50","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-253-50)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46672005310","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46672-053-10","proprietary_name":"butalbital, acetaminophen and caffeine","nonproprietary_name":"butalbital, acetaminophen and caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Mikart, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (46672-053-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46672005350","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46672-053-50","proprietary_name":"butalbital, acetaminophen and caffeine","nonproprietary_name":"butalbital, acetaminophen and caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Mikart, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (46672-053-50)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268055311","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268055313","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-553-13","proprietary_name":"Butalbital, Acetaminophen, Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-553-13) / 1 TABLET in 1 BLISTER PACK (50268-553-11)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135075101","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-751-01","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Chartwell RX, LLC","package_description":"100 TABLET in 1 BOTTLE (62135-751-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015701","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015702","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367020301","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-203-01","proprietary_name":"Butalbital, Acetaminophen, Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-203-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367020305","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-203-05","proprietary_name":"Butalbital, Acetaminophen, Caffeine","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-203-05)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010014901","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-149-01","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-149-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010014905","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-149-05","proprietary_name":"Butalbital, Acetaminophen and Caffeine","nonproprietary_name":"Butalbital, Acetaminophen and Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-149-05)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752014210","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-142-10","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-142-10)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752014214","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-142-14","proprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","nonproprietary_name":"BUTALBITAL, ACETAMINOPHEN AND CAFFEINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (70752-142-14)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.12231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054065025","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE-CODEINE 50-300-40-30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0650-25","proprietary_name":"Butalbital, Acetaminophen, Caffeine and Codeine Phosphate","nonproprietary_name":"Butalbital, Acetaminophen, Caffeine and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1; 30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0650-25)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Opioid Agonist [EPC]","Xanthines [CS]"]},"nadac":{"value":5.29695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591264101","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE-CODEINE 50-300-40-30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2641-01","proprietary_name":"Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate","nonproprietary_name":"Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1; 30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-2641-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Opioid Agonist [EPC]","Xanthines [CS]"]},"nadac":{"value":5.29695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054300001","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE-CODEINE 50-325-40-30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3000-01","proprietary_name":"Butalbital, Acetaminophen, Caffeine and Codeine Phosphate","nonproprietary_name":"Butalbital, Acetaminophen, Caffeine and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1; 30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-3000-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Opioid Agonist [EPC]","Xanthines [CS]"]},"nadac":{"value":0.79784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591322001","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE-CODEINE 50-325-40-30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3220-01","proprietary_name":"Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate","nonproprietary_name":"Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1; 50 mg/1; 40 mg/1; 325 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0591-3220-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Opioid Agonist [EPC]","Xanthines [CS]"]},"nadac":{"value":0.79784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991007301","name":"BUTALBITAL-ACETAMINOPHEN-CAFFEINE-CODEINE 50-325-40-30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-073-01","proprietary_name":"Butalbital, Acetaminophen, Caffeine and Codeine Phosphate","nonproprietary_name":"Butalbital, Acetaminophen, Caffeine and Codeine Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1; 30 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (51991-073-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Full Opioid Agonists [MoA]","Methylxanthine [EPC]","Opioid Agonist [EPC]","Xanthines [CS]"]},"nadac":{"value":0.79784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527155201","name":"BUTALBITAL-ASPIRIN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1552-01","proprietary_name":"Butalbital, aspirin, and caffeine","nonproprietary_name":"Butalbital, aspirin, and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0527-1552-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.94823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Aspirin-Caffeine|Butalbital/Aspirin/Caffeine","basis":"generic"},"part_b":null}, {"ndc":"00781227001","name":"BUTALBITAL-ASPIRIN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2270-01","proprietary_name":"Butalbital, aspirin, and caffeine","nonproprietary_name":"Butalbital, aspirin, and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2270-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.94823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Aspirin-Caffeine|Butalbital/Aspirin/Caffeine","basis":"generic"},"part_b":null}, {"ndc":"62135043390","name":"BUTALBITAL-ASPIRIN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-433-90","proprietary_name":"butalbital, aspirin, and caffeine","nonproprietary_name":"butalbital, aspirin, and caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-433-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.94823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Aspirin-Caffeine|Butalbital/Aspirin/Caffeine","basis":"generic"},"part_b":null}, {"ndc":"69367041601","name":"BUTALBITAL-ASPIRIN-CAFFEINE 50-325-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-416-01","proprietary_name":"BUTALBITAL, ASPIRIN, AND CAFFEINE","nonproprietary_name":"BUTALBITAL, ASPIRIN, AND CAFFEINE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 325 mg/1; 40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69367-416-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.94823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butalbital-Aspirin-Caffeine|Butalbital/Aspirin/Caffeine","basis":"generic"},"part_b":null}, {"ndc":"51672210002","name":"BUTENAFINE HCL 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2100-2","proprietary_name":"Athletes Foot","nonproprietary_name":"Butenafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2100-2) / 30 g in 1 TUBE","pharm_classes":["Benzylamine Antifungal [EPC]","Benzylamines [CS]"]},"nadac":{"value":0.30701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672210008","name":"BUTENAFINE HCL 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2100-8","proprietary_name":"Athletes Foot","nonproprietary_name":"Butenafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2100-8) / 12 g in 1 TUBE","pharm_classes":["Benzylamine Antifungal [EPC]","Benzylamines [CS]"]},"nadac":{"value":0.53005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00054309036","name":"BUTORPHANOL 10 MG/ML SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3090-36","proprietary_name":"Butorphanol Tartrate","nonproprietary_name":"Butorphanol Tartrate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, SPRAY in 1 CONTAINER (0054-3090-36) / 2.5 mL in 1 BOTTLE, SPRAY","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":15.45983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Butorphanol Tartrate*|Butorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505081301","name":"BUTORPHANOL 10 MG/ML SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0813-1","proprietary_name":"Butorphanol Tartrate","nonproprietary_name":"Butorphanol Tartrate","dosage_form":"SPRAY","route":"NASAL","strength":"10 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CONTAINER (60505-0813-1) / 2.5 mL in 1 BOTTLE, SPRAY","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":15.45983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Butorphanol Tartrate*|Butorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59011075104","name":"BUTRANS 10 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-751-04","proprietary_name":"Butrans","nonproprietary_name":"buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"10 ug/h","labeler":"Knoa Pharma LLC","package_description":"4 POUCH in 1 CARTON (59011-751-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":73.60023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":32.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butrans|Buprenorphine","basis":"brand"},"part_b":null}, {"ndc":"59011075804","name":"BUTRANS 15 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-758-04","proprietary_name":"Butrans","nonproprietary_name":"buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"15 ug/h","labeler":"Knoa Pharma LLC","package_description":"4 POUCH in 1 CARTON (59011-758-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":124.62313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":53.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butrans|Buprenorphine","basis":"brand"},"part_b":null}, {"ndc":"59011075204","name":"BUTRANS 20 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-752-04","proprietary_name":"Butrans","nonproprietary_name":"buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"20 ug/h","labeler":"Knoa Pharma LLC","package_description":"4 POUCH in 1 CARTON (59011-752-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":131.09389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":58.8288,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butrans|Buprenorphine","basis":"brand"},"part_b":null}, {"ndc":"59011075004","name":"BUTRANS 5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-750-04","proprietary_name":"Butrans","nonproprietary_name":"buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"5 ug/h","labeler":"Knoa Pharma LLC","package_description":"4 POUCH in 1 CARTON (59011-750-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":48.86594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":23.44849,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butrans|Buprenorphine","basis":"brand"},"part_b":null}, {"ndc":"59011075704","name":"BUTRANS 7.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-757-04","proprietary_name":"Butrans","nonproprietary_name":"buprenorphine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7.5 ug/h","labeler":"Knoa Pharma LLC","package_description":"4 POUCH in 1 CARTON (59011-757-04) / 1 PATCH in 1 POUCH / 168 h in 1 PATCH","pharm_classes":["Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":68.82197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":37.67882,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Butrans|Buprenorphine","basis":"brand"},"part_b":null}, {"ndc":"00456141090","name":"BYSTOLIC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1410-90","proprietary_name":"Bystolic","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Allergan, Inc.","package_description":"90 TABLET in 1 BOTTLE (0456-1410-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.40917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bystolic|Nebivolol HCl","basis":"brand"},"part_b":null}, {"ndc":"00456140230","name":"BYSTOLIC 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1402-30","proprietary_name":"Bystolic","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Allergan, Inc.","package_description":"30 TABLET in 1 BOTTLE (0456-1402-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.4462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bystolic|Nebivolol HCl","basis":"brand"},"part_b":null}, {"ndc":"00456142090","name":"BYSTOLIC 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1420-90","proprietary_name":"Bystolic","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Allergan, Inc.","package_description":"90 TABLET in 1 BOTTLE (0456-1420-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.42189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bystolic|Nebivolol HCl","basis":"brand"},"part_b":null}, {"ndc":"00456140590","name":"BYSTOLIC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1405-90","proprietary_name":"Bystolic","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Allergan, Inc.","package_description":"90 TABLET in 1 BOTTLE (0456-1405-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.45128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Bystolic|Nebivolol HCl","basis":"brand"},"part_b":null}, {"ndc":"00093542088","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5420-88","proprietary_name":"Cabergoline","nonproprietary_name":"Cabergoline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BOTTLE in 1 CARTON (0093-5420-88) / 8 TABLET in 1 BOTTLE","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":null}, {"ndc":"23155082373","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-823-73","proprietary_name":"Cabergoline","nonproprietary_name":"Cabergoline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"8 TABLET in 1 BOTTLE (23155-823-73)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":null}, {"ndc":"50742011808","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-118-08","proprietary_name":"Cabergoline","nonproprietary_name":"Cabergoline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"8 TABLET in 1 BOTTLE (50742-118-08)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":null}, {"ndc":"59762100501","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1005-1","proprietary_name":"Cabergoline","nonproprietary_name":"cabergoline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 TABLET in 1 BOTTLE (59762-1005-1)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":null}, {"ndc":"69238269301","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2693-1","proprietary_name":"Cabergoline","nonproprietary_name":"Cabergoline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"8 TABLET in 1 BOTTLE (69238-2693-1)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":{"hcpcs":"J8515","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8515 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (16 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (8 TABLET in 1 BOTTLE (69238-2693-1)) gives 8 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70069082408","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-824-08","proprietary_name":"CABERGOLINE","nonproprietary_name":"CABERGOLINE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"8 TABLET in 1 BOTTLE (70069-824-08)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":null}, {"ndc":"70512086008","name":"CABERGOLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-860-08","proprietary_name":"Cabergoline","nonproprietary_name":"cabergoline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"8 TABLET in 1 BOTTLE (70512-860-08)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":1.29524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cabergoline|Cabergoline","basis":"generic"},"part_b":null}, {"ndc":"70000040901","name":"CAFFEINE 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0409-1","proprietary_name":"Caffeine","nonproprietary_name":"Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (70000-0409-1) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.08299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536100715","name":"CAL-GEST 500 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1007-15","proprietary_name":"Rugby Cal-Gest Antacid Assorted Flavors","nonproprietary_name":"Antacid Tablets","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (0536-1007-15)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000039701","name":"CALAMINE CLEAR LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0397-1","proprietary_name":"Calamine Clear","nonproprietary_name":"Pramoxine Hydrochloride and Zinc Acetate Lotion","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL; 1 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"177 mL in 1 BOTTLE, PLASTIC (70000-0397-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904253321","name":"CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-2533-21","proprietary_name":"Calamine","nonproprietary_name":"FERRIC OXIDE RED","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 80 mg/mL","labeler":"Major Pharmaceuticals","package_description":"177 mL in 1 BOTTLE, PLASTIC (0904-2533-21)"},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000040001","name":"CALAMINE PLUS 1%-8% LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0400-1","proprietary_name":"Leader Calamine Plus","nonproprietary_name":"zinc oxide lotion","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 10 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"177 mL in 1 CONTAINER (70000-0400-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385041396","name":"CALAMINE SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-413-96","proprietary_name":"GNP Calamine Topical Suspension","nonproprietary_name":"Calamine 8% and Zinc Oxide 8%","dosage_form":"LOTION","route":"TOPICAL","strength":"160 mg/mL","labeler":"Amerisource Bergen","package_description":"177 mL in 1 BOTTLE, PLASTIC (24385-413-96)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714076301","name":"CALCIPOTRIENE 0.005% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-763-01","proprietary_name":"calcipotriene","nonproprietary_name":"calcipotriene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CARTON (16714-763-01) / 60 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.05567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"16714076302","name":"CALCIPOTRIENE 0.005% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-763-02","proprietary_name":"calcipotriene","nonproprietary_name":"calcipotriene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CARTON (16714-763-02) / 120 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.04341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"66993087761","name":"CALCIPOTRIENE 0.005% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-877-61","proprietary_name":"Calcipotriene","nonproprietary_name":"Calcipotriene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-877-61) / 60 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.05567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"66993087778","name":"CALCIPOTRIENE 0.005% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-877-78","proprietary_name":"Calcipotriene","nonproprietary_name":"Calcipotriene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-877-78) / 120 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.04341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"68462050165","name":"CALCIPOTRIENE 0.005% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-501-65","proprietary_name":"calcipotriene","nonproprietary_name":"calcipotriene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"1 TUBE in 1 CARTON (68462-501-65) / 60 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.05567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"68462050166","name":"CALCIPOTRIENE 0.005% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-501-66","proprietary_name":"calcipotriene","nonproprietary_name":"calcipotriene","dosage_form":"CREAM","route":"TOPICAL","strength":"50 ug/g","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"1 TUBE in 1 CARTON (68462-501-66) / 120 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.04341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"66993087861","name":"CALCIPOTRIENE 0.005% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-878-61","proprietary_name":"calcipotriene","nonproprietary_name":"calcipotriene","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-878-61) / 60 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.08437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"66993087878","name":"CALCIPOTRIENE 0.005% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-878-78","proprietary_name":"calcipotriene","nonproprietary_name":"calcipotriene","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-878-78) / 120 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.3377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"68462031065","name":"CALCIPOTRIENE 0.005% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-310-65","proprietary_name":"Calcipotriene","nonproprietary_name":"Calcipotriene","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 g in 1 TUBE (68462-310-65)","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.08437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"68462031066","name":"CALCIPOTRIENE 0.005% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-310-66","proprietary_name":"Calcipotriene","nonproprietary_name":"Calcipotriene","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-310-66) / 120 g in 1 TUBE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.3377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Calcipotriene|Calcipotriene","basis":"generic"},"part_b":null}, {"ndc":"00713031853","name":"CALCIPOTRIENE 0.005% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0318-53","proprietary_name":"Calcipotriene","nonproprietary_name":"Calcipotriene","dosage_form":"SOLUTION","route":"TOPICAL","strength":".05 mg/mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (0713-0318-53) / 60 mL in 1 BOTTLE","pharm_classes":["Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.71166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802081601","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-816-01","proprietary_name":"Calcipotriene and Betamethasone Dipropionate","nonproprietary_name":"Calcipotriene, Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g; .643 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-816-01) / 100 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.43306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802081696","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-816-96","proprietary_name":"Calcipotriene and Betamethasone Dipropionate","nonproprietary_name":"Calcipotriene, Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g; .643 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-816-96) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.1825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993093861","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-938-61","proprietary_name":"Calcipotriene and Betamethasone Dipropionate","nonproprietary_name":"Calcipotriene and Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g; .5 mg/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-938-61) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":2.1825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993093865","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-938-65","proprietary_name":"Calcipotriene and Betamethasone Dipropionate","nonproprietary_name":"Calcipotriene and Betamethasone Dipropionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 ug/g; .5 mg/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-938-65) / 100 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.43306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713084860","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0848-60","proprietary_name":"calcipotriene and betamethasone dipropionate","nonproprietary_name":"calcipotriene and betamethasone dipropionate","dosage_form":"SUSPENSION","route":"TOPICAL","strength":".5 mg/g; 50 ug/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (0713-0848-60) / 60 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.42087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713084892","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0848-92","proprietary_name":"calcipotriene and betamethasone dipropionate","nonproprietary_name":"calcipotriene and betamethasone dipropionate","dosage_form":"SUSPENSION","route":"TOPICAL","strength":".5 mg/g; 50 ug/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"2 BOTTLE in 1 CARTON (0713-0848-92) / 60 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.21327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672140204","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1402-4","proprietary_name":"Calcipotriene and Betamethasone Dipropionate","nonproprietary_name":"Calcipotriene and Betamethasone Dipropionate","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"50 ug/g; 50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1402-4) / 60 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.42087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672140208","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1402-8","proprietary_name":"Calcipotriene and Betamethasone Dipropionate","nonproprietary_name":"Calcipotriene and Betamethasone Dipropionate","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"50 ug/g; 50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"2 BOTTLE in 1 CARTON (51672-1402-8) / 60 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":1.21327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"63646004012","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":1.21327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"63646004060","name":"CALCIPOTRIENE-BETAMETHASONE DP 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.42087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49884016111","name":"CALCITONIN-SALMON 200 UNIT SPR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-161-11","proprietary_name":"CALCITONIN SALMON","nonproprietary_name":"CALCITONIN SALMON","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"200 [iU]/.09mL","labeler":"Par Health USA, LLC","package_description":"3.7 mL in 1 BOTTLE, GLASS (49884-161-11)","pharm_classes":["Calcitonin [CS]","Calcitonin [EPC]"]},"nadac":{"value":13.10383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505082306","name":"CALCITONIN-SALMON 200 UNIT SPR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0823-6","proprietary_name":"Calcitonin Salmon","nonproprietary_name":"Calcitonin Salmon","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"200 [iU]/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, GLASS in 1 CARTON (60505-0823-6) / 30 SPRAY, METERED in 1 BOTTLE, GLASS","pharm_classes":["Calcitonin [CS]","Calcitonin [EPC]"]},"nadac":{"value":13.10383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093735201","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7352-01","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".25 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (0093-7352-01)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155066201","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-662-01","proprietary_name":"CALCITRIOL","nonproprietary_name":"CALCITRIOL","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-662-01)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155066203","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-662-03","proprietary_name":"CALCITRIOL","nonproprietary_name":"CALCITRIOL","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (23155-662-03)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806073201","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-732-01","proprietary_name":"CALCITRIOL","nonproprietary_name":"CALCITRIOL","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"EPIC PHARMA LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-732-01)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687034501","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-345-01","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol Capsules 0.25 mcg","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-345-01) / 1 CAPSULE in 1 BLISTER PACK (60687-345-11)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687034511","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135061090","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-610-90","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-610-90)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072304","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-723-04","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol Capsules 0.25 mcg","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"Strides Pharma Science Limited","package_description":"30 CAPSULE in 1 CONTAINER (64380-723-04)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072306","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-723-06","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol Capsules 0.25 mcg","dosage_form":"CAPSULE","route":"ORAL","strength":".25 ug/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-723-06)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452020713","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-207-13","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".25 ug/1","labeler":"BIONPHARMA INC.","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69452-207-13)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452020720","name":"CALCITRIOL 0.25 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-207-20","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".25 ug/1","labeler":"BIONPHARMA INC.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69452-207-20)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.15317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093735301","name":"CALCITRIOL 0.5 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7353-01","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (0093-7353-01)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.23399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155066301","name":"CALCITRIOL 0.5 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-663-01","proprietary_name":"CALCITRIOL","nonproprietary_name":"CALCITRIOL","dosage_form":"CAPSULE","route":"ORAL","strength":".5 ug/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-663-01)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.23399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806073301","name":"CALCITRIOL 0.5 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-733-01","proprietary_name":"CALCITRIOL","nonproprietary_name":"CALCITRIOL","dosage_form":"CAPSULE","route":"ORAL","strength":".5 ug/1","labeler":"EPIC PHARMA LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-733-01)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.23399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135061190","name":"CALCITRIOL 0.5 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-611-90","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE","route":"ORAL","strength":".5 ug/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-611-90)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.23399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072406","name":"CALCITRIOL 0.5 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-724-06","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol Capsules 0.5 mcg","dosage_form":"CAPSULE","route":"ORAL","strength":".5 ug/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-724-06)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.23399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452020820","name":"CALCITRIOL 0.5 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-208-20","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 ug/1","labeler":"BIONPHARMA INC.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69452-208-20)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":0.23399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054312041","name":"CALCITRIOL 1 MCG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3120-41","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"SOLUTION","route":"ORAL","strength":"1 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (0054-3120-41) / 15 mL in 1 BOTTLE, GLASS","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":6.60188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980044715","name":"CALCITRIOL 1 MCG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-447-15","proprietary_name":"Calcitriol","nonproprietary_name":"Calcitriol","dosage_form":"SOLUTION","route":"ORAL","strength":"1 ug/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (64980-447-15) / 15 mL in 1 BOTTLE, GLASS","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":6.60188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054008813","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0088-13","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0054-0088-13)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054008826","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0088-26","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"200 CAPSULE in 1 BOTTLE (0054-0088-26)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"00904711906","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7119-06","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7119-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"00904711961","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7119-61","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7119-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"16571081320","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-813-20","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"200 CAPSULE in 1 BOTTLE, PLASTIC (16571-813-20)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"23155053102","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-531-02","proprietary_name":"calcium acetate","nonproprietary_name":"calcium acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"200 CAPSULE in 1 BOTTLE (23155-531-02)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"60687058911","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"60687058965","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-589-65","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-589-65) / 1 CAPSULE in 1 BLISTER PACK (60687-589-11)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"62135019122","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-191-22","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Chartwell RX, LLC.","package_description":"200 CAPSULE in 1 BOTTLE (62135-191-22)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"68084047901","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-479-01","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-479-01) / 1 CAPSULE in 1 BLISTER PACK (68084-479-11)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"68084047911","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"69097086283","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-862-83","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Cipla USA Inc.,","package_description":"200 CAPSULE in 1 BOTTLE (69097-862-83)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"69367041102","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-411-02","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"200 CAPSULE in 1 BOTTLE (69367-411-02)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"75834032302","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-323-02","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"200 CAPSULE in 1 BOTTLE (75834-323-02)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"76282037702","name":"CALCIUM ACETATE 667 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-377-02","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"CAPSULE","route":"ORAL","strength":"667 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"200 CAPSULE in 1 BOTTLE (76282-377-02)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"00781208102","name":"CALCIUM ACETATE 667 MG GELCAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.16972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"23155062102","name":"CALCIUM ACETATE 667 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23155-621-02","proprietary_name":"CALCIUM ACETATE","nonproprietary_name":"CALCIUM ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"667 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"200 TABLET in 1 BOTTLE (23155-621-02)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.43873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"62135019222","name":"CALCIUM ACETATE 667 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-192-22","proprietary_name":"Calcium Acetate","nonproprietary_name":"Calcium Acetate","dosage_form":"TABLET","route":"ORAL","strength":"667 mg/1","labeler":"Chartwell RX LLC","package_description":"200 TABLET in 1 BOTTLE (62135-192-22)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.43873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Calcium Acetate|Calcium Acetate","basis":"generic"},"part_b":null}, {"ndc":"00536104815","name":"CALCIUM ANTACID 500 MG CHW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1048-15","proprietary_name":"Rugby","nonproprietary_name":"Antacid Tablets","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Rugby Laboratories","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (0536-1048-15)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904641292","name":"CALCIUM ANTACID 500 MG CHW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6412-92","proprietary_name":"Major Regular Strength Assorted Flavors","nonproprietary_name":"Antacid Tablets","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (0904-6412-92)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536104922","name":"CALCIUM ANTACID 750 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1049-22","proprietary_name":"calcium antacidextra strength extra strength","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Rugby Laboratories","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (0536-1049-22)"},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536105022","name":"CALCIUM ANTACID 750 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1050-22","proprietary_name":"Rugby Extra Strength Assorted Berries","nonproprietary_name":"Antacid Tablets","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Rugby Laboratories","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (0536-1050-22)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121076616","name":"CALCIUM CARB 1,250 MG/5 ML SUS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0766-16","proprietary_name":"Calcium Carbonate","nonproprietary_name":"Calcium Carbonate","dosage_form":"SUSPENSION","route":"ORAL","strength":"1250 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"12 BOTTLE in 1 CASE (0121-0766-16) / 473 mL in 1 BOTTLE","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536120610","name":"CALCIUM CARBONATE 648 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1206-10","proprietary_name":"Calcium Carbonate 10 gr (648 mg) (Antacid)","nonproprietary_name":"Calcium Carbonate 10gr (648 mg)","dosage_form":"TABLET","route":"ORAL","strength":"648 mg/1","labeler":"RUGBY LABORATORIES","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0536-1206-10)"},"nadac":{"value":0.00807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536126958","name":"CALDYPHEN CLEAR LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1269-58","proprietary_name":"Rugby Caldyphen Clear","nonproprietary_name":"pramoxine hydrochloride and zinc acetate lotion","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL; 1 mg/mL","labeler":"Rugby Laboratories","package_description":"177 mL in 1 CONTAINER (0536-1269-58)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385043930","name":"CALDYPHEN CLEAR LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-439-30","proprietary_name":"Caldyphen Clear","nonproprietary_name":"Pramoxine Hydrochloride and Zinc acetate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL; 1 mg/mL","labeler":"Amerisource Bergen","package_description":"177 mL in 1 BOTTLE, PLASTIC (24385-439-30)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385007282","name":"CALDYPHEN LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-072-82","proprietary_name":"GNP Caldyphen","nonproprietary_name":"Calamine and Pramoxine Hydrochloride","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 10 mg/mL","labeler":"Amerisource Bergen","package_description":"177 mL in 1 BOTTLE, PLASTIC (24385-072-82)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122052413","name":"CALLUS REMOVERS PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-524-13","proprietary_name":"Salicylic Acid","nonproprietary_name":"Medicated Callus Removers","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/41","labeler":"AmerisourceBergen Drug Corporation","package_description":"4 PATCH in 1 PACKAGE (46122-524-13)"},"nadac":{"value":0.10249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000033301","name":"CALLUS REMOVERS PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0333-1","proprietary_name":"Salicylic Acid","nonproprietary_name":"Medicated Callus Removers","dosage_form":"PATCH","route":"TOPICAL","strength":"400 mg/g","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"4 PATCH in 1 CARTON (70000-0333-1) / 1 g in 1 PATCH"},"nadac":{"value":0.10249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907007428","name":"CAMILA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Camila|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"75907007432","name":"CAMILA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-074-32","proprietary_name":"CAMILA","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (75907-074-32) / 28 TABLET in 1 BLISTER PACK (75907-074-28)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Camila|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"70000039601","name":"CAMPHOR SPIRIT","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0396-1","proprietary_name":"LEADER Camphor Spirit","nonproprietary_name":"Camphor (natural)","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"59 mL in 1 BOTTLE (70000-0396-1)"},"nadac":{"value":0.04804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093313482","name":"CAMRESE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3134-82","proprietary_name":"Camrese","nonproprietary_name":"Levonorgestrel / Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 POUCH in 1 CARTON (0093-3134-82) / 1 BLISTER PACK in 1 POUCH (0093-3134-91) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Camrese|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"00093313491","name":"CAMRESE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Camrese|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"00093614882","name":"CAMRESE LO TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6148-82","proprietary_name":"camrese Lo","nonproprietary_name":"Levonorgestrel/Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 POUCH in 1 CARTON (0093-6148-82) / 1 BLISTER PACK in 1 POUCH (0093-6148-91) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.23385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Camrese Lo|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"00093614891","name":"CAMRESE LO TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.23385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Camrese Lo|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"58914050156","name":"CANASA 1,000 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58914-501-56","proprietary_name":"Canasa","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Allergan, Inc.","package_description":"30 SUPPOSITORY in 1 BOX (58914-501-56)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":37.10967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Canasa|Mesalamine","basis":"brand"},"part_b":null}, {"ndc":"00378323177","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3231-77","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-3231-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378323193","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3231-93","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3231-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011607","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-116-07","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 CONTAINER (33342-116-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011610","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-116-10","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 CONTAINER (33342-116-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332034330","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-343-30","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-343-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332034390","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-343-90","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-343-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"72603072001","name":"CANDESARTAN CILEXETIL 16 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-720-01","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 CARTON (72603-720-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.47843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378323277","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3232-77","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-3232-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378323293","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3232-93","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3232-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011707","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-117-07","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 CONTAINER (33342-117-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011710","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-117-10","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 CONTAINER (33342-117-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332006030","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-060-30","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-060-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332006090","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-060-90","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-060-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"72603072101","name":"CANDESARTAN CILEXETIL 32 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-721-01","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 CARTON (72603-721-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.51886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378322477","name":"CANDESARTAN CILEXETIL 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3224-77","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-3224-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.56857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378322493","name":"CANDESARTAN CILEXETIL 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3224-93","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3224-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.56857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011407","name":"CANDESARTAN CILEXETIL 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-114-07","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 CONTAINER (33342-114-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.56857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011410","name":"CANDESARTAN CILEXETIL 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-114-10","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 CONTAINER (33342-114-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.56857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332034130","name":"CANDESARTAN CILEXETIL 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-341-30","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-341-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.56857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332034190","name":"CANDESARTAN CILEXETIL 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-341-90","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-341-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.56857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378322577","name":"CANDESARTAN CILEXETIL 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3225-77","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-3225-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.5364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378322593","name":"CANDESARTAN CILEXETIL 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3225-93","proprietary_name":"candesartan cilexetil","nonproprietary_name":"candesartan cilexetil","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-3225-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.5364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011507","name":"CANDESARTAN CILEXETIL 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-115-07","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 CONTAINER (33342-115-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.5364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"33342011510","name":"CANDESARTAN CILEXETIL 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-115-10","proprietary_name":"Candesartan","nonproprietary_name":"Candesartan","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 CONTAINER (33342-115-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.5364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332034230","name":"CANDESARTAN CILEXETIL 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-342-30","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-342-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.5364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"62332034290","name":"CANDESARTAN CILEXETIL 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-342-90","proprietary_name":"CANDESARTAN CILEXETIL","nonproprietary_name":"CANDESARTAN CILEXETIL","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-342-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.5364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Candesartan Cilexetil|Candesartan Cilexetil","basis":"generic"},"part_b":null}, {"ndc":"00378300177","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3001-77","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"candesartan cilexetil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1; 12.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-3001-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.95417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013110","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-131-10","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-131-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.95417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013115","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-131-15","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-131-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.95417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547045909","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-459-09","proprietary_name":"candesartan cilexetil and hydrochlorothiazide","nonproprietary_name":"candesartan cilexetil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"90 TABLET in 1 BOTTLE (43547-459-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.95417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559066090","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-660-90","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1; 12.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-660-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.95417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013210","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-132-10","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-132-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.81993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013215","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-132-15","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-132-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.81993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547046009","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-460-09","proprietary_name":"candesartan cilexetil and hydrochlorothiazide","nonproprietary_name":"candesartan cilexetil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"90 TABLET in 1 BOTTLE (43547-460-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.81993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559066190","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-661-90","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 12.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-661-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.81993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013310","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-133-10","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-133-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.07781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013315","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-133-15","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-133-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.07781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547046109","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-461-09","proprietary_name":"candesartan cilexetil and hydrochlorothiazide","nonproprietary_name":"candesartan cilexetil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 25 mg/1","labeler":"Solco Healthcare LLC","package_description":"90 TABLET in 1 BOTTLE (43547-461-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.07781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559066290","name":"CANDESARTAN-HYDROCHLOROTHIAZIDE 32-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-662-90","proprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","nonproprietary_name":"Candesartan Cilexetil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1; 25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-662-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.07781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093747306","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-7473-06","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0093-7473-06)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET, FILM COATED in 1 BOTTLE (0093-7473-06)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722077460","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-774-60","proprietary_name":"capecitabine","nonproprietary_name":"capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-774-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"55111049660","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55111-496-60","proprietary_name":"capecitabine","nonproprietary_name":"capecitabine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 TABLET in 1 BOTTLE (55111-496-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (55111-496-60)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651020460","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-204-60","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (59651-204-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (59651-204-60)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135078360","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"67877045860","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67877-458-60","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-458-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET, FILM COATED in 1 BOTTLE (67877-458-60)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001064306","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68001-643-06","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68001-643-06)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET, FILM COATED in 1 BOTTLE (68001-643-06)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69097094903","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69097-949-03","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69097-949-03)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET, FILM COATED in 1 BOTTLE (69097-949-03)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70756081560","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70756-815-60","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Lifestar Pharma LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70756-815-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70756-815-60)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72205000660","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72205-006-60","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-006-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET, FILM COATED in 1 BOTTLE (72205-006-60)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"82249020760","name":"CAPECITABINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82249-207-60","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"CivicaScript LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (82249-207-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.36154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"00093747489","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7474-89","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (0093-7474-89)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE (0093-7474-89)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729007329","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-073-29","proprietary_name":"CAPECITABINE","nonproprietary_name":"CAPECITABINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Accord Healthcare Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16729-073-29)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16729-073-29)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722077512","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-775-12","proprietary_name":"capecitabine","nonproprietary_name":"capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-775-12)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"31722077560","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-775-60","proprietary_name":"capecitabine","nonproprietary_name":"capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-775-60)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"55111049704","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-497-04","proprietary_name":"capecitabine","nonproprietary_name":"capecitabine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"120 TABLET in 1 BOTTLE (55111-497-04)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET in 1 BOTTLE (55111-497-04)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651020508","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-205-08","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET in 1 BOTTLE (59651-205-08)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET in 1 BOTTLE (59651-205-08)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687014911","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"60687014994","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-149-94","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-149-94) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-149-11)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-149-94) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-149-11)) gives 20 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135078412","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"67877045912","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-459-12","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (67877-459-12)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE (67877-459-12)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001064407","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-644-07","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68001-644-07)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE (68001-644-07)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69097094808","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-948-08","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Cipla USA Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (69097-948-08)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE (69097-948-08)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70756081622","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-816-22","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lifestar Pharma LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70756-816-22)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70756-816-22)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72205000792","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-007-92","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (72205-007-92)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, FILM COATED in 1 BOTTLE (72205-007-92)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72603030301","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-303-01","proprietary_name":"capecitabine","nonproprietary_name":"capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar RxLLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (72603-303-01)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"82009011212","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-112-12","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"120 TABLET in 1 BOTTLE (82009-112-12)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":{"hcpcs":"J8522","bill_units_per_package":{"value":1200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8522 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET in 1 BOTTLE (82009-112-12)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"82249021012","name":"CAPECITABINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-210-12","proprietary_name":"Capecitabine","nonproprietary_name":"Capecitabine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"CivicaScript LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (82249-210-12)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Capecitabine|Capecitabine","basis":"generic"},"part_b":null}, {"ndc":"72060011040","name":"CAPLYTA 10.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72060-110-40","proprietary_name":"CAPLYTA","nonproprietary_name":"lumateperone","dosage_form":"CAPSULE","route":"ORAL","strength":"10.5 mg/1","labeler":"Intra-Cellular Therapies, Inc","package_description":"30 CAPSULE in 1 BOTTLE (72060-110-40)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":57.24296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Caplyta|Lumateperone Tosylate","basis":"brand"},"part_b":null}, {"ndc":"72060012140","name":"CAPLYTA 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72060-121-40","proprietary_name":"CAPLYTA","nonproprietary_name":"lumateperone","dosage_form":"CAPSULE","route":"ORAL","strength":"21 mg/1","labeler":"Intra-Cellular Therapies, Inc","package_description":"30 CAPSULE in 1 BOTTLE (72060-121-40)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":57.2004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Caplyta|Lumateperone Tosylate","basis":"brand"},"part_b":null}, {"ndc":"72060014240","name":"CAPLYTA 42 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72060-142-40","proprietary_name":"CAPLYTA","nonproprietary_name":"lumateperone","dosage_form":"CAPSULE","route":"ORAL","strength":"42 mg/1","labeler":"Intra-Cellular Therapies, Inc","package_description":"30 CAPSULE in 1 BOTTLE (72060-142-40)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":57.24714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Caplyta|Lumateperone Tosylate","basis":"brand"},"part_b":null}, {"ndc":"29978012716","name":"CAPRON DM LIQUID","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"29978-127-16","proprietary_name":"Capron DM","nonproprietary_name":"Dextromethorphan HBr and Pyrilamine Maleate","dosage_form":"LIQUID","route":"ORAL","strength":"7.5 mg/5mL; 7.5 mg/5mL","labeler":"Capital Pharmaceutical, LLC","package_description":"1 BOTTLE in 1 BOX (29978-127-16) / 473 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"29978012810","name":"CAPRON DMT TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"29978-128-10","proprietary_name":"Capron DMT","nonproprietary_name":"Dextromethorphan HBr and Pyrilamine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1; 30 mg/1","labeler":"Capital Pharma","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29978-128-10)","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.32758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536252525","name":"CAPSAICIN 0.025% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-2525-25","proprietary_name":"Capsaicin","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-2525-25) / 60 g in 1 TUBE"},"nadac":{"value":0.08205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"50268019560","name":"CAPSAICIN 0.025% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-195-60","proprietary_name":"Capsaicin External Analgesic","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"AvPAK","package_description":"1 TUBE in 1 CARTON (50268-195-60) / 60 g in 1 TUBE"},"nadac":{"value":0.08205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000055601","name":"CAPSAICIN 0.025% HEAT PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0556-1","proprietary_name":"CAPSAICIN HOT PATCHES","nonproprietary_name":"CAPSAICIN","dosage_form":"PATCH","route":"TOPICAL","strength":".025 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"2 PATCH in 1 BOX (70000-0556-1) / 9 g in 1 PATCH"},"nadac":{"value":1.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268019657","name":"CAPSAICIN 0.075% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-196-57","proprietary_name":"Capsaicin Topical Analgesic","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".75 mg/g","labeler":"AvPAK","package_description":"1 TUBE in 1 CARTON (50268-196-57) / 57 g in 1 TUBE"},"nadac":{"value":0.07134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536126456","name":"CAPSAICIN 0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1264-56","proprietary_name":"Rugby Capsaicin Cream","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".1 g/100g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1264-56) / 42.5 g in 1 TUBE"},"nadac":{"value":0.20681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"50268019842","name":"CAPSAICIN 0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-198-42","proprietary_name":"Capsaicin","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".1 g/100g","labeler":"AvPAK","package_description":"1 TUBE in 1 CARTON (50268-198-42) / 42.5 g in 1 TUBE"},"nadac":{"value":0.20681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000054901","name":"CAPSAICIN 0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0549-1","proprietary_name":"Leader Capsaicin Pain Relief Cream","nonproprietary_name":"Capsaicin","dosage_form":"CREAM","route":"TOPICAL","strength":".1 g/100g","labeler":"Cardinal Health 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0549-1) / 42.5 g in 1 TUBE"},"nadac":{"value":0.20681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70512001610","name":"CAPSIMIDE 0.025% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-016-10","proprietary_name":"Capsimide","nonproprietary_name":"Capsaicin 0.025% Topical Patch","dosage_form":"PATCH","route":"TOPICAL","strength":".025 g/100g","labeler":"Sola Pharmaceuticals","package_description":"10 POUCH in 1 BOX (70512-016-10) / 9 g in 1 POUCH"},"nadac":{"value":1.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143117401","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-1174-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1174-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"11788013801","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"11788-138-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-138-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"27241016301","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"27241-163-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-163-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"31722014401","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-144-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-144-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"43547036610","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43547-366-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-366-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657073801","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58657-738-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-738-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093803","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58657-938-03","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"30 BLISTER PACK in 1 CARTON (58657-938-03) / 1 TABLET in 1 BLISTER PACK (58657-938-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093810","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052801","name":"CAPTOPRIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69292-528-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"100 TABLET in 1 BOTTLE (69292-528-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.32292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00143117101","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1171-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1171-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00143117110","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1171-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (0143-1171-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00904710561","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7105-61","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7105-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"11788013501","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-135-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-135-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"27241016001","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-160-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-160-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"31722014101","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-141-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-141-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"43547036310","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-363-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-363-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657073501","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-735-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-735-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093501","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-935-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-935-01) / 1 TABLET in 1 BLISTER PACK (58657-935-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093503","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-935-03","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"30 BLISTER PACK in 1 CARTON (58657-935-03) / 1 TABLET in 1 BLISTER PACK (58657-935-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093510","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"60687030411","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"60687030421","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-304-21","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-304-21) / 1 TABLET in 1 BLISTER PACK (60687-304-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052201","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-522-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"100 TABLET in 1 BOTTLE (69292-522-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052210","name":"CAPTOPRIL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-522-10","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"1000 TABLET in 1 BOTTLE (69292-522-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.22839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00143117201","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1172-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1172-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00143117210","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1172-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (0143-1172-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00904710661","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7106-61","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7106-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"11788013601","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-136-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-136-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"27241016101","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-161-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-161-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"31722014201","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-142-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-142-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"43547036410","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-364-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-364-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657073601","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-736-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-736-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093601","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-936-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-936-01) / 1 TABLET in 1 BLISTER PACK (58657-936-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093603","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-936-03","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"30 BLISTER PACK in 1 CARTON (58657-936-03) / 1 TABLET in 1 BLISTER PACK (58657-936-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093610","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"60687031511","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"60687031521","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-315-21","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-315-21) / 1 TABLET in 1 BLISTER PACK (60687-315-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052401","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-524-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"100 TABLET in 1 BOTTLE (69292-524-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052410","name":"CAPTOPRIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-524-10","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"1000 TABLET in 1 BOTTLE (69292-524-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.17282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00143117301","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1173-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1173-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"00143117310","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1173-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (0143-1173-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"11788013701","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-137-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-137-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"27241016201","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-162-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-162-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"31722014301","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-143-01","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-143-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"43547036510","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-365-10","proprietary_name":"Captopril","nonproprietary_name":"Captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-365-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657073701","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-737-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (58657-737-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093703","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-937-03","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"30 BLISTER PACK in 1 CARTON (58657-937-03) / 1 TABLET in 1 BLISTER PACK (58657-937-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58657093710","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052601","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-526-01","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"100 TABLET in 1 BOTTLE (69292-526-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"69292052610","name":"CAPTOPRIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-526-10","proprietary_name":"captopril","nonproprietary_name":"captopril","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AMICI PHARMA, INC.","package_description":"1000 TABLET in 1 BOTTLE (69292-526-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.36903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Captopril|Captopril","basis":"generic"},"part_b":null}, {"ndc":"58914017110","name":"CARAFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58914-171-10","proprietary_name":"Carafate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Allergan, Inc.","package_description":"100 TABLET in 1 BOTTLE (58914-171-10)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":4.73077,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carafate|Sucralfate","basis":"brand"},"part_b":null}, {"ndc":"00904385461","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-3854-61","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-3854-61) / 1 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668027101","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-271-01","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (13668-271-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668027105","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-271-05","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, CHEWABLE in 1 BOTTLE (13668-271-05)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672404101","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4041-1","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (51672-4041-1)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672404102","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4041-2","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, CHEWABLE in 1 BOTTLE (51672-4041-2)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687047901","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-479-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-479-01) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (60687-479-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687047911","name":"CARBAMAZEPINE 100 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672404704","name":"CARBAMAZEPINE 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4047-4","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4047-4) / 450 mL in 1 BOTTLE","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.09255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672404709","name":"CARBAMAZEPINE 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.09255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135080253","name":"CARBAMAZEPINE 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-802-53","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"450 mL in 1 BOTTLE (62135-802-53)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.09255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954024010","name":"CARBAMAZEPINE 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-240-10","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70954-240-10) / 450 mL in 1 BOTTLE","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.09255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904617250","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6172-50","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"2000 TABLET in 1 BOTTLE (0904-6172-50)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904617261","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6172-61","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6172-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668026801","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-268-01","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-268-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668026805","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-268-05","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-268-05)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668026810","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-268-10","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (13668-268-10)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300038201","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-382-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-382-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300038210","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-382-10","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-382-10)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016011","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016015","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-160-15","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-160-15) / 1 TABLET in 1 BLISTER PACK (50268-160-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672400501","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4005-1","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4005-1)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672400502","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4005-2","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE (51672-4005-2)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672400503","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4005-3","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4005-3)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505018300","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0183-0","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0183-0)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505018301","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0183-1","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0183-1)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084044401","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-444-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-444-01) / 1 TABLET in 1 BLISTER PACK (68084-444-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084044411","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452031220","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-312-20","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.,","package_description":"100 TABLET in 1 BOTTLE (69452-312-20)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452031232","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-312-32","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.,","package_description":"1000 TABLET in 1 BOTTLE (69452-312-32)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834022100","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-221-00","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-221-00)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834022101","name":"CARBAMAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-221-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"100 TABLET in 1 BOTTLE (75834-221-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268017011","name":"CARBAMAZEPINE ER 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.06785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50268017013","name":"CARBAMAZEPINE ER 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-170-13","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-170-13) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-170-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.06785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60505280507","name":"CARBAMAZEPINE ER 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2805-7","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-2805-7)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.06785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62559048412","name":"CARBAMAZEPINE ER 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-484-12","proprietary_name":"Carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62559-484-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.06785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"00832602211","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6022-11","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-6022-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"13668028401","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-284-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-284-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"16571068001","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-680-01","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-680-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"16714006301","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-063-01","proprietary_name":"carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-063-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50742025701","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-257-01","proprietary_name":"Carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-257-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"51672412301","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4123-1","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4123-1)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"59746078901","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-789-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59746-789-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62135092760","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-927-60","proprietary_name":"Carbamazepine ER","nonproprietary_name":"Carbamazepine ER","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-927-60)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62332042031","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-420-31","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-420-31)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"72603088601","name":"CARBAMAZEPINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-886-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72603-886-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"00904688504","name":"CARBAMAZEPINE ER 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6885-04","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6885-04) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.05271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50268017111","name":"CARBAMAZEPINE ER 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.05271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50268017113","name":"CARBAMAZEPINE ER 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-171-13","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-171-13) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-171-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.05271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60505280607","name":"CARBAMAZEPINE ER 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2806-7","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-2806-7)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.05271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62559048512","name":"CARBAMAZEPINE ER 200 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-485-12","proprietary_name":"Carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62559-485-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.05271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"00832602311","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6023-11","proprietary_name":"Carbamazepin","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-6023-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"13668028501","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-285-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-285-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"16571068101","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-681-01","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-681-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"16714006401","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-064-01","proprietary_name":"carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-064-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50742025801","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-258-01","proprietary_name":"Carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-258-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"51672412401","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4124-1","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4124-1)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"59746079001","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-790-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59746-790-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60687058311","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60687058321","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-583-21","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-583-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-583-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62135092860","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-928-60","proprietary_name":"Carbamazepine ER","nonproprietary_name":"Carbamazepine ER","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-928-60)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62332042131","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-421-31","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-421-31)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"68382055601","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-556-01","proprietary_name":"carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-556-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"72516002001","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-020-01","proprietary_name":"Carbamazepine ER","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-020-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"72603088701","name":"CARBAMAZEPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-887-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72603-887-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50268017211","name":"CARBAMAZEPINE ER 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.07458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50268017213","name":"CARBAMAZEPINE ER 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-172-13","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-172-13) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-172-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.07458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60505280707","name":"CARBAMAZEPINE ER 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2807-7","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Apotex Corp.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-2807-7)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.07458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62559048612","name":"CARBAMAZEPINE ER 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-486-12","proprietary_name":"Carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62559-486-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.07458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"00832602411","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6024-11","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-6024-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"13668028601","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-286-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-286-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"16571068201","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-682-01","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-682-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"50742025901","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-259-01","proprietary_name":"Carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-259-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"51672412501","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4125-1","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4125-1)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"59746079101","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-791-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59746-791-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60687059411","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"60687059421","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-594-21","proprietary_name":"CARBAMAZEPINE","nonproprietary_name":"CARBAMAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-594-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-594-11)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62135093060","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-930-60","proprietary_name":"Carbamazepine ER","nonproprietary_name":"Carbamazepine ER","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-930-60)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"62332042231","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-422-31","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-422-31)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"68382055701","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-557-01","proprietary_name":"carbamazepine","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-557-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"72516002101","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-021-01","proprietary_name":"Carbamazepine ER","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-021-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"72603088801","name":"CARBAMAZEPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-888-01","proprietary_name":"Carbamazepine","nonproprietary_name":"Carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72603-888-01)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbamazepine ER|Carbamazepine","basis":"generic"},"part_b":null}, {"ndc":"54092017112","name":"CARBATROL ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-171-12","proprietary_name":"Carbatrol","nonproprietary_name":"carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-171-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.69958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.06785,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092017212","name":"CARBATROL ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-172-12","proprietary_name":"Carbatrol","nonproprietary_name":"carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-172-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.69319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.05271,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092017312","name":"CARBATROL ER 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-173-12","proprietary_name":"Carbatrol","nonproprietary_name":"carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-173-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.6954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.07458,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714006701","name":"CARBIDOPA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-067-01","proprietary_name":"Carbidopa","nonproprietary_name":"Carbidopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-067-01)"},"nadac":{"value":0.53596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa|Carbidopa","basis":"generic"},"part_b":null}, {"ndc":"42799012301","name":"CARBIDOPA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-123-01","proprietary_name":"Carbidopa","nonproprietary_name":"Carbidopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-123-01)"},"nadac":{"value":0.53596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa|Carbidopa","basis":"generic"},"part_b":null}, {"ndc":"59651014601","name":"CARBIDOPA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-146-01","proprietary_name":"Carbidopa","nonproprietary_name":"Carbidopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-146-01)"},"nadac":{"value":0.53596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa|Carbidopa","basis":"generic"},"part_b":null}, {"ndc":"70710122101","name":"CARBIDOPA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1221-1","proprietary_name":"CARBIDOPA","nonproprietary_name":"CARBIDOPA","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1221-1)"},"nadac":{"value":0.53596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa|Carbidopa","basis":"generic"},"part_b":null}, {"ndc":"16571015801","name":"CARBIDOPA-LEVO 25-100 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-158-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (16571-158-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.68655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335018788","name":"CARBIDOPA-LEVO 25-100 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-187-88","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"CARBIDOPA AND LEVODOPA","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (47335-187-88)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.68655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710213901","name":"CARBIDOPA-LEVO ER 23.75-95 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2139-1","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"23.75 mg/1; 95 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-2139-1)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.15323,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00378008801","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0088-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-0088-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228046001","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-460-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50228-460-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228046010","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-460-10","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (50228-460-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"51079097801","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"51079097820","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-978-20","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-978-20) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (51079-978-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"60219203301","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2033-1","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"CARBIDOPA and LEVODOPA","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60219-2033-1)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888015501","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-155-01","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-155-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888015530","name":"CARBIDOPA-LEVO ER 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-155-30","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-155-30)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"70710214001","name":"CARBIDOPA-LEVO ER 36.25-145 CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2140-1","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"36.25 mg/1; 145 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-2140-1)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.3941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"70710214101","name":"CARBIDOPA-LEVO ER 48.75-195 CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2141-1","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"48.75 mg/1; 195 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-2141-1)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.18794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00378009401","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0094-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-0094-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228046101","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-461-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50228-461-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228046110","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-461-10","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (50228-461-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"51079092301","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"51079092320","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-923-20","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-923-20) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (51079-923-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"60219203401","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2034-1","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"CARBIDOPA and LEVODOPA","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60219-2034-1)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888015601","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-156-01","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-156-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888015630","name":"CARBIDOPA-LEVO ER 50-200 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-156-30","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 200 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-156-30)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"70710214201","name":"CARBIDOPA-LEVO ER 61.25-245 CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2142-1","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"61.25 mg/1; 245 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-2142-1)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.92786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa ER|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970101","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9701-01","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9701-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970105","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9701-05","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-9701-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038101","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-381-01","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-381-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038105","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-381-05","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-381-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045701","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-457-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-457-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045705","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-457-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-457-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039010","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-390-10","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-390-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039050","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-390-50","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"TruPharma, LLC","package_description":"500 TABLET in 1 BOTTLE (52817-390-50)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"59651045601","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-456-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-456-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"68002010002","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"68002010004","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68002-100-04","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (68002-100-04) / 1 TABLET in 1 BLISTER PACK (68002-100-02)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367033801","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-338-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69367-338-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367033805","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-338-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (69367-338-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010600","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-106-00","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"1000 TABLET in 1 BOTTLE (72888-106-00)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010601","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-106-01","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"100 TABLET in 1 BOTTLE (72888-106-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010605","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-106-05","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"500 TABLET in 1 BOTTLE (72888-106-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"75907002201","name":"CARBIDOPA-LEVODOPA 10-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-022-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 100 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE (75907-022-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.06826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970201","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9702-01","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9702-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970205","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9702-05","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-9702-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970210","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9702-10","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-9702-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00904750161","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7501-61","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7501-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038201","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-382-01","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-382-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038205","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-382-05","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-382-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038210","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-382-10","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-382-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045801","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-458-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-458-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045805","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-458-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-458-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045810","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-458-10","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-458-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039100","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-391-00","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"TruPharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-391-00)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039110","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-391-10","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-391-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039150","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-391-50","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"TruPharma, LLC","package_description":"500 TABLET in 1 BOTTLE (52817-391-50)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"59651045701","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-457-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-457-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"59651045705","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-457-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-457-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"60687066101","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-661-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-661-01) / 1 TABLET in 1 BLISTER PACK (60687-661-11)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"60687066111","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367033901","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-339-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69367-339-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367033905","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-339-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (69367-339-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367033910","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-339-10","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69367-339-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010700","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-107-00","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"1000 TABLET in 1 BOTTLE (72888-107-00)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010701","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-107-01","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"100 TABLET in 1 BOTTLE (72888-107-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010705","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-107-05","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"500 TABLET in 1 BOTTLE (72888-107-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"75907002001","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-020-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE (75907-020-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"75907002005","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-020-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (75907-020-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"75907002010","name":"CARBIDOPA-LEVODOPA 25-100 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-020-10","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (75907-020-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970301","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9703-01","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9703-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970305","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9703-05","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-9703-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00093970310","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9703-10","proprietary_name":"Carbidopa and levodopa","nonproprietary_name":"Carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-9703-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00904754961","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7549-61","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7549-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038301","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-383-01","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-383-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038305","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-383-05","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-383-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"31722038310","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-383-10","proprietary_name":"CARBIDOPA AND LEVODOPA","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-383-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045901","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-459-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-459-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"50228045905","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-459-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-459-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039200","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-392-00","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"TruPharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-392-00)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039210","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-392-10","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-392-10)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"52817039250","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-392-50","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"TruPharma, LLC","package_description":"500 TABLET in 1 BOTTLE (52817-392-50)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"59651045801","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-458-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-458-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"59651045805","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-458-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-458-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"60687083601","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-836-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-836-01) / 1 TABLET in 1 BLISTER PACK (60687-836-11)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"60687083611","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367034001","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-340-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69367-340-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"69367034005","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-340-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (69367-340-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010800","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-108-00","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"1000 TABLET in 1 BOTTLE (72888-108-00)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010801","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-108-01","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"100 TABLET in 1 BOTTLE (72888-108-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"72888010805","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-108-05","proprietary_name":"Carbidopa-levodopa","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"500 TABLET in 1 BOTTLE (72888-108-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"75907002101","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-021-01","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE (75907-021-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"75907002105","name":"CARBIDOPA-LEVODOPA 25-250 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-021-05","proprietary_name":"Carbidopa and Levodopa","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 250 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (75907-021-05)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":0.11894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa|Carbidopa/Levodopa","basis":"generic"},"part_b":null}, {"ndc":"00781561301","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 12.5-50-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5613-01","proprietary_name":"Carbidopa, Levodopa, and Entacapone","nonproprietary_name":"Carbidopa, Levodopa, and Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 50 mg/1; 200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5613-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16571068901","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 12.5-50-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-689-01","proprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","nonproprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 50 mg/1; 200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-689-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332079531","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 12.5-50-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-795-31","proprietary_name":"carbidopa, levodopa and entacapone","nonproprietary_name":"carbidopa, levodopa and entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 50 mg/1; 200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-795-31)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00781562501","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 18.75-75-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5625-01","proprietary_name":"Carbidopa, Levodopa, and Entacapone","nonproprietary_name":"Carbidopa, Levodopa, and Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"18.75 mg/1; 75 mg/1; 200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5625-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.62814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16571069001","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 18.75-75-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-690-01","proprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","nonproprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"18.75 mg/1; 75 mg/1; 200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-690-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.62814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332079631","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 18.75-75-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-796-31","proprietary_name":"carbidopa, levodopa and entacapone","nonproprietary_name":"carbidopa, levodopa and entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"18.75 mg/1; 75 mg/1; 200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-796-31)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.62814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00781563701","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5637-01","proprietary_name":"Carbidopa, Levodopa, and Entacapone","nonproprietary_name":"Carbidopa, Levodopa, and Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 100 mg/1; 200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5637-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.69542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16571069101","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-691-01","proprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","nonproprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 100 mg/1; 200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-691-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.69542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332079731","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-797-31","proprietary_name":"carbidopa, levodopa and entacapone","nonproprietary_name":"carbidopa, levodopa and entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 100 mg/1; 200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-797-31)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.69542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00781564101","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 31.25-125-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5641-01","proprietary_name":"Carbidopa, Levodopa, and Entacapone","nonproprietary_name":"Carbidopa, Levodopa, and Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"31.25 mg/1; 125 mg/1; 200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5641-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.6409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16571069201","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 31.25-125-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-692-01","proprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","nonproprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"31.25 mg/1; 125 mg/1; 200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-692-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.6409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332079831","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 31.25-125-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-798-31","proprietary_name":"carbidopa, levodopa and entacapone","nonproprietary_name":"carbidopa, levodopa and entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"31.25 mg/1; 125 mg/1; 200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-798-31)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.6409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00781565401","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 37.5-150-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5654-01","proprietary_name":"Carbidopa, Levodopa, and Entacapone","nonproprietary_name":"Carbidopa, Levodopa, and Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 150 mg/1; 200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5654-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.80237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16571069301","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 37.5-150-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-693-01","proprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","nonproprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 150 mg/1; 200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-693-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.80237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332079931","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 37.5-150-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-799-31","proprietary_name":"carbidopa, levodopa and entacapone","nonproprietary_name":"carbidopa, levodopa and entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 150 mg/1; 200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-799-31)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.80237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00781566901","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 50-200-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5669-01","proprietary_name":"Carbidopa, Levodopa, and Entacapone","nonproprietary_name":"Carbidopa, Levodopa, and Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 mg/1; 200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5669-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.75691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16571069401","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 50-200-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-694-01","proprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","nonproprietary_name":"CARBIDOPA, LEVODOPA AND ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 mg/1; 200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-694-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.75691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332080031","name":"CARBIDOPA-LEVODOPA-ENTACAPONE 50-200-200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-800-31","proprietary_name":"carbidopa, levodopa and entacapone","nonproprietary_name":"carbidopa, levodopa and entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 mg/1; 200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-800-31)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]","Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.75691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbidopa-Levodopa-Entacapone|Carbidopa/Levodopa/Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62542010105","name":"CARBINOXAMINE ER 4 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62542-101-05","proprietary_name":"Carbinoxamine Maleate Extended-Release Oral Suspension","nonproprietary_name":"Carbinoxamine Maleate","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/5mL","labeler":"Neos Therapeutics, LP","package_description":"480 mL in 1 BOTTLE, PLASTIC (62542-101-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.04689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"44523082501","name":"CARBINOXAMINE MALEATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44523-825-01","proprietary_name":"Carbinoxamine Maleate","nonproprietary_name":"Carbinoxamine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Biocomp Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (44523-825-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.39806,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbinoxamine Maleate|Carbinoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"64950021101","name":"CARBINOXAMINE MALEATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-211-01","proprietary_name":"Carbinoxamine Maleate","nonproprietary_name":"Carbinoxamine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Genus Lifesciences Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64950-211-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.39806,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carbinoxamine Maleate|Carbinoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"00536138635","name":"CARBOXYMETHYLCELL 0.5% EYE DRP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1386-35","proprietary_name":"Rugby Carboxymethylcellulose Sodium 0.5% Eye Drops","nonproprietary_name":"Carboxymethylcellulose Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Rugby Laboratories","package_description":"2 BOTTLE, DROPPER in 1 BOX (0536-1386-35) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.28017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536138694","name":"CARBOXYMETHYLCELL 0.5% EYE DRP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1386-94","proprietary_name":"Rugby Carboxymethylcellulose Sodium 0.5% Eye Drops","nonproprietary_name":"Carboxymethylcellulose Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, DROPPER in 1 BOX (0536-1386-94) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.32365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50268006730","name":"CARBOXYMETHYLCELL 0.5% EYE DRP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-067-30","proprietary_name":"carboxymethylcellulose sodium","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"AvPAK","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (50268-067-30) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.22679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006750","name":"CARBOXYMETHYLCELL 0.5% EYE DRP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-067-50","proprietary_name":"carboxymethylcellulose sodium","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"AvPAK","package_description":"50 VIAL, SINGLE-USE in 1 CARTON (50268-067-50) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.2548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006770","name":"CARBOXYMETHYLCELL 0.5% EYE DRP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-067-70","proprietary_name":"carboxymethylcellulose sodium","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"AvPAK","package_description":"70 VIAL, SINGLE-USE in 1 CARTON (50268-067-70) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.16275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268006815","name":"CARBOXYMETHYLCELL 0.5% EYE DRP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-068-15","proprietary_name":"carboxymethylcellulose sodium","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"AvPAK","package_description":"1 BOTTLE, DROPPER in 1 CARTON (50268-068-15) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.32365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83468007002","name":"CARDAMYST 70 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":790.1,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83468007003","name":"CARDAMYST 70 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83468-070-03","proprietary_name":"Cardamyst","nonproprietary_name":"etripamil","dosage_form":"SPRAY","route":"NASAL","strength":"70 mg/.2mL","labeler":"Milestone Pharmaceuticals USA, Inc.","package_description":"2 CONTAINER in 1 CARTON (83468-070-03) / 2 VIAL, SINGLE-DOSE in 1 CONTAINER (83468-070-02) / .2 mL in 1 VIAL, SINGLE-DOSE (83468-070-01)"},"nadac":{"value":790.1,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151007893","name":"CARDURA XL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-078-93","proprietary_name":"Cardura XL","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (58151-078-93)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.98895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cardura XL|Doxazosin Mesylate","basis":"brand"},"part_b":null}, {"ndc":"16571078001","name":"CARISOPRODOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-780-01","proprietary_name":"carisoprodol","nonproprietary_name":"carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-780-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.47389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"51525590101","name":"CARISOPRODOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51525-5901-1","proprietary_name":"Carisoprodol","nonproprietary_name":"carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (51525-5901-1)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.47389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"52536068210","name":"CARISOPRODOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-682-10","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (52536-682-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.47389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"69367041901","name":"CARISOPRODOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-419-01","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-419-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.47389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"16571078101","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-781-01","proprietary_name":"carisoprodol","nonproprietary_name":"carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-781-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"16571078110","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-781-10","proprietary_name":"carisoprodol","nonproprietary_name":"carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-781-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"16571078150","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-781-50","proprietary_name":"carisoprodol","nonproprietary_name":"carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-781-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"50228010901","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-109-01","proprietary_name":"CARISOPRODOL","nonproprietary_name":"CARISOPRODOL","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-109-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"50228010905","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-109-05","proprietary_name":"CARISOPRODOL","nonproprietary_name":"CARISOPRODOL","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-109-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"50228010910","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-109-10","proprietary_name":"CARISOPRODOL","nonproprietary_name":"CARISOPRODOL","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-109-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"50742065601","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-656-01","proprietary_name":"CARISOPRODOL","nonproprietary_name":"CARISOPRODOL","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-656-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"62135024112","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-241-12","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-241-12)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"63561012701","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0127-1","proprietary_name":"Carisoprodol Tablets, USP, 350 mg","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Granulation Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (63561-0127-1)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"63561012702","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0127-2","proprietary_name":"Carisoprodol Tablets, USP, 350 mg","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Granulation Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (63561-0127-2)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"69367042001","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-420-01","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-420-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"69367042005","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-420-05","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-420-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"69584011110","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-111-10","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-111-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"69584011150","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-111-50","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-111-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"69584011190","name":"CARISOPRODOL 350 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-111-90","proprietary_name":"Carisoprodol","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-111-90)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carisoprodol|Carisoprodol","basis":"generic"},"part_b":null}, {"ndc":"46287002004","name":"CAROSPIR 25 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-020-04","proprietary_name":"CaroSpir","nonproprietary_name":"CaroSpir","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"CMP Pharma, Inc.","package_description":"118 mL in 1 BOTTLE (46287-020-04)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":3.45207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.61922,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314023805","name":"CARTEOLOL HCL 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-238-05","proprietary_name":"Carteolol Hydrochloride","nonproprietary_name":"Carteolol Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"5 mL in 1 BOTTLE, PLASTIC (61314-238-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.62978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Carteolol HCl|Carteolol HCl","basis":"generic"},"part_b":null}, {"ndc":"61314023810","name":"CARTEOLOL HCL 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-238-10","proprietary_name":"Carteolol Hydrochloride","nonproprietary_name":"Carteolol Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"10 mL in 1 BOTTLE, PLASTIC (61314-238-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.36449,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Carteolol HCl|Carteolol HCl","basis":"generic"},"part_b":null}, {"ndc":"61314023815","name":"CARTEOLOL HCL 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-238-15","proprietary_name":"Carteolol Hydrochloride","nonproprietary_name":"Carteolol Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"15 mL in 1 BOTTLE, PLASTIC (61314-238-15)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.72987,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Carteolol HCl|Carteolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62037059705","name":"CARTIA XT 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-597-05","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-597-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037059790","name":"CARTIA XT 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-597-90","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-597-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037059805","name":"CARTIA XT 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-598-05","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-598-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037059890","name":"CARTIA XT 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-598-90","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-598-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037059905","name":"CARTIA XT 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-599-05","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-599-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037059990","name":"CARTIA XT 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-599-90","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-599-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037060005","name":"CARTIA XT 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-600-05","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-600-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"62037060090","name":"CARTIA XT 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-600-90","proprietary_name":"Cartia XT","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62037-600-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cartia Xt|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"00093729501","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7295-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-7295-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093729505","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7295-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-7295-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00904730761","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7307-61","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7307-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014401","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-144-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-144-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014405","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-144-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-144-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015100","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-151-00","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-151-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015103","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-151-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-151-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009401","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-094-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-094-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009405","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-094-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-094-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016401","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-164-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-164-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016405","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-164-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-164-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68645035159","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003600","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-036-00","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-036-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003601","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-036-01","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-036-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003605","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-036-05","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-036-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050101","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-501-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-501-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050102","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-501-02","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-501-02)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050103","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-501-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-501-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"76385011250","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-112-50","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (76385-112-50)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"82009012705","name":"CARVEDILOL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-127-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-127-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093729601","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7296-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-7296-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093729605","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7296-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-7296-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00904730861","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7308-61","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7308-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014501","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-145-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-145-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014505","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-145-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-145-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015200","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-152-00","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-152-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015203","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-152-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-152-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009501","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-095-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-095-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009505","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-095-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-095-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016501","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-165-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-165-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016505","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-165-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-165-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68645049659","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003700","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-037-00","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-037-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003701","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-037-01","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-037-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003705","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-037-05","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-037-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050202","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-502-02","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-502-02)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050203","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-502-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-502-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"76385011350","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-113-50","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (76385-113-50)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"82009012805","name":"CARVEDILOL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-128-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-128-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.03235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093005101","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0051-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0051-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093005105","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0051-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-0051-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00781522101","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00904730561","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7305-61","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7305-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014201","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-142-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-142-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014205","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-142-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-142-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015300","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-153-00","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-153-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015303","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-153-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-153-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009201","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-092-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-092-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009205","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-092-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-092-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016201","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-162-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-162-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016205","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-162-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-162-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003400","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-034-00","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-034-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003401","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-034-01","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-034-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003405","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-034-05","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-034-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888049901","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-499-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-499-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888049902","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-499-02","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-499-02)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888049903","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-499-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-499-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"76385011050","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-110-50","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (76385-110-50)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"82009012505","name":"CARVEDILOL 3.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-125-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3.125 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-125-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093013501","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0135-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0135-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00093013505","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0135-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-0135-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00904730661","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7306-61","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7306-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014301","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-143-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-143-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"65862014305","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-143-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-143-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015400","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-154-00","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-154-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68001015403","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-154-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-154-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68084085401","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-854-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-854-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-854-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68084085411","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009301","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-093-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-093-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68382009305","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-093-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-093-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016301","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-163-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-163-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68462016305","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-163-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-163-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"68645035059","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003500","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-035-00","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-035-00)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003501","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-035-01","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-035-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888003505","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-035-05","proprietary_name":"CARVEDILOL","nonproprietary_name":"CARVEDILOL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-035-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050001","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-500-01","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-500-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050002","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-500-02","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-500-02)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"72888050003","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-500-03","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72888-500-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"76385011150","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-111-50","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (76385-111-50)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"82009012605","name":"CARVEDILOL 6.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-126-05","proprietary_name":"Carvedilol","nonproprietary_name":"Carvedilol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6.25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-126-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol|Carvedilol","basis":"generic"},"part_b":null}, {"ndc":"00115124808","name":"CARVEDILOL ER 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1248-08","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"CARVEDILOL PHOSPHATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1248-08)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.52042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"16714022701","name":"CARVEDILOL ER 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-227-01","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16714-227-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.52042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"57664066383","name":"CARVEDILOL ER 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-663-83","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (57664-663-83)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.52042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00115124908","name":"CARVEDILOL ER 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1249-08","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"CARVEDILOL PHOSPHATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1249-08)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.73661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"16714022801","name":"CARVEDILOL ER 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-228-01","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16714-228-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.73661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"57664066483","name":"CARVEDILOL ER 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-664-83","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (57664-664-83)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.73661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00115125008","name":"CARVEDILOL ER 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1250-08","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"CARVEDILOL PHOSPHATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1250-08)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"16714022901","name":"CARVEDILOL ER 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-229-01","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16714-229-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"57664066583","name":"CARVEDILOL ER 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-665-83","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (57664-665-83)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00115125108","name":"CARVEDILOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1251-08","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"CARVEDILOL PHOSPHATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1251-08)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":5.79162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"16714023001","name":"CARVEDILOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-230-01","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16714-230-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":5.79162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"57664066683","name":"CARVEDILOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-666-83","proprietary_name":"Carvedilol Phosphate","nonproprietary_name":"Carvedilol Phosphate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (57664-666-83)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","Adrenergic beta1-Antagonists [MoA]","Adrenergic beta2-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":5.79162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Carvedilol ER|Carvedilol Phosphate","basis":"generic"},"part_b":null}, {"ndc":"24385051530","name":"CASTOR OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-515-30","proprietary_name":"GNP Castor Oil","nonproprietary_name":"Castor Oil","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/mL","labeler":"Amerisource Bergen","package_description":"177 mL in 1 BOTTLE, PLASTIC (24385-515-30)"},"nadac":{"value":0.01988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000002401","name":"CASTOR OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0024-1","proprietary_name":"Leader Castor Oil","nonproprietary_name":"Castor oil","dosage_form":"OIL","route":"ORAL","strength":"1 g/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"118 mL in 1 BOTTLE, PLASTIC (70000-0024-1)"},"nadac":{"value":0.0188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50242004164","name":"CATHFLO ACTIVASE 2 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50242-041-64","proprietary_name":"Cathflo Activase","nonproprietary_name":"Alteplase","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"2.2 mg/2mL","labeler":"Genentech, Inc.","package_description":"1 VIAL in 1 CARTON (50242-041-64) / 2 mL in 1 VIAL"},"nadac":{"value":186.3796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2997","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2997 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (50242-041-64) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009518101","name":"CAVERJECT IMPULSE 10 MCG KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-5181-01","proprietary_name":"Caverject Impulse","nonproprietary_name":"Alprostadil","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRACAVERNOUS","strength":"10 ug/.5mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"2 SYRINGE in 1 CARTON (0009-5181-01) / .5 mL in 1 SYRINGE (0009-5181-10)","pharm_classes":["Genitourinary Arterial Vasodilation [PE]","Prostaglandin Analog [EPC]","Prostaglandin E1 Agonist [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]","Venous Vasodilation [PE]"]},"nadac":{"value":82.49054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00009518201","name":"CAVERJECT IMPULSE 20 MCG KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-5182-01","proprietary_name":"Caverject Impulse","nonproprietary_name":"Alprostadil","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRACAVERNOUS","strength":"20 ug/.5mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"2 SYRINGE in 1 CARTON (0009-5182-01) / .5 mL in 1 SYRINGE (0009-5182-11)","pharm_classes":["Genitourinary Arterial Vasodilation [PE]","Prostaglandin Analog [EPC]","Prostaglandin E1 Agonist [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]","Venous Vasodilation [PE]"]},"nadac":{"value":106.23769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442017130","name":"CEFACLOR 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-171-30","proprietary_name":"Cefaclor","nonproprietary_name":"Cefaclor","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (61442-171-30)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.93233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefaclor|Cefaclor","basis":"generic"},"part_b":null}, {"ndc":"61442017230","name":"CEFACLOR 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-172-30","proprietary_name":"Cefaclor","nonproprietary_name":"Cefaclor","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (61442-172-30)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefaclor|Cefaclor","basis":"generic"},"part_b":null}, {"ndc":"00093405953","name":"CEFADROXIL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4059-53","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 TABLET in 1 BOTTLE (0093-4059-53)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":3.37367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714038901","name":"CEFADROXIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-389-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"100 mL in 1 BOTTLE (16714-389-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.16745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237009701","name":"CEFADROXIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-097-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 BOTTLE (57237-097-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.16745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862008301","name":"CEFADROXIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-083-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-083-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.16745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180018102","name":"CEFADROXIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-181-02","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-181-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.16745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093319601","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3196-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3196-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093319653","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3196-53","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (0093-3196-53)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714038801","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-388-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"50 CAPSULE in 1 BOTTLE (16714-388-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714038802","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-388-02","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-388-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237009601","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-096-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-096-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237009650","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-096-50","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (57237-096-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862008501","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-085-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-085-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862008550","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-085-50","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 CAPSULE in 1 BOTTLE (65862-085-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180018001","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-180-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-180-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180018008","name":"CEFADROXIL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-180-08","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (68180-180-08)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039001","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-390-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"75 mL in 1 BOTTLE (16714-390-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714039002","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-390-02","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"100 mL in 1 BOTTLE (16714-390-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.22431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237009801","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-098-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 BOTTLE (57237-098-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.22431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237009875","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-098-75","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"75 mL in 1 BOTTLE (57237-098-75)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862008401","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-084-01","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (65862-084-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.22431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862008475","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-084-75","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"75 mL in 1 BOTTLE (65862-084-75)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180018202","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-182-02","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"75 mL in 1 BOTTLE (68180-182-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.26533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180018203","name":"CEFADROXIL 500 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-182-03","proprietary_name":"Cefadroxil","nonproprietary_name":"Cefadroxil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"500 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-182-03)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.22431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143926225","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9262-25","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"330 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0143-9262-25) / 3 mL in 1 VIAL (0143-9262-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0143-9262-25) / 3 mL in 1 VIAL (0143-9262-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00143992490","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9924-90","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"330 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"3 mL in 1 VIAL (0143-9924-90)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00781345196","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3451-96","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; PARENTERAL","strength":"1 g/1","labeler":"Sandoz Inc","package_description":"25 VIAL in 1 CARTON (0781-3451-96) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (0781-3451-70)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"25021010110","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"44567012025","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-120-25","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"25 VIAL in 1 CARTON (44567-120-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (44567-120-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567070725","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-707-25","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"25 VIAL in 1 CARTON (44567-707-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (44567-707-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505614205","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6142-5","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Apotex Corp.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (60505-6142-5) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (60505-6142-0)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (60505-6142-5) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (60505-6142-0)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505624304","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6243-4","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Apotex Corp.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (60505-6243-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (60505-6243-0)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (60505-6243-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (60505-6243-0)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323023710","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-237-10","proprietary_name":"CEFAZOLIN","nonproprietary_name":"CEFAZOLIN SODIUM","dosage_form":"POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/3mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 CARTON (63323-237-10) / 3 mL in 1 VIAL (63323-237-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (63323-237-10) / 3 mL in 1 VIAL (63323-237-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572005525","name":"CEFAZOLIN 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-055-25","proprietary_name":"Cefazolin","nonproprietary_name":"Cefazolin","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-055-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (72572-055-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.07031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefazolin Sodium*|Cefazolin Sodium","basis":"generic"},"part_b":{"hcpcs":"J0690","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0690 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-055-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (72572-055-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00093413664","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4136-64","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 mL in 1 BOTTLE (0093-4136-64)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093413673","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4136-73","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4136-73)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862021801","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-218-01","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-218-01) / 100 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862021860","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-218-60","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-218-60) / 60 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054788","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-547-88","proprietary_name":"cefdinir","nonproprietary_name":"cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"100 mL in 1 BOTTLE (67877-547-88)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054798","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-547-98","proprietary_name":"cefdinir","nonproprietary_name":"cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"60 mL in 1 BOTTLE (67877-547-98)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180072204","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-722-04","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 mL in 1 BOTTLE (68180-722-04)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180072205","name":"CEFDINIR 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-722-05","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-722-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093413764","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4137-64","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 mL in 1 BOTTLE (0093-4137-64)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093413773","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4137-73","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4137-73)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862021901","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-219-01","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-219-01) / 100 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862021960","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-219-60","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-219-60) / 60 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054888","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-548-88","proprietary_name":"cefdinir","nonproprietary_name":"cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"100 mL in 1 BOTTLE (67877-548-88)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054898","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-548-98","proprietary_name":"cefdinir","nonproprietary_name":"cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"60 mL in 1 BOTTLE (67877-548-98)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180072304","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-723-04","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 mL in 1 BOTTLE (68180-723-04)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.11757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180072305","name":"CEFDINIR 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-723-05","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-723-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.10999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093316006","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3160-06","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (0093-3160-06)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904756304","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7563-04","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"3 BLISTER PACK in 1 CARTON (0904-7563-04) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237009960","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-099-60","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (57237-099-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687069911","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687069921","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-699-21","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-699-21) / 1 CAPSULE in 1 BLISTER PACK (60687-699-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862017760","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-177-60","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-177-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877054360","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-543-60","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE (67877-543-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001036206","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-362-06","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"60 CAPSULE in 1 BOTTLE (68001-362-06)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180071160","name":"CEFDINIR 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-711-60","proprietary_name":"Cefdinir","nonproprietary_name":"Cefdinir","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (68180-711-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.45808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862075150","name":"CEFIXIME 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-751-50","proprietary_name":"Cefixime","nonproprietary_name":"cefixime","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (65862-751-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":2.44303,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862075250","name":"CEFIXIME 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-752-50","proprietary_name":"Cefixime","nonproprietary_name":"cefixime","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (65862-752-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":3.42661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180040703","name":"CEFIXIME 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-407-03","proprietary_name":"CEFIXIME","nonproprietary_name":"CEFIXIME","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 mL in 1 BOTTLE (68180-407-03)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":3.42661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651064750","name":"CEFIXIME 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-647-50","proprietary_name":"Cefixime","nonproprietary_name":"Cefixime","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 CAPSULE in 1 BOTTLE (59651-647-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":10.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877058433","name":"CEFIXIME 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-584-33","proprietary_name":"CEFIXIME","nonproprietary_name":"CEFIXIME","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"10 BLISTER PACK in 1 CARTON (67877-584-33) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":10.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877058450","name":"CEFIXIME 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-584-50","proprietary_name":"CEFIXIME","nonproprietary_name":"CEFIXIME","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"50 CAPSULE in 1 BOTTLE (67877-584-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":10.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180042308","name":"CEFIXIME 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-423-08","proprietary_name":"CEFIXIME","nonproprietary_name":"CEFIXIME","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (68180-423-08)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":10.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180042311","name":"CEFIXIME 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-423-11","proprietary_name":"CEFIXIME","nonproprietary_name":"CEFIXIME","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-423-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":10.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781543820","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5438-20","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sandoz Inc","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0781-5438-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039401","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-394-01","proprietary_name":"CEFPODOXIME PROXETIL","nonproprietary_name":"CEFPODOXIME PROXETIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (16714-394-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862009501","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-095-01","proprietary_name":"CEFPODOXIME PROXETIL","nonproprietary_name":"CEFPODOXIME PROXETIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-095-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862009520","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-095-20","proprietary_name":"CEFPODOXIME PROXETIL","nonproprietary_name":"CEFPODOXIME PROXETIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (65862-095-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877087820","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-878-20","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (67877-878-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292051001","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292051401","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-514-01","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Amici Pharmaceuticals, LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69292-514-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292051450","name":"CEFPODOXIME 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-514-50","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Amici Pharmaceuticals, LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69292-514-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.0434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714040301","name":"CEFPODOXIME 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-403-01","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (16714-403-01) / 50 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.04666,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714040302","name":"CEFPODOXIME 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-403-02","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (16714-403-02) / 100 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.98096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980040310","name":"CEFPODOXIME 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-403-10","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-403-10) / 100 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.98096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980040350","name":"CEFPODOXIME 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-403-50","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-403-50) / 50 mL in 1 BOTTLE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.04666,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781543901","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5439-01","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5439-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781543920","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5439-20","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Sandoz Inc","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0781-5439-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039501","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-395-01","proprietary_name":"CEFPODOXIME PROXETIL","nonproprietary_name":"CEFPODOXIME PROXETIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (16714-395-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862009620","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-096-20","proprietary_name":"CEFPODOXIME PROXETIL","nonproprietary_name":"CEFPODOXIME PROXETIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (65862-096-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877087920","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-879-20","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (67877-879-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292051201","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292051601","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-516-01","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amici Pharmaceuticals, LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69292-516-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292051650","name":"CEFPODOXIME 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-516-50","proprietary_name":"Cefpodoxime Proxetil","nonproprietary_name":"Cefpodoxime Proxetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amici Pharmaceuticals, LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69292-516-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.37245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039603","name":"CEFPROZIL 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-396-03","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"100 mL in 1 BOTTLE (16714-396-03)"},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003401","name":"CEFPROZIL 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-034-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 BOTTLE (57237-034-01)"},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003450","name":"CEFPROZIL 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-034-50","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 mL in 1 BOTTLE (57237-034-50)"},"nadac":{"value":0.17606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003475","name":"CEFPROZIL 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-034-75","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"75 mL in 1 BOTTLE (57237-034-75)"},"nadac":{"value":0.12065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180040103","name":"CEFPROZIL 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-401-03","proprietary_name":"CEFPROZIL","nonproprietary_name":"CEFPROZIL","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-401-03)"},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093107701","name":"CEFPROZIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1077-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-1077-01)"},"nadac":{"value":0.4821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039801","name":"CEFPROZIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-398-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-398-01)"},"nadac":{"value":0.4821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237003601","name":"CEFPROZIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-036-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-036-01)"},"nadac":{"value":0.4821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877024401","name":"CEFPROZIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-244-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-244-01)"},"nadac":{"value":0.4821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180040301","name":"CEFPROZIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-403-01","proprietary_name":"CEFPROZIL","nonproprietary_name":"CEFPROZIL","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-403-01)"},"nadac":{"value":0.4821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039701","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-397-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"50 mL in 1 BOTTLE (16714-397-01)"},"nadac":{"value":0.22766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714039702","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-397-02","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"75 mL in 1 BOTTLE (16714-397-02)"},"nadac":{"value":0.20641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714039703","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-397-03","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"100 mL in 1 BOTTLE (16714-397-03)"},"nadac":{"value":0.15109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003501","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-035-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 BOTTLE (57237-035-01)"},"nadac":{"value":0.15109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003550","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-035-50","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 mL in 1 BOTTLE (57237-035-50)"},"nadac":{"value":0.22766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237003575","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-035-75","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"75 mL in 1 BOTTLE (57237-035-75)"},"nadac":{"value":0.20641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180027303","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-273-03","proprietary_name":"CEFPROZIL","nonproprietary_name":"cefprozil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-273-03)"},"nadac":{"value":0.15109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180040201","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-402-01","proprietary_name":"CEFPROZIL","nonproprietary_name":"CEFPROZIL","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 mL in 1 BOTTLE (68180-402-01)"},"nadac":{"value":0.22766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180040202","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-402-02","proprietary_name":"CEFPROZIL","nonproprietary_name":"CEFPROZIL","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"75 mL in 1 BOTTLE (68180-402-02)"},"nadac":{"value":0.20641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180040203","name":"CEFPROZIL 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-402-03","proprietary_name":"CEFPROZIL","nonproprietary_name":"CEFPROZIL","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-402-03)"},"nadac":{"value":0.15109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093107853","name":"CEFPROZIL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1078-53","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (0093-1078-53)"},"nadac":{"value":0.92524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714039901","name":"CEFPROZIL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-399-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (16714-399-01)"},"nadac":{"value":0.92524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237003750","name":"CEFPROZIL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-037-50","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (57237-037-50)"},"nadac":{"value":0.92524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862006901","name":"CEFPROZIL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-069-01","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-069-01)"},"nadac":{"value":0.92524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877024350","name":"CEFPROZIL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-243-50","proprietary_name":"Cefprozil","nonproprietary_name":"Cefprozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (67877-243-50)"},"nadac":{"value":0.92524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180040401","name":"CEFPROZIL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-404-01","proprietary_name":"CEFPROZIL","nonproprietary_name":"CEFPROZIL","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 TABLET in 1 BOTTLE (68180-404-01)"},"nadac":{"value":0.92524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"25021012720","name":"CEFTAZIDIME 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"25021-127-20","proprietary_name":"Ceftazidime","nonproprietary_name":"ceftazidime","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-127-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":3.70448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ceftazidime|Ceftazidime","basis":"generic"},"part_b":{"hcpcs":"J0713","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0713 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-127-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567023525","name":"CEFTAZIDIME 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"44567-235-25","proprietary_name":"Ceftazidime","nonproprietary_name":"Ceftazidime","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"25 VIAL in 1 CARTON (44567-235-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":3.70448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ceftazidime|Ceftazidime","basis":"generic"},"part_b":{"hcpcs":"J0713","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0713 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (44567-235-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00143985725","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9857-25","proprietary_name":"Ceftriaxone","nonproprietary_name":"Ceftriaxone","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 BOX (0143-9857-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (0143-9857-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.44341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 BOX (0143-9857-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (0143-9857-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733201","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-7332-01","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7332-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7332-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.17324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7332-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7332-11)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733220","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-7332-20","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7332-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7332-21)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.17324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7332-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7332-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781320895","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3208-95","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Sandoz Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0781-3208-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.17324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0781-3208-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"25021010610","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-106-10","proprietary_name":"ceftriaxone","nonproprietary_name":"ceftriaxone","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-106-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.44341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-106-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567070125","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-701-25","proprietary_name":"Ceftriaxone","nonproprietary_name":"Ceftriaxone","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"25 VIAL in 1 CARTON (44567-701-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.44341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (44567-701-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567070195","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-701-95","proprietary_name":"Ceftriaxone","nonproprietary_name":"Ceftriaxone","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"25 VIAL in 1 CARTON (44567-701-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.44341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (44567-701-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505614804","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6148-4","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Apotex Corp.","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (60505-6148-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.17324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (60505-6148-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323034610","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-346-10","proprietary_name":"Ceftriaxone","nonproprietary_name":"Ceftriaxone","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 CARTON (63323-346-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (63323-346-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.44341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (63323-346-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (63323-346-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572006125","name":"CEFTRIAXONE 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-061-25","proprietary_name":"Ceftriaxone","nonproprietary_name":"Ceftriaxone","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 BOX (72572-061-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (72572-061-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.44341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 BOX (72572-061-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (72572-061-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733503","name":"CEFTRIAXONE 2 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-7335-03","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 g/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7335-03) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7335-13)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":2.833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7335-03) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7335-13)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733520","name":"CEFTRIAXONE 2 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-7335-20","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 g/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7335-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7335-21)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":2.833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7335-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7335-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781320995","name":"CEFTRIAXONE 2 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3209-95","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 g/1","labeler":"Sandoz Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0781-3209-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0781-3209-90)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":2.833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0781-3209-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0781-3209-90)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505614904","name":"CEFTRIAXONE 2 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6149-4","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 g/1","labeler":"Apotex Corp.","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (60505-6149-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (60505-6149-0)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":2.833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (60505-6149-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (60505-6149-0)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733701","name":"CEFTRIAXONE 250 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-7337-01","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7337-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7337-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.8622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7337-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7337-11)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733720","name":"CEFTRIAXONE 250 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-7337-20","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7337-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7337-21)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.8622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7337-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7337-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781320695","name":"CEFTRIAXONE 250 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-3206-95","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0781-3206-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.8622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0781-3206-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505615101","name":"CEFTRIAXONE 250 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-6151-1","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/1","labeler":"Apotex Corp.","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (60505-6151-1) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.8622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (60505-6151-1) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00143985801","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.84224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409733801","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-7338-01","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7338-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7338-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.31395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7338-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7338-11)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733811","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.84224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409733820","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-7338-20","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/1","labeler":"Hospira, Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0409-7338-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7338-21)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.31395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0409-7338-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE (0409-7338-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409733821","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.84224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781320785","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3207-85","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (0781-3207-85) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.84224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (0781-3207-85) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781320795","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3207-95","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0781-3207-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.31395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0781-3207-95) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505615201","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6152-1","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/1","labeler":"Apotex Corp.","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (60505-6152-1) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.31395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (60505-6152-1) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505615204","name":"CEFTRIAXONE 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6152-4","proprietary_name":"Ceftriaxone Sodium","nonproprietary_name":"Ceftriaxone Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"500 mg/1","labeler":"Apotex Corp.","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (60505-6152-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.84224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0696","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0696 (250 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (60505-6152-4) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904754210","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7542-10","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-7542-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"16714040001","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-400-01","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"20 TABLET in 1 BOTTLE (16714-400-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"16714040002","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-400-02","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 TABLET in 1 BOTTLE (16714-400-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"57237005820","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-058-20","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (57237-058-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"57237005860","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-058-60","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-058-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"60687027211","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"60687027294","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-272-94","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-272-94) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-272-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"65862069920","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-699-20","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET in 1 BOTTLE (65862-699-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"65862069960","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-699-60","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-699-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"67877021520","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-215-20","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (67877-215-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"67877021560","name":"CEFUROXIME AXETIL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-215-60","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-215-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.2798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"16714040101","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-401-01","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"20 TABLET in 1 BOTTLE (16714-401-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"16714040102","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-401-02","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 TABLET in 1 BOTTLE (16714-401-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"57237005920","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-059-20","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (57237-059-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"57237005960","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-059-60","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-059-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"60687028311","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"60687028394","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-283-94","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-283-94) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-283-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"65862070020","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-700-20","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET in 1 BOTTLE (65862-700-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"65862070060","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-700-60","proprietary_name":"Cefuroxime Axetil","nonproprietary_name":"Cefuroxime Axetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-700-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"67877021620","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-216-20","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (67877-216-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"67877021660","name":"CEFUROXIME AXETIL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-216-60","proprietary_name":"Cefuroxime axetil","nonproprietary_name":"Cefuroxime axetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-216-60)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.36555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cefuroxime|Cefuroxime Axetil","basis":"generic"},"part_b":null}, {"ndc":"58151008301","name":"CELEBREX 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-083-01","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE in 1 BOTTLE (58151-083-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.53398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008305","name":"CELEBREX 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-083-05","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"500 CAPSULE in 1 BOTTLE (58151-083-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.53398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008332","name":"CELEBREX 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.53398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008388","name":"CELEBREX 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-083-88","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-083-88) / 1 CAPSULE in 1 BLISTER PACK (58151-083-32)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.53398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008401","name":"CELEBREX 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-084-01","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE in 1 BOTTLE (58151-084-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.64674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008405","name":"CELEBREX 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-084-05","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Viatris Specialty LLC","package_description":"500 CAPSULE in 1 BOTTLE (58151-084-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.64674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008432","name":"CELEBREX 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.64674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008488","name":"CELEBREX 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-084-88","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-084-88) / 1 CAPSULE in 1 BLISTER PACK (58151-084-32)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":15.64674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008532","name":"CELEBREX 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":23.49717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008588","name":"CELEBREX 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-085-88","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-085-88) / 1 CAPSULE in 1 BLISTER PACK (58151-085-32)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":23.49717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"58151008591","name":"CELEBREX 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-085-91","proprietary_name":"CELEBREX","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Viatris Specialty LLC","package_description":"60 CAPSULE in 1 BOTTLE (58151-085-91)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":23.49717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celebrex|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"00904755061","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7550-61","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7550-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"11788011301","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-113-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (11788-113-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"11788011305","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-113-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (11788-113-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"16714073201","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-732-01","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-732-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"16714073202","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-732-02","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-732-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"23155096401","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-964-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-964-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"23155096405","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-964-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-964-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"27808029601","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-296-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (27808-296-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"27808029602","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-296-02","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (27808-296-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"33342015611","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-156-11","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (33342-156-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"33342015615","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-156-15","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-156-15)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"42571014301","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-143-01","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-143-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"42571014305","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-143-05","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Micro Labs Limited","package_description":"500 CAPSULE in 1 BOTTLE (42571-143-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50228015701","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-157-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50228-157-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50228015705","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-157-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (50228-157-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50268016811","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50268016815","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-168-15","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-168-15) / 1 CAPSULE in 1 BLISTER PACK (50268-168-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60505384801","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3848-1","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-3848-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60687043601","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-436-01","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-436-01) / 1 CAPSULE in 1 BLISTER PACK (60687-436-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60687043611","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60687043665","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-436-65","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-436-65) / 1 CAPSULE in 1 BLISTER PACK (60687-436-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62135002160","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-021-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-021-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014131","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-141-31","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-141-31)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014171","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-141-71","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (62332-141-71)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"65862090801","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-908-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-908-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"65862090805","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-908-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-908-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"68180039601","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-396-01","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-396-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69097042207","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-422-07","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-422-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69097042212","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-422-12","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69097-422-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69367030101","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-301-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69367-301-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69367030105","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-301-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-301-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"72241002305","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-023-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72241-023-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"72241002310","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-023-10","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"500 CAPSULE in 1 BOTTLE (72241-023-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"75834023701","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-237-01","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"100 CAPSULE in 1 BOTTLE (75834-237-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"75834023705","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-237-05","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"500 CAPSULE in 1 BOTTLE (75834-237-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"82009006805","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-068-05","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 CAPSULE in 1 BOTTLE (82009-068-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"83301001101","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0011-1","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 CAPSULE in 1 BOTTLE (83301-0011-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"83301001102","name":"CELECOXIB 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0011-2","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 CAPSULE in 1 BOTTLE (83301-0011-2)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"00591398401","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3984-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0591-3984-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"00591398405","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3984-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0591-3984-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"00904755161","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7551-61","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7551-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"11788011401","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-114-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (11788-114-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"11788011405","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-114-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (11788-114-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"16714073301","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-733-01","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-733-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"16714073302","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-733-02","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar RxLLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-733-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"27808029701","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-297-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (27808-297-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"27808029702","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-297-02","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (27808-297-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"33342015711","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-157-11","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (33342-157-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"33342015715","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-157-15","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-157-15)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"42571014401","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-144-01","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-144-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"42571014405","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-144-05","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Micro Labs Limited","package_description":"500 CAPSULE in 1 BOTTLE (42571-144-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50228015801","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-158-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50228-158-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50228015805","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-158-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (50228-158-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50268016911","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50268016915","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-169-15","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-169-15) / 1 CAPSULE in 1 BLISTER PACK (50268-169-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60505384901","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3849-1","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-3849-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60505384905","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3849-5","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"500 CAPSULE in 1 BOTTLE (60505-3849-5)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60687044701","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-447-01","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-447-01) / 1 CAPSULE in 1 BLISTER PACK (60687-447-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60687044711","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"60687044765","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-447-65","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-447-65) / 1 CAPSULE in 1 BLISTER PACK (60687-447-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62135002260","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-022-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-022-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014231","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-142-31","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-142-31)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014271","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-142-71","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (62332-142-71)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014291","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-142-91","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (62332-142-91)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"65862090901","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-909-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-909-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"65862090905","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-909-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-909-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"68180039901","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-399-01","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-399-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69097042107","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-421-07","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-421-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69097042112","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-421-12","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69097-421-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69367030201","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-302-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69367-302-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69367030205","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-302-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-302-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"72241002405","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-024-05","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72241-024-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"72241002410","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-024-10","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"500 CAPSULE in 1 BOTTLE (72241-024-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"75834023801","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-238-01","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"100 CAPSULE in 1 BOTTLE (75834-238-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"75834023805","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-238-05","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"500 CAPSULE in 1 BOTTLE (75834-238-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"82009006905","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-069-05","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 CAPSULE in 1 BOTTLE (82009-069-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"83301001201","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0012-1","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 CAPSULE in 1 BOTTLE (83301-0012-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"83301001202","name":"CELECOXIB 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0012-2","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 CAPSULE in 1 BOTTLE (83301-0012-2)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"11788011560","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-115-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (11788-115-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"16714073401","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-734-01","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"NorthStar RxLLC","package_description":"60 CAPSULE in 1 BOTTLE (16714-734-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"33342015809","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-158-09","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-158-09)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50228015960","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-159-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (50228-159-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62135002360","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-023-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-023-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014360","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-143-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-143-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"65862091060","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-910-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-910-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69097042003","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-420-03","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Cipla USA Inc.","package_description":"60 CAPSULE in 1 BOTTLE (69097-420-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"72241002503","name":"CELECOXIB 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-025-03","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72241-025-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.24804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"00591398260","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3982-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (0591-3982-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"11788011260","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-112-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (11788-112-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"16714073101","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-731-01","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"60 CAPSULE in 1 BOTTLE (16714-731-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"27808029501","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-295-01","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"60 CAPSULE in 1 BOTTLE (27808-295-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"33342015509","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-155-09","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-155-09)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"42571014260","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-142-60","proprietary_name":"CELECOXIB","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Micro Labs Limited","package_description":"60 CAPSULE in 1 BOTTLE (42571-142-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"50228015660","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-156-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (50228-156-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"62332014060","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-140-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-140-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"65862090760","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-907-60","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-907-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"68180039507","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-395-07","proprietary_name":"celecoxib","nonproprietary_name":"celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (68180-395-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"69097042303","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-423-03","proprietary_name":"CELECOXIB","nonproprietary_name":"CELECOXIB","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"60 CAPSULE in 1 BOTTLE (69097-423-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"72241002203","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-022-03","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72241-022-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"83301002801","name":"CELECOXIB 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0028-1","proprietary_name":"Celecoxib","nonproprietary_name":"Celecoxib","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"60 CAPSULE in 1 BOTTLE (83301-0028-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celecoxib|Celecoxib","basis":"generic"},"part_b":null}, {"ndc":"78206011801","name":"CELESTONE SOLUSPAN 30 MG/5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-118-01","proprietary_name":"CELESTONE SOLUSPAN","nonproprietary_name":"Betamethasone Acetate and Betamethasone Sodium Phosphate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"3 mg/mL; 3 mg/mL","labeler":"Organon LLC","package_description":"1 VIAL, MULTI-DOSE in 1 BOX (78206-118-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":9.13831,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0702","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0702 (3 MG & 3 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 BOX (78206-118-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00456402001","name":"CELEXA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-4020-01","proprietary_name":"Celexa","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0456-4020-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":9.00923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celexa|Citalopram Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"00456404001","name":"CELEXA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-4040-01","proprietary_name":"Celexa","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0456-4040-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":9.469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celexa|Citalopram Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"00004026129","name":"CELLCEPT 200 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0004-0261-29","proprietary_name":"CellCept","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"Genentech, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0004-0261-29) / 225 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":8.31442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7529","bill_units_per_package":{"value":7000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7529 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (7000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":175,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00004025901","name":"CELLCEPT 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0004-0259-01","proprietary_name":"CellCept","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Genentech, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0004-0259-01) / 100 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":8.64903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, PLASTIC in 1 CARTON (0004-0259-01) / 100 CAPSULE in 1 BOTTLE, PLASTIC) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00004025943","name":"CELLCEPT 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0004-0259-43","proprietary_name":"CellCept","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Genentech, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0004-0259-43) / 500 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":8.64903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, PLASTIC in 1 CARTON (0004-0259-43) / 500 CAPSULE in 1 BOTTLE, PLASTIC) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00004026001","name":"CELLCEPT 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0004-0260-01","proprietary_name":"CellCept","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Genentech, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0004-0260-01) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":17.33941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, PLASTIC in 1 CARTON (0004-0260-01) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00004026043","name":"CELLCEPT 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0004-0260-43","proprietary_name":"CellCept","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Genentech, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0004-0260-43) / 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":17.33941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":50000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, PLASTIC in 1 CARTON (0004-0260-43) / 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00071052524","name":"CELONTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0071-0525-24","proprietary_name":"Celontin","nonproprietary_name":"methsuximide","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Parke-Davis Div of Pfizer Inc","package_description":"100 CAPSULE in 1 BOTTLE (0071-0525-24)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.40212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Celontin|Methsuximide","basis":"brand"},"part_b":null}, {"ndc":"00093417573","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4175-73","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4175-73)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093417574","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4175-74","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"200 mL in 1 BOTTLE (0093-4175-74)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651032201","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-322-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (59651-322-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651032202","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-322-02","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"200 mL in 1 BOTTLE (59651-322-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135048042","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-480-42","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"100 mL in 1 BOTTLE (62135-480-42)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135048049","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-480-49","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"200 mL in 1 BOTTLE (62135-480-49)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054468","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-544-68","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"200 mL in 1 BOTTLE (67877-544-68)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054488","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-544-88","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"100 mL in 1 BOTTLE (67877-544-88)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180044001","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-440-01","proprietary_name":"cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-440-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180044002","name":"CEPHALEXIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-440-02","proprietary_name":"cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"200 mL in 1 BOTTLE (68180-440-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093314501","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3145-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3145-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093314505","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3145-05","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-3145-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904733661","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7336-61","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7336-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268015111","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268015115","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-151-15","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-151-15) / 1 CAPSULE in 1 BLISTER PACK (50268-151-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687015201","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-152-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-152-01) / 1 CAPSULE in 1 BLISTER PACK (60687-152-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687015211","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071074","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-710-74","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"40 CAPSULE in 1 BOTTLE (62135-710-74)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001801","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-018-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-018-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001805","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-018-05","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-018-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001840","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-018-40","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"40 CAPSULE in 1 BOTTLE (65862-018-40)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877022001","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-220-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-220-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877022005","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-220-05","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-220-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180012101","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-121-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-121-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180012102","name":"CEPHALEXIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-121-02","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (68180-121-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.09048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093223801","name":"CEPHALEXIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2238-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2238-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.74316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651078301","name":"CEPHALEXIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-783-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-783-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.74316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877089101","name":"CEPHALEXIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-891-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-891-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.74316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093417773","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4177-73","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4177-73)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093417774","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4177-74","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"200 mL in 1 BOTTLE (0093-4177-74)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651032301","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-323-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"100 mL in 1 BOTTLE (59651-323-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651032302","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-323-02","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"200 mL in 1 BOTTLE (59651-323-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135048142","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-481-42","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"100 mL in 1 BOTTLE (62135-481-42)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135048149","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-481-49","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"200 mL in 1 BOTTLE (62135-481-49)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054568","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-545-68","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"200 mL in 1 BOTTLE (67877-545-68)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877054588","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-545-88","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"100 mL in 1 BOTTLE (67877-545-88)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180044101","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-441-01","proprietary_name":"cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (68180-441-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180044102","name":"CEPHALEXIN 250 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-441-02","proprietary_name":"cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"200 mL in 1 BOTTLE (68180-441-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093314701","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3147-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3147-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093314705","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3147-05","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-3147-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904733706","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7337-06","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7337-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904733735","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904733761","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7337-61","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7337-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268015211","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268015215","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-152-15","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-152-15) / 1 CAPSULE in 1 BLISTER PACK (50268-152-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687016301","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-163-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-163-01) / 1 CAPSULE in 1 BLISTER PACK (60687-163-11)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687016311","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071174","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-711-74","proprietary_name":"Cephalexin","nonproprietary_name":"cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"40 CAPSULE in 1 BOTTLE (62135-711-74)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001901","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-019-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-019-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001905","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-019-05","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-019-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862001940","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-019-40","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"40 CAPSULE in 1 BOTTLE (65862-019-40)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877021901","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-219-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-219-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877021905","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-219-05","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-219-05)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180012201","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-122-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-122-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180012202","name":"CEPHALEXIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-122-02","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (68180-122-02)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":0.12004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093224001","name":"CEPHALEXIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2240-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2240-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.26538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651078401","name":"CEPHALEXIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-784-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-784-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.26538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877089201","name":"CEPHALEXIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-892-01","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-892-01)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":1.26538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651072820","name":"CEPHALEXIN 750 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-728-20","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 CAPSULE in 1 BOTTLE (59651-728-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":5.11155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651072850","name":"CEPHALEXIN 750 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-728-50","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 CAPSULE in 1 BOTTLE (59651-728-50)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":5.11155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877025520","name":"CEPHALEXIN 750 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-255-20","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"20 CAPSULE in 1 BOTTLE (67877-255-20)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":5.11155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877025523","name":"CEPHALEXIN 750 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-255-23","proprietary_name":"Cephalexin","nonproprietary_name":"Cephalexin","dosage_form":"CAPSULE","route":"ORAL","strength":"750 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"50 CAPSULE in 1 BOTTLE (67877-255-23)","pharm_classes":["Cephalosporin Antibacterial [EPC]","Cephalosporins [CS]"]},"nadac":{"value":5.11155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335050696","name":"CEQUA 0.09% SOLUTION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-506-96","proprietary_name":"CEQUA","nonproprietary_name":"cyclosporine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC; TOPICAL","strength":".0009 g/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 BOX (47335-506-96) / 10 VIAL, SINGLE-DOSE in 1 POUCH / .25 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":10.38279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cequa|Cyclosporine","basis":"brand"},"part_b":null}, {"ndc":"00299392804","name":"CETAPHIL DAILY FACIAL LOT","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0299-3928-04","proprietary_name":"Cetaphil","nonproprietary_name":"octocrylene, avobenzone","dosage_form":"LOTION","route":"TOPICAL","strength":"10 g/100mL; 3 g/100mL","labeler":"Galderma Laboratories, L.P.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0299-3928-04) / 118 mL in 1 BOTTLE, PUMP"},"nadac":{"value":0.10999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121087404","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0874-04","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"120 mL in 1 BOTTLE (0121-0874-04)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"00121087416","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0874-16","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"480 mL in 1 BOTTLE (0121-0874-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571013448","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-134-48","proprietary_name":"CETIRIZINE HYDROCHLORIDE","nonproprietary_name":"CETIRIZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"480 mL in 1 BOTTLE, PLASTIC (16571-134-48)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155092952","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23155-929-52","proprietary_name":"Cetirizine hydrochloride","nonproprietary_name":"Cetirizine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"473 mL in 1 BOTTLE (23155-929-52)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.3318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"45802062626","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-626-26","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-626-26) / 120 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"45802097426","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-974-26","proprietary_name":"cetirizine hydrochloride","nonproprietary_name":"cetirizine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-974-26) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672210208","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2102-8","proprietary_name":"Childrens Cetirizine Hydrochloride Sugar Free Grape","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-2102-8) / 120 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672407008","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4070-8","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4070-8) / 120 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135005741","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-057-41","proprietary_name":"Cetirizine Hydrochloride Oral Solution","nonproprietary_name":"Cetirizine Hydrochloride Oral Solution","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"120 mL in 1 BOTTLE (62135-057-41)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135005747","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-057-47","proprietary_name":"Cetirizine Hydrochloride Oral Solution","nonproprietary_name":"Cetirizine Hydrochloride Oral Solution","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-057-47)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.3318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452042655","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-426-55","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Bionpharma Inc.","package_description":"120 mL in 1 BOTTLE (69452-426-55)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452042688","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-426-88","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Bionpharma Inc.","package_description":"480 mL in 1 BOTTLE (69452-426-88)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888048001","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-480-01","proprietary_name":"Cetirizine hydrochloride","nonproprietary_name":"Cetirizine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Advagen Pharma Ltd.,","package_description":"120 mL in 1 BOTTLE (72888-480-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"83745018504","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-185-04","proprietary_name":"Cetirizine Hydrochloride Oral Solution","nonproprietary_name":"Cetirizine Hydrochloride Oral Solution","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"120 mL in 1 BOTTLE (83745-185-04)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"83745018516","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-185-16","proprietary_name":"Cetirizine Hydrochloride Oral Solution","nonproprietary_name":"Cetirizine Hydrochloride Oral Solution","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"480 mL in 1 BOTTLE (83745-185-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"83745018804","name":"CETIRIZINE HCL 1 MG/ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-188-04","proprietary_name":"Cetrizine Hydrochloride","nonproprietary_name":"CETIRIZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"1 BOTTLE in 1 CARTON (83745-188-04) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571013412","name":"CETIRIZINE HCL 1 MG/ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-134-12","proprietary_name":"CETIRIZINE HYDROCHLORIDE","nonproprietary_name":"CETIRIZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (16571-134-12)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cetirizine HCl|Cetirizine HCl","basis":"generic"},"part_b":null}, {"ndc":"00781528464","name":"CETIRIZINE HCL 10 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5284-64","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"30 BLISTER PACK in 1 CARTON (0781-5284-64) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (0781-5284-06)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":2.11353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378363701","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3637-01","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"cetirizine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3637-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378363705","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3637-05","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"cetirizine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3637-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671740","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-40","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0904-6717-40)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671741","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-41","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"14 BLISTER PACK in 1 CARTON (0904-6717-41) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671743","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-43","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6717-43) / 45 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671746","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-46","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6717-46) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671760","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-60","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6717-60) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671772","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-72","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6717-72) / 300 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671786","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6717-86","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6717-86) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904751061","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7510-61","proprietary_name":"Cetirizine","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7510-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571040210","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-402-10","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-402-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571040250","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-402-50","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-402-50)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079901","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-799-01","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-799-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079902","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-799-02","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-799-02)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079903","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-799-03","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"300 TABLET in 1 BOTTLE (16714-799-03)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079904","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-799-04","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (16714-799-04)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598081112","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-811-12","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-811-12)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598081115","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-811-15","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-811-15)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802091939","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-919-39","proprietary_name":"cetirizine hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-919-39) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802091987","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-919-87","proprietary_name":"cetirizine hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-919-87) / 300 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079059701","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079059720","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-597-20","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"cetirizine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (51079-597-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-597-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660093901","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-939-01","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"100 TABLET in 1 BOTTLE (51660-939-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660093930","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-939-30","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"30 TABLET in 1 BOTTLE (51660-939-30)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660093954","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-939-54","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"14 TABLET in 1 BLISTER PACK (51660-939-54)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660093990","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-939-90","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"90 TABLET in 1 BOTTLE (51660-939-90)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111069990","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-699-90","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55111-699-90)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043604","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-436-04","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-436-04) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043616","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043696","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-436-96","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"10 BLISTER PACK in 1 CARTON (68001-436-96) / 10 TABLET in 1 BLISTER PACK (68001-436-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043697","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-436-97","proprietary_name":"Cetirizine Hydrochloride (Allergy)","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-436-97) / 300 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016305","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-163-05","proprietary_name":"Cetirizine hydrochloride","nonproprietary_name":"Cetirizine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (70010-163-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016309","name":"CETIRIZINE HCL 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-163-09","proprietary_name":"Cetirizine hydrochloride","nonproprietary_name":"Cetirizine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (70010-163-09)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781528364","name":"CETIRIZINE HCL 5 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5283-64","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"30 BLISTER PACK in 1 CARTON (0781-5283-64) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (0781-5283-06)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.99212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378363501","name":"CETIRIZINE HCL 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3635-01","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"cetirizine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3635-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571040110","name":"CETIRIZINE HCL 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-401-10","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-401-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536127912","name":"CETIRIZINE-PSE ER 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1279-12","proprietary_name":"Rugby Cetirizine Hydrochloride and Pseudoephedrine Hydrochloride","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Rugby Laboratories","package_description":"12 BLISTER PACK in 1 CARTON (0536-1279-12) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536127935","name":"CETIRIZINE-PSE ER 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1279-35","proprietary_name":"Rugby Cetirizine Hydrochloride and Pseudoephedrine Hydrochloride","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Rugby Laboratories","package_description":"24 BLISTER PACK in 1 CARTON (0536-1279-35) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802014753","name":"CETIRIZINE-PSE ER 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-147-53","proprietary_name":"Cetirizine hydrochloride and Pseudoephedrine hydrochloride","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"12 BLISTER PACK in 1 CARTON (45802-147-53) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802014762","name":"CETIRIZINE-PSE ER 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-147-62","proprietary_name":"Cetirizine hydrochloride and Pseudoephedrine hydrochloride","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"24 BLISTER PACK in 1 CARTON (45802-147-62) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054033425","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0334-25","proprietary_name":"Cevimeline Hydrochloride","nonproprietary_name":"Cevimeline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0334-25)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"00713093701","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0937-01","proprietary_name":"cevimeline hydrochloride","nonproprietary_name":"cevimeline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0713-0937-01)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"16571065710","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-657-10","proprietary_name":"Cevimeline Hydrochloride","nonproprietary_name":"Cevimeline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-657-10)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"33342021611","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-216-11","proprietary_name":"Cevimeline Hydrochloride","nonproprietary_name":"Cevimeline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (33342-216-11)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"59651042201","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-422-01","proprietary_name":"Cevimeline Hydrochloride","nonproprietary_name":"Cevimeline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-422-01)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"63304047901","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-479-01","proprietary_name":"Cevimeline","nonproprietary_name":"Cevimeline","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (63304-479-01)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"69452031620","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-316-20","proprietary_name":"CEVIMELINE","nonproprietary_name":"CEVIMELINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Bionpharma Inc","package_description":"100 CAPSULE in 1 BOTTLE (69452-316-20)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"72578020801","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-208-01","proprietary_name":"Cevimeline Hydrochloride","nonproprietary_name":"Cevimeline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-208-01)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011801","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-118-01","proprietary_name":"CEVIMELINE HYDROCHLORIDE","nonproprietary_name":"CEVIMELINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (72888-118-01)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011830","name":"CEVIMELINE HCL 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-118-30","proprietary_name":"CEVIMELINE HYDROCHLORIDE","nonproprietary_name":"CEVIMELINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (72888-118-30)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cevimeline HCl|Cevimeline HCl","basis":"generic"},"part_b":null}, {"ndc":"00069046928","name":"CHANTIX 1 MG CONT MONTH BOX","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0469-28","proprietary_name":"CHANTIX","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"56 TABLET, FILM COATED in 1 BLISTER PACK (0069-0469-28)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":3.40803,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chantix|Varenicline Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00069046956","name":"CHANTIX 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0469-56","proprietary_name":"CHANTIX","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (0069-0469-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":3.40803,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chantix|Varenicline Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00069047128","name":"CHANTIX STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0471-28","proprietary_name":"CHANTIX","nonproprietary_name":"varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 KIT in 1 BLISTER PACK (0069-0471-28) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":3.41102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chantix|Varenicline Tartrate","basis":"brand"},"part_b":null}, {"ndc":"68462085229","name":"CHARLOTTE 24 FE CHEWABLE TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-852-29","proprietary_name":"Charlotte 24Fe","nonproprietary_name":"norethindrone acetate and ethinyl estradiol and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-852-29) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Charlotte 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68462085284","name":"CHARLOTTE 24 FE CHEWABLE TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Charlotte 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"50102023021","name":"CHATEAL EQ-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chateal Eq|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023023","name":"CHATEAL EQ-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-230-23","proprietary_name":"Chateal EQ","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 POUCH in 1 CARTON (50102-230-23) / 1 BLISTER PACK in 1 POUCH (50102-230-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chateal Eq|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00536131208","name":"CHEST CONG RLF DM 400-20 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1312-08","proprietary_name":"Rugby Chest Congestion Relief DM","nonproprietary_name":"Dextromethorphan Hydrobromide / Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"Rugby Laboratories","package_description":"60 TABLET in 1 BOTTLE (0536-1312-08)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000005601","name":"CHEST CONG RLF DM 400-20 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0056-1","proprietary_name":"Leader Chest Congestion Relief DM","nonproprietary_name":"Dextromethorphan Hydrobromide / Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"Cardinal Health","package_description":"1 BOTTLE in 1 CARTON (70000-0056-1) / 60 TABLET in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536130908","name":"CHEST CONG RLF PE 400-10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1309-08","proprietary_name":"Rugby Chest Congestion Relief PE","nonproprietary_name":"Guaifenesin/phenylephrine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 10 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0536-1309-08) / 60 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536131108","name":"CHEST CONGEST RLF 400 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1311-08","proprietary_name":"Rugby Chest Congestion Relief G450","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Rugby Laboratories","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (0536-1311-08)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000005501","name":"CHEST CONGEST RLF 400 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0055-1","proprietary_name":"Leader Chest Congestion Relief G450","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Cardinal Health","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0055-1) / 60 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536131385","name":"CHEST CONGESTION RELIEF DM SYR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1313-85","proprietary_name":"Chest Congestion Relief DM","nonproprietary_name":"Dextromethorphan Hydrobromide, Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"RUGBY LABORATORIES","package_description":"473 mL in 1 BOTTLE (0536-1313-85)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.00905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536131485","name":"CHEST CONGESTION RELIEF SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1314-85","proprietary_name":"Chest Congestion Relief","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"RUGBY LABORATORIES","package_description":"473 mL in 1 BOTTLE (0536-1314-85)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385002671","name":"CHEST CONGST-COUGH RELIEF TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-026-71","proprietary_name":"Good Neighbor Pharmacy Mucus Relief DM","nonproprietary_name":"Dextromethorphan Hydrobromide / Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (24385-026-71) / 50 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000048001","name":"CHEST RUB","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0480-1","proprietary_name":"Medicated Chest Rub","nonproprietary_name":"camphor, eucalyptus oil, menthol","dosage_form":"OINTMENT","route":"TOPICAL","strength":"48 mg/g; 12 mg/g; 26 mg/g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"1 JAR in 1 CARTON (70000-0480-1) / 50 g in 1 JAR"},"nadac":{"value":0.0392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000030901","name":"CHILD ACETAMINOPHEN 160 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0309-1","proprietary_name":"Chewable Acetaminophen Childrens","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0309-1) / 24 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.11643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000031001","name":"CHILD ACETAMINOPHEN 160 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0310-1","proprietary_name":"Chewable Acetaminophen Childrens","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0310-1) / 24 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.11643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122010126","name":"CHILD ALL DAY ALLERGY 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-101-26","proprietary_name":"All Day Allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-101-26) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122020326","name":"CHILD ALL DAY ALLERGY 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-203-26","proprietary_name":"Good Neighbor Pharmacy Childrens All Day Allergy","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-203-26) / 120 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000021401","name":"CHILD ALL DAY ALLERGY 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0214-1","proprietary_name":"Leader Childrens All Day Allergy","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0214-1) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000021501","name":"CHILD ALL DAY ALLERGY 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0215-1","proprietary_name":"Leader Childrens all day allergy","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0215-1) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61269052794","name":"CHILD ALLERGY (FEXO) 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-527-94","proprietary_name":"Childrens Allergy","nonproprietary_name":"fexofenadine hydrochloride","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"H2-Pharma, LLC","package_description":"1 BOTTLE in 1 CARTON (61269-527-94) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000012501","name":"CHILD ALLERGY 5 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0125-1","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Cardinal Health, 110 dba LEADER","package_description":"1 BOTTLE in 1 CARTON (70000-0125-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.04364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230031611","name":"CHILD ALLERGY RELIEF 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-316-11","proprietary_name":"CHILDRENS ALLERGY RELIEF","nonproprietary_name":"cetirizine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-316-11) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000047301","name":"CHILD ALLERGY RELIEF 5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0473-1","proprietary_name":"leader childrens allergy relief","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0473-1) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904753315","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7533-15","proprietary_name":"Allergy Relief Childrens","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"473 mL in 1 BOTTLE, PLASTIC (0904-7533-15)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904753320","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7533-20","proprietary_name":"Allergy Relief Childrens","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-7533-20) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000047401","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0474-1","proprietary_name":"leader childrens allergy relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0474-1) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000049201","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000069301","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0693-1","proprietary_name":"Childrens Allergy Relief Dye Free","nonproprietary_name":"Diphenhydramine HCL","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 BOTTLE in 1 CARTON (70000-0693-1) / 236 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000070101","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0701-1","proprietary_name":"Childrens Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0701-1) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001604","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0016-4","proprietary_name":"DIPHENHYDRAMINE HCL 12.5 MG PER 5 ML","nonproprietary_name":"DIPHENHYDRAMINE HCL 12.5 MG PER 5 ML","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"AARNA USA INC.","package_description":"118 mL in 1 BOTTLE (82568-0016-4)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001606","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0016-6","proprietary_name":"DIPHENHYDRAMINE HCL 12.5 MG PER 5 ML","nonproprietary_name":"DIPHENHYDRAMINE HCL 12.5 MG PER 5 ML","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"AARNA USA INC.","package_description":"473 mL in 1 BOTTLE (82568-0016-6)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001608","name":"CHILD ALLERGY RLF 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0016-8","proprietary_name":"DIPHENHYDRAMINE HCL 12.5 MG PER 5 ML","nonproprietary_name":"DIPHENHYDRAMINE HCL 12.5 MG PER 5 ML","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"AARNA USA INC.","package_description":"236 mL in 1 BOTTLE (82568-0016-8)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904676520","name":"CHILD CETIRIZINE HCL 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6765-20","proprietary_name":"childrens cetirizine hydrochloride","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6765-20) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237035712","name":"CHILD CETIRIZINE HCL 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-357-12","proprietary_name":"CETIRIZINE HYDROCHLORIDE","nonproprietary_name":"CETIRIZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (57237-357-12)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237035812","name":"CHILD CETIRIZINE HCL 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-358-12","proprietary_name":"CETIRIZINE HYDROCHLORIDE","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (57237-358-12)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752010406","name":"CHILD CETIRIZINE HCL 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-104-06","proprietary_name":"CETIRIZINE HYDROCHLORIDE","nonproprietary_name":"CETIRIZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70752-104-06) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000005701","name":"CHILD COLD-ALLERGY LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0057-1","proprietary_name":"Childrens Dibromm Cold and Allergy","nonproprietary_name":"Brompheniramine maleate, Phenylephrine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"2 mg/10mL; 5 mg/10mL","labeler":"Cardinal Health (Leader) 70000","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70000-0057-1) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000019501","name":"CHILD COUGH DM ER 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0195-1","proprietary_name":"leader childrens cough dm","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0195-1) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237032621","name":"CHILD GLYCERIN 1.2 GM SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-326-21","proprietary_name":"Glycerin Children","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1.2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (57237-326-21) / 6 SUPPOSITORY in 1 BLISTER PACK (57237-326-16)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.12192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032652","name":"CHILD GLYCERIN 1.2 GM SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-326-52","proprietary_name":"Glycerin Children","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1.2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-326-52) / 5 SUPPOSITORY in 1 BLISTER PACK (57237-326-51)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.12192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000042901","name":"CHILD GLYCERIN SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0429-1","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1 g/1","labeler":"Cardinal Health","package_description":"25 SUPPOSITORY in 1 JAR (70000-0429-1)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.12192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660011231","name":"CHILD LORATADINE 5 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-112-31","proprietary_name":"Dye-Free Childrens Loratadine","nonproprietary_name":"LORATADINE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (51660-112-31) / 10 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.52124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660072630","name":"CHILD LORATADINE 5 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-726-30","proprietary_name":"DYE-FREE CHILDRENS LORATADINE","nonproprietary_name":"LORATADINE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (51660-726-30) / 10 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.52124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-14","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904676720","name":"CHILD LORATADINE 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6767-20","proprietary_name":"Childrens Loratadine Oral","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6767-20) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122042326","name":"CHILD LORATADINE 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672213108","name":"CHILD LORATADINE 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2131-8","proprietary_name":"Childrens Loratadine Sugar Free","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-2131-8) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230032212","name":"CHILD LORATADINE 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-322-12","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-322-12) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230032224","name":"CHILD LORATADINE 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-322-24","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-322-24) / 240 mL in 1 BOTTLE"},"nadac":{"value":0.06302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122020926","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-209-26","proprietary_name":"Good Neighbor Pharmacy Childrens Pain and Fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-209-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122021026","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-210-26","proprietary_name":"good neighbor pharmacy childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-210-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122021126","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-211-26","proprietary_name":"Good Neighbor Pharmacy childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-211-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122032226","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-322-26","proprietary_name":"good neighbor pharmacy pain and fever childrens","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-322-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000002801","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0028-1","proprietary_name":"leader childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0028-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000048101","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0481-1","proprietary_name":"leader childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0481-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83474000104","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83474-001-04","proprietary_name":"Childrens Pain Relief and Fever Reducer Oral Suspension Cherry","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Puro Pharma Inc.","package_description":"1 BOTTLE in 1 CARTON (83474-001-04) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83720050016","name":"CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237033821","name":"CHILD PROCTOZONE-G 1.2 GM SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-338-21","proprietary_name":"Proctozone-G","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1.2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (57237-338-21) / 6 SUPPOSITORY in 1 BLISTER PACK (57237-338-16)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.12192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033852","name":"CHILD PROCTOZONE-G 1.2 GM SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-338-52","proprietary_name":"Proctozone-G","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1.2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-338-52) / 5 SUPPOSITORY in 1 BLISTER PACK (57237-338-51)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.12192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904664524","name":"CHILD'S MAPAP 160 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6645-24","proprietary_name":"childrens mapap","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1","labeler":"Major Pharmaceuticals","package_description":"4 BLISTER PACK in 1 CARTON (0904-6645-24) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.11643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000062901","name":"CHILD'S MULTI-SYMPTOM COLD LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0629-1","proprietary_name":"Leader Childrens Multi Symptom Cold","nonproprietary_name":"Dextromethorphan HBr, guaifenesin, Phenylephrine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"5 mg/5mL; 100 mg/5mL; 2.5 mg/5mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 BOTTLE in 1 CARTON (70000-0629-1) / 118 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904530909","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5309-09","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-5309-09) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904530920","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5309-20","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-5309-20) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904557720","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5577-20","proprietary_name":"Ibuprofen Childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-5577-20) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385000926","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-009-26","proprietary_name":"Good Neighbor Pharmacy ibuprofen childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-009-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385000934","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-009-34","proprietary_name":"Good Neighbor Pharmacy ibuprofen childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-009-34) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385036126","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-361-26","proprietary_name":"Good Neighbor Pharmacy Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-361-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385036134","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-361-34","proprietary_name":"Good Neighbor Pharmacy Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-361-34) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385037226","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-372-26","proprietary_name":"Good Neighbor Pharmacy Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-372-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385090526","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-905-26","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-905-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385090534","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-905-34","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-905-34) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802013326","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-133-26","proprietary_name":"Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-133-26) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802014026","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-140-26","proprietary_name":"Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-140-26) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802089726","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-897-26","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-897-26) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802089734","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-897-34","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-897-34) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672213008","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2130-8","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-2130-8) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672532108","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-5321-8","proprietary_name":"ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-5321-8) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68001052192","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-521-92","proprietary_name":"CHILDRENS IBUPROFEN","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-521-92) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68001052194","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-521-94","proprietary_name":"CHILDRENS IBUPROFEN","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-521-94) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230030811","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-308-11","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-308-11) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230030812","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-308-12","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-308-12) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230030911","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-309-11","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-309-11) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230030912","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-309-12","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-309-12) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230031011","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-310-11","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-310-11) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230031012","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-310-12","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-310-12) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230031111","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-311-11","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-311-11) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69230031112","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-311-12","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-311-12) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000018101","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0181-1","proprietary_name":"Leader Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0181-1) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000026201","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0262-1","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0262-1) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000026301","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0263-1","proprietary_name":"LEADER CHILDRENS IBUPROFEN","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0263-1) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000026302","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0263-2","proprietary_name":"LEADER CHILDRENS IBUPROFEN","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0263-2) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000026401","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0264-1","proprietary_name":"leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0264-1) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83474000204","name":"CHILDREN IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83474-002-04","proprietary_name":"Childrens Ibuprofen Oral Suspension Original Berry Flavor","nonproprietary_name":"IBUPROFEN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Puro Pharma Inc.","package_description":"1 BOTTLE in 1 CARTON (83474-002-04) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000063101","name":"CHILDREN'S COLD-COUGH LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.07504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904579146","name":"CHILDREN'S MAPAP 80 MG TAB CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5791-46","proprietary_name":"Childrens Mapap","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-5791-46) / 30 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904753120","name":"CHILDRENS COLD AND COUGH LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7531-20","proprietary_name":"childrens cold and cough","nonproprietary_name":"brompheniramine maleate, dextromethorphan hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7531-20) / 118 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000071501","name":"CHILDRENS COLD AND COUGH LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0715-1","proprietary_name":"Leader Childrens Cold and Cough","nonproprietary_name":"brompheniramine maleate, dextromethorphan hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0715-1) / 118 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536132197","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1321-97","proprietary_name":"Rugby Childrens Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1321-97) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904701416","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7014-16","proprietary_name":"Children Acetaminophen Oral Solution","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"MAJOR PHARMACEUTICALS","package_description":"473 mL in 1 BOTTLE (0904-7014-16)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904701420","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7014-20","proprietary_name":"Children Acetaminophen Oral Solution","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"MAJOR PHARMACEUTICALS","package_description":"118 mL in 1 BOTTLE (0904-7014-20)"},"nadac":{"value":0.02406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904744520","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7445-20","proprietary_name":"childrens acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7445-20) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802020126","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-201-26","proprietary_name":"Childrens Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-201-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888045901","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-459-01","proprietary_name":"Childrens Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Advagen Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (72888-459-01) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568000804","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0008-4","proprietary_name":"Children Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"AARNA USA INC.","package_description":"1 BOTTLE in 1 PACKAGE (82568-0008-4) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568000806","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0008-6","proprietary_name":"Children Acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"AARNA USA INC.","package_description":"473 mL in 1 BOTTLE (82568-0008-6)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001104","name":"CHLD ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0011-4","proprietary_name":"CHILDRENS ACETAMINOPHEN","nonproprietary_name":"Children Acetaminophen Cherry","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"AARNA USA INC.","package_description":"1 BOTTLE in 1 CARTON (82568-0011-4) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122042589","name":"CHLD ALLRGY RLF 12.5 MG CHEW TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"46122-425-89","proprietary_name":"Allergy Relief Childrens","nonproprietary_name":"diphenhydramine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"12.5 mg/1","labeler":"Amerisource Bergen","package_description":"4 BLISTER PACK in 1 CARTON (46122-425-89) / 5 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378021101","name":"CHLORDIAZEPO-AMITRIPTYL 5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-0211-01","proprietary_name":"Chlordiazepoxide and Amitriptyline Hydrochloride","nonproprietary_name":"chlordiazepoxide and amitriptyline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 14 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0211-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide-Amitriptyline|Amitriptyline/Chlordiazepoxide","basis":"generic"},"part_b":null}, {"ndc":"00378021105","name":"CHLORDIAZEPO-AMITRIPTYL 5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-0211-05","proprietary_name":"Chlordiazepoxide and Amitriptyline Hydrochloride","nonproprietary_name":"chlordiazepoxide and amitriptyline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 14 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0211-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide-Amitriptyline|Amitriptyline/Chlordiazepoxide","basis":"generic"},"part_b":null}, {"ndc":"00555003302","name":"CHLORDIAZEPOXIDE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0033-02","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0033-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.14347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"00555003305","name":"CHLORDIAZEPOXIDE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0033-05","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (0555-0033-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.14347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"43547025210","name":"CHLORDIAZEPOXIDE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079037501","name":"CHLORDIAZEPOXIDE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079037520","name":"CHLORDIAZEPOXIDE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-375-20","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-375-20) / 1 CAPSULE in 1 BLISTER PACK (51079-375-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.14347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"62135022160","name":"CHLORDIAZEPOXIDE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-221-60","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-221-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.14347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"00555015902","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0159-02","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0159-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"00555015904","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0159-04","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0555-0159-04)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"43547025310","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079014101","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079014120","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-141-20","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-141-20) / 1 CAPSULE in 1 BLISTER PACK (51079-141-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"60687080701","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-807-01","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-807-01) / 1 CAPSULE in 1 BLISTER PACK (60687-807-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"60687080711","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"62135022260","name":"CHLORDIAZEPOXIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-222-60","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-222-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.15817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"00555015802","name":"CHLORDIAZEPOXIDE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0158-02","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0158-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.18674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"00555015804","name":"CHLORDIAZEPOXIDE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0158-04","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0555-0158-04)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.18674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"43547025110","name":"CHLORDIAZEPOXIDE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079037401","name":"CHLORDIAZEPOXIDE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079037420","name":"CHLORDIAZEPOXIDE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"62135022060","name":"CHLORDIAZEPOXIDE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-220-60","proprietary_name":"Chlordiazepoxide Hydrochloride","nonproprietary_name":"Chlordiazepoxide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-220-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.18674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlordiazepoxide HCl|Chlordiazepoxide HCl","basis":"generic"},"part_b":null}, {"ndc":"11534019701","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-197-01","proprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","nonproprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Sunrise Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (11534-197-01)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155080801","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571038101","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-381-01","proprietary_name":"CHLORDIAZEPOXIDE HCL AND CLIDINIUM BROMIDE","nonproprietary_name":"CHLORDIAZEPOXIDE HCL AND CLIDINIUM BROMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-381-01)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651052401","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-524-01","proprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","nonproprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-524-01)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219167701","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1677-1","proprietary_name":"chlordiazepoxide hydrochloride and clidinium bromide","nonproprietary_name":"chlordiazepoxide hydrochloride and clidinium bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (60219-1677-1)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687063911","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687063994","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-639-94","proprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","nonproprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-639-94) / 1 CAPSULE in 1 BLISTER PACK (60687-639-11)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135069612","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-696-12","proprietary_name":"CHLORDIAZEPOXIDE HYDROCHLORIDE AND CLIDINIUM BROMIDE","nonproprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE in 1 BOTTLE (62135-696-12)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332074431","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-744-31","proprietary_name":"Chlordiazepoxide hydrochloride and clidinium bromide","nonproprietary_name":"Chlordiazepoxide hydrochloride and clidinium bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-744-31)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877073101","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-731-01","proprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","nonproprietary_name":"Chlordiazepoxide Hydrochloride and Clidinium Bromide","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-731-01)","pharm_classes":["Anticholinergic [EPC]","Benzodiazepine [EPC]","Benzodiazepines [CS]","Cholinergic Antagonists [MoA]","Decreased Parasympathetic Acetylcholine Activity [PE]","Digestive/GI System Activity Alteration [PE]","GI Motility Alteration [PE]"]},"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700018501","name":"CHLORDIAZEPOXIDE-CLIDINIUM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00116200116","name":"CHLORHEXIDINE 0.12% RINSE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-2001-16","proprietary_name":"Chlorhexidine Gluconate","nonproprietary_name":"Chlorhexidine Gluconate","dosage_form":"RINSE","route":"ORAL","strength":"1.2 mg/mL","labeler":"Xttrium Laboratories, Inc.","package_description":"473 mL in 1 BOTTLE (0116-2001-16)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.00734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Chlorhexidine Gluconate|Chlorhexidine Gluconate","basis":"generic"},"part_b":null}, {"ndc":"16571012848","name":"CHLORHEXIDINE 0.12% RINSE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-128-48","proprietary_name":"Chlorhexidine Gluconate Oral Rinse","nonproprietary_name":"Chlorhexidine Gluconate Oral Rinse","dosage_form":"SOLUTION","route":"DENTAL","strength":"1.2 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (16571-128-48)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.00734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135064947","name":"CHLORHEXIDINE 0.12% RINSE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-649-47","proprietary_name":"Chlorhexidine Gluconate 0.12% Oral Rinse","nonproprietary_name":"Chlorhexidine Gluconate 0.12% Oral Rinse","dosage_form":"SOLUTION","route":"ORAL","strength":"1.2 mg/mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-649-47)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.00734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571011112","name":"CHLORHEXIDINE 4% LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-111-12","proprietary_name":"CHLORHEXIDINE GLUCONATE","nonproprietary_name":"chlorhexidine gluconate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118 mL in 1 BOTTLE (16571-111-12)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571011124","name":"CHLORHEXIDINE 4% LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-111-24","proprietary_name":"CHLORHEXIDINE GLUCONATE","nonproprietary_name":"chlorhexidine gluconate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"237 mL in 1 BOTTLE (16571-111-24)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.02849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571011148","name":"CHLORHEXIDINE 4% LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-111-48","proprietary_name":"CHLORHEXIDINE GLUCONATE","nonproprietary_name":"chlorhexidine gluconate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (16571-111-48)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.01776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115279006","name":"CHLOROQUINE PH 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-2790-06","proprietary_name":"Chloroquine Phosphate","nonproprietary_name":"CHLOROQUINE PHOSPHATE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"50 TABLET in 1 BOTTLE (0115-2790-06)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":2.53965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chloroquine Phosphate|Chloroquine Phosphate","basis":"generic"},"part_b":null}, {"ndc":"64980017750","name":"CHLOROQUINE PH 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-177-50","proprietary_name":"Chloroquine Phosphate","nonproprietary_name":"Chloroquine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 TABLET in 1 BOTTLE, PLASTIC (64980-177-50)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":2.53965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chloroquine Phosphate|Chloroquine Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00115701009","name":"CHLOROQUINE PH 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-7010-09","proprietary_name":"Chloroquine Phosphate","nonproprietary_name":"CHLOROQUINE PHOSPHATE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"25 TABLET in 1 BOTTLE (0115-7010-09)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":6.65389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chloroquine Phosphate|Chloroquine Phosphate","basis":"generic"},"part_b":null}, {"ndc":"23155085074","name":"CHLOROQUINE PH 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.65389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071726","name":"CHLOROQUINE PH 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-717-26","proprietary_name":"CHLOROQUINE PHOSPHATE","nonproprietary_name":"chloroquine phosphate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"25 TABLET, COATED in 1 BOTTLE (62135-717-26)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":6.65389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chloroquine Phosphate|Chloroquine Phosphate","basis":"generic"},"part_b":null}, {"ndc":"64980017802","name":"CHLOROQUINE PH 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-178-02","proprietary_name":"Chloroquine Phosphate","nonproprietary_name":"Chloroquine Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"25 TABLET in 1 BOTTLE, PLASTIC (64980-178-02)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":6.65389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chloroquine Phosphate|Chloroquine Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00527296137","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2961-37","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0527-2961-37)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601700","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6017-00","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6017-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714004701","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-047-01","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-047-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155080301","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016211","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-162","inner_of":["50268-162-15"]},"part_b":null}, {"ndc":"50268016215","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-162-15","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-162-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-162-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687041901","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-419-01","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-419-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-419-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687041911","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-419","inner_of":["60687-419-01"]},"part_b":null}, {"ndc":"62135042090","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-420-90","proprietary_name":"chlorpromazine hydrochloride","nonproprietary_name":"chlorpromazine hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, SUGAR COATED in 1 BOTTLE (62135-420-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332073531","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-735-31","proprietary_name":"Chlorpromazine","nonproprietary_name":"Chlorpromazine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-735-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462086101","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-861-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-861-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105401","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1054-1","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1054-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710112901","name":"CHLORPROMAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1129-1","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1129-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.24183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527296437","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2964-37","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0527-2964-37)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602000","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6020-00","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6020-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602001","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6020-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BLISTER PACK in 1 CARTON (0832-6020-01) / 100 TABLET, FILM COATED in 1 BLISTER PACK (0832-6020-89)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602010","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6020-10","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0832-6020-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602089","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"0832-6020","inner_of":["0832-6020-01"]},"part_b":null}, {"ndc":"16714005001","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-050-01","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-050-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155080601","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016511","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-165","inner_of":["50268-165-15"]},"part_b":null}, {"ndc":"50268016515","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-165-15","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-165-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-165-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687045201","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-452-01","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-452-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-452-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687045211","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-452","inner_of":["60687-452-01"]},"part_b":null}, {"ndc":"60687096001","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-960-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-960-01) / 1 TABLET, SUGAR COATED in 1 BLISTER PACK (60687-960-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687096011","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-960","inner_of":["60687-960-01"]},"part_b":null}, {"ndc":"62135042390","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-423-90","proprietary_name":"chlorpromazine hydrochloride","nonproprietary_name":"chlorpromazine hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, SUGAR COATED in 1 BOTTLE (62135-423-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332073831","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-738-31","proprietary_name":"Chlorpromazine","nonproprietary_name":"Chlorpromazine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-738-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462086401","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-864-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-864-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238106001","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1060-1","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1060-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710113201","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1132-1","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1132-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205010691","name":"CHLORPROMAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-106-91","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (72205-106-91)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.55242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527296537","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2965-37","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0527-2965-37)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602100","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6021-00","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6021-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602101","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6021-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BLISTER PACK in 1 CARTON (0832-6021-01) / 100 TABLET, FILM COATED in 1 BLISTER PACK (0832-6021-89)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602110","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6021-10","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0832-6021-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832602189","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"0832-6021","inner_of":["0832-6021-01"]},"part_b":null}, {"ndc":"23155080701","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016611","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-166","inner_of":["50268-166-12"]},"part_b":null}, {"ndc":"50268016612","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-166-12","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-166-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-166-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687046301","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-463-01","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-463-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-463-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687046311","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-463","inner_of":["60687-463-01"]},"part_b":null}, {"ndc":"60687097101","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-971-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-971-01) / 1 TABLET, SUGAR COATED in 1 BLISTER PACK (60687-971-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687097111","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-971","inner_of":["60687-971-01"]},"part_b":null}, {"ndc":"62135042490","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-424-90","proprietary_name":"chlorpromazine hydrochloride","nonproprietary_name":"chlorpromazine hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, SUGAR COATED in 1 BOTTLE (62135-424-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332073931","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-739-31","proprietary_name":"Chlorpromazine","nonproprietary_name":"Chlorpromazine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-739-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462086501","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-865-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-865-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238106201","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1062-1","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1062-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710113301","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1133-1","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1133-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205010791","name":"CHLORPROMAZINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-107-91","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"200 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (72205-107-91)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.66357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527296237","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2962-37","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0527-2962-37)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601800","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6018-00","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6018-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601810","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6018-10","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0832-6018-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155080401","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016311","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-163","inner_of":["50268-163-15"]},"part_b":null}, {"ndc":"50268016315","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-163-15","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-163-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-163-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043001","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-430-01","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-430-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-430-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043011","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-430","inner_of":["60687-430-01","60687-430-65"]},"part_b":null}, {"ndc":"60687043065","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-430-65","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-430-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-430-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687093801","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-938-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-938-01) / 1 TABLET, SUGAR COATED in 1 BLISTER PACK (60687-938-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687093811","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-938","inner_of":["60687-938-01","60687-938-65"]},"part_b":null}, {"ndc":"60687093865","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-938-65","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-938-65) / 1 TABLET, SUGAR COATED in 1 BLISTER PACK (60687-938-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135042190","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-421-90","proprietary_name":"chlorpromazine hydrochloride","nonproprietary_name":"chlorpromazine hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, SUGAR COATED in 1 BOTTLE (62135-421-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332073631","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-736-31","proprietary_name":"Chlorpromazine","nonproprietary_name":"Chlorpromazine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-736-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462086201","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-862-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-862-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105601","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1056-1","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1056-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710113001","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1130-1","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1130-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205010491","name":"CHLORPROMAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-104-91","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (72205-104-91)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.32443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527296337","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2963-37","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0527-2963-37)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601900","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6019-00","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6019-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601901","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6019-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BLISTER PACK in 1 CARTON (0832-6019-01) / 100 TABLET, FILM COATED in 1 BLISTER PACK (0832-6019-89)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601910","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6019-10","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0832-6019-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832601989","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"0832-6019","inner_of":["0832-6019-01"]},"part_b":null}, {"ndc":"23155080501","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268016411","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-164","inner_of":["50268-164-15"]},"part_b":null}, {"ndc":"50268016415","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-164-15","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-164-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-164-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044101","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-441-01","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-441-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-441-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044111","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-441","inner_of":["60687-441-01"]},"part_b":null}, {"ndc":"60687094901","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-949-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-949-01) / 1 TABLET, SUGAR COATED in 1 BLISTER PACK (60687-949-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687094911","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-949","inner_of":["60687-949-01"]},"part_b":null}, {"ndc":"62135042290","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-422-90","proprietary_name":"chlorpromazine hydrochloride","nonproprietary_name":"chlorpromazine hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, SUGAR COATED in 1 BOTTLE (62135-422-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332073731","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-737-31","proprietary_name":"Chlorpromazine","nonproprietary_name":"Chlorpromazine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-737-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462086301","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-863-01","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-863-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105801","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1058-1","proprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","nonproprietary_name":"CHLORPROMAZINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1058-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710113101","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1131-1","proprietary_name":"Chlorpromazine hydrochloride","nonproprietary_name":"Chlorpromazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1131-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205010591","name":"CHLORPROMAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-105-91","proprietary_name":"Chlorpromazine Hydrochloride","nonproprietary_name":"Chlorpromazine Hydrochloride","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (72205-105-91)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.41446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorpromazine HCl*|Chlorpromazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378022201","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0222-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0222-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00378022210","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0222-10","proprietary_name":"Chlorthalidone","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0222-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00904690004","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6900-04","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6900-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00904690061","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6900-61","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6900-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00904758361","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7583-61","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7583-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"16714012801","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-128-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET in 1 BOTTLE (16714-128-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"27241021601","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-216-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-216-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"29300033301","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-333-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-333-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598017001","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-170-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET in 1 BOTTLE (43598-170-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598017010","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-170-10","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1000 TABLET in 1 BOTTLE (43598-170-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598071901","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-719-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET in 1 BOTTLE (43598-719-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598071910","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-719-10","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1000 TABLET in 1 BOTTLE (43598-719-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"50268016711","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"50268016715","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-167-15","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-167-15) / 1 TABLET in 1 BLISTER PACK (50268-167-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"51079005801","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"51079005820","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-058-20","proprietary_name":"Chlorthalidone","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-058-20) / 1 TABLET in 1 BLISTER PACK (51079-058-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"57664064888","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-648-88","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-648-88)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"60687031701","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-317-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-317-01) / 1 TABLET in 1 BLISTER PACK (60687-317-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"60687031711","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"60687031725","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-317-25","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-317-25) / 1 TABLET in 1 BLISTER PACK (60687-317-95)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"60687031795","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"62135050530","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-505-30","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-505-30)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"62135050590","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-505-90","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-505-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"62332067631","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-676-31","proprietary_name":"CHLORTHALIDONE CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-676-31)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"64980030301","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-303-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64980-303-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"64980030310","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-303-10","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64980-303-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"64980059901","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-599-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-599-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"64980059910","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-599-10","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-599-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"65162024709","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-247-09","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-247-09)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"67877069601","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-696-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-696-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"67877069610","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-696-10","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-696-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"68382097001","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-970-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-970-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"68382097010","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-970-10","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-970-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70756001111","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-011-11","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-011-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70756001112","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-011-12","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-011-12)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"75834010901","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-109-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Nivagen Pharmaceuticals, INC.","package_description":"100 TABLET in 1 BOTTLE (75834-109-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"75834010910","name":"CHLORTHALIDONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-109-10","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Nivagen Pharmaceuticals, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-109-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.07433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00378021301","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0213-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (0378-0213-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"00378021310","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0213-10","proprietary_name":"Chlorthalidone","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (0378-0213-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"16714012901","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-129-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET in 1 BOTTLE (16714-129-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"27241021701","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-217-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-217-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"29300033401","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-334-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-334-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598016701","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-167-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET in 1 BOTTLE (43598-167-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598016710","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-167-10","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1000 TABLET in 1 BOTTLE (43598-167-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598072001","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-720-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET in 1 BOTTLE (43598-720-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"43598072010","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-720-10","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1000 TABLET in 1 BOTTLE (43598-720-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"57664064988","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-649-88","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-649-88)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"62135050630","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-506-30","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-506-30)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"62135050690","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-506-90","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-506-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"62332067731","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-677-31","proprietary_name":"CHLORTHALIDONE CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-677-31)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"64980030401","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-304-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"CHLORTHALIDONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64980-304-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"64980060001","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-600-01","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-600-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"65162025009","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-250-09","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-250-09)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"67877069701","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-697-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-697-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"68382097101","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-971-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-971-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70756002011","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-020-11","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-020-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"70756002012","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-020-12","proprietary_name":"CHLORTHALIDONE","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-020-12)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"75834011001","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-110-01","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Nivagen Pharmaceuticals, INC.","package_description":"100 TABLET in 1 BOTTLE (75834-110-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"75834011010","name":"CHLORTHALIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-110-10","proprietary_name":"Chlorthalidone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Nivagen Pharmaceuticals, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-110-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.12175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorthalidone|Chlorthalidone","basis":"generic"},"part_b":null}, {"ndc":"31722097460","name":"CHLORZOXAZONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-974-60","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-974-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.52084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"64980058206","name":"CHLORZOXAZONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64980-582-06","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET in 1 BOTTLE (64980-582-06)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.52084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"69499033060","name":"CHLORZOXAZONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69499-330-60","proprietary_name":"chlorzoxazone","nonproprietary_name":"chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Solubiomix","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (69499-330-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.52084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"72336022560","name":"CHLORZOXAZONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72336-225-60","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Lifsa Drugs LLC","package_description":"60 TABLET in 1 BOTTLE (72336-225-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.52084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"87127080160","name":"CHLORZOXAZONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"87127-801-60","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Happy Robin, LLC","package_description":"60 TABLET in 1 BOTTLE (87127-801-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.52084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"00254205301","name":"CHLORZOXAZONE 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-2053-01","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0254-2053-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.66652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"16571072501","name":"CHLORZOXAZONE 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-725-01","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-725-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.66652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"59651030501","name":"CHLORZOXAZONE 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-305-01","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-305-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.66652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"00591252001","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2520-01","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-2520-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"00591252005","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2520-05","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-2520-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"16571072601","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-726-01","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-726-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"59651030601","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-306-01","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-306-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"59651030605","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-306-05","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-306-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"70954008510","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-085-10","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-085-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"70954008520","name":"CHLORZOXAZONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-085-20","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Novitium Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70954-085-20)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.2101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"00254200501","name":"CHLORZOXAZONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-2005-01","proprietary_name":"Chlorzoxazone","nonproprietary_name":"Chlorzoxazone","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0254-2005-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.67545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"16571072701","name":"CHLORZOXAZONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-727-01","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-727-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.67545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"59651030701","name":"CHLORZOXAZONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-307-01","proprietary_name":"CHLORZOXAZONE","nonproprietary_name":"CHLORZOXAZONE","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-307-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.67545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Chlorzoxazone|Chlorzoxazone","basis":"generic"},"part_b":null}, {"ndc":"70000047701","name":"CHOCOLATED LAXATIVE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0477-1","proprietary_name":"Leader Regular Strength Chocolate Laxative sennosides","nonproprietary_name":"sennosides","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"CARDINAL HEALTH","package_description":"2 POUCH in 1 CARTON (70000-0477-1) / 12 TABLET in 1 POUCH"},"nadac":{"value":0.10625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658027095","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-270-95","proprietary_name":"CHOLESTYRAMINE LIGHT","nonproprietary_name":"cholestyramine light","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.7g","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"60 POUCH in 1 CARTON (24658-270-95) / 5.7 g in 1 POUCH","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806027095","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-270-95","proprietary_name":"CHOLESTYRAMINE LIGHT","nonproprietary_name":"cholestyramine light","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.7g","labeler":"EPIC PHARMA, LLC","package_description":"60 POUCH in 1 CARTON (42806-270-95) / 5.7 g in 1 POUCH (42806-270-98)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884046663","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884046665","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-466-65","proprietary_name":"Cholestyramine","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5g","labeler":"Par Health USA, LLC","package_description":"60 PACKET in 1 CARTON (49884-466-65) / 5 g in 1 PACKET (49884-466-63)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877042257","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877042260","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-422-60","proprietary_name":"Choleystyramine Light","nonproprietary_name":"Choleystyramine Light","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.718g","labeler":"Ascend Laboratories, LLC","package_description":"60 POUCH in 1 CARTON (67877-422-60) / 5.718 g in 1 POUCH (67877-422-57)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094090620","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-906-20","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/4.8g","labeler":"Precision Dose, Inc.","package_description":"60 POUCH in 1 CARTON (68094-906-20) / 4.8 g in 1 POUCH","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382052960","name":"CHOLESTYRAMINE LIGHT PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-529-60","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"CHOLESTYRAMINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.5g","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"60 POUCH in 1 CARTON (68382-529-60) / 5.5 g in 1 POUCH","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658027193","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-271-93","proprietary_name":"CHOLESTYRAMINE LIGHT","nonproprietary_name":"cholestyramine light","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.7g","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"239.4 g in 1 JAR (24658-271-93)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.11311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24658027197","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-271-97","proprietary_name":"CHOLESTYRAMINE LIGHT","nonproprietary_name":"cholestyramine light","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.7g","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"239.4 g in 1 CAN (24658-271-97)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.11311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42806027193","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-271-93","proprietary_name":"CHOLESTYRAMINE LIGHT","nonproprietary_name":"cholestyramine light","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.7g","labeler":"EPIC PHARMA, LLC","package_description":"239.6 g in 1 JAR (42806-271-93)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.11311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49884046667","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-466-67","proprietary_name":"Cholestyramine","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5g","labeler":"Par Health USA, LLC","package_description":"210 g in 1 CAN (49884-466-67)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.28353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62135093754","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-937-54","proprietary_name":"Cholestyramine for Oral Suspension","nonproprietary_name":"Cholestyramine for Oral Suspension","dosage_form":"POWDER","route":"ORAL","strength":"4 g/5.7g","labeler":"Chartwell RX, LLC","package_description":"239.4 g in 1 CAN (62135-937-54)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.11311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Cholestyramine Light|Cholestyramine","basis":"generic"},"part_b":null}, {"ndc":"68094090610","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68094-906-10","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/4.8g","labeler":"Precision Dose, Inc.","package_description":"201.6 g in 1 CAN (68094-906-10)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.14543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68382052942","name":"CHOLESTYRAMINE LIGHT POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-529-42","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"CHOLESTYRAMINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.5g","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"231 g in 1 CONTAINER (68382-529-42)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.16976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24658026695","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-266-95","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"60 POUCH in 1 CARTON (24658-266-95) / 9 g in 1 POUCH","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241013421","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241013436","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-134-36","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Ajanta Pharma USA Inc.","package_description":"60 PACKET in 1 CARTON (27241-134-36) / 9 g in 1 PACKET (27241-134-21)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342029370","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-293-70","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 POUCH in 1 CARTON (33342-293-70) / 9 g in 1 POUCH (33342-293-75)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571050829","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-508-29","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Micro Labs Limited","package_description":"60 POUCH in 1 CARTON (42571-508-29) / 9 g in 1 POUCH (42571-508-04)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806026695","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-266-95","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"EPIC PHARMA, LLC","package_description":"60 POUCH in 1 CARTON (42806-266-95) / 9 g in 1 POUCH (42806-266-98)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884046564","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884046565","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-465-65","proprietary_name":"Cholestyramine","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Par Health USA, LLC","package_description":"60 PACKET in 1 CARTON (49884-465-65) / 9 g in 1 PACKET (49884-465-64)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877029809","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877029860","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-298-60","proprietary_name":"cholestyramine powder for suspension","nonproprietary_name":"cholestyramine powder for suspension","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/8.78g","labeler":"Ascend Laboratories, LLC","package_description":"60 POUCH in 1 CARTON (67877-298-60) / 8.78 g in 1 POUCH (67877-298-09)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094080620","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-806-20","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Precision Dose, Inc.","package_description":"60 POUCH in 1 CARTON (68094-806-20) / 9 g in 1 POUCH","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382052860","name":"CHOLESTYRAMINE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-528-60","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"CHOLESTYRAMINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"60 POUCH in 1 CARTON (68382-528-60) / 9 g in 1 POUCH","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658026693","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-266-93","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"378 g in 1 JAR (24658-266-93)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24658026697","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-266-97","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"378 g in 1 CAN (24658-266-97)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"27241013451","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-134-51","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Ajanta Pharma USA Inc.","package_description":"378 g in 1 BOTTLE (27241-134-51)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342029371","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-293-71","proprietary_name":"Cholestyramine","nonproprietary_name":"Cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Macleods Pharmaceuticals Limited","package_description":"378 g in 1 JAR (33342-293-71)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42806026793","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-267-93","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"EPIC PHARMA, LLC","package_description":"378 g in 1 JAR (42806-267-93)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49884046566","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-465-66","proprietary_name":"Cholestyramine","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Par Health USA, LLC","package_description":"378 g in 1 CAN (49884-465-66)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62135000856","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-008-56","proprietary_name":"Cholestyramine for Oral Suspension","nonproprietary_name":"Cholestyramine for Oral Suspension","dosage_form":"POWDER","route":"ORAL","strength":"4 g/9g","labeler":"Chartwell RX, LLC","package_description":"378 g in 1 CAN (62135-008-56)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877029837","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-298-37","proprietary_name":"cholestyramine powder for suspension","nonproprietary_name":"cholestyramine powder for suspension","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/8.78g","labeler":"Ascend Laboratories, LLC","package_description":"368.76 g in 1 JAR (67877-298-37)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.08508,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68382052842","name":"CHOLESTYRAMINE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-528-42","proprietary_name":"CHOLESTYRAMINE","nonproprietary_name":"CHOLESTYRAMINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/9g","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"378 g in 1 CAN (68382-528-42)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"63323003011","name":"CHORIONIC GONAD 10,000 UNIT VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-030-11","proprietary_name":"Chorionic Gonadotropin","nonproprietary_name":"Chorionic Gonadotropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Fresenius Kabi USA, LLC","package_description":"1 KIT in 1 CARTON (63323-030-11) * 10 mL in 1 VIAL, MULTI-DOSE * 10 mL in 1 VIAL, MULTI-DOSE"},"nadac":{"value":253.04769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0725","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0725 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (63323-030-11) * 10 mL in 1 VIAL, MULTI-DOSE * 10 mL in 1 VIAL, MULTI-DOSE) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00002446330","name":"CIALIS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-4463-30","proprietary_name":"Cialis","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Eli Lilly and Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0002-4463-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":53.6874,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cialis|Tadalafil","basis":"brand"},"part_b":null}, {"ndc":"00002446430","name":"CIALIS 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4464-30","proprietary_name":"Cialis","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Eli Lilly and Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0002-4464-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":53.82543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cialis|Tadalafil","basis":"brand"},"part_b":null}, {"ndc":"00002446230","name":"CIALIS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4462-30","proprietary_name":"Cialis","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Eli Lilly and Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0002-4462-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":9.20446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cialis|Tadalafil","basis":"brand"},"part_b":null}, {"ndc":"00069033530","name":"CIBINQO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0335-30","proprietary_name":"Cibinqo","nonproprietary_name":"abrocitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0069-0335-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":197.09241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cibinqo|Abrocitinib","basis":"brand"},"part_b":null}, {"ndc":"00713063815","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0638-15","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 BOX (0713-0638-15) / 15 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.20766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063818","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0638-18","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 BOX (0713-0638-18) / 90 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.1025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063831","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0638-31","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 BOX (0713-0638-31) / 30 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.16869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802013811","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-138-11","proprietary_name":"Ciclopirox olamine","nonproprietary_name":"Ciclopirox olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-138-11) / 30 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.16869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802013818","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-138-18","proprietary_name":"Ciclopirox olamine","nonproprietary_name":"Ciclopirox olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-138-18) / 90 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.1025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802013835","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-138-35","proprietary_name":"Ciclopirox olamine","nonproprietary_name":"Ciclopirox olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-138-35) / 15 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.20766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131801","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1318-1","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"ciclopirox olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1318-1) / 15 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.20766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131802","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1318-2","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"ciclopirox olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1318-2) / 30 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.16869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131808","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1318-8","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"ciclopirox olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1318-8) / 90 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.1025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462029717","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-297-17","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"15 g in 1 CARTON (68462-297-17)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.20766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462029735","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-297-35","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 g in 1 CARTON (68462-297-35)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.16869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462029792","name":"CICLOPIROX 0.77% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-297-92","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"CREAM","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 g in 1 CARTON (68462-297-92)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.1025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574206101","name":"CICLOPIROX 0.77% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2061-01","proprietary_name":"CICLOPIROX","nonproprietary_name":"CICLOPIROX","dosage_form":"GEL","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2061-01) / 100 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.76886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574206130","name":"CICLOPIROX 0.77% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2061-30","proprietary_name":"CICLOPIROX","nonproprietary_name":"CICLOPIROX","dosage_form":"GEL","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2061-30) / 30 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.84751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574206145","name":"CICLOPIROX 0.77% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2061-45","proprietary_name":"CICLOPIROX","nonproprietary_name":"CICLOPIROX","dosage_form":"GEL","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2061-45) / 45 g in 1 TUBE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.78726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462045535","name":"CICLOPIROX 0.77% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-455-35","proprietary_name":"ciclopirox","nonproprietary_name":"ciclopirox","dosage_form":"GEL","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 g in 1 TUBE (68462-455-35)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.84751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462045547","name":"CICLOPIROX 0.77% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-455-47","proprietary_name":"ciclopirox","nonproprietary_name":"ciclopirox","dosage_form":"GEL","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"45 g in 1 TUBE (68462-455-47)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.78726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462045594","name":"CICLOPIROX 0.77% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-455-94","proprietary_name":"ciclopirox","nonproprietary_name":"ciclopirox","dosage_form":"GEL","route":"TOPICAL","strength":"7.7 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 g in 1 TUBE (68462-455-94)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.76886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802040046","name":"CICLOPIROX 0.77% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-400-46","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"7.7 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-400-46) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.7215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802040049","name":"CICLOPIROX 0.77% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-400-49","proprietary_name":"Ciclopirox Olamine","nonproprietary_name":"Ciclopirox Olamine","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"7.7 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-400-49) / 30 mL in 1 BOTTLE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.80936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591215990","name":"CICLOPIROX 1% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2159-90","proprietary_name":"Ciclopirox","nonproprietary_name":"Ciclopirox","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"10 mg/.96mL","labeler":"Actavis Pharma, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (0591-2159-90)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.2108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922010552","name":"CICLOPIROX 1% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-105-52","proprietary_name":"CICLOPIROX","nonproprietary_name":"ciclopirox","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"1 g/100mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-105-52) / 120 mL in 1 BOTTLE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.2108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802040109","name":"CICLOPIROX 1% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-401-09","proprietary_name":"Ciclopirox","nonproprietary_name":"Ciclopirox","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"1 g/100mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"120 mL in 1 BOTTLE (45802-401-09)","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.2108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135108","name":"CICLOPIROX 1% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1351-8","proprietary_name":"Ciclopirox","nonproprietary_name":"ciclopirox","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"10 mg/.96mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-1351-8) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.2108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922005351","name":"CICLOPIROX 8% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-053-51","proprietary_name":"CICLOPIROX","nonproprietary_name":"ciclopirox","dosage_form":"SOLUTION","route":"TOPICAL","strength":"80 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (21922-053-51) / 6.6 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":1.15412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192071506","name":"CICLOPIROX 8% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-715-06","proprietary_name":"Ciclopirox","nonproprietary_name":"Ciclopirox","dosage_form":"SOLUTION","route":"TOPICAL","strength":"80 mg/mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (42192-715-06) / 6.6 mL in 1 BOTTLE","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":1.15412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802014167","name":"CICLOPIROX 8% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-141-67","proprietary_name":"Ciclopirox","nonproprietary_name":"Ciclopirox","dosage_form":"SOLUTION","route":"TOPICAL","strength":"80 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (45802-141-67) / 6.6 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased DNA Replication [PE]","Decreased Protein Synthesis [PE]","Decreased RNA Replication [PE]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":1.15412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093206406","name":"CILOSTAZOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2064-06","proprietary_name":"Cilostazol","nonproprietary_name":"Cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-2064-06)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"00093206450","name":"CILOSTAZOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2064-50","proprietary_name":"Cilostazol","nonproprietary_name":"Cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"5000 TABLET in 1 BOTTLE (0093-2064-50)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"50268017711","name":"CILOSTAZOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"50268017715","name":"CILOSTAZOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-177-15","proprietary_name":"cilostazol","nonproprietary_name":"cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-177-15) / 1 TABLET in 1 BLISTER PACK (50268-177-11)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"60505252201","name":"CILOSTAZOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2522-1","proprietary_name":"cilostazol","nonproprietary_name":"cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-2522-1)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"70436015706","name":"CILOSTAZOL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-157-06","proprietary_name":"Cilostazol","nonproprietary_name":"cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (70436-157-06)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"00093206506","name":"CILOSTAZOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2065-06","proprietary_name":"Cilostazol","nonproprietary_name":"Cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-2065-06)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"50268017611","name":"CILOSTAZOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"50268017615","name":"CILOSTAZOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-176-15","proprietary_name":"cilostazol","nonproprietary_name":"cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-176-15) / 1 TABLET in 1 BLISTER PACK (50268-176-11)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"60505252101","name":"CILOSTAZOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2521-1","proprietary_name":"cilostazol","nonproprietary_name":"cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-2521-1)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"70436015606","name":"CILOSTAZOL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-156-06","proprietary_name":"Cilostazol","nonproprietary_name":"cilostazol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (70436-156-06)","pharm_classes":["Phosphodiesterase 3 Inhibitor [EPC]","Phosphodiesterase 3 Inhibitors [MoA]"]},"nadac":{"value":0.13039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cilostazol|Cilostazol","basis":"generic"},"part_b":null}, {"ndc":"66758007138","name":"CILOXAN 0.3% OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-071-38","proprietary_name":"CILOXAN","nonproprietary_name":"ciprofloxacin hydrochloride","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3 mg/g","labeler":"Sandoz Inc","package_description":"3.5 g in 1 TUBE (66758-071-38)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":74.31212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ciloxan|Ciprofloxacin HCl","basis":"brand"},"part_b":null}, {"ndc":"00378005301","name":"CIMETIDINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0053-01","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0053-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.20417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"59651082301","name":"CIMETIDINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-823-01","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-823-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.20417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"62135063030","name":"CIMETIDINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-630-30","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-630-30)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.20417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"69452032320","name":"CIMETIDINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-323-20","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-323-20)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.20417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00093819201","name":"CIMETIDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8192-01","proprietary_name":"Cimetidine","nonproprietary_name":"Cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8192-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.23584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00093819205","name":"CIMETIDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8192-05","proprietary_name":"Cimetidine","nonproprietary_name":"Cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-8192-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.23584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00378031701","name":"CIMETIDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0317-01","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0317-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.23584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"59651082401","name":"CIMETIDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-824-01","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-824-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.23584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"62135063190","name":"CIMETIDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-631-90","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-631-90)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.23584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"69452032420","name":"CIMETIDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-324-20","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-324-20)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.23584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00121102508","name":"CIMETIDINE 300 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1025-08","proprietary_name":"Cimetidine Hydrochloride","nonproprietary_name":"Cimetidine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"300 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"237 mL in 1 BOTTLE (0121-1025-08)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.60019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135080937","name":"CIMETIDINE 300 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-809-37","proprietary_name":"CIMETIDINE HYDROCHLORIDE","nonproprietary_name":"CIMETIDINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"300 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"237 mL in 1 BOTTLE (62135-809-37)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.60019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093820401","name":"CIMETIDINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8204-01","proprietary_name":"Cimetidine","nonproprietary_name":"Cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8204-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.31934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00093820405","name":"CIMETIDINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8204-05","proprietary_name":"Cimetidine","nonproprietary_name":"Cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-8204-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.31934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00378037201","name":"CIMETIDINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0372-01","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0372-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.31934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"59651082501","name":"CIMETIDINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-825-01","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-825-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.31934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"62135063290","name":"CIMETIDINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-632-90","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-632-90)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.31934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"69452032520","name":"CIMETIDINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-325-20","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-325-20)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.31934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00093830501","name":"CIMETIDINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8305-01","proprietary_name":"Cimetidine","nonproprietary_name":"Cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8305-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.72081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"00378054101","name":"CIMETIDINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0541-01","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0541-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.72081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"59651082601","name":"CIMETIDINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-826-01","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-826-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.72081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"62135063390","name":"CIMETIDINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-633-90","proprietary_name":"CIMETIDINE","nonproprietary_name":"CIMETIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-633-90)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.72081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"69452032620","name":"CIMETIDINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-326-20","proprietary_name":"Cimetidine","nonproprietary_name":"cimetidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-326-20)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.72081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cimetidine|Cimetidine","basis":"generic"},"part_b":null}, {"ndc":"50474071079","name":"CIMZIA 2X200 MG/ML SYRINGE KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-710-79","proprietary_name":"Cimzia","nonproprietary_name":"certolizumab pegol","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 mg/mL","labeler":"UCB, Inc.","package_description":"2 SYRINGE, GLASS in 1 CARTON (50474-710-79) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":6094.025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0717","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0717 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. NADAC's description calls this NDC a kit, and OpenBill reads NADAC's EA for a kit as the whole kit, which is 1 per NDC, but package size x quantity is 2 here, so the crosswalk counts something other than the kit NADAC prices and package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":2,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00904750204","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7502-04","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7502-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"31722010330","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-103-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-103-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"43598036730","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-367-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-367-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"50268015311","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"50268015312","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"50268018811","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"50268018812","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-188-12","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-188-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-188-11)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"60687051611","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"60687051621","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-516-21","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-516-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-516-11)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"64380088304","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-883-04","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-883-04)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083105","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083130","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"67877050330","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-503-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-503-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"69097041002","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-410-02","proprietary_name":"CINACALCET","nonproprietary_name":"CINACALCET","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-410-02)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"76282067430","name":"CINACALCET HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-674-30","proprietary_name":"CINACALCET","nonproprietary_name":"CINACALCET","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"30 TABLET in 1 BOTTLE (76282-674-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.41139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"31722010430","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-104-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-104-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"43598036830","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-368-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-368-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"64380088404","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-884-04","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-884-04)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083205","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083230","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"67877050430","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-504-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-504-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"69097041102","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-411-02","proprietary_name":"CINACALCET","nonproprietary_name":"CINACALCET","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-411-02)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"76282067530","name":"CINACALCET HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-675-30","proprietary_name":"CINACALCET","nonproprietary_name":"CINACALCET","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"30 TABLET in 1 BOTTLE (76282-675-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":0.76582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"31722010530","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-105-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-105-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"64380088504","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-885-04","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-885-04)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083305","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083330","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"67877050530","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-505-30","proprietary_name":"Cinacalcet","nonproprietary_name":"Cinacalcet","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-505-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"69097041202","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-412-02","proprietary_name":"CINACALCET","nonproprietary_name":"CINACALCET","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-412-02)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"76282067630","name":"CINACALCET HCL 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-676-30","proprietary_name":"CINACALCET","nonproprietary_name":"CINACALCET","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"30 TABLET in 1 BOTTLE (76282-676-30)","pharm_classes":["Calcium-sensing Receptor Agonist [EPC]","Increased Calcium-sensing Receptor Sensitivity [MoA]"]},"nadac":{"value":1.06212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cinacalcet HCl|Cinacalcet HCl","basis":"generic"},"part_b":null}, {"ndc":"50419077301","name":"CIPRO 10% SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-773-01","proprietary_name":"Cipro","nonproprietary_name":"ciprofloxacin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"1 KIT in 1 KIT (50419-773-01) * 100 mL in 1 BOTTLE, GLASS * 100 mL in 1 BOTTLE, GLASS"},"nadac":{"value":1.45528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50419077701","name":"CIPRO 5% SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-777-01","proprietary_name":"Cipro","nonproprietary_name":"ciprofloxacin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"1 KIT in 1 KIT (50419-777-01) * 100 mL in 1 BOTTLE, GLASS * 100 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":1.24862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66758008770","name":"CIPRO HC OTIC SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-087-70","proprietary_name":"CIPRO HC","nonproprietary_name":"ciprofloxacin hydrochloride and hydrocortisone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"2 mg/mL; 10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (66758-087-70) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":34.9317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":26.90905,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cipro HC|Ciprofloxacin/Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"00781618667","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6186-67","proprietary_name":"Ciprofloxacin and Dexamethasone","nonproprietary_name":"ciprofloxacin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0781-6186-67) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832143075","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1430-75","proprietary_name":"Ciprofloxacin and Dexamethasone","nonproprietary_name":"Ciprofloxacin Hydrochloride and Dexamethasone","dosage_form":"SUSPENSION","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-1430-75) / 7.5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714062801","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-628-01","proprietary_name":"Ciprofloxacin and Dexamethasone","nonproprietary_name":"Ciprofloxacin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (16714-628-01) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598032675","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-326-75","proprietary_name":"Ciprofloxacin and Dexamethasone","nonproprietary_name":"Ciprofloxacin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (43598-326-75) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"53746083153","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-831-53","proprietary_name":"Ciprofloxacin and Dexamethasone","nonproprietary_name":"Ciprofloxacin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (53746-831-53) / 7.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62756042790","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-427-90","proprietary_name":"Ciprofloxacin and dexamethasone","nonproprietary_name":"Ciprofloxacin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (62756-427-90) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70244003301","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-033-01","proprietary_name":"Ciprofloxacin and dexamethasone","nonproprietary_name":"Ciprofloxacin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"Sentiss Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70244-033-01) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485062513","name":"CIPROFLOX-DEXAMETH OTIC SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-625-13","proprietary_name":"Ciprofloxacin and dexamethasone","nonproprietary_name":"Ciprofloxacin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 1 mg/mL","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-625-13) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":7.12383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950038114","name":"CIPROFLOXACIN 0.2% OTIC SOLN","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-381-14","proprietary_name":"Ciprofloxacin Otic","nonproprietary_name":"Ciprofloxacin","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":".5 mg/.25mL","labeler":"Genus Lifesciences","package_description":"14 VIAL in 1 CARTON (64950-381-14) / .25 mL in 1 VIAL","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":6.35188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ciprofloxacin|Ciprofloxacin","basis":"generic"},"part_b":null}, {"ndc":"61314065605","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-656-05","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-656-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.50392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314065610","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-656-10","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-656-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.79641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314065625","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-656-25","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-656-25) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":3.07806,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315030802","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-308-02","proprietary_name":"ciprofloxacin","nonproprietary_name":"Ciprofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69315-308-02) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":3.07806,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315030805","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-308-05","proprietary_name":"ciprofloxacin","nonproprietary_name":"Ciprofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69315-308-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.50392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315030810","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-308-10","proprietary_name":"ciprofloxacin","nonproprietary_name":"Ciprofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69315-308-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.79641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888010221","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-102-21","proprietary_name":"CIPROFLOXACIN HYDROCHLORIDE","nonproprietary_name":"CIPROFLOXACIN HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Advagen Pharma Limited","package_description":"2.5 mL in 1 BOTTLE (72888-102-21)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":3.07806,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888010222","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-102-22","proprietary_name":"CIPROFLOXACIN HYDROCHLORIDE","nonproprietary_name":"CIPROFLOXACIN HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Advagen Pharma Limited","package_description":"5 mL in 1 BOTTLE (72888-102-22)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.50392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888010223","name":"CIPROFLOXACIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-102-23","proprietary_name":"CIPROFLOXACIN HYDROCHLORIDE","nonproprietary_name":"CIPROFLOXACIN HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Advagen Pharma Limited","package_description":"10 mL in 1 BOTTLE (72888-102-23)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.79641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571041110","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-411-10","proprietary_name":"ciprofloxacin","nonproprietary_name":"ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-411-10)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547068810","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-688-10","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofolxacin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-688-10)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651086601","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-866-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-866-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651097601","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-976-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-976-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022201","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-222-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (61442-222-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135030801","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-308-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-308-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862007601","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-076-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-076-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367038501","name":"CIPROFLOXACIN HCL 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-385-01","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-385-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.0751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ciprofloxacin HCl*|Ciprofloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"00143992801","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9928-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0143-9928-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904724361","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7243-61","proprietary_name":"ciprofloxacin","nonproprietary_name":"ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7243-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904724395","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7243-95","proprietary_name":"ciprofloxacin","nonproprietary_name":"ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0904-7243-95)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107007701","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16252051501","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16252-515-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16252-515-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571041210","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-412-10","proprietary_name":"ciprofloxacin","nonproprietary_name":"ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-412-10)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571041250","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-412-50","proprietary_name":"ciprofloxacin","nonproprietary_name":"ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-412-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547068910","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-689-10","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofolxacin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-689-10)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547068950","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-689-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofolxacin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-689-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651086701","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-867-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-867-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651086705","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-867-05","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-867-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651097701","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-977-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-977-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651097705","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-977-05","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-977-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086001","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-860-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-860-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-860-11)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086011","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687094701","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-947-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-947-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-947-11)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687094711","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022301","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-223-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (61442-223-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022305","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-223-05","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (61442-223-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135030901","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-309-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-309-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135030905","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-309-05","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-309-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135030920","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-309-20","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-309-20)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862007701","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-077-01","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-077-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862007705","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-077-05","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-077-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367038601","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-386-01","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-386-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ciprofloxacin HCl*|Ciprofloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038605","name":"CIPROFLOXACIN HCL 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-386-05","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-386-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.12284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ciprofloxacin HCl*|Ciprofloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"00143992950","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9929-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (0143-9929-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571041305","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-413-05","proprietary_name":"ciprofloxacin","nonproprietary_name":"ciprofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (16571-413-05)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651087350","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-873-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (59651-873-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651097850","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-978-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (59651-978-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022450","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-224-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (61442-224-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135031050","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-310-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Chartwell RX, LLC.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-310-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862007850","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-078-50","proprietary_name":"Ciprofloxacin","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (65862-078-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367038750","name":"CIPROFLOXACIN HCL 750 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-387-50","proprietary_name":"Ciprofloxacin Hydrochloride","nonproprietary_name":"Ciprofloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (69367-387-50)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":0.25021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ciprofloxacin HCl*|Ciprofloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"00713085109","name":"CIPROFLOXACIN-HYDROCORT 0.2-1%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0851-09","proprietary_name":"ciprofloxacin hydrochloride and hydrocortisone","nonproprietary_name":"ciprofloxacin hydrochloride and hydrocortisone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"2 mg/mL; 10 mg/mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (0713-0851-09) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":26.90905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781621870","name":"CIPROFLOXACIN-HYDROCORT 0.2-1%","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6218-70","proprietary_name":"ciprofloxacin hydrochloride and hydrocortisone","nonproprietary_name":"ciprofloxacin hydrochloride and hydrocortisone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"2 mg/mL; 10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (0781-6218-70) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":26.90905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378623101","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6231-01","proprietary_name":"Citalopram","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6231-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378623105","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6231-05","proprietary_name":"Citalopram","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6231-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00904608461","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6084-61","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6084-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668000901","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-009-01","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-009-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668000905","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-009-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-009-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668000909","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-009-09","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"9990 TABLET, FILM COATED in 1 BOTTLE (13668-009-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"65862000501","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-005-01","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-005-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"65862000505","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-005-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-005-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097082207","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-822-07","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-822-07)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097082212","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-822-12","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-822-12)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"76282062810","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-628-10","proprietary_name":"CITALOPRAM HYDROBROMIDE","nonproprietary_name":"CITALOPRAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-628-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"76282062890","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-628-90","proprietary_name":"CITALOPRAM HYDROBROMIDE","nonproprietary_name":"CITALOPRAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-628-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"82009010605","name":"CITALOPRAM HBR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-106-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-106-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00054006258","name":"CITALOPRAM HBR 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0062-58","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0054-0062-58) / 240 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.17955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722056424","name":"CITALOPRAM HBR 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-564-24","proprietary_name":"Citalopram Hydrobromide","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"240 mL in 1 BOTTLE (31722-564-24)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.17955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378623201","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6232-01","proprietary_name":"Citalopram","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6232-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378623205","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6232-05","proprietary_name":"Citalopram","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6232-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00904608561","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6085-61","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6085-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668001001","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-010-01","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-010-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668001005","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-010-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-010-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668001006","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-010-06","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"5600 TABLET, FILM COATED in 1 BOTTLE (13668-010-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"65862000601","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-006-01","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-006-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"65862000605","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-006-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-006-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097082307","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-823-07","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-823-07)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097082312","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-823-12","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-823-12)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"76282062910","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-629-10","proprietary_name":"CITALOPRAM HYDROBROMIDE","nonproprietary_name":"CITALOPRAM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-629-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"76282062990","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-629-90","proprietary_name":"CITALOPRAM HYDROBROMIDE","nonproprietary_name":"CITALOPRAM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-629-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"82009010705","name":"CITALOPRAM HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-107-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-107-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.0296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"52427069130","name":"CITALOPRAM HBR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-691-30","proprietary_name":"citalopram","nonproprietary_name":"citalopram","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE in 1 BOTTLE (52427-691-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.76996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"59651096430","name":"CITALOPRAM HBR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-964-30","proprietary_name":"CITALOPRAM","nonproprietary_name":"CITALOPRAM","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-964-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.76996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378623301","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6233-01","proprietary_name":"Citalopram","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6233-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378623305","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6233-05","proprietary_name":"Citalopram","nonproprietary_name":"citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6233-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668001101","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-011-01","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-011-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668001105","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-011-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-011-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668001108","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-011-08","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"2800 TABLET, FILM COATED in 1 BOTTLE (13668-011-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"65862000701","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-007-01","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-007-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"65862000705","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-007-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-007-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"68645055954","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097082407","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-824-07","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-824-07)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097082412","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-824-12","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-824-12)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"76282020810","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-208-10","proprietary_name":"CITALOPRAM HYDROBROMIDE","nonproprietary_name":"CITALOPRAM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-208-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"76282020890","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-208-90","proprietary_name":"CITALOPRAM HYDROBROMIDE","nonproprietary_name":"CITALOPRAM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-208-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"82009010805","name":"CITALOPRAM HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-108-05","proprietary_name":"Citalopram","nonproprietary_name":"Citalopram Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-108-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Citalopram HBr|Citalopram Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00178082130","name":"CITRANATAL 90 DHA COMBO PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0178-0821-30","proprietary_name":"CitraNatal 90 DHA","nonproprietary_name":"Vitamin C, Calcium, Iron, Vitamin D3, Vitamin E, Thiamin, Riboflavin, Niacinamide, Vitamin B6, Folic Acid, Iodine, Zinc, Copper, Docusate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1; 85 mg/1; 30 [iU]/1; 3 mg/1; 20 mg/1; 20 mg/1; 1 mg/1; 25 mg/1; 2 mg/1; 50 mg/1; 159 mg/1; 4.54 mg/1; 150 ug/1; 5 mg/1; 400 [iU]/1; 3.4 mg/1","labeler":"Mission Pharmacal Company","package_description":"6 BLISTER PACK in 1 CARTON (0178-0821-30) / 5 BLISTER PACK in 1 BLISTER PACK / 5 TABLET in 1 BLISTER PACK","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":1.94143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00178089130","name":"CITRANATAL ASSURE COMBO PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0178-0891-30","proprietary_name":"CitraNatal Assure","nonproprietary_name":"ascorbic acid, calcium citrate, iron, vitamin d, dl- alpha- tocopherol acetate, thiamine, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, iodine, zinc, copper, docusate sodium, doconexent and icosapent","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mission Pharmacal Company","package_description":"30 BLISTER PACK in 1 CARTON (0178-0891-30) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":1.89036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555105456","name":"CLARAVIS 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1054-56","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0555-1054-56) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1054-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105460","name":"CLARAVIS 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105486","name":"CLARAVIS 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1054-86","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0555-1054-86) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1054-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105556","name":"CLARAVIS 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1055-56","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0555-1055-56) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1055-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105560","name":"CLARAVIS 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105586","name":"CLARAVIS 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1055-86","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0555-1055-86) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1055-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105660","name":"CLARAVIS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105686","name":"CLARAVIS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1056-86","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0555-1056-86) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1056-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105756","name":"CLARAVIS 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1057-56","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0555-1057-56) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1057-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105760","name":"CLARAVIS 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"00555105786","name":"CLARAVIS 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-1057-86","proprietary_name":"Claravis","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0555-1057-86) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0555-1057-60)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Claravis|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"78206018801","name":"CLARINEX 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-188-01","proprietary_name":"Clarinex","nonproprietary_name":"Desloratadine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Organon LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (78206-188-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":8.84762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.25755,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clarinex|Desloratadine","basis":"brand"},"part_b":null}, {"ndc":"78206012001","name":"CLARINEX-D 12 HR 2.5-120 MG TB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-120-01","proprietary_name":"CLARINEX-D 12 HOUR","nonproprietary_name":"desloratadine and pseudoephedrine sulfate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 120 mg/1","labeler":"Organon LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (78206-120-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.06832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clarinex-D 12 Hour|Desloratadine/Pseudoephedrine","basis":"brand"},"part_b":null}, {"ndc":"00781602246","name":"CLARITHROMYCIN 125 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6022-46","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6022-46)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.93931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527193106","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1931-06","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lannett Company, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1931-06)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268017811","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268017815","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-178-15","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-178-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-178-11)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004460","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-044-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-044-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135061660","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-616-60","proprietary_name":"CLARITHROMYCIN","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-616-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332034460","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-344-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-344-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380090503","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862022560","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-225-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-225-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73473090960","name":"CLARITHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-909-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (73473-909-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.39391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781602346","name":"CLARITHROMYCIN 250 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6023-46","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Sandoz Inc","package_description":"100 mL in 1 BOTTLE (0781-6023-46)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.34544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781602352","name":"CLARITHROMYCIN 250 MG/5 ML SUS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6023-52","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Sandoz Inc","package_description":"50 mL in 1 BOTTLE (0781-6023-52)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.56592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527193206","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1932-06","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1932-06)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904687204","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6872-04","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6872-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268017911","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268017913","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-179-13","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-179-13) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-179-11)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004560","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-045-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-045-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043511","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043521","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-435-21","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-435-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-435-11)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135061560","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-615-60","proprietary_name":"CLARITHROMYCIN","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (62135-615-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332034560","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-345-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-345-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862022660","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-226-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-226-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68002010402","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68002010404","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68002-104-04","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (68002-104-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68002-104-02)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73473091060","name":"CLARITHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-910-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (73473-910-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.46583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527193006","name":"CLARITHROMYCIN ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1930-06","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0527-1930-06)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.91822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clarithromycin ER|Clarithromycin","basis":"generic"},"part_b":null}, {"ndc":"00591280560","name":"CLARITHROMYCIN ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2805-60","proprietary_name":"clarithromycin","nonproprietary_name":"clarithromycin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-2805-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.91822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clarithromycin ER|Clarithromycin","basis":"generic"},"part_b":null}, {"ndc":"62135088360","name":"CLARITHROMYCIN ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-883-60","proprietary_name":"CLARITHROMYCIN","nonproprietary_name":"CLARITHROMYCIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-883-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.91822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clarithromycin ER|Clarithromycin","basis":"generic"},"part_b":null}, {"ndc":"73473091160","name":"CLARITHROMYCIN ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-911-60","proprietary_name":"Clarithromycin","nonproprietary_name":"Clarithromycin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Solaris Pharma Corporation","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (73473-911-60)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Macrolide Antimicrobial [EPC]","Macrolides [CS]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.91822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clarithromycin ER|Clarithromycin","basis":"generic"},"part_b":null}, {"ndc":"46122001431","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-014-31","proprietary_name":"Good Neighbor Pharmacy ClearLax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Amerisource Bergen","package_description":"119 g in 1 BOTTLE (46122-014-31)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122001433","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-014-33","proprietary_name":"Good Neighbor Pharmacy ClearLax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Amerisource Bergen","package_description":"238 g in 1 BOTTLE (46122-014-33)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122001471","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-014-71","proprietary_name":"Good Neighbor Pharmacy ClearLax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Amerisource Bergen","package_description":"510 g in 1 BOTTLE (46122-014-71)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000041501","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0415-1","proprietary_name":"leader clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"119 g in 1 BOTTLE (70000-0415-1)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000041502","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0415-2","proprietary_name":"leader clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"238 g in 1 BOTTLE (70000-0415-2)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000041503","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0415-3","proprietary_name":"leader clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"510 g in 1 BOTTLE (70000-0415-3)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000070401","name":"CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0704-1","proprietary_name":"Leader ClearLax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"238 g in 1 BOTTLE (70000-0704-1)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122001452","name":"CLEARLAX POWDER PACKET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-014-52","proprietary_name":"Good Neighbor Pharmacy ClearLax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Amerisource Bergen","package_description":"10 PACKET in 1 CARTON (46122-014-52) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64950032412","name":"CLEMASTINE 0.5 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-324-12","proprietary_name":"Clemastine Fumarate","nonproprietary_name":"Clemastine Fumarate","dosage_form":"SYRUP","route":"ORAL","strength":".67 mg/5mL","labeler":"Genus Lifesciences","package_description":"120 mL in 1 BOTTLE (64950-324-12)"},"nadac":{"value":5.49167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950026810","name":"CLEMASTINE FUM 2.68 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-268-10","proprietary_name":"Clemastine Fumarate","nonproprietary_name":"Clemastine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"2.68 mg/1","labeler":"Genus Lifesciences","package_description":"100 TABLET in 1 BOTTLE (64950-268-10)"},"nadac":{"value":3.17751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71085008130","name":"CLEMSZA 2.68 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71085-081-30","proprietary_name":"CLEMSZA","nonproprietary_name":"Clemastine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"2.68 mg/1","labeler":"IPG Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (71085-081-30)"},"nadac":{"value":3.17751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55566680001","name":"CLENPIQ 175 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55566-6800-1","proprietary_name":"CLENPIQ","nonproprietary_name":"SODIUM PICOSULFATE, MAGNESIUM OXIDE, and ANHYDROUS CITRIC ACID","dosage_form":"LIQUID","route":"ORAL","strength":"10 mg/175mL; 3.5 g/175mL; 12 g/175mL","labeler":"Ferring Pharmaceuticals Inc.","package_description":"2 BOTTLE in 1 CARTON (55566-6800-1) / 175 mL in 1 BOTTLE (55566-6800-0)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.51785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Clenpiq|Sod Picosulf/Mag Ox/Citric Ac","basis":"brand"},"part_b":null}, {"ndc":"00009766705","name":"CLEOCIN 100 MG VAGINAL OVULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-7667-05","proprietary_name":"Cleocin","nonproprietary_name":"clindamycin phosphate","dosage_form":"SUPPOSITORY","route":"VAGINAL","strength":"100 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 BLISTER PACK in 1 CARTON (0009-7667-05) / 3 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":60.17905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00009344801","name":"CLEOCIN 2% VAGINAL CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-3448-01","proprietary_name":"Cleocin","nonproprietary_name":"clindamycin phosphate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0009-3448-01) / 40 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.79228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":1.85916,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"50419045401","name":"CLIMARA 0.025 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.22764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.75493,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045404","name":"CLIMARA 0.025 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-454-04","proprietary_name":"Climara","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-454-04) / 7 d in 1 PATCH (50419-454-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.22764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.75493,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045601","name":"CLIMARA 0.0375 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.29817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.93041,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045604","name":"CLIMARA 0.0375 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-456-04","proprietary_name":"Climara","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-456-04) / 7 d in 1 PATCH (50419-456-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.29817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.93041,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045101","name":"CLIMARA 0.05 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.25678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.28267,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045104","name":"CLIMARA 0.05 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-451-04","proprietary_name":"Climara","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-451-04) / 7 d in 1 PATCH (50419-451-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.25678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.28267,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045901","name":"CLIMARA 0.06 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.14596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":12.25248,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045904","name":"CLIMARA 0.06 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-459-04","proprietary_name":"Climara","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".06 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-459-04) / 7 d in 1 PATCH (50419-459-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.14596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":12.25248,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045301","name":"CLIMARA 0.075 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.25087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":13.05876,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045304","name":"CLIMARA 0.075 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-453-04","proprietary_name":"Climara","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-453-04) / 7 d in 1 PATCH (50419-453-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.25087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":13.05876,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045201","name":"CLIMARA 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.27935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":12.76731,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419045204","name":"CLIMARA 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-452-04","proprietary_name":"Climara","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-452-04) / 7 d in 1 PATCH (50419-452-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.27935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":12.76731,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419049104","name":"CLIMARA PRO PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-491-04","proprietary_name":"Climara Pro","nonproprietary_name":"Estradiol and Levonorgestrel","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".045 mg/d; .015 mg/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-491-04) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":59.6446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Climara Pro|Estradiol/Levonorgestrel","basis":"brand"},"part_b":null}, {"ndc":"21922007440","name":"CLIND PH-BENZOYL PERO 1.2-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-074-40","proprietary_name":"CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE","nonproprietary_name":"CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (21922-074-40) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.81911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802059701","name":"CLIND PH-BENZOYL PERO 1.2-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-597-01","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate, Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"25 mg/g; 10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, PUMP in 1 CARTON (45802-597-01) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.81911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136703","name":"CLIND PH-BENZOYL PERO 1.2-2.5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1367-3","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1367-3) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.81911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002206","name":"CLIND PH-BENZOYL PEROX 1.2-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-022-06","proprietary_name":"CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE","nonproprietary_name":"CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-022-06) / 45 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.4106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802073684","name":"CLIND PH-BENZOYL PEROX 1.2-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-736-84","proprietary_name":"clindamycin phosphate and benzoyl peroxide","nonproprietary_name":"Clindamycin, Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-736-84) / 45 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.4106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136606","name":"CLIND PH-BENZOYL PEROX 1.2-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1366-6","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1366-6) / 45 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.4106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70710144504","name":"CLIND PH-BENZOYL PEROX 1.2-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1445-4","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 TUBE in 1 CARTON (70710-1445-4) / 45 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.4106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603032201","name":"CLIND PH-BENZOYL PEROX 1.2-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-322-01","proprietary_name":"CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE","nonproprietary_name":"CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CARTON (72603-322-01) / 45 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.4106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472179030","name":"CLINDA-TRETINOIN 1.2%-0.025%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-1790-30","proprietary_name":"Clindamycin Phosphate and Tretinoin","nonproprietary_name":"Clindamycin Phosphate and Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":"12 mg/g; .25 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-1790-30) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.31193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clindamycin Phos-Tretinoin|Clindamycin/Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00472179060","name":"CLINDA-TRETINOIN 1.2%-0.025%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-1790-60","proprietary_name":"Clindamycin Phosphate and Tretinoin","nonproprietary_name":"Clindamycin Phosphate and Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":"12 mg/g; .25 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-1790-60) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.50632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clindamycin Phos-Tretinoin|Clindamycin/Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922005005","name":"CLINDA-TRETINOIN 1.2%-0.025%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-050-05","proprietary_name":"Clindamycin Phosphate and Tretinoin Gel 1.2%/0.025%","nonproprietary_name":"Clindamycin Phosphate and Tretinoin Gel 1.2%/0.025%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; .25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-050-05) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.31193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922005007","name":"CLINDA-TRETINOIN 1.2%-0.025%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-050-07","proprietary_name":"Clindamycin Phosphate and Tretinoin Gel 1.2%/0.025%","nonproprietary_name":"Clindamycin Phosphate and Tretinoin Gel 1.2%/0.025%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; .25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-050-07) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.50632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"73473030630","name":"CLINDA-TRETINOIN 1.2%-0.025%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-306-30","proprietary_name":"Clindamycin Phosphate and Tretinoin","nonproprietary_name":"clindamycin phosphate and tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; .25 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-306-30) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.31193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clindamycin Phos-Tretinoin|Clindamycin/Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"73473030660","name":"CLINDA-TRETINOIN 1.2%-0.025%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-306-60","proprietary_name":"Clindamycin Phosphate and Tretinoin","nonproprietary_name":"clindamycin phosphate and tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; .25 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-306-60) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.50632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clindamycin Phos-Tretinoin|Clindamycin/Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"43538017910","name":"CLINDACIN 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43538-179-10","proprietary_name":"Clindacin","nonproprietary_name":"clindamycin phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Medimetriks Pharmaceuticals, Inc.","package_description":"1 CAN in 1 CARTON (43538-179-10) / 100 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.83049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clindacin|Clindamycin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"45802038301","name":"CLINDAMYC-BNZ PEROX 1.2-3.75%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-383-01","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 37.5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"50 g in 1 BOTTLE, PUMP (45802-383-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":2.344,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672140304","name":"CLINDAMYC-BNZ PEROX 1.2-3.75%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1403-4","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"50 g in 1 BOTTLE, PUMP (51672-1403-4)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":2.344,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308012750","name":"CLINDAMYC-BNZ PEROX 1.2-3.75%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-127-50","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 37.5 mg/g","labeler":"Mayne Pharma","package_description":"50 g in 1 BOTTLE, PUMP (68308-127-50)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":2.344,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714048301","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-483-01","proprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","nonproprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","dosage_form":"SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (16714-483-01) / 100 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714048302","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-483-02","proprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","nonproprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","dosage_form":"SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (16714-483-02) / 100 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155060351","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-603-51","proprietary_name":"clindamycin palmitate hydrochloride","nonproprietary_name":"clindamycin palmitate hydrochloride","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (23155-603-51) / 100 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Clindamycin (Pediatric)|Clindamycin Palmitate HCl","basis":"generic"},"part_b":null}, {"ndc":"53746046819","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-468-19","proprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","nonproprietary_name":"Clindamycin Palmitate Hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 BOTTLE in 1 CARTON (53746-468-19) / 100 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Clindamycin (Pediatric)|Clindamycin Palmitate HCl","basis":"generic"},"part_b":null}, {"ndc":"64980051110","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-511-10","proprietary_name":"CLINDAMYCIN PALMITATE HYDROCHLORIDE (Pediatric)","nonproprietary_name":"CLINDAMYCIN PALMITATE HYDROCHLORIDE","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 BOTTLE (64980-511-10)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Clindamycin (Pediatric)|Clindamycin Palmitate HCl","basis":"generic"},"part_b":null}, {"ndc":"65162046819","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862059601","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-596-01","proprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","nonproprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","dosage_form":"SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-596-01) / 100 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862059602","name":"CLINDAMYCIN (PEDI) 75 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-596-02","proprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","nonproprietary_name":"Clindamycin Palmitate Hydrochloride (Pediatric)","dosage_form":"SOLUTION","route":"ORAL","strength":"75 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (65862-596-02) / 100 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.12876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168027740","name":"CLINDAMYCIN 2% VAGINAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0277-40","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"40 g in 1 TUBE, WITH APPLICATOR (0168-0277-40)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.85916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59762500901","name":"CLINDAMYCIN 2% VAGINAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5009-1","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-5009-1) / 40 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.85916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904595961","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5959-61","proprietary_name":"Clindamycin hydrochloride","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5959-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"42571025101","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-251-01","proprietary_name":"CLINDAMYCIN HYDROCHLORIDE","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-251-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"59762332801","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135076501","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-765-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Chartwell RX, LLC","package_description":"100 CAPSULE in 1 BOTTLE (62135-765-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"63304069201","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-692-01","proprietary_name":"Clindamycin hydrochloride","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (63304-692-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"63304069205","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-692-05","proprietary_name":"Clindamycin hydrochloride","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (63304-692-05)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862018501","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-185-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-185-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862018505","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-185-05","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-185-05)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084024301","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-243-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-243-01) / 1 CAPSULE in 1 BLISTER PACK (68084-243-11)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084024311","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462014301","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-143-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-143-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462014305","name":"CLINDAMYCIN HCL 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-143-05","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"500 CAPSULE in 1 BOTTLE (68462-143-05)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904719461","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7194-61","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7194-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"42571025201","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-252-01","proprietary_name":"CLINDAMYCIN HYDROCHLORIDE","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-252-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268018511","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268018515","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-185-15","proprietary_name":"CLINDAMYCIN HYDROCHLORIDE","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-185-15) / 1 CAPSULE in 1 BLISTER PACK (50268-185-11)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135076601","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-766-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"100 CAPSULE in 1 BOTTLE (62135-766-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"63304069301","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-693-01","proprietary_name":"Clindamycin hydrochloride","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (63304-693-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862018601","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-186-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-186-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084024401","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-244-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-244-01) / 1 CAPSULE in 1 BLISTER PACK (68084-244-11)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084024411","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462014401","name":"CLINDAMYCIN HCL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-144-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-144-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.17458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"42571025001","name":"CLINDAMYCIN HCL 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-250-01","proprietary_name":"CLINDAMYCIN HYDROCHLORIDE","nonproprietary_name":"Clindamycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-250-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.25869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135076401","name":"CLINDAMYCIN HCL 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-764-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"100 CAPSULE in 1 BOTTLE (62135-764-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.25869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462014201","name":"CLINDAMYCIN HCL 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-142-01","proprietary_name":"Clindamycin Hydrochloride","nonproprietary_name":"Clindamycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-142-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.25869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clindamycin HCl|Clindamycin HCl","basis":"generic"},"part_b":null}, {"ndc":"00168020230","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0202-30","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0202-30) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168020260","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0202-60","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0202-60) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714016101","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-161-01","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-161-01) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714016102","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-161-02","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-161-02) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002705","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-027-05","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate Gel USP, 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-027-05) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002707","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-027-07","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate Gel USP, 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-027-07) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802090094","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-900-94","proprietary_name":"CLINDAMYCIN PHOSPHATE","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-900-94) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802090096","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-900-96","proprietary_name":"CLINDAMYCIN PHOSPHATE","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-900-96) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672139902","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1399-2","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1399-2) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672139903","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1399-3","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1399-3) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59762374301","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3743-1","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-3743-1) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59762374302","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3743-2","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-3743-2) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332062330","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-623-30","proprietary_name":"CLINDAMYCIN PHOSPHATE","nonproprietary_name":"CLINDAMYCIN PHOSPHATE","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-623-30) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332062360","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-623-60","proprietary_name":"CLINDAMYCIN PHOSPHATE","nonproprietary_name":"CLINDAMYCIN PHOSPHATE","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-623-60) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462086635","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-866-35","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 TUBE in 1 CARTON (68462-866-35) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462086665","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-866-65","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 TUBE in 1 CARTON (68462-866-65) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578011801","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-118-01","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-118-01) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578011802","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-118-02","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-118-02) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"73473030030","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-300-30","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-300-30) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"73473030060","name":"CLINDAMYCIN PH 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-300-60","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-300-60) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.13074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168020130","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0201-30","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (0168-0201-30) / 30 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168020160","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0201-60","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (0168-0201-60) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922000201","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-002-01","proprietary_name":"Clindamycin Phoaphate Topical Solution USP, 1%","nonproprietary_name":"Clindamycin Phosphate Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-002-01) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922000221","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-002-21","proprietary_name":"Clindamycin Phoaphate Topical Solution USP, 1%","nonproprietary_name":"Clindamycin Phosphate Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-002-21) / 30 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802056201","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-562-01","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (45802-562-01) / 30 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802056202","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-562-02","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (45802-562-02) / 60 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802056230","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-562-30","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 mL in 1 BOTTLE, WITH APPLICATOR (45802-562-30)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802056260","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-562-60","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 mL in 1 BOTTLE, WITH APPLICATOR (45802-562-60)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672408103","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4081-3","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (51672-4081-3) / 30 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672408104","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4081-4","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (51672-4081-4) / 60 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72578008402","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-084-02","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (72578-084-02) / 30 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72578008403","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-084-03","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (72578-084-03) / 60 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603032101","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-321-01","proprietary_name":"Clindamycin Phoaphate Topical Solution USP, 1%","nonproprietary_name":"Clindamycin Phosphate Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Northstar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (72603-321-01) / 30 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.1788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603032102","name":"CLINDAMYCIN PH 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-321-02","proprietary_name":"Clindamycin Phoaphate Topical Solution USP, 1%","nonproprietary_name":"Clindamycin Phosphate Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Northstar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (72603-321-02) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.14989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571025660","name":"CLINDAMYCIN PHOS 1% PLEDGET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-256-60","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 APPLICATOR in 1 JAR (16571-256-60) / 1 mL in 1 APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.28544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802026337","name":"CLINDAMYCIN PHOS 1% PLEDGET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-263-37","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 APPLICATOR in 1 JAR (45802-263-37) / 1 mL in 1 APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.28544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72319069660","name":"CLINDAMYCIN PHOS 1% PLEDGET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-696-60","proprietary_name":"Clindamycin phosphate","nonproprietary_name":"Clindamycin phosphate topical","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 APPLICATOR in 1 JAR (72319-696-60) / 1 mL in 1 APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.28544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"80005013109","name":"CLINDAMYCIN PHOS 1% PLEDGET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-131-09","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate Topical","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Carnegie Pharmaceuticals, LLC","package_description":"60 APPLICATOR in 1 JAR (80005-131-09) / 1 mL in 1 APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.28544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00168020360","name":"CLINDAMYCIN PHOSP 1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0203-60","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (0168-0203-60) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.24475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714024601","name":"CLINDAMYCIN PHOSP 1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-246-01","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 ug/mL","labeler":"NORTHSTAR RX LLC","package_description":"1 BOTTLE in 1 CARTON (16714-246-01) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.24475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922003601","name":"CLINDAMYCIN PHOSP 1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-036-01","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 ug/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-036-01) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.24475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802012801","name":"CLINDAMYCIN PHOSP 1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-128-01","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 mL in 1 BOTTLE (45802-128-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.24475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672140004","name":"CLINDAMYCIN PHOSP 1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1400-4","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1400-4) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.24475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762374401","name":"CLINDAMYCIN PHOSP 1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3744-1","proprietary_name":"clindamycin phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-3744-1) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.24475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802066032","name":"CLINDAMYCIN PHOSPHATE 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-660-32","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-660-32) / 50 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":2.20962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802066033","name":"CLINDAMYCIN PHOSPHATE 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-660-33","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-660-33) / 100 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.83049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672419403","name":"CLINDAMYCIN PHOSPHATE 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4194-3","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 CARTON (51672-4194-3) / 50 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":2.20962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672419407","name":"CLINDAMYCIN PHOSPHATE 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4194-7","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 CARTON (51672-4194-7) / 100 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.83049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462060527","name":"CLINDAMYCIN PHOSPHATE 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-605-27","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 CAN in 1 CARTON (68462-605-27) / 50 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":2.20962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462060594","name":"CLINDAMYCIN PHOSPHATE 1% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-605-94","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"10 mg/g","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 CAN in 1 CARTON (68462-605-94) / 100 g in 1 CAN","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.83049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238203107","name":"CLINDAMYCIN PHOSPHATE 1% GEL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2031-7","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"Clindamycin Phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"1 g/100mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-2031-7) / 75 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":3.40149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72336011275","name":"CLINDAMYCIN PHOSPHATE 1% GEL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.40149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73473030275","name":"CLINDAMYCIN PHOSPHATE 1% GEL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-302-75","proprietary_name":"Clindamycin Phosphate","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"TOPICAL","strength":"1 g/10mL","labeler":"Solaris Pharma Corporation","package_description":"1 BOTTLE in 1 CARTON (73473-302-75) / 75 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":3.40149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378868835","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8688-35","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"clindamycin phosphate and benzoyl peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 KIT in 1 CARTON (0378-8688-35) * 5 g in 1 BOTTLE, PLASTIC * 20 g in 1 JAR"},"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378868854","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8688-54","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"clindamycin phosphate and benzoyl peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 KIT in 1 CARTON (0378-8688-54) * 10 g in 1 BOTTLE, PLASTIC * 40 g in 1 JAR"},"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098425","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-984-25","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"NorthStar RxLLC","package_description":"1 JAR in 1 CARTON (16714-984-25) / 25 g in 1 JAR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098450","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-984-50","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"NorthStar RxLLC","package_description":"1 JAR in 1 CARTON (16714-984-50) / 50 g in 1 JAR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006843","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-068-43","proprietary_name":"Clindamycin and Benzoyl Peroxide","nonproprietary_name":"Clindamycin and Benzoyl Peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Encube Ethicals, Inc.","package_description":"1 KIT in 1 CARTON (21922-068-43) * 20 g in 1 JAR (21922-067-62) * 40 g in 1 JAR (21922-067-41) * 28 g in 1 BOTTLE, PUMP (21922-067-39) * 40 g in 1 BOTTLE, PUMP (21922-067-42) * 10 g in 1 BOTTLE (21922-066-12) * 7 g in 1 BOTTLE (21922-066-37) * 5 g in 1 BOTTLE (21922-066-36)"},"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006845","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-068-45","proprietary_name":"Clindamycin and Benzoyl Peroxide","nonproprietary_name":"Clindamycin and Benzoyl Peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Encube Ethicals, Inc.","package_description":"1 KIT in 1 CARTON (21922-068-45) * 20 g in 1 JAR (21922-067-62) * 40 g in 1 JAR (21922-067-41) * 28 g in 1 BOTTLE, PUMP (21922-067-39) * 40 g in 1 BOTTLE, PUMP (21922-067-42) * 10 g in 1 BOTTLE (21922-066-12) * 7 g in 1 BOTTLE (21922-066-37) * 5 g in 1 BOTTLE (21922-066-36)"},"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802050702","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-507-02","proprietary_name":"CLINDAMYCIN AND BENZOYL PEROXIDE","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 KIT in 1 CARTON (45802-507-02) * .6 g in 1 VIAL * 39.4 g in 1 JAR"},"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802050901","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-509-01","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 KIT in 1 CARTON (45802-509-01) * .3 g in 1 VIAL (45802-737-01) * 19.7 g in 1 JAR (45802-997-01)"},"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802099602","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802099701","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138102","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1381-2","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin and Benzoyl Peroxide Gel","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 KIT in 1 CARTON (51672-1381-2) * 5 g in 1 BOTTLE, PLASTIC (51672-1382-1) * 20 g in 1 JAR"},"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138104","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1381-4","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin and Benzoyl Peroxide Gel","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 KIT in 1 CARTON (51672-1381-4) * 10 g in 1 BOTTLE, PLASTIC (51672-1382-2) * 40 g in 1 JAR"},"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462048619","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-486-19","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 JAR in 1 CARTON (68462-486-19) / 25 g in 1 JAR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.7423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462048627","name":"CLINDAMYCIN-BENZOYL PEROX 1-5%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-486-27","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 JAR in 1 CARTON (68462-486-27) / 50 g in 1 JAR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.50073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802050704","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-507-04","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 KIT in 1 CARTON (45802-507-04) * .6 g in 1 VIAL * 39.4 g in 1 BOTTLE, PUMP"},"nadac":{"value":0.90109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802051003","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-510-03","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"KIT","route":null,"strength":null,"labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 KIT in 1 CARTON (45802-510-03) * .4 g in 1 VIAL (45802-738-03) * 27.6 g in 1 BOTTLE, PUMP (45802-998-03)"},"nadac":{"value":1.12784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138105","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1381-5","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin and Benzoyl Peroxide Gel","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 KIT in 1 CARTON (51672-1381-5) * 7 g in 1 BOTTLE, PLASTIC (51672-1382-3) * 28 g in 1 BOTTLE, PUMP"},"nadac":{"value":1.12784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138106","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1381-6","proprietary_name":"Clindamycin Phosphate and Benzoyl Peroxide","nonproprietary_name":"Clindamycin and Benzoyl Peroxide Gel","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 KIT in 1 CARTON (51672-1381-6) * 10 g in 1 BOTTLE, PLASTIC (51672-1382-2) * 40 g in 1 BOTTLE, PUMP"},"nadac":{"value":0.90109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462085824","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.12784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462085827","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.90109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462085924","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-859-24","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE, PUMP in 1 CARTON (68462-859-24) / 35 g in 1 BOTTLE, PUMP","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":1.12784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462085927","name":"CLINDAMYCIN-BNZ PEROX 1-5% PMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-859-27","proprietary_name":"clindamycin and benzoyl peroxide","nonproprietary_name":"clindamycin and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g; 50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE, PUMP in 1 CARTON (68462-859-27) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":0.90109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004201","name":"CLINDESSE 2% VAGINAL CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-042-01","proprietary_name":"Clindesse","nonproprietary_name":"clindamycin phosphate","dosage_form":"CREAM","route":"VAGINAL","strength":"100 mg/5g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 APPLICATOR in 1 CARTON (45802-042-01) / 5 g in 1 APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":26.6211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clindesse|Clindamycin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00832058011","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0580-11","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0580-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714088701","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-887-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-887-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571031501","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-315-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-315-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687042311","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687042321","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-423-21","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-423-21) / 1 TABLET in 1 BLISTER PACK (60687-423-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877066501","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-665-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CARTON in 1 CONTAINER (67877-665-01) / 1 TABLET in 1 CARTON","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180015701","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-157-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-157-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238130501","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1305-1","proprietary_name":"CLOBAZAM","nonproprietary_name":"CLOBAZAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1305-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205004791","name":"CLOBAZAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-047-91","proprietary_name":"CLOBAZAM","nonproprietary_name":"CLOBAZAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-047-91) / 100 TABLET in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714008701","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-087-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (16714-087-01) / 120 mL in 1 BOTTLE, GLASS","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672422708","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4227-8","proprietary_name":"Clobazam","nonproprietary_name":"clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"120 mL in 1 BOTTLE (51672-4227-8)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651040112","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-401-12","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-401-12) / 120 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135052741","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-527-41","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Chartwell RX, LLC","package_description":"120 mL in 1 BOTTLE (62135-527-41)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877065861","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-658-61","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (67877-658-61) / 120 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238153502","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1535-2","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (69238-1535-2) / 120 mL in 1 BOTTLE, GLASS","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452011645","name":"CLOBAZAM 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-116-45","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Bionpharma Inc.","package_description":"1 BOTTLE in 1 CARTON (69452-116-45) / 120 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832058111","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0581-11","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0581-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714088801","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-888-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-888-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571031601","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-316-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-316-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877066601","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-666-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CARTON in 1 CONTAINER (67877-666-01) / 1 TABLET in 1 CARTON","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180015801","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-158-01","proprietary_name":"Clobazam","nonproprietary_name":"Clobazam","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-158-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238130601","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1306-1","proprietary_name":"CLOBAZAM","nonproprietary_name":"CLOBAZAM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1306-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205004891","name":"CLOBAZAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-048-91","proprietary_name":"CLOBAZAM","nonproprietary_name":"CLOBAZAM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-048-91) / 100 TABLET in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00168016315","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0163-15","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.","package_description":"15 g in 1 TUBE (0168-0163-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168016330","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0163-30","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.","package_description":"30 g in 1 TUBE (0168-0163-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668056901","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-569-01","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"15 g in 1 TUBE (13668-569-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668056902","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-569-02","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 g in 1 TUBE (13668-569-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668056904","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-569-04","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"45 g in 1 TUBE (13668-569-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668056905","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-569-05","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 g in 1 TUBE (13668-569-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001604","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-016-04","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"15 g in 1 TUBE (21922-016-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001605","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-016-05","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"30 g in 1 TUBE (21922-016-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001606","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-016-06","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"45 g in 1 TUBE (21922-016-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001607","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-016-07","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"60 g in 1 TUBE (21922-016-07)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125801","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1258-1","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1258-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125802","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1258-2","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1258-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125803","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1258-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1258-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125806","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1258-6","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1258-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332054715","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-547-15","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-547-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332054730","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-547-30","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-547-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332054745","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-547-45","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-547-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332054760","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-547-60","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-547-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180095601","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-956-01","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-956-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180095602","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-956-02","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-956-02) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180095603","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-956-03","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-956-03) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180095604","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-956-04","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-956-04) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153203","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1532-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (69238-1532-3) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153204","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1532-4","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (69238-1532-4) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153205","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1532-5","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (69238-1532-5) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153206","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1532-6","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (69238-1532-6) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010915","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-109-15","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"1 TUBE in 1 CARTON (70700-109-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010916","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-109-16","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"1 TUBE in 1 CARTON (70700-109-16) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010917","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-109-17","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"1 TUBE in 1 CARTON (70700-109-17) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010918","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-109-18","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"1 TUBE in 1 CARTON (70700-109-18) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603032301","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-323-01","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC","package_description":"15 g in 1 TUBE (72603-323-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603032302","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-323-02","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC","package_description":"30 g in 1 TUBE (72603-323-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.16675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603032303","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-323-03","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC","package_description":"45 g in 1 TUBE (72603-323-03)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603032304","name":"CLOBETASOL 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-323-04","proprietary_name":"Clobetasol Propionate Cream USP, 0.05% Clobetasol Propionate Cream USP, 0.05%","nonproprietary_name":"Clobetasol Propionate Cream USP, 0.05%","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC","package_description":"60 g in 1 TUBE (72603-323-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802092514","name":"CLOBETASOL 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-925-14","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol propionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-925-14) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.86248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802092594","name":"CLOBETASOL 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-925-94","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol propionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-925-94) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802092596","name":"CLOBETASOL 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-925-96","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol propionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-925-96) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129401","name":"CLOBETASOL 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1294-1","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1294-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.86248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129402","name":"CLOBETASOL 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1294-2","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1294-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129403","name":"CLOBETASOL 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1294-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1294-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.46115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065615","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0656-15","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0656-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065631","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0656-31","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0656-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065637","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0656-37","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0656-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065660","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0656-60","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0656-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001704","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-017-04","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate Ointment USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-017-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001705","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-017-05","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate Ointment USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-017-05) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001706","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-017-06","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate Ointment USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-017-06) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001707","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-017-07","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate Ointment USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-017-07) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342050615","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-506-15","proprietary_name":"Clobetasol Propionate ANDA","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-506-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342050630","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-506-30","proprietary_name":"Clobetasol Propionate ANDA","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-506-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342050645","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-506-45","proprietary_name":"Clobetasol Propionate ANDA","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-506-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342050660","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-506-60","proprietary_name":"Clobetasol Propionate ANDA","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-506-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43386009660","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-096-60","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 TUBE in 1 CARTON (43386-096-60) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43386009661","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-096-61","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 TUBE in 1 CARTON (43386-096-61) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43386009662","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-096-62","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 TUBE in 1 CARTON (43386-096-62) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43386009663","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-096-63","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 TUBE in 1 CARTON (43386-096-63) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125901","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1259-1","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1259-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125902","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1259-2","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1259-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125903","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1259-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1259-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125906","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1259-6","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1259-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651073214","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-732-14","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-732-14) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651073230","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-732-30","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-732-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651073246","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-732-46","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-732-46) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651073260","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-732-60","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-732-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332046515","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-465-15","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-465-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332046530","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-465-30","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-465-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332046545","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-465-45","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-465-45) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332046560","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-465-60","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-465-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010615","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-106-15","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"15 g in 1 TUBE (70700-106-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010616","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-106-16","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"30 g in 1 TUBE (70700-106-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010617","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-106-17","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"60 g in 1 TUBE (70700-106-17)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700010618","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-106-18","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Xiromed, LLC","package_description":"45 g in 1 TUBE (70700-106-18)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603085501","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-855-01","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (72603-855-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603085502","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-855-02","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (72603-855-02) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603085503","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-855-03","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (72603-855-03) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603085504","name":"CLOBETASOL 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-855-04","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (72603-855-04) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472040394","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714003001","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-030-01","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".05 g/100mL","labeler":"NORTHSTAR RX LLC","package_description":"1 BOTTLE in 1 CARTON (16714-030-01) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802096126","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-961-26","proprietary_name":"clobetasol propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".05 g/100mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"118 mL in 1 BOTTLE (45802-961-26)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672134708","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1347-8","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".05 g/100mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1347-8) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332054804","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-548-04","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".05 g/100mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-548-04) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68308066404","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-664-04","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".05 g/100mL","labeler":"Mayne Pharma Inc.","package_description":"1 BOTTLE in 1 CARTON (68308-664-04) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238173208","name":"CLOBETASOL 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1732-8","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".05 g/100mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1732-8) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168026950","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0269-50","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"50 mL in 1 BOTTLE, PLASTIC (0168-0269-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922006122","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-061-22","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-061-22) / 25 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922006127","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-061-27","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-061-27) / 50 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"33342032186","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-321-86","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".4625 mg/mL","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BOTTLE in 1 CARTON (33342-321-86) / 50 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571036281","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-362-81","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-362-81) / 25 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571036299","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-362-99","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-362-99) / 50 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672129302","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1293-2","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-1293-2) / 25 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672129303","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1293-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-1293-3) / 50 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332048625","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-486-25","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-486-25) / 25 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332048650","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-486-50","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-486-50) / 50 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752015304","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-153-04","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Quagen Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (70752-153-04) / 50 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752015320","name":"CLOBETASOL 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-153-20","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"clobetasol propionate","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Quagen Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (70752-153-20) / 25 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00472040492","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0404-92","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".05 g/100mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (0472-0404-92) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00472040494","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0404-94","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".05 g/100mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (0472-0404-94) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135004","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1350-4","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1350-4) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135008","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1350-8","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1350-8) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180053601","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-536-01","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".05 g/100mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-536-01) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180053602","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-536-02","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".05 g/100mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-536-02) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72578008501","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-085-01","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".05 g/100mL","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE in 1 CARTON (72578-085-01) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72578008502","name":"CLOBETASOL 0.05% TOPICAL LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-085-02","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".05 g/100mL","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE in 1 CARTON (72578-085-02) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672129701","name":"CLOBETASOL EMOLLIENT 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1297-1","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1297-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129702","name":"CLOBETASOL EMOLLIENT 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1297-2","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1297-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.68023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129703","name":"CLOBETASOL EMOLLIENT 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1297-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1297-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.56058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83148006415","name":"CLOBETASOL EMOLLIENT 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83148-064-15","proprietary_name":"Clobetasol Propionate (emollient)","nonproprietary_name":"clobetasol propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"The J. Molner Company LLC","package_description":"1 TUBE in 1 CARTON (83148-064-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83148006430","name":"CLOBETASOL EMOLLIENT 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83148-064-30","proprietary_name":"Clobetasol Propionate (emollient)","nonproprietary_name":"clobetasol propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"The J. Molner Company LLC","package_description":"1 TUBE in 1 CARTON (83148-064-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.68023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83148006460","name":"CLOBETASOL EMOLLIENT 0.05% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83148-064-60","proprietary_name":"Clobetasol Propionate (emollient)","nonproprietary_name":"clobetasol propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"The J. Molner Company LLC","package_description":"1 TUBE in 1 CARTON (83148-064-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.56058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802063732","name":"CLOBETASOL EMOLLNT 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-637-32","proprietary_name":"clobetasol propionate emollient formulation","nonproprietary_name":"clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-637-32) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.23631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802063733","name":"CLOBETASOL EMOLLNT 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-637-33","proprietary_name":"clobetasol propionate emollient formulation","nonproprietary_name":"clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-637-33) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.78921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462062527","name":"CLOBETASOL EMULSION 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-625-27","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"50 g in 1 CAN (68462-625-27)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.23631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462062594","name":"CLOBETASOL EMULSION 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-625-94","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 g in 1 CAN (68462-625-94)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.78921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802043732","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-437-32","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-437-32) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.40496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802043733","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-437-33","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CAN in 1 CARTON (45802-437-33) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672419303","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4193-3","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 CARTON (51672-4193-3) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.40496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672419307","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4193-7","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 CARTON (51672-4193-7) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332070731","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-707-31","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CAN in 1 CARTON (62332-707-31) / 100 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332070750","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-707-50","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CAN in 1 CARTON (62332-707-50) / 50 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.40496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462060827","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-608-27","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"50 g in 1 CAN (68462-608-27)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.40496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462060894","name":"CLOBETASOL PROP 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-608-94","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 g in 1 CAN (68462-608-94)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672137104","name":"CLOBETASOL PROP 0.05% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1371-4","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SPRAY","route":"TOPICAL","strength":".05 g/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1371-4) / 59 mL in 1 BOTTLE, PUMP","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672137108","name":"CLOBETASOL PROP 0.05% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1371-8","proprietary_name":"Clobetasol Propionate","nonproprietary_name":"Clobetasol Propionate","dosage_form":"SPRAY","route":"TOPICAL","strength":".05 g/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1371-8) / 125 mL in 1 BOTTLE, PUMP","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332042512","name":"CLOBETASOL PROP 0.05% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-425-12","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"SPRAY","route":"TOPICAL","strength":".05 g/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-425-12) / 125 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332042559","name":"CLOBETASOL PROP 0.05% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-425-59","proprietary_name":"CLOBETASOL PROPIONATE","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"SPRAY","route":"TOPICAL","strength":".05 g/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-425-59) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68382099801","name":"CLOBETASOL PROP 0.05% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-998-01","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"SPRAY","route":"TOPICAL","strength":".05 g/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (68382-998-01) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68382099802","name":"CLOBETASOL PROP 0.05% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-998-02","proprietary_name":"clobetasol propionate","nonproprietary_name":"clobetasol propionate","dosage_form":"SPRAY","route":"TOPICAL","strength":".05 g/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (68382-998-02) / 125 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43538095004","name":"CLODAN 0.05% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43538-950-04","proprietary_name":"Clodan","nonproprietary_name":"clobetasol propionate","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".5 mg/mL","labeler":"Medimetriks Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (43538-950-04) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Clodan|Clobetasol Propionate","basis":"brand"},"part_b":null}, {"ndc":"00713088509","name":"CLOMID 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0885-09","proprietary_name":"Clomid","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0713-0885-09) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":16.74327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-12","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomid|Clomiphene Citrate","basis":"brand"},"part_b":null}, {"ndc":"00713088530","name":"CLOMID 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0885-30","proprietary_name":"Clomid","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0713-0885-30) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":16.74327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-12","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomid|Clomiphene Citrate","basis":"brand"},"part_b":null}, {"ndc":"16729072344","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"16729072351","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-723-51","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1 BLISTER PACK in 1 CARTON (16729-723-51) / 30 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"64980069001","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-690-01","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrtae","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"10 TABLET in 1 BOTTLE (64980-690-01)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980069003","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-690-03","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrtae","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"30 TABLET in 1 BOTTLE (64980-690-03)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980069090","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-690-90","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrtae","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"1 BLISTER PACK in 1 CARTON (64980-690-90) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954082520","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-825-20","proprietary_name":"Clomiphene citrate","nonproprietary_name":"Clomiphene citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (70954-825-20) / 1 TABLET in 1 BLISTER PACK (70954-825-10)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"70954082530","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-825-30","proprietary_name":"Clomiphene citrate","nonproprietary_name":"Clomiphene citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (70954-825-30) / 1 TABLET in 1 BLISTER PACK (70954-825-10)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888021308","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-213-08","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1 BLISTER PACK in 1 CARTON (72888-213-08) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888021358","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-213-58","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"3 BLISTER PACK in 1 CARTON (72888-213-58) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"83390010709","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83390-107-09","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cosette Pharmaceuticals NC Laboratories, LLC","package_description":"1 BLISTER PACK in 1 CARTON (83390-107-09) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"83390010730","name":"CLOMIPHENE CITRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83390-107-30","proprietary_name":"Clomiphene Citrate","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cosette Pharmaceuticals NC Laboratories, LLC","package_description":"3 BLISTER PACK in 1 CARTON (83390-107-30) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"00406880601","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8806-01","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"clomipramine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-8806-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904703807","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7038-07","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7038-07) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571068303","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-683-03","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (16571-683-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571068309","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-683-09","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (16571-683-09)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714084901","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-849-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"30 CAPSULE in 1 BOTTLE (16714-849-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714084902","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-849-02","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"90 CAPSULE in 1 BOTTLE (16714-849-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714084903","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-849-03","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 CAPSULE in 1 BOTTLE (16714-849-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571034201","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-342-01","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-342-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571034230","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-342-30","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Micro Labs Limited","package_description":"30 CAPSULE in 1 BOTTLE (42571-342-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672401105","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4011-5","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (51672-4011-5)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672401106","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4011-6","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (51672-4011-6)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038101","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-381-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-381-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038130","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-381-30","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-381-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038190","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-381-90","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (59651-381-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332040731","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-407-31","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-407-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084079025","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-790-25","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-790-25) / 1 CAPSULE in 1 BLISTER PACK (68084-790-95)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084079095","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180049201","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-492-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride Capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-492-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315016701","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-167-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69315-167-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756040511","name":"CLOMIPRAMINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-405-11","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-405-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.18882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"00406880701","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8807-01","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"clomipramine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-8807-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904703907","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7039-07","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7039-07) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571068403","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-684-03","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (16571-684-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571068409","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-684-09","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (16571-684-09)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714085001","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-850-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC.","package_description":"30 CAPSULE in 1 BOTTLE (16714-850-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714085002","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-850-02","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC.","package_description":"90 CAPSULE in 1 BOTTLE (16714-850-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714085003","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-850-03","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 CAPSULE in 1 BOTTLE (16714-850-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571034301","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-343-01","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-343-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571034330","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-343-30","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Micro Labs Limited","package_description":"30 CAPSULE in 1 BOTTLE (42571-343-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672401205","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4012-5","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (51672-4012-5)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672401206","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4012-6","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (51672-4012-6)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038201","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-382-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-382-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038230","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-382-30","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-382-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038290","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-382-90","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (59651-382-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332040831","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-408-31","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-408-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084081825","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-818-25","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-818-25) / 1 CAPSULE in 1 BLISTER PACK (68084-818-95)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084081895","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180049301","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-493-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride Capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-493-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315016601","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-166-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69315-166-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756040611","name":"CLOMIPRAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-406-11","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-406-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.25815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"00406880801","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8808-01","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"clomipramine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-8808-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571068503","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-685-03","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (16571-685-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571068509","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-685-09","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (16571-685-09)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714085102","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-851-02","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Northstar Rx LLC.","package_description":"90 CAPSULE in 1 BOTTLE (16714-851-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714085103","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-851-03","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 CAPSULE in 1 BOTTLE (16714-851-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571034401","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-344-01","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-344-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571034430","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-344-30","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Micro Labs Limited","package_description":"30 CAPSULE in 1 BOTTLE (42571-344-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672401305","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4013-5","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (51672-4013-5)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672401306","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4013-6","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (51672-4013-6)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038301","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-383-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-383-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038330","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-383-30","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-383-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651038390","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-383-90","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (59651-383-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332040931","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-409-31","proprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","nonproprietary_name":"CLOMIPRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-409-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180049401","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-494-01","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride Capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-494-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756040711","name":"CLOMIPRAMINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-407-11","proprietary_name":"Clomipramine Hydrochloride","nonproprietary_name":"Clomipramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-407-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.2501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomipramine HCl|Clomipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884030602","name":"CLONAZEPAM 0.125 MG DIS TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-306-02","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"Par Health USA, LLC","package_description":"60 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-306-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.51985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884030652","name":"CLONAZEPAM 0.125 MG DIS TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.51985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929019","name":"CLONAZEPAM 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.51985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929067","name":"CLONAZEPAM 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9290-67","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0093-9290-67) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.51985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036406","name":"CLONAZEPAM 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-364-06","proprietary_name":"CLONAZEPAM","nonproprietary_name":"CLONAZEPAM","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-364-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.51985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929119","name":"CLONAZEPAM 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929167","name":"CLONAZEPAM 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9291-67","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0093-9291-67) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.43849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884030702","name":"CLONAZEPAM 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-307-02","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".25 mg/1","labeler":"Par Health USA, LLC","package_description":"60 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-307-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.43849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884030752","name":"CLONAZEPAM 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036506","name":"CLONAZEPAM 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-365-06","proprietary_name":"CLONAZEPAM","nonproprietary_name":"CLONAZEPAM","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-365-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.43849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884030802","name":"CLONAZEPAM 0.5 MG DIS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-308-02","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"60 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-308-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884030852","name":"CLONAZEPAM 0.5 MG DIS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.52314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929219","name":"CLONAZEPAM 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.52314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929267","name":"CLONAZEPAM 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9292-67","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0093-9292-67) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036606","name":"CLONAZEPAM 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-366-06","proprietary_name":"CLONAZEPAM","nonproprietary_name":"CLONAZEPAM","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-366-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093083201","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0832-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-0832-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00093083205","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0832-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-0832-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00904722761","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7227-61","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7227-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"16729013600","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-136-00","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (16729-136-00)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"16729013616","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-136-16","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (16729-136-16)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040610","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-406-10","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-406-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040611","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-406-11","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-406-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040650","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-406-50","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-406-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"50268017311","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"50268017315","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-173-15","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-173-15) / 1 TABLET in 1 BLISTER PACK (50268-173-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"59651072201","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-722-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-722-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"59651072299","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-722-99","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-722-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"60687086101","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-861-01","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-861-01) / 1 TABLET in 1 BLISTER PACK (60687-861-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"60687086111","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"62135076990","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-769-90","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-769-90)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030701","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-307-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-307-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030702","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-307-02","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-307-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015200","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-152-00","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-152-00)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015201","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-152-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-152-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015205","name":"CLONAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-152-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-152-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"49884030902","name":"CLONAZEPAM 1 MG DIS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-309-02","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"60 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-309-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.56689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884030952","name":"CLONAZEPAM 1 MG DIS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.56689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929319","name":"CLONAZEPAM 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.56689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929367","name":"CLONAZEPAM 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9293-67","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0093-9293-67) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.56689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036706","name":"CLONAZEPAM 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-367-06","proprietary_name":"CLONAZEPAM","nonproprietary_name":"CLONAZEPAM","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-367-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.56689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093321201","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3212-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-3212-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00093321205","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3212-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-3212-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00904772861","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7728-61","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7728-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"16729013700","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-137-00","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (16729-137-00)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"16729013716","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-137-16","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (16729-137-16)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040710","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-407-10","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-407-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040711","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-407-11","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-407-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040750","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-407-50","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-407-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"50268017411","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"50268017415","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-174-15","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-174-15) / 1 TABLET in 1 BLISTER PACK (50268-174-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"59651072301","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-723-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-723-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"59651072399","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-723-99","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-723-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"60687087201","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-872-01","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-872-01) / 1 TABLET in 1 BLISTER PACK (60687-872-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"60687087211","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"62135077090","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-770-90","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-770-90)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030801","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-308-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-308-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030802","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-308-02","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-308-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030803","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-308-03","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Northstar Rx LLC","package_description":"1000 TABLET in 1 BOTTLE (72603-308-03)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015300","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-153-00","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-153-00)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015301","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-153-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-153-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015305","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-153-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-153-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015330","name":"CLONAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-153-30","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET in 1 BOTTLE (72888-153-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00093929419","name":"CLONAZEPAM 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.87917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093929467","name":"CLONAZEPAM 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9294-67","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0093-9294-67) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.87917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884031002","name":"CLONAZEPAM 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-310-02","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"60 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-310-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.87917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884031052","name":"CLONAZEPAM 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.87917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036806","name":"CLONAZEPAM 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-368-06","proprietary_name":"CLONAZEPAM","nonproprietary_name":"CLONAZEPAM","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (62332-368-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.87917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093321301","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3213-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-3213-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00093321305","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3213-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-3213-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"16729013800","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-138-00","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (16729-138-00)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"16729013816","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-138-16","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (16729-138-16)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040810","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-408-10","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-408-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"43547040850","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-408-50","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-408-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"50268017511","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"50268017515","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-175-15","proprietary_name":"Clonazepam","nonproprietary_name":"clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-175-15) / 1 TABLET in 1 BLISTER PACK (50268-175-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"59651072401","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-724-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-724-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"59651072405","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-724-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-724-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"62135077190","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-771-90","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-771-90)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030901","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-309-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-309-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72603030902","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-309-02","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-309-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015401","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-154-01","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-154-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"72888015405","name":"CLONAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-154-05","proprietary_name":"Clonazepam","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-154-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonazepam|Clonazepam","basis":"generic"},"part_b":null}, {"ndc":"00378087116","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00378087199","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0871-99","proprietary_name":"Clonidine","nonproprietary_name":"clonidine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-0871-99) / 1 PATCH in 1 POUCH (0378-0871-16) / 7 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00591350804","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3508-04","proprietary_name":"Clonidine transdermal system","nonproprietary_name":"Clonidine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Actavis Pharma, Inc.","package_description":"4 POUCH in 1 CARTON (0591-3508-04) / 1 PATCH in 1 POUCH (0591-3508-54) / 7 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00591350854","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"52817050504","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-505-04","proprietary_name":"Clonidine Transdermal System USP, 0.1 mg/day","nonproprietary_name":"clonidine transdermal system","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"TruPharma, LLC","package_description":"4 POUCH in 1 CARTON (52817-505-04) / 1 PATCH in 1 POUCH / 1 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"52817061004","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-610-04","proprietary_name":"Clonidine Transdermal System USP, 0.1 mg/day","nonproprietary_name":"clonidine transdermal system","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"TruPharma, LLC","package_description":"4 POUCH in 1 CARTON (52817-610-04) / 1 PATCH in 1 POUCH / 1 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"75907002311","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907002348","name":"CLONIDINE 0.1 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-023-48","proprietary_name":"Clonidine","nonproprietary_name":"CLONIDINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/24h","labeler":"Dr. Reddy's Labratories Inc.","package_description":"4 POUCH in 1 CARTON (75907-023-48) / 1 PATCH in 1 POUCH (75907-023-11) / 24 h in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":6.64381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378087216","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00378087299","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0872-99","proprietary_name":"Clonidine","nonproprietary_name":"clonidine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".2 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-0872-99) / 1 PATCH in 1 POUCH (0378-0872-16) / 7 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00591350904","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3509-04","proprietary_name":"Clonidine transdermal system","nonproprietary_name":"Clonidine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".2 mg/d","labeler":"Actavis Pharma, Inc.","package_description":"4 POUCH in 1 CARTON (0591-3509-04) / 1 PATCH in 1 POUCH (0591-3509-54) / 7 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00591350954","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"52817061104","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-611-04","proprietary_name":"Clonidine Transdermal System USP, 0.2 mg/day","nonproprietary_name":"clonidine transdermal system","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".2 mg/d","labeler":"TruPharma, LLC","package_description":"4 POUCH in 1 CARTON (52817-611-04) / 1 PATCH in 1 POUCH / 1 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"75907002411","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907002448","name":"CLONIDINE 0.2 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-024-48","proprietary_name":"Clonidine","nonproprietary_name":"CLONIDINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".2 mg/24h","labeler":"Dr. Reddy's Labratories Inc.","package_description":"4 POUCH in 1 CARTON (75907-024-48) / 1 PATCH in 1 POUCH (75907-024-11) / 24 h in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.04585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378087316","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00378087399","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0873-99","proprietary_name":"Clonidine","nonproprietary_name":"clonidine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".3 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-0873-99) / 1 PATCH in 1 POUCH (0378-0873-16) / 7 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00591351004","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3510-04","proprietary_name":"Clonidine transdermal system","nonproprietary_name":"Clonidine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".3 mg/d","labeler":"Actavis Pharma, Inc.","package_description":"4 POUCH in 1 CARTON (0591-3510-04) / 1 PATCH in 1 POUCH (0591-3510-54) / 7 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"00591351054","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"52817050704","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-507-04","proprietary_name":"Clonidine Transdermal System USP, 0.3 mg/day","nonproprietary_name":"clonidine transdermal system","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".3 mg/d","labeler":"TruPharma, LLC","package_description":"4 POUCH in 1 CARTON (52817-507-04) / 1 PATCH in 1 POUCH / 1 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"52817061204","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-612-04","proprietary_name":"Clonidine Transdermal System USP, 0.3 mg/day","nonproprietary_name":"clonidine transdermal system","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".3 mg/d","labeler":"TruPharma, LLC","package_description":"4 POUCH in 1 CARTON (52817-612-04) / 1 PATCH in 1 POUCH / 1 d in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine|Clonidine","basis":"generic"},"part_b":null}, {"ndc":"75907002511","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907002548","name":"CLONIDINE 0.3 MG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-025-48","proprietary_name":"Clonidine","nonproprietary_name":"CLONIDINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".3 mg/24h","labeler":"Dr. Reddy's Labratories Inc.","package_description":"4 POUCH in 1 CARTON (75907-025-48) / 1 PATCH in 1 POUCH (75907-025-11) / 24 h in 1 PATCH","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":12.29116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228212710","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2127-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2127-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228212750","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2127-50","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0228-2127-50)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904744261","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7442-61","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7442-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046801","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-468-01","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-468-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046805","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-468-05","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-468-05)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046810","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-468-10","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-468-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547056510","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-565-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-565-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547056511","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-565-11","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-565-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019211","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019215","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-192-15","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-192-15) / 1 TABLET in 1 BLISTER PACK (50268-192-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817018000","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-180-00","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"TruPharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-180-00)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817018010","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-180-10","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-180-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064701","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-647-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-647-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064710","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-647-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-647-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064750","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-647-50","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (58657-647-50)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651023201","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-232-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-232-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651023299","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-232-99","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-232-99)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687011301","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-113-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-113-01) / 1 TABLET in 1 BLISTER PACK (60687-113-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687011311","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005431","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-054-31","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-054-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005471","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-054-71","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-054-71)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005491","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-054-91","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-054-91)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001023700","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-237-00","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-237-00)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001023703","name":"CLONIDINE HCL 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-237-03","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-237-03)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228212810","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2128-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2128-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228212850","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2128-50","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0228-2128-50)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904744361","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7443-61","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7443-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300013601","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-136-01","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-136-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300013605","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-136-05","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-136-05)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300013610","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-136-10","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-136-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547056610","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-566-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-566-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547056611","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-566-11","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-566-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019311","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019315","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-193-15","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-193-15) / 1 TABLET in 1 BLISTER PACK (50268-193-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817018100","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-181-00","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"TruPharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-181-00)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817018110","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-181-10","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-181-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064801","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-648-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-648-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064810","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-648-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-648-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064850","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-648-50","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (58657-648-50)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651023301","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-233-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-233-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651023305","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-233-05","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-233-05)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687012401","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-124-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-124-01) / 1 TABLET in 1 BLISTER PACK (60687-124-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687012411","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005531","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-055-31","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-055-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005571","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-055-71","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-055-71)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005591","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-055-91","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-055-91)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001023800","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-238-00","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-238-00)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001023803","name":"CLONIDINE HCL 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-238-03","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-238-03)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228212910","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2129-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2129-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300013701","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-137-01","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-137-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300013705","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-137-05","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-137-05)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547056710","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-567-10","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-567-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019411","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019415","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-194-15","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-194-15) / 1 TABLET in 1 BLISTER PACK (50268-194-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817018200","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-182-00","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"TruPharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-182-00)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817018210","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-182-10","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-182-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064901","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-649-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-649-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"58657064950","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-649-50","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (58657-649-50)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651023401","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-234-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-234-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005631","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-056-31","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-056-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332005671","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-056-71","proprietary_name":"clonidine hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-056-71)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001023900","name":"CLONIDINE HCL 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-239-00","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-239-00)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228424106","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-4241-06","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (0228-4241-06)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241010806","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-108-06","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-108-06)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547043506","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-435-06","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/1","labeler":"Solco Healthcare LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-435-06)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687046211","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687046221","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-462-21","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-462-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-462-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001056806","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-568-06","proprietary_name":"Clonidine hydrochloride","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-568-06)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"70069004401","name":"CLONIDINE HCL ER 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-044-01","proprietary_name":"Clonidine Hydrochloride","nonproprietary_name":"Clonidine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (70069-044-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.21173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817037530","name":"CLONIDINE HCL ER 0.17 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-375-30","proprietary_name":"Clonidine","nonproprietary_name":"Clonidine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".17 mg/1","labeler":"TruPharma, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52817-375-30)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":15.23568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clonidine HCl ER|Clonidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904646707","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6467-07","proprietary_name":"Clopidogrel","nonproprietary_name":"clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6467-07) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"00904646710","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6467-10","proprietary_name":"Clopidogrel","nonproprietary_name":"clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-6467-10) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"43598012206","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"43598012259","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-122-59","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Dr.Reddy's Laboratories Inc","package_description":"5 BLISTER PACK in 1 CARTON (43598-122-59) / 6 TABLET, FILM COATED in 1 BLISTER PACK (43598-122-06)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"50268018411","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"50268018412","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-184-12","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-184-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-184-11)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"55111067106","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"55111067131","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-671-31","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"5 BLISTER PACK in 1 CARTON (55111-671-31) / 6 TABLET, FILM COATED in 1 BLISTER PACK (55111-671-06)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"60505353205","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3532-5","proprietary_name":"Clopidogrel","nonproprietary_name":"clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (60505-3532-5)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"63739017830","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63739-178-30","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"McKesson Corporation dba SKY Packaging","package_description":"5 BLISTER PACK in 1 CARTON (63739-178-30) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"68084075218","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"68084075219","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-752-19","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (68084-752-19) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-752-18)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"69367019405","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-194-05","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-194-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"69367019430","name":"CLOPIDOGREL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-194-30","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-194-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":5.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"00093731405","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7314-05","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-7314-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"00093731456","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7314-56","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7314-56)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"13668014105","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-141-05","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-141-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"13668014130","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-141-30","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-141-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"13668014190","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-141-90","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13668-141-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"16714005201","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-052-01","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-052-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"16714005202","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-052-02","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-052-02)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"16714005203","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-052-03","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-052-03)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"16714005204","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-052-04","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (16714-052-04)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"16714005210","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-052-10","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"10 TABLET in 1 BLISTER PACK (16714-052-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"16714005211","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-052-11","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOX, UNIT-DOSE (16714-052-11)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"33342006010","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-060-10","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-060-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"33342006015","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-060-15","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-060-15)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"43598012105","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-121-05","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddy's Laboratories Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-121-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"43598012130","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-121-30","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddy's Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-121-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"43598012190","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-121-90","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddy's Laboratories Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43598-121-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"50228012405","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-124-05","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-124-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"50228012410","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-124-10","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-124-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"50228012430","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-124-30","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-124-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"50228012490","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-124-90","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-124-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"55111019605","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-196-05","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (55111-196-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"55111019690","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-196-90","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55111-196-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"60505025302","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0253-2","proprietary_name":"Clopidogrel","nonproprietary_name":"clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (60505-0253-2)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"60505025303","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0253-3","proprietary_name":"Clopidogrel","nonproprietary_name":"clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0253-3)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"65862035705","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-357-05","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-357-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"65862035730","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-357-30","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-357-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"65862035761","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"65862035790","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-357-90","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-357-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"67877027605","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-276-05","proprietary_name":"CLOPIDOGREL","nonproprietary_name":"CLOPIDOGREL BISULFATE","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-276-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"67877027690","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-276-90","proprietary_name":"CLOPIDOGREL","nonproprietary_name":"CLOPIDOGREL BISULFATE","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-276-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"68084053601","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-536-01","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-536-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-536-11)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"68084053611","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"68645059090","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-590-90","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68645-590-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"69367020005","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-200-05","proprietary_name":"Clopidogrel","nonproprietary_name":"Clopidogrel Bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-200-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"72205019901","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-199-01","proprietary_name":"CLOPIDOGREL","nonproprietary_name":"CLOPIDOGREL BISULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-199-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"72205019905","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-199-05","proprietary_name":"CLOPIDOGREL","nonproprietary_name":"CLOPIDOGREL BISULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-199-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"72205019930","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-199-30","proprietary_name":"CLOPIDOGREL","nonproprietary_name":"CLOPIDOGREL BISULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-199-30)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"72205019990","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-199-90","proprietary_name":"CLOPIDOGREL","nonproprietary_name":"CLOPIDOGREL BISULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-199-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"82009002105","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-021-05","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-021-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"82009002190","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"82009018205","name":"CLOPIDOGREL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-182-05","proprietary_name":"Clopidogrel bisulfate","nonproprietary_name":"Clopidogrel bisulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-182-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clopidogrel|Clopidogrel Bisulfate","basis":"generic"},"part_b":null}, {"ndc":"13107028401","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-284-01","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13107-284-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107032101","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-321-01","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13107-321-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"51672404401","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4044-1","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4044-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"60505475601","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4756-1","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/mg","labeler":"Apotex Corp.","package_description":"100 mg in 1 BOTTLE (60505-4756-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015710","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-157-10","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-157-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015720","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-157-20","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-157-20)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015740","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-157-40","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (70954-157-40) / 1 TABLET in 1 BLISTER PACK (70954-157-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"72603011401","name":"CLORAZEPATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-114-01","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET in 1 BOTTLE (72603-114-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.80796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107028201","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-282-01","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-282-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107028205","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-282-05","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13107-282-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107031901","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-319-01","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-319-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107031905","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-319-05","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13107-319-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"51672404201","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4042-1","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4042-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"51672404202","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4042-2","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE (51672-4042-2)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"60505475401","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4754-1","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/mg","labeler":"Apotex Corp.","package_description":"100 mg in 1 BOTTLE (60505-4754-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015910","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-159-10","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-159-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015930","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-159-30","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-159-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015950","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-159-50","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (70954-159-50) / 1 TABLET in 1 BLISTER PACK (70954-159-40)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"72603011201","name":"CLORAZEPATE 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-112-01","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET in 1 BOTTLE (72603-112-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.52409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107028301","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-283-01","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13107-283-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107028305","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-283-05","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13107-283-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107032001","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-320-01","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13107-320-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"13107032005","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-320-05","proprietary_name":"CLORAZEPATE DIPOTASSIUM","nonproprietary_name":"CLORAZEPATE DIPOTASSIUM","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13107-320-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"51672404301","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4043-1","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4043-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"51672404302","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4043-2","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE (51672-4043-2)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"60505475501","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4755-1","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/mg","labeler":"Apotex Corp.","package_description":"100 mg in 1 BOTTLE (60505-4755-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015810","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-158-10","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-158-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015830","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-158-30","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-158-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"70954015850","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-158-50","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (70954-158-50) / 1 TABLET in 1 BLISTER PACK (70954-158-40)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"72603011301","name":"CLORAZEPATE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-113-01","proprietary_name":"Clorazepate Dipotassium","nonproprietary_name":"Clorazepate Dipotassium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET in 1 BOTTLE (72603-113-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clorazepate Dipotassium|Clorazepate Dipotassium","basis":"generic"},"part_b":null}, {"ndc":"00536144370","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1443-70","proprietary_name":"CLOTRIMAZOLE","nonproprietary_name":"CLOTRIMAZOLE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 g/100mL","labeler":"Rugby Laboratories, Inc.","package_description":"1 BOTTLE in 1 CARTON (0536-1443-70) / 10 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.01789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50228050208","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-502-08","proprietary_name":"Clotrimazole Topical Solution USP, 1%","nonproprietary_name":"Clotrimazole Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (50228-502-08) / 10 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50228050230","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-502-30","proprietary_name":"Clotrimazole Topical Solution USP, 1%","nonproprietary_name":"Clotrimazole Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (50228-502-30) / 30 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.42569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672126003","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1260-3","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-1260-3) / 30 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.42569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52817080030","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-800-30","proprietary_name":"Clotrimazole Topical Solution USP, 1%","nonproprietary_name":"Clotrimazole Topical Solution USP, 1%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"TruPharma LLC","package_description":"1 BOTTLE in 1 CARTON (52817-800-30) / 30 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.42569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70010022954","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-229-54","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 g/mL","labeler":"Granules Pharmaceuticals Inc.","package_description":"10 mL in 1 BOTTLE (70010-229-54)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.01789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954003620","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-036-20","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole topical","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Novitium Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70954-036-20) / 30 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.42569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83474000334","name":"CLOTRIMAZOLE 1% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83474-003-34","proprietary_name":"Clotrimazole (Topical Solution), 1%","nonproprietary_name":"Clotrimazole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Puro Pharma Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (83474-003-34) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.01789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536126511","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1265-11","proprietary_name":"Rugby Clotrimazole Antifungal Cream","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1265-11) / 14.17 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536126526","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1265-26","proprietary_name":"Rugby Clotrimazole Antifungal Cream","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1265-26) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.04735,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536126595","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1265-95","proprietary_name":"Rugby Clotrimazole Antifungal Cream","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1265-95) / 28 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.06293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802043411","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-434-11","proprietary_name":"clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-434-11) / 28 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.11771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127501","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1275-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1275-1) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.19892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127502","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1275-2","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1275-2) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.13296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127506","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1275-6","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1275-6) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.16222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127507","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1275-7","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"2 TUBE in 1 CARTON (51672-1275-7) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.34307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672200201","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2002-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2002-1) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.21853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672200202","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2002-2","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2002-2) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.11771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462018117","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-181-17","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"15 g in 1 TUBE (68462-181-17)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.19892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462018135","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-181-35","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 g in 1 TUBE (68462-181-35)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.13296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462018147","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-181-47","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"45 g in 1 TUBE (68462-181-47)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.16222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70512010030","name":"CLOTRIMAZOLE 1% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.08701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672200306","name":"CLOTRIMAZOLE 1% VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2003-6","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2003-6) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269022041","name":"CLOTRIMAZOLE 1% VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-220-41","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"10 mg/g","labeler":"H2-Pharma, LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (61269-220-41) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269022063","name":"CLOTRIMAZOLE 1% VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-220-63","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"10 mg/g","labeler":"H2-Pharma, LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (61269-220-63) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000072901","name":"CLOTRIMAZOLE 1% VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0729-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"10 mg/g","labeler":"Cardinal Health (Leader) 70000","package_description":"1 TUBE in 1 BOX (70000-0729-1) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16571068607","name":"CLOTRIMAZOLE 10 MG LOZENGE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-686-07","proprietary_name":"CLOTRIMAZOLE","nonproprietary_name":"CLOTRIMAZOLE","dosage_form":"LOZENGE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"70 LOZENGE in 1 BOTTLE (16571-686-07)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.29232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571068614","name":"CLOTRIMAZOLE 10 MG LOZENGE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-686-14","proprietary_name":"CLOTRIMAZOLE","nonproprietary_name":"CLOTRIMAZOLE","dosage_form":"LOZENGE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"140 LOZENGE in 1 BOTTLE (16571-686-14)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.29232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054414622","name":"CLOTRIMAZOLE 10 MG TROCHE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4146-22","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"LOZENGE","route":"ORAL; TOPICAL","strength":"10 mg/1","labeler":"Hikma Pharmacuticals USA USA Inc.","package_description":"70 LOZENGE in 1 BOTTLE, PLASTIC (0054-4146-22)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.29232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054414623","name":"CLOTRIMAZOLE 10 MG TROCHE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4146-23","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"LOZENGE","route":"ORAL; TOPICAL","strength":"10 mg/1","labeler":"Hikma Pharmacuticals USA USA Inc.","package_description":"140 LOZENGE in 1 BOTTLE, PLASTIC (0054-4146-23)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.29232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574010714","name":"CLOTRIMAZOLE 10 MG TROCHE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0107-14","proprietary_name":"Clotrimazole","nonproprietary_name":"clotrimazole","dosage_form":"LOZENGE","route":"ORAL","strength":"10 mg/1","labeler":"Padagis US LLC","package_description":"140 LOZENGE in 1 BOTTLE, PLASTIC (0574-0107-14)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.29232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574010770","name":"CLOTRIMAZOLE 10 MG TROCHE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0107-70","proprietary_name":"Clotrimazole","nonproprietary_name":"clotrimazole","dosage_form":"LOZENGE","route":"ORAL","strength":"10 mg/1","labeler":"Padagis US LLC","package_description":"70 LOZENGE in 1 BOTTLE, PLASTIC (0574-0107-70)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.29232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385011009","name":"CLOTRIMAZOLE-3 2% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-110-09","proprietary_name":"Good Neighbor Pharmacy Clotrimazole 3","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (24385-110-09) / 21 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.3124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168025815","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0258-15","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"15 g in 1 TUBE (0168-0258-15)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"00168025846","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0258-46","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"45 g in 1 TUBE (0168-0258-46)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"00472037915","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0379-15","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0379-15) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"00472037945","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0379-45","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0379-45) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"16714049601","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-496-01","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-496-01) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"16714049602","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-496-02","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-496-02) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"51672404801","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4048-1","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4048-1) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"51672404806","name":"CLOTRIMAZOLE-BETAMETHASONE CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4048-6","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; .5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4048-6) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Clotrimazole-Betamethasone|Clotrimazole/Betamethasone Dip","basis":"generic"},"part_b":null}, {"ndc":"51672130803","name":"CLOTRIMAZOLE-BETAMETHASONE LOT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1308-3","proprietary_name":"Clotrimazole and Betamethasone Dipropionate","nonproprietary_name":"Clotrimazole and Betamethasone Dipropionate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL; .5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1308-3) / 30 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.15199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378086001","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0860-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0860-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378086005","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0860-05","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0860-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00904708761","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7087-61","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7087-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079092201","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079092220","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-922-20","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-922-20) / 1 TABLET in 1 BLISTER PACK (51079-922-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687041501","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-415-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-415-01) / 1 TABLET in 1 BLISTER PACK (60687-415-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687041511","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"65862084601","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-846-01","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-846-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"65862084605","name":"CLOZAPINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-846-05","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-846-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378097301","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0973-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0973-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00904708861","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7088-61","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7088-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079074901","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079074920","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-749-20","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-749-20) / 1 TABLET in 1 BLISTER PACK (51079-749-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687042601","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-426-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-426-01) / 1 TABLET in 1 BLISTER PACK (60687-426-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687042611","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"65862084701","name":"CLOZAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-847-01","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-847-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.96891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378082501","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0825-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0825-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00904708961","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7089-61","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7089-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079092101","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079092120","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-921-20","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-921-20) / 1 TABLET in 1 BLISTER PACK (51079-921-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687040401","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-404-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-404-01) / 1 TABLET in 1 BLISTER PACK (60687-404-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687040411","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"65862084401","name":"CLOZAPINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-844-01","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-844-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378097201","name":"CLOZAPINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0972-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0972-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.54183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00904740661","name":"CLOZAPINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7406-61","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7406-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.54183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687054801","name":"CLOZAPINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-548-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-548-01) / 1 TABLET in 1 BLISTER PACK (60687-548-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.54183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"60687054811","name":"CLOZAPINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"65862084501","name":"CLOZAPINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-845-01","proprietary_name":"CLOZAPINE","nonproprietary_name":"CLOZAPINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-845-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.54183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093541901","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5419-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0093-5419-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093541919","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093541984","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5419-84","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"48 BLISTER PACK in 1 CARTON (0093-5419-84) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5419-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378381501","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3815-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-3815-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079028801","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"51079028804","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-288-04","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"40 BLISTER PACK in 1 CARTON (51079-288-04) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (51079-288-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"59651026201","name":"CLOZAPINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-262-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (59651-262-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.26464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093537601","name":"CLOZAPINE ODT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-5376-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0093-5376-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":14.97084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093537619","name":"CLOZAPINE ODT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":14.97084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093537684","name":"CLOZAPINE ODT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-5376-84","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"48 BLISTER PACK in 1 CARTON (0093-5376-84) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5376-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":14.97084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378381601","name":"CLOZAPINE ODT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-3816-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"150 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-3816-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":14.97084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"59651026301","name":"CLOZAPINE ODT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-263-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (59651-263-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":14.97084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093537701","name":"CLOZAPINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5377-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0093-5377-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.20325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093537719","name":"CLOZAPINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.20325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093537784","name":"CLOZAPINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5377-84","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"48 BLISTER PACK in 1 CARTON (0093-5377-84) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5377-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.20325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378381701","name":"CLOZAPINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3817-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-3817-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.20325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"59651026401","name":"CLOZAPINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-264-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (59651-264-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.20325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093541701","name":"CLOZAPINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5417-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0093-5417-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.65786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093541719","name":"CLOZAPINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.65786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00093541784","name":"CLOZAPINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5417-84","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"48 BLISTER PACK in 1 CARTON (0093-5417-84) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5417-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.65786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"00378381301","name":"CLOZAPINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3813-01","proprietary_name":"Clozapine","nonproprietary_name":"clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-3813-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.65786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"59651026101","name":"CLOZAPINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-261-01","proprietary_name":"Clozapine","nonproprietary_name":"Clozapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (59651-261-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.65786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozapine ODT|Clozapine","basis":"generic"},"part_b":null}, {"ndc":"69809012705","name":"CLOZARIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69809-0127-5","proprietary_name":"Clozaril","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"HLS Therapeutics (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (69809-0127-5)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":16.83316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.61031,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozaril|Clozapine","basis":"brand"},"part_b":null}, {"ndc":"69809012605","name":"CLOZARIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69809-0126-5","proprietary_name":"Clozaril","nonproprietary_name":"clozapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"HLS Therapeutics (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (69809-0126-5)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":6.54457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24238,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clozaril|Clozapine","basis":"brand"},"part_b":null}, {"ndc":"00078056845","name":"COARTEM TABLETS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0568-45","proprietary_name":"COARTEM","nonproprietary_name":"artemether and lumefantrine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 120 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"24 TABLET in 1 BOTTLE (0078-0568-45)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":5.36284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Coartem|Artemether/Lumefantrine","basis":"brand"},"part_b":null}, {"ndc":"70211070304","name":"COATS ALOE CREME","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.18498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00003110001","name":"COBENFY 100 MG-20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":30.13193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003110060","name":"COBENFY 100 MG-20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-1100-60","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"100 mg/1; 20 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (0003-1100-60)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":30.13193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003110098","name":"COBENFY 100 MG-20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-1100-98","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"100 mg/1; 20 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"10 BLISTER PACK in 1 CARTON (0003-1100-98) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":30.13193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003012560","name":"COBENFY 125 MG-30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0125-60","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1; 30 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (0003-0125-60)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":30.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003012598","name":"COBENFY 125 MG-30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0125-98","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1; 30 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"10 BLISTER PACK in 1 CARTON (0003-0125-98) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":30.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003005060","name":"COBENFY 50 MG-20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0050-60","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"50 mg/1; 20 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (0003-0050-60)","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":30.2312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003005098","name":"COBENFY 50 MG-20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0050-98","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"50 mg/1; 20 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"10 BLISTER PACK in 1 CARTON (0003-0050-98) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Agonist [EPC]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":30.2312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cobenfy|Xanomeline Tart/Trospium Chlor","basis":"brand"},"part_b":null}, {"ndc":"00003520056","name":"COBENFY STARTER PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-5200-56","proprietary_name":"Cobenfy","nonproprietary_name":"xanomeline and trospium chloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 KIT in 1 CARTON (0003-5200-56) * 1 BLISTER PACK in 1 PACKAGE (0003-0050-04) / 4 CAPSULE, COATED PELLETS in 1 BLISTER PACK * 1 BLISTER PACK in 1 PACKAGE (0003-1100-01) / 52 CAPSULE, COATED PELLETS in 1 BLISTER PACK"},"nadac":{"value":30.07068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054024324","name":"CODEINE SULFATE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0243-24","proprietary_name":"Codeine sulfate","nonproprietary_name":"codeine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 BOX (0054-0243-24) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.67735,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Codeine Sulfate|Codeine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00054024424","name":"CODEINE SULFATE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0244-24","proprietary_name":"Codeine sulfate","nonproprietary_name":"codeine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 BOX (0054-0244-24) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.72645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Codeine Sulfate|Codeine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00054024425","name":"CODEINE SULFATE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0244-25","proprietary_name":"Codeine sulfate","nonproprietary_name":"codeine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0244-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.72645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Codeine Sulfate|Codeine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00527169801","name":"CODEINE SULFATE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1698-01","proprietary_name":"Codeine Sulfate","nonproprietary_name":"Codeine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-1698-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.72645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Codeine Sulfate|Codeine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00054024525","name":"CODEINE SULFATE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0245-25","proprietary_name":"Codeine sulfate","nonproprietary_name":"codeine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0245-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.27998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Codeine Sulfate|Codeine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"58657050004","name":"CODEINE-GUAIFEN 10-100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-500-04","proprietary_name":"Codeine-Guaifenesin","nonproprietary_name":"Codeine Phosphate and Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"120 mL in 1 BOTTLE (58657-500-04)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Full Opioid Agonists [MoA]","Increased Respiratory Secretions [PE]","Opioid Agonist [EPC]"]},"nadac":{"value":0.05877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657050016","name":"CODEINE-GUAIFEN 10-100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-500-16","proprietary_name":"Codeine-Guaifenesin","nonproprietary_name":"Codeine Phosphate and Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (58657-500-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Full Opioid Agonists [MoA]","Increased Respiratory Secretions [PE]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367027204","name":"CODEINE-GUAIFEN 10-100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-272-04","proprietary_name":"Codeine-Guaifenesin","nonproprietary_name":"Codeine Phosphate and Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"118 mL in 1 BOTTLE (69367-272-04)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Full Opioid Agonists [MoA]","Increased Respiratory Secretions [PE]","Opioid Agonist [EPC]"]},"nadac":{"value":0.06445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367027216","name":"CODEINE-GUAIFEN 10-100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-272-16","proprietary_name":"Codeine-Guaifenesin","nonproprietary_name":"Codeine Phosphate and Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (69367-272-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Full Opioid Agonists [MoA]","Increased Respiratory Secretions [PE]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67618010101","name":"COLACE 100 MG CAPSULE","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-101-01","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-101-01) / 100 CAPSULE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.30566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618010110","name":"COLACE 100 MG CAPSULE","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-101-10","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (67618-101-10) / 5 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.30566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618010130","name":"COLACE 100 MG CAPSULE","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-101-30","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-101-30) / 30 CAPSULE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.30566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618010152","name":"COLACE 100 MG CAPSULE","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-101-52","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"250 CAPSULE in 1 BOTTLE, PLASTIC (67618-101-52)"},"nadac":{"value":0.30566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618010160","name":"COLACE 100 MG CAPSULE","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-101-60","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-101-60) / 60 CAPSULE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.30566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618011010","name":"COLACE 2-IN-1 TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-110-10","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium - sennosides","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (67618-110-10) / 5 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.41197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618011030","name":"COLACE 2-IN-1 TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-110-30","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium - sennosides","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-110-30) / 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.41197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618011060","name":"COLACE 2-IN-1 TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-110-60","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium - sennosides","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-110-60) / 60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.41197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618011128","name":"COLACE CLEAR 50 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67618-111-28","proprietary_name":"Colace","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE in 1 CARTON (67618-111-28) / 28 CAPSULE, LIQUID FILLED in 1 BOTTLE"},"nadac":{"value":0.25629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143301801","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-3018-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0143-3018-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00143301810","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-3018-10","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0143-3018-10)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00143301830","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-3018-30","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0143-3018-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00254046001","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-0460-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0254-0460-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00904673204","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6732-04","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6732-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"31722009901","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-099-01","proprietary_name":"COLCHICINE","nonproprietary_name":"COLCHICINE","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-099-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"31722009930","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-099-30","proprietary_name":"COLCHICINE","nonproprietary_name":"COLCHICINE","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-099-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"42571034101","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-341-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-341-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"42571034130","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-341-30","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Micro Labs Limited","package_description":"30 CAPSULE in 1 BOTTLE (42571-341-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"59651044601","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-446-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-446-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"59651044630","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-446-30","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-446-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"60687035825","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-358-25","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-358-25) / 1 CAPSULE in 1 BLISTER PACK (60687-358-95)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"60687035895","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"70010000101","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-001-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Granules Pharmaceutical Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-001-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"70010000103","name":"COLCHICINE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-001-03","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Granules Pharmaceutical Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70010-001-03)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00591256201","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00591256230","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"00904712004","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7120-04","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7120-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"16714003901","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-039-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Northstar Rx LLC.","package_description":"1 BOTTLE in 1 CARTON (16714-039-01) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"16714003902","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-039-02","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Northstar Rx LLC.","package_description":"1 BOTTLE in 1 CARTON (16714-039-02) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"23155085501","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"23155085503","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"31722089901","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-899-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-899-01)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Interactions [MoA]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"31722089930","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-899-30","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-899-30)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Interactions [MoA]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"43598037201","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-372-01","proprietary_name":"colchicine","nonproprietary_name":"colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Dr.Reddys Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (43598-372-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"43598037210","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-372-10","proprietary_name":"colchicine","nonproprietary_name":"colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Dr.Reddys Laboratories, Inc.","package_description":"1000 TABLET in 1 BOTTLE (43598-372-10)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"43598037230","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-372-30","proprietary_name":"colchicine","nonproprietary_name":"colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Dr.Reddys Laboratories, Inc.","package_description":"30 TABLET in 1 BOTTLE (43598-372-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"49884017101","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-171-01","proprietary_name":"Colchicine","nonproprietary_name":"colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49884-171-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"49884017111","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-171-11","proprietary_name":"Colchicine","nonproprietary_name":"colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-171-11)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"50268018711","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"50268018715","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-187-15","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-187-15) / 1 TABLET in 1 BLISTER PACK (50268-187-11)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"59651045501","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-455-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-455-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"59651045530","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-455-30","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-455-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"60687072711","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"60687072721","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-727-21","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-727-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-727-11)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"60687072765","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-727-65","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-727-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-727-11)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"62135078930","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-789-30","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-789-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"62135078990","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-789-90","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-789-90)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"65162071003","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-710-03","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-710-03)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"65162071009","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-710-09","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-710-09)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"67877058901","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-589-01","proprietary_name":"colchicine","nonproprietary_name":"colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-589-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"70010000201","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-002-01","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".6 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70010-002-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"70710135101","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1351-1","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1351-1) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"70710135103","name":"COLCHICINE 0.6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1351-3","proprietary_name":"Colchicine","nonproprietary_name":"Colchicine","dosage_form":"TABLET","route":"ORAL","strength":".6 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1351-3) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.1221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colchicine|Colchicine","basis":"generic"},"part_b":null}, {"ndc":"70000055801","name":"COLD AND HOT 4%-1% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0558-1","proprietary_name":"Cold and Heat Lidocaine Patch Plus Menthol","nonproprietary_name":"Lidocaine, Menthol","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g; 1 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"5 PATCH in 1 POUCH (70000-0558-1) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.95193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385051926","name":"COLD-COUGH ELIXIR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-519-26","proprietary_name":"good neighbor pharmacy cold and cough","nonproprietary_name":"Brompheniramine maleate, Dextromethorphan HBr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL; 5 mg/10mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-519-26) / 118 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115132019","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1320-19","proprietary_name":"Colesevelam Hydrochloride","nonproprietary_name":"COLESEVELAM HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0115-1320-19)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"00713093681","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"27808019001","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-190-01","proprietary_name":"Colesevelam hydrochloride","nonproprietary_name":"Colesevelam hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"180 TABLET in 1 BOTTLE (27808-190-01)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"43598023018","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-230-18","proprietary_name":"Colesevelam Hydrochloride","nonproprietary_name":"Colesevelam Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"180 TABLET in 1 BOTTLE (43598-230-18)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"60687038525","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-385-25","proprietary_name":"Colesevelam Hydrochloride","nonproprietary_name":"Colesevelam Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-385-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-385-95)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"60687038595","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"67877050651","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-506-51","proprietary_name":"Colesevelam HCL","nonproprietary_name":"Colesevelam HCL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (67877-506-51)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"68462043318","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-433-18","proprietary_name":"colesevelam hydrochloride","nonproprietary_name":"colesevelam hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (68462-433-18)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"69452015825","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-158-25","proprietary_name":"COLESEVELAM HYDROCHLORIDE","nonproprietary_name":"colesevelam hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Bionpharma Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (69452-158-25)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"69452049325","name":"COLESEVELAM 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-493-25","proprietary_name":"COLESEVELAM HYDROCHLORIDE","nonproprietary_name":"colesevelam hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Bionpharma Inc.","package_description":"180 TABLET in 1 BOTTLE (69452-493-25)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"00713093530","name":"COLESEVELAM HCL 3.75 G PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":2.70422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"67877052330","name":"COLESEVELAM HCL 3.75 G PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-523-30","proprietary_name":"Colesevelam hydrochloride","nonproprietary_name":"Colesevelam hydrochloride","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"3.75 g/1","labeler":"Ascend Laboratories, LLC","package_description":"30 POWDER, FOR SUSPENSION in 1 PACKET (67877-523-30)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":2.70422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"68462062030","name":"COLESEVELAM HCL 3.75 G PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-620-30","proprietary_name":"Colesevelam Hydrochloride","nonproprietary_name":"Colesevelam Hydrochloride","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"3.75 g/1","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"30 PACKET in 1 BOX (68462-620-30) / 1 POWDER, FOR SUSPENSION in 1 PACKET","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":2.70422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Colesevelam HCl|Colesevelam HCl","basis":"generic"},"part_b":null}, {"ndc":"00115521116","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-5211-16","proprietary_name":"COLESTIPOL HYDROCHLORIDE","nonproprietary_name":"COLESTIPOL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0115-5211-16)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799011501","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-115-01","proprietary_name":"Colestipol Hydrochloride","nonproprietary_name":"Colestipol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"120 TABLET in 1 BOTTLE (42799-115-01)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742028412","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-284-12","proprietary_name":"Colestipol Hydrochloride","nonproprietary_name":"Colestipol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (50742-284-12)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762045001","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0450-1","proprietary_name":"Colestipol Hydrochloride","nonproprietary_name":"Colestipol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"120 TABLET in 1 BOTTLE (59762-0450-1)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071511","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071521","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-715-21","proprietary_name":"Colestipol Hydrochloride","nonproprietary_name":"Colestipol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-715-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-715-11)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559039512","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-395-12","proprietary_name":"COLESTIPOL HYDROCHLORIDE","nonproprietary_name":"COLESTIPOL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62559-395-12)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710146707","name":"COLESTIPOL HCL 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1467-7","proprietary_name":"Colestipol hydrochloride","nonproprietary_name":"Colestipol hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (70710-1467-7)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.65794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762026003","name":"COLESTIPOL HCL GRANULES","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59762-0260-3","proprietary_name":"Colestipol Hydrochloride","nonproprietary_name":"Colestipol Hydrochloride","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"5 g/5g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 g in 1 BOTTLE (59762-0260-3)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.26866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00143944301","name":"COLISTIMETHATE 150 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9443-01","proprietary_name":"Colistimethate","nonproprietary_name":"Colistimethate Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"150 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (0143-9443-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS","pharm_classes":["Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":15.48667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-03","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0770","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0770 (150 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0143-9443-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"23155019331","name":"COLISTIMETHATE 150 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23155-193-31","proprietary_name":"COLISTIMETHATE SODIUM","nonproprietary_name":"COLISTIMETHATE SODIUM","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"150 mg/4mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (23155-193-31) / 4 mL in 1 VIAL, GLASS","pharm_classes":["Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":15.48667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0770","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0770 (150 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (23155-193-31) / 4 mL in 1 VIAL, GLASS) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323039306","name":"COLISTIMETHATE 150 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-393-06","proprietary_name":"Colistimethate","nonproprietary_name":"COLISTIMETHATE SODIUM","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"150 mg/2mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL in 1 BOX (63323-393-06) / 2 mL in 1 VIAL","pharm_classes":["Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":15.48667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0770","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0770 (150 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX (63323-393-06) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70594002301","name":"COLISTIMETHATE 150 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70594-023-01","proprietary_name":"Colistimethate","nonproprietary_name":"Colistimethate Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"150 mg/1","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"1 VIAL, GLASS in 1 VIAL (70594-023-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS","pharm_classes":["Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":15.48667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0770","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0770 (150 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 VIAL (70594-023-01) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70594002309","name":"COLISTIMETHATE 150 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70594-023-09","proprietary_name":"Colistimethate","nonproprietary_name":"colistimethate sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"150 mg/1","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"1 VIAL in 1 CARTON (70594-023-09) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":15.48667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0770","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0770 (150 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70594-023-09) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00023921105","name":"COMBIGAN 0.2%-0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9211-05","proprietary_name":"COMBIGAN","nonproprietary_name":"brimonidine tartrate, timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9211-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":39.15623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":2.71747,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Combigan|Brimonidine Tartrate/Timolol","basis":"brand"},"part_b":null}, {"ndc":"00023921110","name":"COMBIGAN 0.2%-0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9211-10","proprietary_name":"COMBIGAN","nonproprietary_name":"brimonidine tartrate, timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9211-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":39.09588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":2.15126,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Combigan|Brimonidine Tartrate/Timolol","basis":"brand"},"part_b":null}, {"ndc":"00023921115","name":"COMBIGAN 0.2%-0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9211-15","proprietary_name":"COMBIGAN","nonproprietary_name":"brimonidine tartrate, timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9211-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":39.09128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.97168,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Combigan|Brimonidine Tartrate/Timolol","basis":"brand"},"part_b":null}, {"ndc":"68968051401","name":"COMBIPATCH 0.05-0.14 MG PTCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":31.83617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Combipatch|Estradiol/Norethindrone Acet","basis":"brand"},"part_b":null}, {"ndc":"68968051408","name":"COMBIPATCH 0.05-0.14 MG PTCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0514-8","proprietary_name":"CombiPatch (estradiol/norethindrone acetate transdermal system)","nonproprietary_name":"estradiol/norethindrone acetate transdermal system","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d; .14 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-0514-8) / 1 PATCH in 1 POUCH / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":31.83617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Combipatch|Estradiol/Norethindrone Acet","basis":"brand"},"part_b":null}, {"ndc":"68968052501","name":"COMBIPATCH 0.05-0.25 MG PTCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":31.7862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Combipatch|Estradiol/Norethindrone Acet","basis":"brand"},"part_b":null}, {"ndc":"68968052508","name":"COMBIPATCH 0.05-0.25 MG PTCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0525-8","proprietary_name":"CombiPatch (estradiol/norethindrone acetate transdermal system)","nonproprietary_name":"estradiol/norethindrone acetate transdermal system","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d; .25 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-0525-8) / 1 PATCH in 1 POUCH / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":31.7862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Combipatch|Estradiol/Norethindrone Acet","basis":"brand"},"part_b":null}, {"ndc":"00597002402","name":"COMBIVENT RESPIMAT 20-100 MCG","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0024-02","proprietary_name":"Combivent Respimat","nonproprietary_name":"ipratropium bromide and albuterol","dosage_form":"SPRAY, METERED","route":"RESPIRATORY (INHALATION)","strength":"20 ug/1; 100 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 CARTRIDGE in 1 CARTON (0597-0024-02) / 120 SPRAY, METERED in 1 CARTRIDGE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":124.15814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Combivent Respimat|Ipratropium/Albuterol Sulfate","basis":"brand"},"part_b":null}, {"ndc":"61958110101","name":"COMPLERA TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-1101-1","proprietary_name":"COMPLERA","nonproprietary_name":"emtricitabine, rilpivirine hydrochloride, and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 25 mg/1; 300 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (61958-1101-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":130.31417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":114.503,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Complera|Emtricita/Rilpivirine/Tenof Df","basis":"brand"},"part_b":null}, {"ndc":"13811001030","name":"COMPLETE NATAL DHA","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Complete Natal DHA|PNV Cmb 52/Iron/FA/Omega-3/DHA","basis":"brand"},"part_b":null}, {"ndc":"13811001490","name":"COMPLETENATE TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574722612","name":"COMPRO 25 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-7226-12","proprietary_name":"Compro","nonproprietary_name":"PROCHLORPERAZINE","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"25 mg/1","labeler":"Padagis US LLC","package_description":"12 PACKET in 1 CARTON (0574-7226-12) / 1 SUPPOSITORY in 1 PACKET","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":6.74227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.86511,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Compro|Prochlorperazine","basis":"brand"},"part_b":null}, {"ndc":"52747062130","name":"CONCEPT DHA CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52747-621-30","proprietary_name":"Concept DHA","nonproprietary_name":"Vitamin- Mineral Omega-3 Supplement","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"17.5 mg/1; 17.5 mg/1; 25 mg/1; 1 mg/1; 2 mg/1; 3 mg/1; 1.8 mg/1; 5 mg/1; 25 mg/1; 300 ug/1; 12.5 ug/1; 2 mg/1; 5 mg/1; 10 mg/1; 200 mg/1","labeler":"U.S. Pharmaceutical Corporation","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (52747-621-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Calculi Dissolution Agent [EPC]","Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Fatty Acids, Omega-3 [CS]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Omega-3 Fatty Acid [EPC]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":1.161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458058501","name":"CONCERTA ER 18 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-585-01","proprietary_name":"CONCERTA","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-585-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.32528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458058801","name":"CONCERTA ER 27 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-588-01","proprietary_name":"CONCERTA","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-588-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.65426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458058601","name":"CONCERTA ER 36 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-586-01","proprietary_name":"CONCERTA","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-586-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":13.04275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458058701","name":"CONCERTA ER 54 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-587-01","proprietary_name":"CONCERTA","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-587-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.17967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65219066801","name":"CONEXXENCE 60 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-668-01","proprietary_name":"CONEXXENCE","nonproprietary_name":"Denosumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (65219-668-01) / 1 mL in 1 SYRINGE, PLASTIC","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":1740.44875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5158","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5158 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, PLASTIC in 1 CARTON (65219-668-01) / 1 mL in 1 SYRINGE, PLASTIC) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50742038901","name":"CONJUGATED ESTROGEN 0.625 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-389-01","proprietary_name":"estrogens, conjugated","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".625 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50742-389-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.46982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993029702","name":"CONJUGATED ESTROGEN 0.625 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-297-02","proprietary_name":"Conjugated Estrogens","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".625 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-297-02)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.46982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742038701","name":"CONJUGATED ESTROGENS 0.3 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-387-01","proprietary_name":"estrogens, conjugated","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".3 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50742-387-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.37279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993029502","name":"CONJUGATED ESTROGENS 0.3 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-295-02","proprietary_name":"Conjugated Estrogens","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".3 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-295-02)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.37279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742038801","name":"CONJUGATED ESTROGENS 0.45 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-388-01","proprietary_name":"estrogens, conjugated","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".45 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50742-388-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.4808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993029602","name":"CONJUGATED ESTROGENS 0.45 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-296-02","proprietary_name":"Conjugated Estrogens","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".45 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-296-02)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.4808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742039001","name":"CONJUGATED ESTROGENS 0.9 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-390-01","proprietary_name":"estrogens, conjugated","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".9 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50742-390-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.57252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993029802","name":"CONJUGATED ESTROGENS 0.9 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-298-02","proprietary_name":"Conjugated Estrogens","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".9 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-298-02)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.57252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742039101","name":"CONJUGATED ESTROGENS 1.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-391-01","proprietary_name":"estrogens, conjugated","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50742-391-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.47658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993029902","name":"CONJUGATED ESTROGENS 1.25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-299-02","proprietary_name":"Conjugated Estrogens","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-299-02)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":5.47658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45963043963","name":"CONSTULOSE 10 GM/15 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-439-63","proprietary_name":"Constulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Actavis Pharma, Inc.","package_description":"237 mL in 1 BOTTLE (45963-439-63)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Constulose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"45963043965","name":"CONSTULOSE 10 GM/15 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-439-65","proprietary_name":"Constulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Actavis Pharma, Inc.","package_description":"946 mL in 1 BOTTLE (45963-439-65)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Constulose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"70000061701","name":"COOLING PAIN RELIEF 4% GEL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0617-1","proprietary_name":"Leader Roll-On Cooling Pain Relief Topical Analgesic","nonproprietary_name":"MENTHOL, UNSPECIFIED FORM","dosage_form":"GEL","route":"TOPICAL","strength":"40 mg/mL","labeler":"Cardinal Health, 110 dba LEADER","package_description":"74 mL in 1 BOTTLE, WITH APPLICATOR (70000-0617-1)"},"nadac":{"value":0.0593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000061801","name":"COOLING PAIN RELIEF 4% GEL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0618-1","proprietary_name":"Leader Cooling Pain Relief Topical Analgesic","nonproprietary_name":"MENTHOL, UNSPECIFIED FORM","dosage_form":"GEL","route":"TOPICAL","strength":"40 mg/mL","labeler":"Cardinal Health, 110 dba LEADER","package_description":"89 mL in 1 TUBE (70000-0618-1)"},"nadac":{"value":0.05218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68546031730","name":"COPAXONE 20 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-317-30","proprietary_name":"Copaxone","nonproprietary_name":"Glatiramer Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/mL","labeler":"Teva Neuroscience, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (68546-317-30) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS"},"nadac":{"value":229.7988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":41.75705,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Copaxone|Glatiramer Acetate","basis":"brand"},"part_b":null}, {"ndc":"68546032512","name":"COPAXONE 40 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68546-325-12","proprietary_name":"Copaxone","nonproprietary_name":"Glatiramer Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/mL","labeler":"Teva Neuroscience, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (68546-325-12) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS"},"nadac":{"value":541.11563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":86.09516,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Copaxone|Glatiramer Acetate","basis":"brand"},"part_b":null}, {"ndc":"55513080060","name":"CORLANOR 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-800-60","proprietary_name":"Corlanor","nonproprietary_name":"ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amgen Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55513-800-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":10.01046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Corlanor|IVabradine HCl","basis":"brand"},"part_b":null}, {"ndc":"55513081060","name":"CORLANOR 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-810-60","proprietary_name":"Corlanor","nonproprietary_name":"ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Amgen Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55513-810-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":9.99769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Corlanor|IVabradine HCl","basis":"brand"},"part_b":null}, {"ndc":"70000033001","name":"CORN REMOVER 40% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0330-1","proprietary_name":"Salicylic Acid","nonproprietary_name":"Medicated Corn Removers","dosage_form":"PATCH","route":"TOPICAL","strength":"400 mg/g","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"9 PATCH in 1 CARTON (70000-0330-1) / 1 g in 1 PATCH"},"nadac":{"value":0.10249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00009003101","name":"CORTEF 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0031-01","proprietary_name":"CORTEF","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"100 TABLET in 1 BOTTLE (0009-0031-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.63356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cortef|Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"00009001201","name":"CORTEF 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0012-01","proprietary_name":"CORTEF","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"50 TABLET in 1 BOTTLE (0009-0012-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.9751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cortef|Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"00037683015","name":"CORTIFOAM 10% AEROSOL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-6830-15","proprietary_name":"Cortifoam","nonproprietary_name":"hydrocortisone acetate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1500 mg/15g","labeler":"Viatris Specialty LLC","package_description":"1 CANISTER in 1 CARTON (0037-6830-15) / 15 g in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.66807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Cortifoam|Hydrocortisone Acetate","basis":"brand"},"part_b":null}, {"ndc":"63481052910","name":"CORTISPORIN-TC EAR SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63481-529-10","proprietary_name":"Cortisporin TC","nonproprietary_name":"colistin sulfate, neomycin sulfate, thonzonium bromide and hydrocortisone acetate","dosage_form":"SUSPENSION","route":"AURICULAR (OTIC)","strength":"3 mg/mL; 3.3 mg/mL; .5 mg/mL; 10 mg/mL","labeler":"Endo USA, Inc.","package_description":"10 mL in 1 BOTTLE, DROPPER (63481-529-10)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":21.981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078063998","name":"COSENTYX (150 MG/ML) 300 MG DOSE-2 SYRINGES","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0639-98","proprietary_name":"COSENTYX","nonproprietary_name":"secukinumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"2 mL in 1 CARTON (0078-0639-98)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":3924.35313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078063997","name":"COSENTYX 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0639-97","proprietary_name":"COSENTYX","nonproprietary_name":"secukinumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 mL in 1 CARTON (0078-0639-97)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":7879.81111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078063968","name":"COSENTYX SENSOREADY 150 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0639-68","proprietary_name":"COSENTYX","nonproprietary_name":"secukinumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 mL in 1 CARTON (0078-0639-68)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":7858.47545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078063941","name":"COSENTYX SENSOREADY 300 MG DOSE/2 PENS (150 MG/PEN)","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0639-41","proprietary_name":"COSENTYX","nonproprietary_name":"secukinumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"2 mL in 1 CARTON (0078-0639-41)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":3946.34864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078107068","name":"COSENTYX UNOREADY 300 MG/2 ML PEN (1 PEN)","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-1070-68","proprietary_name":"COSENTYX","nonproprietary_name":"secukinumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"300 mg/2mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 SYRINGE, GLASS in 1 CARTON (0078-1070-68) / 2 mL in 1 SYRINGE, GLASS","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":4087.40667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82584060510","name":"COSOPT EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82584-605-10","proprietary_name":"COSOPT","nonproprietary_name":"dorzolamide hydrochloride and timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Thea Pharma Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82584-605-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":23.16154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cosopt|Dorzolamide HCl/Timolol Maleat","basis":"brand"},"part_b":null}, {"ndc":"82584060430","name":"COSOPT PF EYE DROPS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82584-604-30","proprietary_name":"COSOPT PF","nonproprietary_name":"dorzolamide hydrochloride and timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Thea Pharma Inc.","package_description":"4 POUCH in 1 CARTON (82584-604-30) / 15 VIAL, SINGLE-DOSE in 1 POUCH (82584-604-01) / .2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":3.29952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.09395,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cosopt PF|Dorzolamide/Timolol/PF","basis":"brand"},"part_b":null}, {"ndc":"70165020030","name":"COTEMPLA XR-ODT 17.3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-200-30","proprietary_name":"Cotempla XR-ODT","nonproprietary_name":"Methylphenidate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"17.3 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"5 BLISTER PACK in 1 CARTON (70165-200-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":17.89343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cotempla XR-ODT|Methylphenidate","basis":"brand"},"part_b":null}, {"ndc":"70165030030","name":"COTEMPLA XR-ODT 25.9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-300-30","proprietary_name":"Cotempla XR-ODT","nonproprietary_name":"Methylphenidate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25.9 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"5 BLISTER PACK in 1 CARTON (70165-300-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":17.97122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cotempla XR-ODT|Methylphenidate","basis":"brand"},"part_b":null}, {"ndc":"70165010030","name":"COTEMPLA XR-ODT 8.6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70165-100-30","proprietary_name":"Cotempla XR-ODT","nonproprietary_name":"Methylphenidate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8.6 mg/1","labeler":"Neos Therapeutics Brands, LLC","package_description":"5 BLISTER PACK in 1 CARTON (70165-100-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":18.04904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cotempla XR-ODT|Methylphenidate","basis":"brand"},"part_b":null}, {"ndc":"00536134897","name":"COUGH DM 20-200 MG/20 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1348-97","proprietary_name":"rugby cough syrup","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1348-97) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904631256","name":"COUGH DM ER 30 MG/5 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6312-56","proprietary_name":"cough dm","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6312-56) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122014121","name":"COUGH DM ER 30 MG/5 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-141-21","proprietary_name":"Good Neighbor Pharmacy Cough DM ER","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-141-21) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122014125","name":"COUGH DM ER 30 MG/5 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-141-25","proprietary_name":"Good Neighbor Pharmacy Cough DM ER","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-141-25) / 148 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.05255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000018701","name":"COUGH DM ER 30 MG/5 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0187-1","proprietary_name":"Leader Cough DM","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0187-1) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000030201","name":"COUGH DM ER 30 MG/5 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0302-1","proprietary_name":"Leader Cough DM","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0302-1) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000063801","name":"COUGH DROPS 5.4 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0638-1","proprietary_name":"Cough Drops Menthol","nonproprietary_name":"Menthol Cough Drops","dosage_form":"PASTILLE","route":"ORAL","strength":"5.4 mg/1","labeler":"Cardinal Health 110, Inc.","package_description":"30 PASTILLE in 1 BAG (70000-0638-1)"},"nadac":{"value":0.03404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000064001","name":"COUGH DROPS 5.8 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0640-1","proprietary_name":"Cough Drops Cherry","nonproprietary_name":"Cherry Flavor Cough Drops","dosage_form":"PASTILLE","route":"ORAL","strength":"5.8 mg/1","labeler":"Cardinal Health 110, Inc.","package_description":"30 PASTILLE in 1 BAG (70000-0640-1)"},"nadac":{"value":0.04242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000064101","name":"COUGH DROPS 5.8 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0641-1","proprietary_name":"Sugar Free Cough Drops","nonproprietary_name":"Menthol","dosage_form":"PASTILLE","route":"ORAL","strength":"5.8 mg/1","labeler":"Cardinal Health 110, Inc.","package_description":"25 PASTILLE in 1 BAG (70000-0641-1)"},"nadac":{"value":0.04242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000064301","name":"COUGH DROPS 5.8 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0643-1","proprietary_name":"Sugar Free Cough Drops Black Cherry","nonproprietary_name":"Menthol","dosage_form":"PASTILLE","route":"ORAL","strength":"5.8 mg/1","labeler":"Cardinal Health 110, Inc.","package_description":"25 PASTILLE in 1 BAG (70000-0643-1)"},"nadac":{"value":0.04242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000063901","name":"COUGH DROPS 7.5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0639-1","proprietary_name":"Cough Drops Menthol Honey Lemon","nonproprietary_name":"Cough Drops Menthol","dosage_form":"PASTILLE","route":"ORAL","strength":"7.5 mg/1","labeler":"Cardinal Health 110, Inc.","package_description":"30 PASTILLE in 1 BAG (70000-0639-1)"},"nadac":{"value":0.03382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599050003","name":"COUGH DROPS 7.6 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-0500-3","proprietary_name":"McKesson Cough Supressant","nonproprietary_name":"Menthol","dosage_form":"LOZENGE","route":"ORAL","strength":"7.6 mg/1","labeler":"McKesson Medical-Surgical","package_description":"300 LOZENGE in 1 CARTON (68599-0500-3)"},"nadac":{"value":0.04354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000064201","name":"COUGH DROPS 7.6 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0642-1","proprietary_name":"Sugar Free Cough Drops Honey Lemon","nonproprietary_name":"Menthol","dosage_form":"PASTILLE","route":"ORAL","strength":"7.6 mg/1","labeler":"Cardinal Health 110, Inc.","package_description":"25 PASTILLE in 1 BAG (70000-0642-1)"},"nadac":{"value":0.04354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000032401","name":"COUGH-COLD HBP TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0324-1","proprietary_name":"Cough and Cold HBP","nonproprietary_name":"Chlorpheniramine maleate, Dextromethorphan HBr","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1; 30 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0324-1) / 8 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904663444","name":"COUGH-COLD TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6634-44","proprietary_name":"Cough and Cold","nonproprietary_name":"Chlorpheniramine maleate, Dextromethorphan HBr","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1; 30 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-6634-44) / 8 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"78206012301","name":"COZAAR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-123-01","proprietary_name":"COZAAR","nonproprietary_name":"losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-123-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":6.13999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cozaar|Losartan Potassium","basis":"brand"},"part_b":null}, {"ndc":"78206012302","name":"COZAAR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-123-02","proprietary_name":"COZAAR","nonproprietary_name":"losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-123-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":6.13999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cozaar|Losartan Potassium","basis":"brand"},"part_b":null}, {"ndc":"78206012101","name":"COZAAR 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-121-01","proprietary_name":"COZAAR","nonproprietary_name":"losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-121-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":3.36363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cozaar|Losartan Potassium","basis":"brand"},"part_b":null}, {"ndc":"78206012201","name":"COZAAR 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-122-01","proprietary_name":"COZAAR","nonproprietary_name":"losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-122-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":4.49351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cozaar|Losartan Potassium","basis":"brand"},"part_b":null}, {"ndc":"78206012202","name":"COZAAR 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-122-02","proprietary_name":"COZAAR","nonproprietary_name":"losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-122-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":4.49351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cozaar|Losartan Potassium","basis":"brand"},"part_b":null}, {"ndc":"00032004770","name":"CREON DR 12,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-0047-70","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60000 [USP'U]/1; 12000 [USP'U]/1; 38000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-0047-70)"},"nadac":{"value":4.20721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032121201","name":"CREON DR 12,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-1212-01","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60000 [USP'U]/1; 12000 [USP'U]/1; 38000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-1212-01)"},"nadac":{"value":4.20721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032122401","name":"CREON DR 24,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-1224-01","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"24000 [USP'U]/1; 76000 [USP'U]/1; 120000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-1224-01)"},"nadac":{"value":8.34176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032263601","name":"CREON DR 24,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-2636-01","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"24000 [USP'U]/1; 76000 [USP'U]/1; 120000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-2636-01)"},"nadac":{"value":8.34176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032004570","name":"CREON DR 3,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-0045-70","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15000 [USP'U]/1; 3000 [USP'U]/1; 9500 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"70 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0032-0045-70)"},"nadac":{"value":1.7761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032120370","name":"CREON DR 3,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-1203-70","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15000 [USP'U]/1; 3000 [USP'U]/1; 9500 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"1 BOTTLE in 1 CARTON (0032-1203-70) / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":1.7761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032263701","name":"CREON DR 36,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-2637-01","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"36000 [USP'U]/1; 180000 [USP'U]/1; 114000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-2637-01)"},"nadac":{"value":12.67101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032301613","name":"CREON DR 36,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-3016-13","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"36000 [USP'U]/1; 180000 [USP'U]/1; 114000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-3016-13)"},"nadac":{"value":12.67101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032004670","name":"CREON DR 6,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-0046-70","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30000 [USP'U]/1; 6000 [USP'U]/1; 19000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0032-0046-70)"},"nadac":{"value":2.10487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00032120601","name":"CREON DR 6,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0032-1206-01","proprietary_name":"Creon","nonproprietary_name":"Pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30000 [USP'U]/1; 6000 [USP'U]/1; 19000 [USP'U]/1","labeler":"AbbVie Inc.","package_description":"1 BOTTLE in 1 CARTON (0032-1206-01) / 100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE"},"nadac":{"value":2.10487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00469052001","name":"CRESEMBA 186 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":113.99816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cresemba*|Isavuconazonium Sulfate","basis":"brand","route_from":"fda_product","route":"ORAL","product_ndc":"0469-0520","inner_of":[]},"part_b":null}, {"ndc":"00469052002","name":"CRESEMBA 186 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-0520-02","proprietary_name":"CRESEMBA","nonproprietary_name":"isavuconazonium sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (0469-0520-02) / 7 CAPSULE in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":113.99816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cresemba*|Isavuconazonium Sulfate","basis":"brand"},"part_b":null}, {"ndc":"00310757090","name":"CRESTOR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-7570-90","proprietary_name":"Crestor","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0310-7570-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":8.8111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Crestor|Rosuvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"00310758090","name":"CRESTOR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-7580-90","proprietary_name":"Crestor","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0310-7580-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":8.80624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Crestor|Rosuvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"00310759030","name":"CRESTOR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-7590-30","proprietary_name":"Crestor","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0310-7590-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":8.80663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Crestor|Rosuvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"00310756090","name":"CRESTOR 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-7560-90","proprietary_name":"Crestor","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0310-7560-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":8.81421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Crestor|Rosuvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"64896096716","name":"CREXONT ER 35 MG-140 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64896-967-16","proprietary_name":"CREXONT","nonproprietary_name":"carbidopa and levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1; 140 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (64896-967-16) / 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":4.58989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896096816","name":"CREXONT ER 52.5 MG-210 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64896-968-16","proprietary_name":"CREXONT","nonproprietary_name":"carbidopa and levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"52.5 mg/1; 210 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (64896-968-16) / 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":4.5824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896096916","name":"CREXONT ER 70 MG-280 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64896-969-16","proprietary_name":"CREXONT","nonproprietary_name":"carbidopa and levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"70 mg/1; 280 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (64896-969-16) / 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":4.58002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896097016","name":"CREXONT ER 87.5 MG-350 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64896-970-16","proprietary_name":"CREXONT","nonproprietary_name":"carbidopa and levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"87.5 mg/1; 350 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (64896-970-16) / 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":4.58252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023615004","name":"CRINONE 4% GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-6150-04","proprietary_name":"Crinone","nonproprietary_name":"progesterone","dosage_form":"GEL","route":"VAGINAL","strength":"45 mg/1.125g","labeler":"Allergan, Inc.","package_description":"6 APPLICATOR in 1 CARTON (0023-6150-04) / 1.125 g in 1 APPLICATOR","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":16.84389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Crinone|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"00023615108","name":"CRINONE 8% GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6151-08","proprietary_name":"Crinone","nonproprietary_name":"progesterone","dosage_form":"GEL","route":"VAGINAL","strength":"90 mg/1.125g","labeler":"Allergan, Inc.","package_description":"15 APPLICATOR in 1 CARTON (0023-6151-08) / 1.125 g in 1 APPLICATOR","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":27.97261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Crinone|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"16571060096","name":"CROMOLYN 100 MG/5 ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-600-96","proprietary_name":"CROMOLYN SODIUM","nonproprietary_name":"CROMOLYN SODIUM","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"100 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"12 POUCH in 1 CARTON (16571-600-96) / 8 AMPULE in 1 POUCH / 5 mL in 1 AMPULE","pharm_classes":["Decreased Histamine Release [PE]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.34899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cromolyn Sodium*|Cromolyn Sodium","basis":"generic"},"part_b":null}, {"ndc":"42571013252","name":"CROMOLYN 100 MG/5 ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-132-52","proprietary_name":"CROMOLYN SODIUM","nonproprietary_name":"Cromolyn sodium","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"100 mg/5mL","labeler":"Micro Labs Limited","package_description":"96 CARTON in 1 CARTON (42571-132-52) / 1 TRAY in 1 CARTON / 8 AMPULE in 1 TRAY / 5 mL in 1 AMPULE (42571-132-21)","pharm_classes":["Decreased Histamine Release [PE]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.34899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cromolyn Sodium*|Cromolyn Sodium","basis":"generic"},"part_b":null}, {"ndc":"76204002596","name":"CROMOLYN 100 MG/5 ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.34899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81665010496","name":"CROMOLYN 100 MG/5 ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-104-96","proprietary_name":"CROMOLYN SODIUM","nonproprietary_name":"CROMOLYN SODIUM","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"100 mg/5mL","labeler":"Omnivium Pharmaceuticals LLC","package_description":"12 POUCH in 1 CARTON (81665-104-96) / 8 AMPULE in 1 POUCH / 5 mL in 1 AMPULE","pharm_classes":["Decreased Histamine Release [PE]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.34899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cromolyn Sodium*|Cromolyn Sodium","basis":"generic"},"part_b":null}, {"ndc":"00172640649","name":"CROMOLYN 20 MG/2 ML NEB SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-6406-49","proprietary_name":"Cromolyn Sodium","nonproprietary_name":"Cromolyn Sodium","dosage_form":"SOLUTION","route":"INTRABRONCHIAL","strength":"20 mg/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"12 POUCH in 1 CARTON (0172-6406-49) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0172-6406-05) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Decreased Histamine Release [PE]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.96262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7631","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7631 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (0172-6406-49) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0172-6406-05) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42571035009","name":"CROMOLYN 20 MG/2 ML NEB SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.96262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204002860","name":"CROMOLYN 20 MG/2 ML NEB SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.96262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7631","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7631 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"61314023710","name":"CROMOLYN 4% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-237-10","proprietary_name":"Cromolyn Sodium","nonproprietary_name":"Cromolyn Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"40 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-237-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.59532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00682005130","name":"CROTAN 10% LOTION","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0682-0051-30","proprietary_name":"Crotan","nonproprietary_name":"Crotamiton","dosage_form":"LOTION","route":"TOPICAL","strength":"100 mg/g","labeler":"Marnel Pharmaceuticals, Inc.","package_description":"454 g in 1 BOTTLE, PLASTIC (0682-0051-30)"},"nadac":{"value":3.1167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Crotan|Crotamiton","basis":"brand"},"part_b":null}, {"ndc":"00480349316","name":"CRYSELLE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3493-16","proprietary_name":"Cryselle","nonproprietary_name":"Norgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Teva Pharmaceuticals, Inc.","package_description":"6 POUCH in 1 CARTON (0480-3493-16) / 1 BLISTER PACK in 1 POUCH (0480-3493-24) / 1 KIT in 1 BLISTER PACK * 21 TABLET in 1 BLISTER PACK (0480-5793-11) * 7 TABLET in 1 BLISTER PACK (0480-5794-22)"},"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cryselle|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00480349324","name":"CRYSELLE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cryselle|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555904958","name":"CRYSELLE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9049-58","proprietary_name":"Cryselle","nonproprietary_name":"Norgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9049-58) / 1 BLISTER PACK in 1 POUCH (0555-9049-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cryselle|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555904979","name":"CRYSELLE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cryselle|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00259050116","name":"CUVPOSA 1 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0259-0501-16","proprietary_name":"Cuvposa","nonproprietary_name":"glycopyrrolate","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/5mL","labeler":"Merz Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (0259-0501-16) / 473 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.00673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cuvposa|Glycopyrrolate","basis":"brand"},"part_b":null}, {"ndc":"00143962125","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9621-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 BOX (0143-9621-25) / 1 mL in 1 VIAL (0143-9621-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 BOX (0143-9621-25) / 1 mL in 1 VIAL (0143-9621-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517003125","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0031-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"American Regent, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0517-0031-25) / 1 mL in 1 VIAL, MULTI-DOSE (0517-0031-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (0517-0031-25) / 1 mL in 1 VIAL, MULTI-DOSE (0517-0031-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021050201","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-502-01","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-502-01) / 1 mL in 1 VIAL","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-502-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323004401","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-044-01","proprietary_name":"Cyanocobalamin","nonproprietary_name":"CYANOCOBALAMIN","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-044-01) / 1 mL in 1 VIAL, MULTI-DOSE (63323-044-00)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-044-01) / 1 mL in 1 VIAL, MULTI-DOSE (63323-044-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323004444","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-044-44","proprietary_name":"Cyanocobalamin","nonproprietary_name":"CYANOCOBALAMIN","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-044-44) / 1 mL in 1 VIAL, MULTI-DOSE (63323-044-41)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-044-44) / 1 mL in 1 VIAL, MULTI-DOSE (63323-044-41)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001054260","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-542-60","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"BluePoint Laboratories","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (68001-542-60) / 1 mL in 1 VIAL, MULTI-DOSE (68001-542-59)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (68001-542-60) / 1 mL in 1 VIAL, MULTI-DOSE (68001-542-59)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001064060","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-640-60","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"BluePoint Laboratories","package_description":"25 VIAL in 1 CARTON (68001-640-60) / 1 mL in 1 VIAL (68001-640-59)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (68001-640-60) / 1 mL in 1 VIAL (68001-640-59)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69680011210","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-112-10","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Vitruvias Therapeutics","package_description":"10 VIAL in 1 BOX (69680-112-10) / 1 mL in 1 VIAL (69680-112-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":2.97018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 BOX (69680-112-10) / 1 mL in 1 VIAL (69680-112-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69680011225","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-112-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Vitruvias Therapeutics","package_description":"25 VIAL in 1 BOX (69680-112-25) / 1 mL in 1 VIAL (69680-112-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 BOX (69680-112-25) / 1 mL in 1 VIAL (69680-112-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069000510","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-005-10","proprietary_name":"cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Somerset Therapeutics, LLC","package_description":"25 VIAL in 1 CARTON (70069-005-10) / 1 mL in 1 VIAL (70069-005-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70069-005-10) / 1 mL in 1 VIAL (70069-005-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70512084025","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-840-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"SOLA Pharmaceuticals","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (70512-840-25) / 1 mL in 1 VIAL, MULTI-DOSE (70512-840-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756063525","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-635-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Lifestar Pharma LLC","package_description":"25 VIAL in 1 CARTON (70756-635-25) / 1 mL in 1 VIAL","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70756-635-25) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288030002","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-300-02","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (71288-300-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-300-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (71288-300-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-300-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288030092","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-300-92","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (71288-300-92) / 1 mL in 1 VIAL, MULTI-DOSE (71288-300-91)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71288030302","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-303-02","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (71288-303-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-303-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (71288-303-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-303-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288030392","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-303-92","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (71288-303-92) / 1 mL in 1 VIAL, MULTI-DOSE (71288-303-91)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (71288-303-92) / 1 mL in 1 VIAL, MULTI-DOSE (71288-303-91)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603065025","name":"CYANOCOBALAMIN 1,000 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-650-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL in 1 CARTON (72603-650-25) / 1 mL in 1 VIAL (72603-650-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":1.47387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72603-650-25) / 1 mL in 1 VIAL (72603-650-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143962001","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.97018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143962010","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9620-10","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (0143-9620-10) / 10 mL in 1 VIAL, MULTI-DOSE (0143-9620-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 BOX (0143-9620-10) / 10 mL in 1 VIAL, MULTI-DOSE (0143-9620-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517003201","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.97018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00517003225","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0032-25","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"American Regent, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0517-0032-25) / 10 mL in 1 VIAL, MULTI-DOSE (0517-0032-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":2.13372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (0517-0032-25) / 10 mL in 1 VIAL, MULTI-DOSE (0517-0032-01)) gives 250 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69680011310","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.97018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69680011399","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-113-99","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Vitruvias Therapeutics","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (69680-113-99) / 10 mL in 1 VIAL, MULTI-DOSE (69680-113-10)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 BOX (69680-113-99) / 10 mL in 1 VIAL, MULTI-DOSE (69680-113-10)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069017201","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.97018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069017210","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-172-10","proprietary_name":"cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL in 1 CARTON (70069-172-10) / 10 mL in 1 VIAL (70069-172-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70069-172-10) / 10 mL in 1 VIAL (70069-172-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288030110","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.97018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71288030111","name":"CYANOCOBALAMIN 10,000 MCG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-301-11","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (71288-301-11) / 10 mL in 1 VIAL, MULTI-DOSE (71288-301-10)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 CARTON (71288-301-11) / 10 mL in 1 VIAL, MULTI-DOSE (71288-301-10)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143961901","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9619-01","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.78707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01)) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143961910","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9619-10","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (0143-9619-10) / 30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01)","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.32805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 BOX (0143-9619-10) / 30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01)) gives 300 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517013001","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0130-01","proprietary_name":"Cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 BOX (0517-0130-01) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.78707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 BOX (0517-0130-01) / 30 mL in 1 VIAL, MULTI-DOSE) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69680012105","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-121-05","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Vitruvias Therapeutics","package_description":"5 VIAL, MULTI-DOSE in 1 BOX (69680-121-05) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.55247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, MULTI-DOSE in 1 BOX (69680-121-05) / 30 mL in 1 VIAL, MULTI-DOSE) gives 150 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69680012110","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69680-121-10","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Vitruvias Therapeutics","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (69680-121-10) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.32805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69680012130","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-121-30","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Vitruvias Therapeutics","package_description":"1 VIAL, MULTI-DOSE in 1 BOX (69680-121-30) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.78707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069017101","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.78707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069017110","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70069-171-10","proprietary_name":"CYANOCOBALAMIN","nonproprietary_name":"CYANOCOBALAMIN","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL in 1 CARTON (70069-171-10) / 30 mL in 1 VIAL","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.32805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70069-171-10) / 30 mL in 1 VIAL) gives 300 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288030230","name":"CYANOCOBALAMIN 30,000 MCG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-302-30","proprietary_name":"Cyanocobalamin","nonproprietary_name":"Cyanocobalamin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"1000 ug/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (71288-302-30) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":0.78707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3420","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3420 (1000 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (71288-302-30) / 30 mL in 1 VIAL, MULTI-DOSE) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43386023770","name":"CYANOCOBALAMIN 500 MCG SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":95.90838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802049184","name":"CYANOCOBALAMIN 500 MCG SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-491-84","proprietary_name":"cyanocobalamin","nonproprietary_name":"cyanocobalamin","dosage_form":"SPRAY","route":"NASAL","strength":"500 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"4 BOTTLE, UNIT-DOSE in 1 CARTON (45802-491-84) / 1 SPRAY in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Vitamin B 12 [CS]","Vitamin B12 [EPC]"]},"nadac":{"value":95.90838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342201","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3422-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-3422-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093342205","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3422-05","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-3422-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093342210","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3422-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-3422-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904740161","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7401-61","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7401-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702000710","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-007-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (10702-007-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702000750","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-007-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (10702-007-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571078301","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-783-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-783-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571078310","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-783-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-783-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571078350","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-783-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-783-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041501","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-415-01","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-415-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041510","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-415-10","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (29300-415-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041519","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-415-19","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (29300-415-19)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547040010","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-400-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-400-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547040011","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-400-11","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-400-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547040050","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-400-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-400-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019111","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019115","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-191-15","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-191-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-191-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817033200","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-332-00","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (52817-332-00)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817033210","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-332-10","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-332-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817033250","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-332-50","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (52817-332-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"59746017706","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-177-06","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-177-06)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"59746017710","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-177-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59746-177-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687055801","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-558-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-558-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-558-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687055811","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065701","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-657-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-657-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065710","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-657-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-657-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065750","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-657-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-657-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019105","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-191-05","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-191-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"69097084607","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-846-07","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69097-846-07)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"69097084615","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-846-15","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69097-846-15)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"70512087210","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-872-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70512-872-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603031201","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-312-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72603-312-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603031202","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-312-02","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-312-02)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603031203","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-312-03","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-312-03)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001400","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-014-00","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-014-00)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001401","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-014-01","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-014-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001405","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-014-05","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-014-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282028310","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-283-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (76282-283-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282028318","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-283-18","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"180 TABLET in 1 BOTTLE (76282-283-18)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282028327","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-283-27","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"270 TABLET in 1 BOTTLE (76282-283-27)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282028330","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-283-30","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"30 TABLET in 1 BOTTLE (76282-283-30)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282028360","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-283-60","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"60 TABLET in 1 BOTTLE (76282-283-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282028390","name":"CYCLOBENZAPRINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-283-90","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"90 TABLET in 1 BOTTLE (76282-283-90)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.01712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093342001","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3420-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-3420-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904740004","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7400-04","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7400-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904740006","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7400-06","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7400-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702000601","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-006-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (10702-006-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702000610","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-006-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (10702-006-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702000650","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-006-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (10702-006-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571078201","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-782-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-782-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571078210","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-782-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-782-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571078250","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-782-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-782-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041301","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-413-01","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-413-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041305","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-413-05","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (29300-413-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041319","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-413-19","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (29300-413-19)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547039910","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-399-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-399-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547039950","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-399-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-399-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019011","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019015","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-190-15","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-190-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-190-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817033010","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-330-10","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-330-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817033050","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-330-50","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (52817-330-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065501","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-655-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-655-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065510","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-655-10","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-655-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065550","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-655-50","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-655-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084075311","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084075325","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-753-25","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-753-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-753-95)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084075365","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-753-65","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-753-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-753-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084075395","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"69097084507","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-845-07","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69097-845-07)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603031001","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-310-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72603-310-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603031002","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-310-02","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-310-02)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001200","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-012-00","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-012-00)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001201","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-012-01","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-012-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001205","name":"CYCLOBENZAPRINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-012-05","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-012-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.02197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093342101","name":"CYCLOBENZAPRINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3421-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-3421-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300041401","name":"CYCLOBENZAPRINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-414-01","proprietary_name":"Cyclobenzaprine hydrochloride","nonproprietary_name":"Cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-414-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237026601","name":"CYCLOBENZAPRINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"59746073501","name":"CYCLOBENZAPRINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-735-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-735-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603031101","name":"CYCLOBENZAPRINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-311-01","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72603-311-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888001301","name":"CYCLOBENZAPRINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-013-01","proprietary_name":"CYCLOBENZAPRINE HYDROCHLORIDE","nonproprietary_name":"cyclobenzaprine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-013-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093192006","name":"CYCLOBENZAPRINE ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1920-06","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-1920-06)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":1.18556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl ER|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00115143613","name":"CYCLOBENZAPRINE ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1436-13","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1436-13)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":1.18556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl ER|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979003504","name":"CYCLOBENZAPRINE ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-035-04","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-035-04)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":1.18556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl ER|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093192106","name":"CYCLOBENZAPRINE ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1921-06","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-1921-06)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":1.0822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl ER|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00115143713","name":"CYCLOBENZAPRINE ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1437-13","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1437-13)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":1.0822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl ER|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979003604","name":"CYCLOBENZAPRINE ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-036-04","proprietary_name":"Cyclobenzaprine Hydrochloride","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-036-04)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":1.0822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl ER|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00065039515","name":"CYCLOGYL 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0395-15","proprietary_name":"Cyclogyl","nonproprietary_name":"cyclopentolate hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0065-0395-15) / 15 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":6.40467,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclogyl|Cyclopentolate HCl","basis":"brand"},"part_b":null}, {"ndc":"00065039702","name":"CYCLOGYL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0397-02","proprietary_name":"Cyclogyl","nonproprietary_name":"cyclopentolate hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0065-0397-02) / 2 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":22.096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclogyl|Cyclopentolate HCl","basis":"brand"},"part_b":null}, {"ndc":"00065039705","name":"CYCLOGYL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0397-05","proprietary_name":"Cyclogyl","nonproprietary_name":"cyclopentolate hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0065-0397-05) / 5 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":14.6264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclogyl|Cyclopentolate HCl","basis":"brand"},"part_b":null}, {"ndc":"24208073506","name":"CYCLOPENTOLATE 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-735-06","proprietary_name":"Cyclopentolate Hydrochloride","nonproprietary_name":"Cyclopentolate Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-735-06) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.86977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclopentolate HCl|Cyclopentolate HCl","basis":"generic"},"part_b":null}, {"ndc":"24208073501","name":"CYCLOPENTOLATE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-735-01","proprietary_name":"Cyclopentolate Hydrochloride","nonproprietary_name":"Cyclopentolate Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-735-01) / 2 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":2.64533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclopentolate HCl|Cyclopentolate HCl","basis":"generic"},"part_b":null}, {"ndc":"61314039601","name":"CYCLOPENTOLATE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-396-01","proprietary_name":"Cyclopentolate Hydrochloride","nonproprietary_name":"Cyclopentolate Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc.","package_description":"2 mL in 1 BOTTLE (61314-396-01)"},"nadac":{"value":2.64533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclopentolate HCl|Cyclopentolate HCl","basis":"generic"},"part_b":null}, {"ndc":"61314039603","name":"CYCLOPENTOLATE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-396-03","proprietary_name":"Cyclopentolate Hydrochloride","nonproprietary_name":"Cyclopentolate Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc.","package_description":"15 mL in 1 BOTTLE (61314-396-03)"},"nadac":{"value":0.86977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Cyclopentolate HCl|Cyclopentolate HCl","basis":"generic"},"part_b":null}, {"ndc":"00054038225","name":"CYCLOPHOSPHAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0054-0382-25","proprietary_name":"Cyclophosphamide","nonproprietary_name":"Cyclophosphamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0382-25)"},"nadac":{"value":1.12118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclophosphamide*|Cyclophosphamide","basis":"generic"},"part_b":{"hcpcs":"J8530","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8530 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0054-0382-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62332061831","name":"CYCLOPHOSPHAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-618-31","proprietary_name":"Cyclophosphamide","nonproprietary_name":"Cyclophosphamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-618-31)"},"nadac":{"value":1.12118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclophosphamide*|Cyclophosphamide","basis":"generic"},"part_b":null}, {"ndc":"69097051607","name":"CYCLOPHOSPHAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69097-516-07","proprietary_name":"Cyclophosphamide","nonproprietary_name":"Cyclophosphamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-516-07)"},"nadac":{"value":1.12118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclophosphamide*|Cyclophosphamide","basis":"generic"},"part_b":{"hcpcs":"J8530","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8530 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (69097-516-07)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054038325","name":"CYCLOPHOSPHAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0383-25","proprietary_name":"Cyclophosphamide","nonproprietary_name":"Cyclophosphamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0383-25)"},"nadac":{"value":1.67057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclophosphamide*|Cyclophosphamide","basis":"generic"},"part_b":{"hcpcs":"J8530","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8530 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0054-0383-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62332061931","name":"CYCLOPHOSPHAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-619-31","proprietary_name":"Cyclophosphamide","nonproprietary_name":"Cyclophosphamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-619-31)"},"nadac":{"value":1.67057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclophosphamide*|Cyclophosphamide","basis":"generic"},"part_b":null}, {"ndc":"69097051707","name":"CYCLOPHOSPHAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-517-07","proprietary_name":"Cyclophosphamide","nonproprietary_name":"Cyclophosphamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-517-07)"},"nadac":{"value":1.67057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclophosphamide*|Cyclophosphamide","basis":"generic"},"part_b":{"hcpcs":"J8530","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8530 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (69097-517-07)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"73515012330","name":"CYCLOSET 0.8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73515-123-30","proprietary_name":"CYCLOSET","nonproprietary_name":"bromocriptine mesylate","dosage_form":"TABLET","route":"ORAL","strength":".8 mg/1","labeler":"Avvisto Therapeutics LLC","package_description":"200 TABLET in 1 BOTTLE (73515-123-30)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":5.25631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cycloset|Bromocriptine Mesylate","basis":"brand"},"part_b":null}, {"ndc":"00378876058","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8760-58","proprietary_name":"Cyclosporine","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"6 POUCH in 1 CARTON (0378-8760-58) / 5 VIAL, SINGLE-USE in 1 POUCH (0378-8760-98) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"00378876091","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8760-91","proprietary_name":"Cyclosporine","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"12 POUCH in 1 CARTON (0378-8760-91) / 5 VIAL, SINGLE-USE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"00480407630","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-4076-30","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Teva Pharmaceuticals, Inc.","package_description":"6 POUCH in 1 CARTON (0480-4076-30) / 5 VIAL, SINGLE-DOSE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"00480407660","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-4076-60","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Teva Pharmaceuticals, Inc.","package_description":"12 POUCH in 1 CARTON (0480-4076-60) / 5 VIAL, SINGLE-DOSE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"10702080803","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-808-03","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"KVK-TECH, INC.","package_description":"30 VIAL, SINGLE-USE in 1 TRAY (10702-808-03) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"10702080806","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-808-06","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"KVK-TECH, INC.","package_description":"60 VIAL, SINGLE-USE in 1 TRAY (10702-808-06) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"24979012618","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-126-18","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 VIAL, SINGLE-USE in 1 CARTON (24979-126-18) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"24979012619","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-126-19","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (24979-126-19) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"60505620201","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6202-1","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Apotex Corp","package_description":"30 VIAL in 1 TRAY (60505-6202-1) / .4 mL in 1 VIAL","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"60505620202","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6202-2","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Apotex Corp","package_description":"60 VIAL in 1 TRAY (60505-6202-2) / .4 mL in 1 VIAL","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"68180021430","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-214-30","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 TRAY (68180-214-30) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"68180021460","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-214-60","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 VIAL, SINGLE-USE in 1 TRAY (68180-214-60) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"71656001230","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-012-30","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"CYCLOSPORINE","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"6 POUCH in 1 CARTON (71656-012-30) / 5 VIAL, SINGLE-DOSE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"71656001260","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-012-60","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"CYCLOSPORINE","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"12 POUCH in 1 CARTON (71656-012-60) / 5 VIAL, SINGLE-DOSE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"73043000501","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-005-01","proprietary_name":"Cyclosporine","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Devatis Inc.","package_description":"3 POUCH in 1 CARTON (73043-005-01) / 10 VIAL, SINGLE-USE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"73043000502","name":"CYCLOSPORINE 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-005-02","proprietary_name":"Cyclosporine","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Devatis Inc.","package_description":"6 POUCH in 1 CARTON (73043-005-02) / 10 VIAL, SINGLE-USE in 1 POUCH / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclosporine*|Cyclosporine","basis":"generic"},"part_b":null}, {"ndc":"60505013400","name":"CYCLOSPORINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0134-0","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-0134-0)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.50676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-0134-0)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084092125","name":"CYCLOSPORINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-921-25","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-921-25) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68084-921-95)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.50676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-921-25) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68084-921-95)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084092195","name":"CYCLOSPORINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.50676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505013300","name":"CYCLOSPORINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0133-0","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-0133-0)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.5957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-0133-0)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084087925","name":"CYCLOSPORINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-879-25","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-879-25) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68084-879-95)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.5957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-879-25) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68084-879-95)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084087995","name":"CYCLOSPORINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.5957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093902019","name":"CYCLOSPORINE MODIFIED 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093902065","name":"CYCLOSPORINE MODIFIED 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9020-65","proprietary_name":"Cyclosporine Modified","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-9020-65) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0093-9020-19)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0093-9020-65) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0093-9020-19)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"23155083911","name":"CYCLOSPORINE MODIFIED 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083930","name":"CYCLOSPORINE MODIFIED 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-839-30","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"CYCLOSPORINE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"5 BLISTER PACK in 1 CARTON (23155-839-30) / 6 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (23155-839-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (23155-839-30) / 6 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (23155-839-11)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505463203","name":"CYCLOSPORINE MODIFIED 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4632-3","proprietary_name":"CycloSPORINE, Modfied","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"30 BLISTER PACK in 1 CARTON (60505-4632-3) / 6 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00172731320","name":"CYCLOSPORINE MODIFIED 100 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-7313-20","proprietary_name":"Cyclosporine","nonproprietary_name":"Cyclosporine","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BOTTLE in 1 PACKAGE (0172-7313-20) / 50 mL in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.03685,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 PACKAGE (0172-7313-20) / 50 mL in 1 BOTTLE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093901819","name":"CYCLOSPORINE MODIFIED 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093901865","name":"CYCLOSPORINE MODIFIED 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9018-65","proprietary_name":"Cyclosporine Modified","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-9018-65) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0093-9018-19)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083711","name":"CYCLOSPORINE MODIFIED 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083730","name":"CYCLOSPORINE MODIFIED 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-837-30","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"CYCLOSPORINE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (23155-837-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (23155-837-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 BLISTER PACK in 1 CARTON (23155-837-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (23155-837-11)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505463003","name":"CYCLOSPORINE MODIFIED 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4630-3","proprietary_name":"CycloSPORINE, Modfied","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"30 BLISTER PACK in 1 CARTON (60505-4630-3) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00093901919","name":"CYCLOSPORINE MODIFIED 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.76459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093901965","name":"CYCLOSPORINE MODIFIED 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9019-65","proprietary_name":"Cyclosporine Modified","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-9019-65) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0093-9019-19)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.76459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0093-9019-65) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0093-9019-19)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"23155083811","name":"CYCLOSPORINE MODIFIED 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.76459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083830","name":"CYCLOSPORINE MODIFIED 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-838-30","proprietary_name":"CYCLOSPORINE","nonproprietary_name":"CYCLOSPORINE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"6 BLISTER PACK in 1 CARTON (23155-838-30) / 5 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (23155-838-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.76459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (23155-838-30) / 5 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (23155-838-11)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505463103","name":"CYCLOSPORINE MODIFIED 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4631-3","proprietary_name":"CycloSPORINE, Modfied","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp.","package_description":"30 BLISTER PACK in 1 CARTON (60505-4631-3) / 5 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.76459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"39328054416","name":"CYPROHEPTADINE 2 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-544-16","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/5mL","labeler":"Patrin Pharma, Inc.","package_description":"473 mL in 1 BOTTLE, GLASS (39328-544-16)"},"nadac":{"value":0.04186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752018512","name":"CYPROHEPTADINE 2 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-185-12","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70752-185-12)"},"nadac":{"value":0.04186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135094947","name":"CYPROHEPTADINE 2 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-949-47","proprietary_name":"CYPROHEPTADINE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-949-47)"},"nadac":{"value":0.04186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980050448","name":"CYPROHEPTADINE 2 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-504-48","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (64980-504-48)"},"nadac":{"value":0.04186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115175701","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1757-01","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0115-1757-01)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571080501","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-805-01","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-805-01)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571080510","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-805-10","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-805-10)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155070301","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268020111","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268020115","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-201-15","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-201-15) / 1 TABLET in 1 BLISTER PACK (50268-201-11)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742019001","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-190-01","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Ingenus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (50742-190-01)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52817021010","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-210-10","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"TRUPHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (52817-210-10)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52817021050","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-210-50","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"TRUPHARMA, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (52817-210-50)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135023690","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-236-90","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-236-90)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380079506","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-795-06","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-795-06)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380079508","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-795-08","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-795-08)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367024601","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367024610","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710111000","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1110-0","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1110-0)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710111001","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1110-1","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1110-1)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752010710","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-107-10","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-107-10)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752010711","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-107-11","proprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","nonproprietary_name":"CYPROHEPTADINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (70752-107-11)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76385013001","name":"CYPROHEPTADINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-130-01","proprietary_name":"Cyproheptadine Hydrochloride","nonproprietary_name":"Cyproheptadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-130-01)"},"nadac":{"value":0.06787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50102025421","name":"CYRED EQ 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyred Eq|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102025423","name":"CYRED EQ 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-254-23","proprietary_name":"Cyred EQ","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 POUCH in 1 CARTON (50102-254-23) / 1 BLISTER PACK in 1 POUCH (50102-254-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyred Eq|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"60793011601","name":"CYTOMEL 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-116-01","proprietary_name":"Cytomel","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-116-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.53303,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cytomel|Liothyronine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793011501","name":"CYTOMEL 5 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-115-01","proprietary_name":"Cytomel","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-115-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.3857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cytomel|Liothyronine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00904725435","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725468","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7254-68","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"110 mg/1","labeler":"Major Pharmaceuticals","package_description":"6 BLISTER PACK in 1 CARTON (0904-7254-68) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7254-35)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722066632","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-666-32","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (31722-666-32) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722066660","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-666-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (31722-666-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598045360","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-453-60","proprietary_name":"Dabigatran etexilate","nonproprietary_name":"Dabigatran etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 CAPSULE in 1 BOTTLE (43598-453-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651097460","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-974-60","proprietary_name":"DABIGATRAN ETEXILATE","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-974-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505434906","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4349-6","proprietary_name":"dabigatran etexilate","nonproprietary_name":"dabigatran etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-4349-6)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62332063506","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-635-06","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"10 BLISTER PACK in 1 CARTON (62332-635-06) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62332063560","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-635-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-635-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"67877062460","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-624-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"110 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-624-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"72205020360","name":"DABIGATRAN ETEXILATE 110 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-203-60","proprietary_name":"DABIGATRAN","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72205-203-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378026691","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0266-91","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (0378-0266-91)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725510","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7255-10","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-7255-10) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7255-35)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725535","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725568","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7255-68","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"6 BLISTER PACK in 1 CARTON (0904-7255-68) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7255-35)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722062232","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-622-32","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (31722-622-32) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722062260","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-622-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (31722-622-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598064160","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-641-60","proprietary_name":"Dabigatran etexilate","nonproprietary_name":"Dabigatran etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 CAPSULE in 1 BOTTLE (43598-641-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651097560","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-975-60","proprietary_name":"DABIGATRAN ETEXILATE","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-975-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505434806","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4348-6","proprietary_name":"dabigatran etexilate","nonproprietary_name":"dabigatran etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-4348-6)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687097432","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-974-32","proprietary_name":"DABIGATRAN","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-974-32) / 1 CAPSULE in 1 BLISTER PACK (60687-974-33)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687097433","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62332063606","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-636-06","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"10 BLISTER PACK in 1 CARTON (62332-636-06) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62332063660","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-636-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-636-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"67877047560","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-475-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-475-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"72205020460","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-204-60","proprietary_name":"DABIGATRAN","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72205-204-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"72603023901","name":"DABIGATRAN ETEXILATE 150 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-239-01","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar RxLLC","package_description":"60 CAPSULE in 1 BOTTLE (72603-239-01)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378026591","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0265-91","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (0378-0265-91)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725304","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7253-04","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"75 mg/1","labeler":"Major Pharmaceuticals","package_description":"3 BLISTER PACK in 1 CARTON (0904-7253-04) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7253-35)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725335","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904725368","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7253-68","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"75 mg/1","labeler":"Major Pharmaceuticals","package_description":"6 BLISTER PACK in 1 CARTON (0904-7253-68) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7253-35)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722062132","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-621-32","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (31722-621-32) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722062160","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-621-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (31722-621-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598064260","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-642-60","proprietary_name":"Dabigatran etexilate","nonproprietary_name":"Dabigatran etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 CAPSULE in 1 BOTTLE (43598-642-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651097360","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-973-60","proprietary_name":"DABIGATRAN ETEXILATE","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-973-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505434706","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4347-6","proprietary_name":"dabigatran etexilate","nonproprietary_name":"dabigatran etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-4347-6)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687096311","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687096321","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-963-21","proprietary_name":"DABIGATRAN","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-963-21) / 1 CAPSULE in 1 BLISTER PACK (60687-963-11)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62332063406","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-634-06","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"10 BLISTER PACK in 1 CARTON (62332-634-06) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62332063460","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-634-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-634-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"67877047460","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-474-60","proprietary_name":"Dabigatran Etexilate","nonproprietary_name":"Dabigatran Etexilate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-474-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"72205020260","name":"DABIGATRAN ETEXILATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-202-60","proprietary_name":"DABIGATRAN","nonproprietary_name":"DABIGATRAN ETEXILATE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72205-202-60)","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dabigatran Etexilate|Dabigatran Etexilate Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00591253360","name":"DALFAMPRIDINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2533-60","proprietary_name":"Dalfampridine","nonproprietary_name":"Dalfampridine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0591-2533-60)","pharm_classes":["Potassium Channel Antagonists [MoA]","Potassium Channel Blocker [EPC]"]},"nadac":{"value":0.39924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dalfampridine ER|Dalfampridine","basis":"generic"},"part_b":null}, {"ndc":"16729029212","name":"DALFAMPRIDINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-292-12","proprietary_name":"Dalfampridine","nonproprietary_name":"Dalfampridine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Accord Healthcare Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16729-292-12)","pharm_classes":["Potassium Channel Antagonists [MoA]","Potassium Channel Blocker [EPC]"]},"nadac":{"value":0.39924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dalfampridine ER|Dalfampridine","basis":"generic"},"part_b":null}, {"ndc":"42571027560","name":"DALFAMPRIDINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-275-60","proprietary_name":"DALFAMPRIDINE","nonproprietary_name":"DALFAMPRIDINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Micro Labs Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (42571-275-60)","pharm_classes":["Potassium Channel Antagonists [MoA]","Potassium Channel Blocker [EPC]"]},"nadac":{"value":0.39924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dalfampridine ER|Dalfampridine","basis":"generic"},"part_b":null}, {"ndc":"67877044460","name":"DALFAMPRIDINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-444-60","proprietary_name":"Dalfampridine","nonproprietary_name":"Dalfampridine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-444-60)","pharm_classes":["Potassium Channel Antagonists [MoA]","Potassium Channel Blocker [EPC]"]},"nadac":{"value":0.39924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dalfampridine ER|Dalfampridine","basis":"generic"},"part_b":null}, {"ndc":"82249070260","name":"DALFAMPRIDINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-702-60","proprietary_name":"Dalfampridine","nonproprietary_name":"Dalfampridine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"CivicaScript LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (82249-702-60)","pharm_classes":["Potassium Channel Antagonists [MoA]","Potassium Channel Blocker [EPC]"]},"nadac":{"value":0.39924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dalfampridine ER|Dalfampridine","basis":"generic"},"part_b":null}, {"ndc":"00310008828","name":"DALIRESP 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0310-0088-28","proprietary_name":"Daliresp","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 BLISTER PACK in 1 BOX, UNIT-DOSE (0310-0088-28) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":14.98256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daliresp|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"00310008839","name":"DALIRESP 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0310-0088-39","proprietary_name":"Daliresp","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0310-0088-39) / 2 TABLET in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":14.98256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daliresp|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"00310009530","name":"DALIRESP 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-0095-30","proprietary_name":"Daliresp","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0310-0095-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":14.9036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daliresp|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"00310009590","name":"DALIRESP 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-0095-90","proprietary_name":"Daliresp","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0310-0095-90)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":14.9036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daliresp|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"00527136801","name":"DANAZOL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1368-01","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0527-1368-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.23171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00555063402","name":"DANAZOL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0634-02","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0634-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.23171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"62135047660","name":"DANAZOL 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-476-60","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 CAPSULE in 1 BOTTLE (62135-476-60)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.23171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00527136901","name":"DANAZOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1369-01","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0527-1369-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.65221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00527136906","name":"DANAZOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1369-06","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Lannett Company, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (0527-1369-06)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.65221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00555063502","name":"DANAZOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0635-02","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0635-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.65221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00555063509","name":"DANAZOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0635-09","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (0555-0635-09)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.65221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"62135047760","name":"DANAZOL 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-477-60","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 CAPSULE in 1 BOTTLE (62135-477-60)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.65221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00527139201","name":"DANAZOL 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0527-1392-01","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0527-1392-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.56444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00555063302","name":"DANAZOL 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0555-0633-02","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0633-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.56444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"62135047560","name":"DANAZOL 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-475-60","proprietary_name":"Danazol","nonproprietary_name":"Danazol","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 CAPSULE in 1 BOTTLE (62135-475-60)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.56444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Danazol|Danazol","basis":"generic"},"part_b":null}, {"ndc":"00115443301","name":"DANTROLENE SODIUM 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-4433-01","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"Dantrolene Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-4433-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":1.00732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"49884036401","name":"DANTROLENE SODIUM 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-364-01","proprietary_name":"dantrolene sodium","nonproprietary_name":"dantrolene sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (49884-364-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":1.00732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"64850084201","name":"DANTROLENE SODIUM 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-842-01","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"dantrolene sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-842-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":1.00732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"00115441101","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-4411-01","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"Dantrolene Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-4411-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904721104","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7211-04","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"Dantrolene Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7211-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"49884036201","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-362-01","proprietary_name":"dantrolene sodium","nonproprietary_name":"dantrolene sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (49884-362-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268021711","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268021715","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-217-15","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"Dantrolene Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-217-15) / 1 CAPSULE in 1 BLISTER PACK (50268-217-11)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"64850084001","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-840-01","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"dantrolene sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-840-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084030011","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084030021","name":"DANTROLENE SODIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-300-21","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"Dantrolene Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-300-21) / 1 CAPSULE in 1 BLISTER PACK (68084-300-11)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.4088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"00115442201","name":"DANTROLENE SODIUM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-4422-01","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"Dantrolene Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-4422-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.55379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"49884036301","name":"DANTROLENE SODIUM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-363-01","proprietary_name":"dantrolene sodium","nonproprietary_name":"dantrolene sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (49884-363-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.55379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"64850084101","name":"DANTROLENE SODIUM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-841-01","proprietary_name":"Dantrolene Sodium","nonproprietary_name":"dantrolene sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-841-01)","pharm_classes":["Decreased Striated Muscle Contraction [PE]","Decreased Striated Muscle Tone [PE]","Skeletal Muscle Relaxant [EPC]"]},"nadac":{"value":0.55379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dantrolene Sodium|Dantrolene Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480352805","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3528-05","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0480-3528-05)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00480352856","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3528-56","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-3528-56)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00480352898","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3528-98","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3528-98)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00781599031","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5990-31","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0781-5990-31)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"27241015201","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-152-01","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-152-01)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"33342058607","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-586-07","proprietary_name":"dapagliflozin","nonproprietary_name":"dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-586-07)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"33342058610","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-586-10","proprietary_name":"dapagliflozin","nonproprietary_name":"dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-586-10)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"59651016030","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-160-30","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-160-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"60505491203","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4912-3","proprietary_name":"Dapagliflozin","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-4912-3)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"62332039330","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-393-30","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-393-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"66993045730","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-457-30","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (66993-457-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"67877060930","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-609-30","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-609-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"67877060990","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-609-90","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-609-90)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"69097038902","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-389-02","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69097-389-02)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"70710138103","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1381-3","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1381-3)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"70748010606","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-106-06","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70748-106-06)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"70954085710","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-857-10","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70954-857-10)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"71921042133","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-421-33","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"30 TABLET in 1 BOTTLE (71921-421-33)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"72205043301","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-433-01","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-433-01)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"72205043303","name":"DAPAGLIFLOZIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-433-03","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-433-03)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00480352705","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3527-05","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0480-3527-05)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00480352756","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3527-56","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-3527-56)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00480352798","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3527-98","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3527-98)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"00781598531","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5985-31","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0781-5985-31)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"27241015101","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-151-01","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-151-01)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"33342058507","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-585-07","proprietary_name":"dapagliflozin","nonproprietary_name":"dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-585-07)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"33342058510","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-585-10","proprietary_name":"dapagliflozin","nonproprietary_name":"dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-585-10)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"59651015930","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-159-30","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-159-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"60505491103","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4911-3","proprietary_name":"Dapagliflozin","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-4911-3)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"62332039230","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-392-30","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-392-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"66993045630","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-456-30","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (66993-456-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"67877060830","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-608-30","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-608-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"67877060890","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-608-90","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-608-90)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"69097038802","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-388-02","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69097-388-02)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"70710138003","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1380-3","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1380-3)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"70748010506","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-105-06","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70748-105-06)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"70954085610","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-856-10","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70954-856-10)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"71921042033","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-420-33","proprietary_name":"DAPAGLIFLOZIN","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"30 TABLET in 1 BOTTLE (71921-420-33)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"72205043201","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-432-01","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-432-01)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"72205043203","name":"DAPAGLIFLOZIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-432-03","proprietary_name":"Dapagliflozin","nonproprietary_name":"Dapagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-432-03)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin|Dapagliflozin Propanediol","basis":"generic"},"part_b":null}, {"ndc":"33342040907","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-409-07","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-409-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"59651015730","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-157-30","proprietary_name":"Dapagliflozin and Metformin hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-157-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"63304002830","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-028-30","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-028-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"66993036230","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-362-30","proprietary_name":"dapagliflozin and metformin hydrochloride","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (66993-362-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"67877062230","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-622-30","proprietary_name":"dapagliflozin and metformin hydrochloride","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-622-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"70748010406","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-104-06","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70748-104-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"72205043701","name":"DAPAGLIFLOZIN-METFORMIN ER 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-437-01","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-437-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"33342040707","name":"DAPAGLIFLOZIN-METFORMIN ER 10-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-407-07","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-407-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"59651015630","name":"DAPAGLIFLOZIN-METFORMIN ER 10-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-156-30","proprietary_name":"Dapagliflozin and Metformin hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-156-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"63304002730","name":"DAPAGLIFLOZIN-METFORMIN ER 10-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-027-30","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-027-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"67877062130","name":"DAPAGLIFLOZIN-METFORMIN ER 10-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-621-30","proprietary_name":"dapagliflozin and metformin hydrochloride","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-621-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"70748010306","name":"DAPAGLIFLOZIN-METFORMIN ER 10-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-103-06","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70748-103-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"72205043601","name":"DAPAGLIFLOZIN-METFORMIN ER 10-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-436-01","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-436-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"33342040809","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-408-09","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-408-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"59651015560","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-155-60","proprietary_name":"Dapagliflozin and Metformin hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-155-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"63304002662","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-026-62","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-026-62)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"66993036160","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-361-60","proprietary_name":"dapagliflozin and metformin hydrochloride","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Prasco Laboratories","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (66993-361-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"67877062060","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-620-60","proprietary_name":"dapagliflozin and metformin hydrochloride","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-620-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"70748010207","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-102-07","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (70748-102-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"72205043503","name":"DAPAGLIFLOZIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-435-03","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-435-03)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"33342040607","name":"DAPAGLIFLOZIN-METFORMIN ER 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-406-07","proprietary_name":"Dapagliflozin and Metformin Hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-406-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"59651015430","name":"DAPAGLIFLOZIN-METFORMIN ER 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-154-30","proprietary_name":"Dapagliflozin and Metformin hydrochloride","nonproprietary_name":"Dapagliflozin and Metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-154-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"67877061930","name":"DAPAGLIFLOZIN-METFORMIN ER 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-619-30","proprietary_name":"dapagliflozin and metformin hydrochloride","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-619-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"70748010106","name":"DAPAGLIFLOZIN-METFORMIN ER 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-101-06","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70748-101-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"72205043401","name":"DAPAGLIFLOZIN-METFORMIN ER 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-434-01","proprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","nonproprietary_name":"DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-434-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dapagliflozin-Metformin ER|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"64980056601","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-566-01","proprietary_name":"Dapsone","nonproprietary_name":"dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-566-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056603","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-566-03","proprietary_name":"Dapsone","nonproprietary_name":"dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-566-03)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367037901","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-379-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-379-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367037930","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-379-30","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (69367-379-30)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367041001","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-410-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-410-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367041030","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-410-30","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (69367-410-30)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954013610","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-136-10","proprietary_name":"DAPSONE","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-136-10)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954013620","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-136-20","proprietary_name":"DAPSONE","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-136-20)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578017801","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-178-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-178-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578017806","name":"DAPSONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-178-06","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-178-06)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.80614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056701","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-567-01","proprietary_name":"Dapsone","nonproprietary_name":"dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-567-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056703","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-567-03","proprietary_name":"Dapsone","nonproprietary_name":"dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-567-03)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367037801","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-378-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-378-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367037830","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-378-30","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (69367-378-30)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367040901","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-409-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-409-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367040930","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-409-30","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (69367-409-30)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954013510","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-135-10","proprietary_name":"DAPSONE","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-135-10)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954013520","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-135-20","proprietary_name":"DAPSONE","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-135-20)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578017701","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-177-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-177-01)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578017706","name":"DAPSONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-177-06","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-177-06)","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.45912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713088618","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0886-18","proprietary_name":"DAPSONE","nonproprietary_name":"dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0886-18) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713088660","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0886-60","proprietary_name":"DAPSONE","nonproprietary_name":"dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0886-60) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714095601","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-956-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-956-01) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714095602","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-956-02","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-956-02) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001807","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-018-07","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone Gel, 5%","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-018-07) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001808","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-018-08","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone Gel, 5%","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-018-08) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138703","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1387-3","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1387-3) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138708","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1387-8","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1387-8) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51862012360","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51862-123-60","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Mayne Pharma","package_description":"1 TUBE in 1 CARTON (51862-123-60) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817083160","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-831-60","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone Gel, 5%","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Trupharma, LLC","package_description":"1 TUBE in 1 CARTON (52817-831-60) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817083190","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-831-90","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone Gel, 5%","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Trupharma, LLC","package_description":"1 TUBE in 1 CARTON (52817-831-90) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651066660","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-666-60","proprietary_name":"DAPSONE","nonproprietary_name":"DAPSONE","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-666-60) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651066690","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-666-90","proprietary_name":"DAPSONE","nonproprietary_name":"DAPSONE","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-666-90) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162033985","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-339-85","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (65162-339-85) / 60 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.6638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162033991","name":"DAPSONE 5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-339-91","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (65162-339-91) / 90 g in 1 TUBE","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.67503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378483060","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4830-60","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0378-4830-60) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378483090","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4830-90","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0378-4830-90) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668060505","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-605-05","proprietary_name":"dapsone","nonproprietary_name":"dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"1 BOTTLE, PUMP in 1 CARTON (13668-605-05) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668060508","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-605-08","proprietary_name":"dapsone","nonproprietary_name":"dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"1 BOTTLE, PUMP in 1 CARTON (13668-605-08) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714097501","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-975-01","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (16714-975-01) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714097502","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-975-02","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (16714-975-02) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138803","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1388-3","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1388-3) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138808","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1388-8","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1388-8) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332066360","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-663-60","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (62332-663-60) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332066390","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-663-90","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (62332-663-90) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308034260","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-342-60","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Mayne Pharma Commercial LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (68308-342-60) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308034290","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-342-90","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Mayne Pharma Commercial LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (68308-342-90) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238162706","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1627-6","proprietary_name":"Dapsone","nonproprietary_name":"Daspone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (69238-1627-6) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238162709","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1627-9","proprietary_name":"Dapsone","nonproprietary_name":"Daspone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (69238-1627-9) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578009402","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-094-02","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE, PUMP in 1 CARTON (72578-094-02) / 60 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.71521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578009403","name":"DAPSONE 7.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-094-03","proprietary_name":"Dapsone","nonproprietary_name":"Dapsone","dosage_form":"GEL","route":"TOPICAL","strength":"75 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE, PUMP in 1 CARTON (72578-094-03) / 90 g in 1 BOTTLE, PUMP","pharm_classes":["Sulfone [EPC]","Sulfones [CS]"]},"nadac":{"value":0.79888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00143944401","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9444-01","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0143-9444-01) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0143-9444-01) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00143946501","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9465-01","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (0143-9465-01) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (0143-9465-01) / 10 mL in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"25021017415","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-174-15","proprietary_name":"daptomycin","nonproprietary_name":"daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"50 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 VIAL in 1 CARTON (25021-174-15) / 10 mL in 1 VIAL","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (25021-174-15) / 10 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"25021017416","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-174-16","proprietary_name":"daptomycin","nonproprietary_name":"daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"50 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-174-16) / 10 mL in 1 VIAL","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-174-16) / 10 mL in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722010210","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":null}, {"ndc":"31722021601","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-216-01","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (31722-216-01) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":null}, {"ndc":"43598041311","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-413-11","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Dr.Reddy's Laboratories Inc.,","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (43598-413-11) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (43598-413-11) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55150034401","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-344-01","proprietary_name":"DAPTOMYCIN","nonproprietary_name":"DAPTOMYCIN","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Eugia US LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (55150-344-01) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (55150-344-01) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505622904","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6229-4","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"APOTEX CORP.","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (60505-6229-4) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (60505-6229-4) / 10 mL in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67457081350","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-813-50","proprietary_name":"daptomycin","nonproprietary_name":"daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Mylan Institutional LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (67457-813-50) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (67457-813-50) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67457094115","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-941-15","proprietary_name":"daptomycin","nonproprietary_name":"daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Mylan Institutional LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (67457-941-15) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (67457-941-15) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001037668","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-376-68","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"BluePoint Laboratories","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (68001-376-68) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (68001-376-68) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377009391","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-093-91","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Biocon Pharma Inc.","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (70377-093-91) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (70377-093-91) / 10 mL in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70594003401","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70594-034-01","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (70594-034-01) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (70594-034-01) / 10 mL in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70594003402","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70594-034-02","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (70594-034-02) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (70594-034-02) / 10 mL in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"71288001615","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-016-15","proprietary_name":"DAPTOMYCIN","nonproprietary_name":"DAPTOMYCIN","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (71288-016-15) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (71288-016-15) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"71288001691","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-016-91","proprietary_name":"DAPTOMYCIN","nonproprietary_name":"DAPTOMYCIN","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (71288-016-91) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (71288-016-91) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"71288001695","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-016-95","proprietary_name":"DAPTOMYCIN","nonproprietary_name":"DAPTOMYCIN","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (71288-016-95) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (71288-016-95) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"71839010701","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-107-01","proprietary_name":"daptomycin","nonproprietary_name":"daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"BE Pharmaceuticals Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (71839-107-01) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (71839-107-01) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572010201","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-102-01","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Civica, Inc.","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (72572-102-01) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (72572-102-01) / 10 mL in 1 VIAL, SINGLE-USE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72603015201","name":"DAPTOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-152-01","proprietary_name":"Daptomycin","nonproprietary_name":"Daptomycin","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"NorthStar RxLLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (72603-152-01) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Lipopeptide Antibacterial [EPC]","Lipopeptides [CS]"]},"nadac":{"value":23.79838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daptomycin|Daptomycin","basis":"generic"},"part_b":{"hcpcs":"J0878","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0878 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (72603-152-01) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"13668020330","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-203-30","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-203-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668020390","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-203-90","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-203-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"16571076803","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-768-03","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16571-768-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"16571076809","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-768-09","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16571-768-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"33342027707","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-277-07","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-277-07)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"62332022430","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-224-30","proprietary_name":"DARIFENACIN","nonproprietary_name":"DARIFENACIN","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-224-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"62332022490","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-224-90","proprietary_name":"DARIFENACIN","nonproprietary_name":"DARIFENACIN","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-224-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097043202","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-432-02","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin Hydrobromide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-432-02)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097043205","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-432-05","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin Hydrobromide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-432-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"70700018330","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"70700018390","name":"DARIFENACIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43232,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668020230","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-202-30","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-202-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"13668020290","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-202-90","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-202-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"16571076703","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-767-03","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16571-767-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"16571076709","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-767-09","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16571-767-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"33342027607","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-276-07","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-276-07)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"62332022330","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-223-30","proprietary_name":"DARIFENACIN","nonproprietary_name":"DARIFENACIN","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-223-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"62332022390","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-223-90","proprietary_name":"DARIFENACIN","nonproprietary_name":"DARIFENACIN","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-223-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097043102","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-431-02","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin Hydrobromide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-431-02)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"69097043105","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-431-05","proprietary_name":"Darifenacin","nonproprietary_name":"Darifenacin Hydrobromide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-431-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"70700018230","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"70700018290","name":"DARIFENACIN ER 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darifenacin ER|Darifenacin Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"31722056860","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-568-60","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-568-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"43598070460","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-704-60","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (43598-704-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"59651008560","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-085-60","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59651-085-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"60219114406","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1144-6","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60219-1144-6) / 60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"60687080811","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"60687080821","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-808-21","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-808-21) / 1 TABLET in 1 BLISTER PACK (60687-808-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"68180034507","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-345-07","proprietary_name":"DARUNAVIR","nonproprietary_name":"DARUNAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68180-345-07)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"69097024803","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-248-03","proprietary_name":"Darunavir 600 and 800 mg","nonproprietary_name":"darunavir","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET in 1 BOTTLE (69097-248-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"72205018460","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-184-60","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72205-184-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"72578014714","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-147-14","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72578-147-14)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"76282073760","name":"DARUNAVIR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-737-60","proprietary_name":"darunavir","nonproprietary_name":"darunavir 600 mg","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"60 TABLET in 1 BOTTLE (76282-737-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"31722008930","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-089-30","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-089-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"43598070530","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-705-30","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-705-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"59651008630","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-086-30","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-086-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"60219114503","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1145-3","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60219-1145-3) / 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"60687081911","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"60687081921","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-819-21","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-819-21) / 1 TABLET in 1 BLISTER PACK (60687-819-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"68180034606","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-346-06","proprietary_name":"DARUNAVIR","nonproprietary_name":"DARUNAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-346-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"69097024402","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-244-02","proprietary_name":"Darunavir 600 and 800 mg","nonproprietary_name":"darunavir","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-244-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"72205018530","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-185-30","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72205-185-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"72578014806","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-148-06","proprietary_name":"Darunavir","nonproprietary_name":"Darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-148-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"76282073830","name":"DARUNAVIR 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-738-30","proprietary_name":"darunavir","nonproprietary_name":"darunavir 800 mg","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"30 TABLET in 1 BOTTLE (76282-738-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Darunavir|Darunavir","basis":"generic"},"part_b":null}, {"ndc":"00480510456","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-5104-56","proprietary_name":"Dasatinib","nonproprietary_name":"Dasatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-5104-56)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"43598060330","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-603-30","proprietary_name":"Dasatinib","nonproprietary_name":"Dasatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-603-30)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"59651054630","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-546-30","proprietary_name":"DASATINIB","nonproprietary_name":"DASATINIB","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-546-30)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"60505363103","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3631-3","proprietary_name":"Dasatinib","nonproprietary_name":"Dasatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3631-3)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"66993023730","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-237-30","proprietary_name":"Dasatinib","nonproprietary_name":"dasatinib","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE in 1 CARTON (66993-237-30) / 30 TABLET in 1 BOTTLE","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"68001066404","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-664-04","proprietary_name":"Dasatinib","nonproprietary_name":"dasatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68001-664-04)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"70377008711","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-087-11","proprietary_name":"Dasatinib","nonproprietary_name":"dasatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-087-11)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"70710174503","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1745-3","proprietary_name":"dasatinib","nonproprietary_name":"dasatinib","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1745-3)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"70748021206","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-212-06","proprietary_name":"Dasatinib","nonproprietary_name":"Dasatinib","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-212-06) / 30 TABLET in 1 BOTTLE","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"72603092601","name":"DASATINIB 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-926-01","proprietary_name":"DASATINIB","nonproprietary_name":"DASATINIB","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-926-01)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasatinib|Dasatinib","basis":"generic"},"part_b":null}, {"ndc":"16714034801","name":"DASETTA 1-35-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-348-01","proprietary_name":"Dasetta 1/35","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-348-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasetta|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714034804","name":"DASETTA 1-35-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-348-04","proprietary_name":"Dasetta 1/35","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-348-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasetta|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714034601","name":"DASETTA 7/7/7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-346-01","proprietary_name":"Dasetta 7/7/7","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-346-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasetta|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714034604","name":"DASETTA 7/7/7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-346-04","proprietary_name":"Dasetta 7/7/7","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-346-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dasetta|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"24385003662","name":"DAY TIME COLD-FLU SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-036-62","proprietary_name":"good neighbor pharmacy day time cold and flu","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Phenylephrine HCl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 5 mg/1","labeler":"Amerisource Bergen","package_description":"12 BLISTER PACK in 1 CARTON (24385-036-62) / 2 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180084611","name":"DAYSEE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daysee|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"68180084613","name":"DAYSEE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-846-13","proprietary_name":"Daysee","nonproprietary_name":"LEVONORGESTREL AND ETHINYL ESTRADIOL","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"2 POUCH in 1 CARTON (68180-846-13) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daysee|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"68180084673","name":"DAYSEE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-846-73","proprietary_name":"Daysee","nonproprietary_name":"LEVONORGESTREL AND ETHINYL ESTRADIOL","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"2 POUCH in 1 CARTON (68180-846-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Daysee|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"70000019102","name":"DAYTIME COLD-FLU RELIEF LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0191-2","proprietary_name":"Leader Daytime Cold and Flu","nonproprietary_name":"acetaminophen, dextromethorphan Hbr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"325 mg/15mL; 10 mg/15mL; 5 mg/15mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"355 mL in 1 BOTTLE (70000-0191-2)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.01144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904699544","name":"DAYTIME COLD-FLU RELIEF SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6995-44","proprietary_name":"Cold and Flu Relief Daytime","nonproprietary_name":"ACETAMINOHPEN, DEXTROMETHORPHAN HBr, PHENYLEPHRINE HCL","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 5 mg/1","labeler":"Major Pharmaceuticals","package_description":"16 BLISTER PACK in 1 CARTON (0904-6995-44) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051501","name":"DAYTIME COLD-FLU RELIEF SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0515-1","proprietary_name":"Cold and Flu Relief","nonproprietary_name":"ACETAMINOHPEN, DEXTROMETHORPHAN HBr, PHENYLEPHRINE HCL","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 5 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"24 BLISTER PACK in 1 CARTON (70000-0515-1) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000075201","name":"DAYTIME COLD-FLU RELIEF SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0752-1","proprietary_name":"Cold and Flu Relief Daytime","nonproprietary_name":"Acetaminophen Dextromethorphan HBr Phenylephrine HCl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 5 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"24 BLISTER PACK in 1 CARTON (70000-0752-1) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000065201","name":"DAYTIME MULTI-SYMP COLD CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0652-1","proprietary_name":"Cold Relief Multi-Symptom","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0652-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000063601","name":"DAYTIME SEVERE COLD-FLU CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0636-1","proprietary_name":"Leader Daytime Severe Cold and Flu Relief","nonproprietary_name":"acetaminophen, dextromethorphan hydrobromide, guaifenesin, phenylephrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"12 BLISTER PACK in 1 CARTON (70000-0636-1) / 2 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62856041030","name":"DAYVIGO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-410-30","proprietary_name":"DAYVIGO","nonproprietary_name":"lemborexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62856-410-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]"]},"nadac":{"value":11.56704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dayvigo|Lemborexant","basis":"brand"},"part_b":null}, {"ndc":"62856040530","name":"DAYVIGO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-405-30","proprietary_name":"DAYVIGO","nonproprietary_name":"lemborexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62856-405-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]"]},"nadac":{"value":11.57757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dayvigo|Lemborexant","basis":"brand"},"part_b":null}, {"ndc":"16714044001","name":"DEBLITANE 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-440-01","proprietary_name":"DEBLITANE","nonproprietary_name":"Norethindrone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-440-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deblitane|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"16714044004","name":"DEBLITANE 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-440-04","proprietary_name":"DEBLITANE","nonproprietary_name":"Norethindrone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-440-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deblitane|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"50991074001","name":"DECONEX DMX 17.5-400-10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50991-740-01","proprietary_name":"DECONEX DMX","nonproprietary_name":"Dextromethorphan Hydrobromide, Guaifenesin, Phenylephrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"17.5 mg/1; 400 mg/1; 10 mg/1","labeler":"Poly Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50991-740-01)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.6717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001230","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-012-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-012-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"43598085230","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-852-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-852-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"59651041130","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-411-30","proprietary_name":"DEFERASIROX","nonproprietary_name":"DEFERASIROX","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-411-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"62332041130","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-411-30","proprietary_name":"DEFERASIROX","nonproprietary_name":"DEFERASIROX","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-411-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"70700027030","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70700-270-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Xiromed, LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (70700-270-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"70710127603","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1276-3","proprietary_name":"deferasirox","nonproprietary_name":"deferasirox","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1276-3)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"72603023201","name":"DEFERASIROX 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-232-01","proprietary_name":"DEFERASIROX","nonproprietary_name":"DEFERASIROX","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-232-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":0.875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"31722001330","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-013-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"360 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-013-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"43598085130","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-851-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET","route":"ORAL","strength":"360 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-851-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"59651041230","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-412-30","proprietary_name":"DEFERASIROX","nonproprietary_name":"DEFERASIROX","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"360 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-412-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"62332041230","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-412-30","proprietary_name":"DEFERASIROX","nonproprietary_name":"DEFERASIROX","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"360 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-412-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"67877055430","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-554-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"360 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-554-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"70700027130","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-271-30","proprietary_name":"Deferasirox","nonproprietary_name":"Deferasirox","dosage_form":"TABLET","route":"ORAL","strength":"360 mg/1","labeler":"Xiromed, LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (70700-271-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"70710127703","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1277-3","proprietary_name":"deferasirox","nonproprietary_name":"deferasirox","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"360 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1277-3)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"72603023301","name":"DEFERASIROX 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-233-01","proprietary_name":"DEFERASIROX","nonproprietary_name":"DEFERASIROX","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"360 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-233-01)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Iron Chelating Activity [MoA]","Iron Chelator [EPC]"]},"nadac":{"value":1.24749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Deferasirox|Deferasirox","basis":"generic"},"part_b":null}, {"ndc":"42023011101","name":"DELESTROGEN 100 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-111-01","proprietary_name":"Delestrogen","nonproprietary_name":"estradiol valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Par Health USA, LLC","package_description":"5 mL in 1 VIAL, MULTI-DOSE (42023-111-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":35.75275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":22.64523,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Delestrogen|Estradiol Valerate","basis":"brand"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, MULTI-DOSE (42023-111-01)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42023011001","name":"DELESTROGEN 50 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-110-01","proprietary_name":"Delestrogen","nonproprietary_name":"estradiol valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"10 mg/mL","labeler":"Par Health USA, LLC","package_description":"5 mL in 1 VIAL, MULTI-DOSE (42023-110-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":25.50486,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":18.29878,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Delestrogen|Estradiol Valerate","basis":"brand"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, MULTI-DOSE (42023-110-01)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00006500701","name":"DELSTRIGO 100-300-300 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5007-01","proprietary_name":"DELSTRIGO","nonproprietary_name":"doravirine, lamivudine, and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 300 mg/1; 300 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5007-01)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":93.06069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Delstrigo|Doravirine/Lamivu/Tenofov Diso","basis":"brand"},"part_b":null}, {"ndc":"42806014301","name":"DEMECLOCYCLINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-143-01","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42806-143-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.27261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"53746055401","name":"DEMECLOCYCLINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-554-01","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-554-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.27261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687069101","name":"DEMECLOCYCLINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-691-01","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-691-01) / 1 TABLET in 1 BLISTER PACK (60687-691-11)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.27261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687069111","name":"DEMECLOCYCLINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.27261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"65162055410","name":"DEMECLOCYCLINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-554-10","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-554-10)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.27261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"42806014448","name":"DEMECLOCYCLINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-144-48","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Epic Pharma, LLC","package_description":"48 TABLET, FILM COATED in 1 BOTTLE (42806-144-48)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":3.04571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"53746055548","name":"DEMECLOCYCLINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-555-48","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"48 TABLET in 1 BOTTLE (53746-555-48)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":3.04571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687070511","name":"DEMECLOCYCLINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.04571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687070565","name":"DEMECLOCYCLINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-705-65","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-705-65) / 1 TABLET in 1 BLISTER PACK (60687-705-11)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":3.04571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"65162055548","name":"DEMECLOCYCLINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-555-48","proprietary_name":"Demeclocycline Hydrochloride","nonproprietary_name":"Demeclocycline","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"48 TABLET in 1 BOTTLE (65162-555-48)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":3.04571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Demeclocycline HCl|Demeclocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00378972055","name":"DENAVIR 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9720-55","proprietary_name":"Denavir","nonproprietary_name":"penciclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-9720-55) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":155.076,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":52.1538,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Denavir|Penciclovir","basis":"brand"},"part_b":null}, {"ndc":"16571081450","name":"DENTA 5000 PLUS CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-814-50","proprietary_name":"Denta 5000 Plus","nonproprietary_name":"Sodium fluoride","dosage_form":"CREAM","route":"ORAL","strength":"1.1 g/100g","labeler":"Rising Pharma Holdings, Inc.","package_description":"51 g in 1 TUBE (16571-814-50)"},"nadac":{"value":0.06333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16571082310","name":"DENTA 5000 PLUS SENSITIV PASTE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-823-10","proprietary_name":"Denta 5000 Plus Sensitive","nonproprietary_name":"Sodium fluoride and Potassium nitrate","dosage_form":"GEL, DENTIFRICE","route":"DENTAL","strength":"5.8 mg/mL; 57.5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 mL in 1 TUBE (16571-823-10)"},"nadac":{"value":0.11606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571081560","name":"DENTAGEL 1.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-815-60","proprietary_name":"DentaGel","nonproprietary_name":"Sodium fluoride","dosage_form":"GEL","route":"ORAL","strength":"1.1 g/100g","labeler":"Rising Pharma Holdings, Inc.","package_description":"56 g in 1 TUBE (16571-815-60)"},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dentagel|Fluoride (Sodium)","basis":"brand"},"part_b":null}, {"ndc":"00074611413","name":"DEPAKOTE DR 125 MG SPRINKLE CP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-6114-13","proprietary_name":"Depakote Sprinkles","nonproprietary_name":"Divalproex Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"AbbVie Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0074-6114-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.96951,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074732513","name":"DEPAKOTE DR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7325-13","proprietary_name":"Depakote","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"AbbVie Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0074-7325-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":2.05517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074732613","name":"DEPAKOTE DR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7326-13","proprietary_name":"Depakote","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"AbbVie Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0074-7326-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":4.0456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074732713","name":"DEPAKOTE DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7327-13","proprietary_name":"Depakote","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AbbVie Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0074-7327-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":7.45557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074740113","name":"DEPAKOTE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7401-13","proprietary_name":"Depakote ER","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"AbbVie Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0074-7401-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":3.68703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Depakote ER|Divalproex Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074740213","name":"DEPAKOTE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7402-13","proprietary_name":"Depakote ER","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AbbVie Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0074-7402-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":6.49213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Depakote ER|Divalproex Sodium","basis":"brand"},"part_b":null}, {"ndc":"00009027101","name":"DEPO-ESTRADIOL 5 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["2","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0271-01","proprietary_name":"Depo-Estradiol","nonproprietary_name":"estradiol cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"5 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL in 1 CARTON (0009-0271-01) / 5 mL in 1 VIAL","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":51.90841,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Estradiol|Estradiol Cypionate","basis":"brand"},"part_b":{"hcpcs":"J1000","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1000 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0009-0271-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00009307301","name":"DEPO-MEDROL 40 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-3073-01","proprietary_name":"Depo-Medrol","nonproprietary_name":"methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"40 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-3073-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.82706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":7.49,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Medrol|Methylprednisolone Acetate","basis":"brand"},"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-3073-01) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00009307322","name":"DEPO-MEDROL 40 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-3073-22","proprietary_name":"Depo-Medrol","nonproprietary_name":"methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRALESIONAL; INTRAMUSCULAR; INTRASYNOVIAL; SOFT TISSUE","strength":"40 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-3073-22) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.82706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":7.49,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Medrol|Methylprednisolone Acetate","basis":"brand"},"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-3073-22) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00009347501","name":"DEPO-MEDROL 80 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-3475-01","proprietary_name":"Depo-Medrol","nonproprietary_name":"methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"80 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-3475-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.65735,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":11.92429,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Medrol|Methylprednisolone Acetate","basis":"brand"},"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-3475-01) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00009737611","name":"DEPO-PROVERA 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-7376-11","proprietary_name":"Depo-Provera","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 SYRINGE in 1 CARTON (0009-7376-11) / 1 mL in 1 SYRINGE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":52.335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":27.36384,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Provera|Medroxyprogesterone Acetate","basis":"brand"},"part_b":null}, {"ndc":"00009074630","name":"DEPO-PROVERA 150 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0746-30","proprietary_name":"Depo-Provera","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL in 1 CARTON (0009-0746-30) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":50.994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Provera|Medroxyprogesterone Acetate","basis":"brand"},"part_b":null}, {"ndc":"00009470913","name":"DEPO-SUBQ PROVERA 104 SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-4709-13","proprietary_name":"Depo-SubQ Provera","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"104 mg/.65mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 SYRINGE in 1 CARTON (0009-4709-13) / .65 mL in 1 SYRINGE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":77.42965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Subq Provera 104|Medroxyprogesterone Acetate","basis":"brand"},"part_b":null}, {"ndc":"00009008510","name":"DEPO-TESTOSTERONE 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0085-10","proprietary_name":"Depo-Testosterone","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL in 1 CARTON (0009-0085-10) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":6.91704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":4.52814,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Testosterone|Testosterone Cypionate","basis":"brand"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0009-0085-10) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00009034702","name":"DEPO-TESTOSTERONE 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0347-02","proprietary_name":"Depo-Testosterone","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL in 1 CARTON (0009-0347-02) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":6.91704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":4.52814,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Depo-Testosterone|Testosterone Cypionate","basis":"brand"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0009-0347-02) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68791010104","name":"DERMA-SMOOTHE-FS BODY OIL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68791-101-04","proprietary_name":"Derma-Smoothe/FS","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/mL","labeler":"Royal Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (68791-101-04) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.17545,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68791010204","name":"DERMA-SMOOTHE-FS SCALP OIL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68791-102-04","proprietary_name":"DERMA-SMOOTHE/FS","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/mL","labeler":"Royal Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (68791-102-04) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.17118,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59088090582","name":"DERMACINRX LIDOCAN 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59088-905-82","proprietary_name":"Lidocan","nonproprietary_name":"Lidocaine 5%","dosage_form":"PATCH","route":"TOPICAL","strength":"700 mg/1","labeler":"PURETEK CORPORATION","package_description":"15 POUCH in 1 PACKAGE (59088-905-82) / 1 PATCH in 1 POUCH (59088-905-84)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dermacinrx Lidocan|Lidocaine","basis":"brand"},"part_b":null}, {"ndc":"68791010320","name":"DERMOTIC OIL 0.01% EAR DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68791-103-20","proprietary_name":"DERMOTIC","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"AURICULAR (OTIC)","strength":".11 mg/mL","labeler":"Royal Pharmaceuticals","package_description":"1 BOTTLE, DROPPER in 1 CARTON (68791-103-20) / 20 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.12859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.92434,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dermotic|Fluocinolone Acetonide Oil","basis":"brand"},"part_b":null}, {"ndc":"61958200501","name":"DESCOVY 120-15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61958-2005-1","proprietary_name":"DESCOVY","nonproprietary_name":"emtricitabine and tenofovir alafenamide","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1; 15 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2005-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":74.85402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-29","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Descovy|Emtricitabine/Tenofov Alafenam","basis":"brand"},"part_b":null}, {"ndc":"61958200201","name":"DESCOVY 200-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61958-2002-1","proprietary_name":"DESCOVY","nonproprietary_name":"emtricitabine and tenofovir alafenamide","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1; 25 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2002-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":74.94147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-29","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Descovy|Emtricitabine/Tenofov Alafenam","basis":"brand"},"part_b":null}, {"ndc":"61958200202","name":"DESCOVY 200-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61958-2002-2","proprietary_name":"DESCOVY","nonproprietary_name":"emtricitabine and tenofovir alafenamide","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1; 25 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BLISTER PACK (61958-2002-2)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":74.94147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-29","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Descovy|Emtricitabine/Tenofov Alafenam","basis":"brand"},"part_b":null}, {"ndc":"23155057801","name":"DESIPRAMINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"45963034102","name":"DESIPRAMINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-341-02","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (45963-341-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.13641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742011201","name":"DESIPRAMINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-112-01","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-112-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.13641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332031531","name":"DESIPRAMINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-315-31","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"DESIPRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-315-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.13641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105301","name":"DESIPRAMINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1053-1","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1053-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.13641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155058201","name":"DESIPRAMINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"45963034502","name":"DESIPRAMINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-345-02","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (45963-345-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.44611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742011601","name":"DESIPRAMINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-116-01","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-116-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.44611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332031931","name":"DESIPRAMINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-319-31","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"DESIPRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-319-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.44611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238106101","name":"DESIPRAMINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1061-1","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1061-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.44611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155058325","name":"DESIPRAMINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"45963034650","name":"DESIPRAMINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-346-50","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (45963-346-50)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.83165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742011750","name":"DESIPRAMINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-117-50","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"50 TABLET in 1 BOTTLE (50742-117-50)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.83165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332032050","name":"DESIPRAMINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-320-50","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"DESIPRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (62332-320-50)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.83165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238106302","name":"DESIPRAMINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1063-2","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (69238-1063-2)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.83165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155057901","name":"DESIPRAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"45963034202","name":"DESIPRAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-342-02","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (45963-342-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.12692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742011301","name":"DESIPRAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-113-01","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-113-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.12692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332031631","name":"DESIPRAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-316-31","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"DESIPRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-316-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.12692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105501","name":"DESIPRAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1055-1","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1055-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.12692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155058001","name":"DESIPRAMINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"45963034302","name":"DESIPRAMINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-343-02","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (45963-343-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.21766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742011401","name":"DESIPRAMINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-114-01","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-114-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.21766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332031731","name":"DESIPRAMINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-317-31","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"DESIPRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-317-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.21766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105701","name":"DESIPRAMINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1057-1","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1057-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.21766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155058101","name":"DESIPRAMINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-581-01","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-581-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"45963034402","name":"DESIPRAMINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-344-02","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (45963-344-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742011501","name":"DESIPRAMINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-115-01","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"desipramine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-115-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332031831","name":"DESIPRAMINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-318-31","proprietary_name":"DESIPRAMINE HYDROCHLORIDE","nonproprietary_name":"DESIPRAMINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-318-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238105901","name":"DESIPRAMINE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1059-1","proprietary_name":"Desipramine Hydrochloride","nonproprietary_name":"Desipramine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1059-1)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desipramine HCl|Desipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111036006","name":"DESLORATADINE 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-360-06","proprietary_name":"Desloratadine","nonproprietary_name":"Desloratadine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (55111-360-06)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":4.77528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111036031","name":"DESLORATADINE 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-360-31","proprietary_name":"Desloratadine","nonproprietary_name":"Desloratadine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"5 BLISTER PACK in 1 CARTON (55111-360-31) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":4.77528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180015301","name":"DESLORATADINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-153-01","proprietary_name":"DESLORATADINE","nonproprietary_name":"DESLORATADINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68180-153-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.25755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desloratadine|Desloratadine","basis":"generic"},"part_b":null}, {"ndc":"68180015302","name":"DESLORATADINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-153-02","proprietary_name":"DESLORATADINE","nonproprietary_name":"DESLORATADINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-153-02)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.25755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desloratadine|Desloratadine","basis":"generic"},"part_b":null}, {"ndc":"69452036320","name":"DESLORATADINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-363-20","proprietary_name":"Desloratadine","nonproprietary_name":"Desloratadine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-363-20)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.25755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desloratadine|Desloratadine","basis":"generic"},"part_b":null}, {"ndc":"69452036330","name":"DESLORATADINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-363-30","proprietary_name":"Desloratadine","nonproprietary_name":"Desloratadine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-363-30)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.25755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desloratadine|Desloratadine","basis":"generic"},"part_b":null}, {"ndc":"60505081500","name":"DESMOPRESSIN 10 MCG/0.1 ML SPR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0815-0","proprietary_name":"DESMOPRESSIN ACETATE","nonproprietary_name":"DESMOPRESSIN ACETATE","dosage_form":"SPRAY","route":"NASAL","strength":"10 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-0815-0) / 50 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":10.11078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021046110","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-461-10","proprietary_name":"desmopressin acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"40 ug/10mL","labeler":"Sagent Pharmaceuticals","package_description":"1 VIAL in 1 CARTON (25021-461-10) / 10 mL in 1 VIAL","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (25021-461-10) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"39822625001","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39822-6250-1","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"XGen Pharmaceuticals DJB, Inc.","package_description":"1 VIAL in 1 CARTON (39822-6250-1) / 10 mL in 1 VIAL","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (39822-6250-1) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598005311","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-053-11","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 VIAL in 1 CARTON (43598-053-11) / 10 mL in 1 VIAL","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (43598-053-11) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65219029510","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-295-10","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (65219-295-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (65219-295-10) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69918090110","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-901-10","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"SOLUTION","route":"INTRAVENOUS","strength":"4 ug/mL","labeler":"Nordic Pharma, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (69918-901-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (69918-901-10) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69918090111","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-901-11","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"SOLUTION","route":"INTRAVENOUS","strength":"4 ug/mL","labeler":"Nordic Pharma, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (69918-901-11) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (69918-901-11) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69918090112","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-901-12","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"SOLUTION","route":"INTRAVENOUS","strength":"4 ug/mL","labeler":"Nordic Pharma, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (69918-901-12) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (69918-901-12) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70095003101","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-031-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 VIAL in 1 CARTON (70095-031-01) / 10 mL in 1 VIAL","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70095-031-01) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485052401","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-524-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"40 ug/10mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (72485-524-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634045110","name":"DESMOPRESSIN 40 MCG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-451-10","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Avenacy, LLC","package_description":"1 VIAL in 1 CARTON (83634-451-10) / 10 mL in 1 VIAL","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (83634-451-10) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021046001","name":"DESMOPRESSIN AC 4 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-460-01","proprietary_name":"desmopressin acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-460-01) / 1 mL in 1 VIAL","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-460-01) / 1 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"39822620002","name":"DESMOPRESSIN AC 4 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39822-6200-2","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"XGen Pharmaceuticals DJB, Inc.","package_description":"10 VIAL in 1 CARTON (39822-6200-2) / 1 mL in 1 VIAL (39822-6200-1)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (39822-6200-2) / 1 mL in 1 VIAL (39822-6200-1)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65219029301","name":"DESMOPRESSIN AC 4 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-293-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (65219-293-01) / 1 mL in 1 VIAL, SINGLE-DOSE (65219-293-00)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (65219-293-01) / 1 mL in 1 VIAL, SINGLE-DOSE (65219-293-00)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70095002602","name":"DESMOPRESSIN AC 4 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-026-02","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (70095-026-02) / 1 mL in 1 VIAL, SINGLE-DOSE (70095-026-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (70095-026-02) / 1 mL in 1 VIAL, SINGLE-DOSE (70095-026-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485052310","name":"DESMOPRESSIN AC 4 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-523-10","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72485-523-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-523-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634045101","name":"DESMOPRESSIN AC 4 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-451-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4 ug/mL","labeler":"Avenacy, LLC","package_description":"10 VIAL in 1 CARTON (83634-451-01) / 1 mL in 1 VIAL (83634-451-41)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":19.14792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2597","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2597 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (83634-451-01) / 1 mL in 1 VIAL (83634-451-41)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155048901","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-489-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-489-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651024901","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-249-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-249-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505025701","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0257-1","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0257-1)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072111","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072121","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-721-21","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-721-21) / 1 TABLET in 1 BLISTER PACK (60687-721-11)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001057400","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-574-00","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-574-00)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69918010101","name":"DESMOPRESSIN ACETATE 0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-101-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (69918-101-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.24294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702017001","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-170-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 TABLET in 1 BOTTLE (10702-170-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155049001","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-490-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-490-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651025001","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-250-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-250-01)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505025801","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0258-1","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0258-1)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073211","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073221","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-732-21","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-732-21) / 1 TABLET in 1 BLISTER PACK (60687-732-11)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001057500","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-575-00","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"desmopressin acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-575-00)","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69918020101","name":"DESMOPRESSIN ACETATE 0.2 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-201-01","proprietary_name":"Desmopressin Acetate","nonproprietary_name":"Desmopressin Acetate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (69918-201-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Factor VIII Activator [EPC]","Increased Coagulation Factor VIII Activity [PE]","Increased Coagulation Factor VIII Concentration [PE]","Vasopressin Analog [EPC]","Vasopressins [CS]"]},"nadac":{"value":0.37257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713066115","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0661-15","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0661-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066160","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0661-60","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0661-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714072901","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-729-01","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-729-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714072902","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-729-02","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-729-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128001","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1280-1","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1280-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128003","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1280-3","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1280-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332063215","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-632-15","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-632-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332063260","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-632-60","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-632-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008601","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-086-01","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-086-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008602","name":"DESONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-086-02","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-086-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472080302","name":"DESONIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0803-02","proprietary_name":"Desonide","nonproprietary_name":"desonide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (0472-0803-02) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00472080304","name":"DESONIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0803-04","proprietary_name":"Desonide","nonproprietary_name":"desonide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (0472-0803-04) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.52466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672407904","name":"DESONIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4079-4","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4079-4) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672407908","name":"DESONIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4079-8","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4079-8) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.52466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332055018","name":"DESONIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-550-18","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-550-18) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.52466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332055059","name":"DESONIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-550-59","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-550-59) / 59 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922000404","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-004-04","proprietary_name":"Desonide Ointment, 0.05%","nonproprietary_name":"Desonide Ointment, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-004-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.3921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922000407","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-004-07","proprietary_name":"Desonide Ointment, 0.05%","nonproprietary_name":"Desonide Ointment, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-004-07) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802042335","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-423-35","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-423-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.3921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802042337","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-423-37","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-423-37) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128101","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1281-1","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1281-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.3921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128103","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1281-3","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1281-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332048515","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-485-15","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-485-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.3921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332048560","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-485-60","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-485-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603016401","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-164-01","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (72603-164-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.3921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603016402","name":"DESONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-164-02","proprietary_name":"Desonide","nonproprietary_name":"Desonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (72603-164-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180094902","name":"DESOXIMETASONE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-949-02","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-949-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.50996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"71656008660","name":"DESOXIMETASONE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-086-60","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"60 TUBE in 1 CARTON (71656-086-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.50996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"51672126101","name":"DESOXIMETASONE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1261-1","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1261-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.75133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"51672126103","name":"DESOXIMETASONE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1261-3","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1261-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.1892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"51672135203","name":"DESOXIMETASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1352-3","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1352-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"68180094804","name":"DESOXIMETASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-948-04","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-948-04) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"83148002160","name":"DESOXIMETASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83148-021-60","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"The J. Molner Company LLC","package_description":"1 TUBE in 1 CARTON (83148-021-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"45802049535","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-495-35","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-495-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"45802049537","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-495-37","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-495-37) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"68180095001","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-950-01","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-950-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"68180095002","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-950-02","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-950-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"68180095004","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-950-04","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-950-04) / 100 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"71656008715","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-087-15","proprietary_name":"DESOXIMETASONE","nonproprietary_name":"DESOXIMETASONE","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"15 TUBE in 1 CARTON (71656-087-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"71656008760","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-087-60","proprietary_name":"DESOXIMETASONE","nonproprietary_name":"DESOXIMETASONE","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"60 TUBE in 1 CARTON (71656-087-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"72578009101","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-091-01","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-091-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39788,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"72578009102","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-091-02","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-091-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.32267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"72578009103","name":"DESOXIMETASONE 0.25% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-091-03","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-091-03) / 100 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"00472047915","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0479-15","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0479-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"00472047960","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0479-60","proprietary_name":"Desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0479-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"45802049614","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-496-14","proprietary_name":"desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-496-14) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"45802049696","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-496-96","proprietary_name":"desoximetasone","nonproprietary_name":"Desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-496-96) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"68180094601","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-946-01","proprietary_name":"DESOXIMETASONE","nonproprietary_name":"DESOXIMETASONE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-946-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"68180094604","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-946-04","proprietary_name":"DESOXIMETASONE","nonproprietary_name":"DESOXIMETASONE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-946-04) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"72578009501","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-095-01","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-095-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"72578009502","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-095-02","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-095-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"72578009503","name":"DESOXIMETASONE 0.25% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-095-03","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-095-03) / 100 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.05556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Desoximetasone|Desoximetasone","basis":"generic"},"part_b":null}, {"ndc":"45802080798","name":"DESOXIMETASONE 0.25% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-807-98","proprietary_name":"desoximetasone","nonproprietary_name":"desoximetasone","dosage_form":"SPRAY","route":"TOPICAL","strength":"2.5 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, SPRAY in 1 CARTON (45802-807-98) / 100 mL in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63304019230","name":"DESVENLAFAXINE ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-192-30","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-192-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":3.81401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304019130","name":"DESVENLAFAXINE ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-191-30","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-191-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":3.75523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054040113","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0401-13","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0054-0401-13)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054040122","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0401-22","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0054-0401-22)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591366030","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3660-30","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0591-3660-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342038907","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-389-07","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-389-07)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"33342038910","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-389-10","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-389-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"51991031210","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-312-10","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-312-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991031233","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-312-33","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-312-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991031290","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-312-90","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-312-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180059306","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-593-06","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-593-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"70436001304","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-013-04","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70436-013-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001306","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-013-06","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70436-013-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603055701","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-557-01","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 PACKAGE (72603-557-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888014430","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-144-30","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, EXTENDED RELEASE in 1 PACKAGE (72888-144-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888014490","name":"DESVENLAFAXINE SUCCNT ER 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-144-90","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"90 TABLET, EXTENDED RELEASE in 1 PACKAGE (72888-144-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054060313","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0603-13","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0054-0603-13)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591406030","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4060-30","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0591-4060-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991000633","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-006-33","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-006-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991000690","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-006-90","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-006-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180060406","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-604-06","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-604-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"70436003604","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-036-04","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70436-036-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603055501","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-555-01","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 PACKAGE (72603-555-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888017530","name":"DESVENLAFAXINE SUCCNT ER 25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-175-30","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, EXTENDED RELEASE in 1 PACKAGE (72888-175-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054040013","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0400-13","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0054-0400-13)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054040022","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0400-22","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0054-0400-22)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591365930","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3659-30","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0591-3659-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342038807","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-388-07","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-388-07)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"33342038810","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-388-10","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-388-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"51991031110","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-311-10","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-311-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991031133","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-311-33","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-311-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991031190","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-311-90","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-311-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687060711","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687060721","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-607-21","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-607-21) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-607-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180059206","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-592-06","proprietary_name":"Desvenlafaxine Succinate","nonproprietary_name":"Desvenlafaxine Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-592-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Desvenlafaxine Succinate ER|Desvenlafaxine Succinate","basis":"generic"},"part_b":null}, {"ndc":"70436001204","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-012-04","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70436-012-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001206","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-012-06","proprietary_name":"Desvenlafaxine","nonproprietary_name":"Desvenlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70436-012-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603055601","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-556-01","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 PACKAGE (72603-556-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603055602","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-556-02","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 PACKAGE (72603-556-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888014305","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-143-05","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, EXTENDED RELEASE in 1 PACKAGE (72888-143-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888014330","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-143-30","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, EXTENDED RELEASE in 1 PACKAGE (72888-143-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888014390","name":"DESVENLAFAXINE SUCCNT ER 50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-143-90","proprietary_name":"DESVENLAFAXINE","nonproprietary_name":"DESVENLAFAXINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"90 TABLET, EXTENDED RELEASE in 1 PACKAGE (72888-143-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208072002","name":"DEXAMETHASONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-720-02","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-720-02) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.17447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054417925","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4179-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4179-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054817925","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8179-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8179-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"60505624901","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6249-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6249-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6249-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954039810","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-398-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-398-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (70954-398-10)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72578016801","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-168-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-168-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72603021201","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-212-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/.5mg","labeler":"NorthStar Rx LLC","package_description":"100 mg in 1 BOTTLE (72603-212-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"72888023501","name":"DEXAMETHASONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-235-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-235-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"62135011437","name":"DEXAMETHASONE 0.5 MG/5 ML ELX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-114-37","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"ELIXIR","route":"ORAL","strength":".5 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"237 mL in 1 BOTTLE (62135-114-37)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980050924","name":"DEXAMETHASONE 0.5 MG/5 ML ELX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-509-24","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"ELIXIR","route":"ORAL","strength":".5 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"237 mL in 1 BOTTLE, PLASTIC (64980-509-24)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954087210","name":"DEXAMETHASONE 0.5 MG/5 ML ELX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-872-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"ELIXIR","route":"ORAL","strength":".5 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70954-872-10) / 237 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"85742000403","name":"DEXAMETHASONE 0.5 MG/5 ML ELX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85742-004-03","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"ELIXIR","route":"ORAL","strength":".5 mg/5mL","labeler":"Kanchan Healthcare Inc","package_description":"237 mL in 1 BOTTLE (85742-004-03)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054317757","name":"DEXAMETHASONE 0.5 MG/5 ML LIQ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3177-57","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"SOLUTION","route":"ORAL","strength":".5 mg/5mL","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"240 mL in 1 BOTTLE, PLASTIC (0054-3177-57)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054317763","name":"DEXAMETHASONE 0.5 MG/5 ML LIQ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3177-63","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"SOLUTION","route":"ORAL","strength":".5 mg/5mL","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"500 mL in 1 BOTTLE, PLASTIC (0054-3177-63)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 mL in 1 BOTTLE, PLASTIC (0054-3177-63)) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054418025","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4180-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4180-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054818025","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8180-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8180-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0054-8180-25) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505625001","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6250-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6250-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6250-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954039910","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-399-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-399-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (70954-399-10)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72578016901","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-169-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-169-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72603021301","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-213-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/.75mg","labeler":"NorthStar Rx LLC","package_description":"100 mg in 1 BOTTLE (72603-213-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"72888023601","name":"DEXAMETHASONE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-236-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-236-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054418125","name":"DEXAMETHASONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4181-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4181-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054817425","name":"DEXAMETHASONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8174-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8174-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"60505625101","name":"DEXAMETHASONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6251-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6251-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6251-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72578016601","name":"DEXAMETHASONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-166-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-166-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72888023701","name":"DEXAMETHASONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-237-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-237-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054418225","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4182-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4182-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054818125","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8181-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8181-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0054-8181-25) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505625201","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6252-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6252-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6252-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954040110","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-401-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-401-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72578017001","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-170-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-170-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72603018701","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-187-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-187-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (72603-187-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888023801","name":"DEXAMETHASONE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-238-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-238-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00641036725","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0367-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-0367-25) / 1 mL in 1 VIAL (0641-0367-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.23567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-0367-25) / 1 mL in 1 VIAL (0641-0367-21)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021005301","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-053-01","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-053-01) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.1568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-053-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150030425","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-304-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL in 1 CARTON (55150-304-25) / 1 mL in 1 VIAL (55150-304-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.1568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (55150-304-25) / 1 mL in 1 VIAL (55150-304-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323050601","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-506-01","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-506-01) / 1 mL in 1 VIAL (63323-506-00)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.1568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-506-01) / 1 mL in 1 VIAL (63323-506-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323050616","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-506-16","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-506-16) / 1 mL in 1 VIAL (63323-506-41)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.1568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-506-16) / 1 mL in 1 VIAL (63323-506-41)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069002125","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-021-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"25 VIAL in 1 CARTON (70069-021-25) / 1 mL in 1 VIAL (70069-021-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.1568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70069-021-25) / 1 mL in 1 VIAL (70069-021-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485011825","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-118-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Armas Pharmaceuticals","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (72485-118-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-118-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.1568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (72485-118-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-118-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572012225","name":"DEXAMETHASONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-122-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-122-25) / 1 mL in 1 VIAL (72572-122-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.23567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-122-25) / 1 mL in 1 VIAL (72572-122-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323051610","name":"DEXAMETHASONE 100 MG/10 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-516-10","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL in 1 TRAY (63323-516-10) / 10 mL in 1 VIAL (63323-516-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 TRAY (63323-516-10) / 10 mL in 1 VIAL (63323-516-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457042010","name":"DEXAMETHASONE 100 MG/10 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-420-10","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Mylan Institutional LLC","package_description":"10 VIAL in 1 CARTON (67457-420-10) / 10 mL in 1 VIAL (67457-420-00)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (67457-420-10) / 10 mL in 1 VIAL (67457-420-00)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457048310","name":"DEXAMETHASONE 100 MG/10 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-483-10","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Mylan Institutional LLC","package_description":"10 VIAL in 1 CARTON (67457-483-10) / 10 mL in 1 VIAL (67457-483-00)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (67457-483-10) / 10 mL in 1 VIAL (67457-483-00)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069002510","name":"DEXAMETHASONE 100 MG/10 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-025-10","proprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL in 1 CARTON (70069-025-10) / 10 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70069-025-10) / 10 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016530","name":"DEXAMETHASONE 120 MG/30 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-165-30","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"4 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 BOX (63323-165-30) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.69401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 BOX (63323-165-30) / 30 mL in 1 VIAL, MULTI-DOSE) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457042100","name":"DEXAMETHASONE 120 MG/30 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.69401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67457048400","name":"DEXAMETHASONE 120 MG/30 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.69401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054418325","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4183-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4183-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054817625","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8176-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8176-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00904744461","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7444-61","proprietary_name":"dexamethasone","nonproprietary_name":"dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7444-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":800,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-7444-61) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60219205601","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2056-1","proprietary_name":"dexamethasone","nonproprietary_name":"dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-2056-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"60505625301","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6253-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6253-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":800,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6253-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687077301","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-773-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-773-01) / 1 TABLET in 1 BLISTER PACK (60687-773-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":800,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (60687-773-01) / 1 TABLET in 1 BLISTER PACK (60687-773-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687077311","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"69452027620","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-276-20","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.,","package_description":"100 TABLET in 1 BOTTLE (69452-276-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"70954040210","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-402-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-402-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72578016701","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-167-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-167-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72603018801","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-188-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-188-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":800,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (72603-188-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888023901","name":"DEXAMETHASONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-239-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-239-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00641614610","name":"DEXAMETHASONE 20 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6146-10","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0641-6146-10) / 5 mL in 1 VIAL (0641-6146-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0641-6146-10) / 5 mL in 1 VIAL (0641-6146-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021005205","name":"DEXAMETHASONE 20 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"25021-052-05","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-052-05) / 5 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-052-05) / 5 mL in 1 VIAL) gives 125 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016505","name":"DEXAMETHASONE 20 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-165-05","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"4 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-165-05) / 5 mL in 1 VIAL, MULTI-DOSE (63323-165-03)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-165-05) / 5 mL in 1 VIAL, MULTI-DOSE (63323-165-03)) gives 125 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016526","name":"DEXAMETHASONE 20 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-165-26","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"4 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-165-26) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-165-26) / 5 mL in 1 VIAL, MULTI-DOSE) gives 125 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457041805","name":"DEXAMETHASONE 20 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67457-418-05","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL in 1 CARTON (67457-418-05) / 5 mL in 1 VIAL (67457-418-00)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (67457-418-05) / 5 mL in 1 VIAL (67457-418-00)) gives 125 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457042254","name":"DEXAMETHASONE 20 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67457-422-54","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL in 1 CARTON (67457-422-54) / 5 mL in 1 VIAL (67457-422-00)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (67457-422-54) / 5 mL in 1 VIAL (67457-422-00)) gives 125 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054418425","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4184-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4184-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0054-4184-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054817525","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8175-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8175-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0054-8175-25) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904726661","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7266-61","proprietary_name":"dexamethasone","nonproprietary_name":"dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7266-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-7266-61) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60219204301","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2043-1","proprietary_name":"dexamethasone","nonproprietary_name":"dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-2043-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"60505625401","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6254-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6254-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6254-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687071801","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-718-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-718-01) / 1 TABLET in 1 BLISTER PACK (60687-718-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (60687-718-01) / 1 TABLET in 1 BLISTER PACK (60687-718-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687071811","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"66993073002","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-730-02","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET in 1 BOTTLE (66993-730-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (66993-730-02)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"66993073051","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"66993073080","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-730-80","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Prasco Laboratories","package_description":"10 BLISTER PACK in 1 CARTON (66993-730-80) / 10 TABLET in 1 BLISTER PACK (66993-730-51)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (66993-730-80) / 10 TABLET in 1 BLISTER PACK (66993-730-51)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69452027720","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-277-20","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Bionpharma Inc.,","package_description":"100 TABLET in 1 BOTTLE (69452-277-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"70954040310","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-403-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-403-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72578017101","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-171-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-171-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72603018901","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-189-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-189-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":1600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (72603-189-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888024001","name":"DEXAMETHASONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-240-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-240-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00641614525","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6145-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6145-25) / 1 mL in 1 VIAL (0641-6145-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6145-25) / 1 mL in 1 VIAL (0641-6145-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021005201","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-052-01","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-052-01) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-052-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016501","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-165-01","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"4 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-165-01) / 1 mL in 1 VIAL (63323-165-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-165-01) / 1 mL in 1 VIAL (63323-165-02)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016516","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-165-16","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"4 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-165-16) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-165-16) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457042312","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-423-12","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL in 1 CARTON (67457-423-12) / 1 mL in 1 VIAL (67457-423-00)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (67457-423-12) / 1 mL in 1 VIAL (67457-423-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572012025","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-120-25","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"Dexamethasone Sodium Phosphate","dosage_form":"INJECTION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRAVENOUS; SOFT TISSUE","strength":"4 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-120-25) / 1 mL in 1 VIAL (72572-120-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-120-25) / 1 mL in 1 VIAL (72572-120-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81565020202","name":"DEXAMETHASONE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81565-202-02","proprietary_name":"Dexamethasone Sodium Phosphate","nonproprietary_name":"DEXAMETHASONE SODIUM PHOSPHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"4 mg/mL","labeler":"Phlow Corporation","package_description":"25 VIAL in 1 TRAY (81565-202-02) / 1 mL in 1 VIAL (81565-202-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1100","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (81565-202-02) / 1 mL in 1 VIAL (81565-202-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054418625","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4186-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4186-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054818325","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8183-25","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-8183-25) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00904726761","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7267-61","proprietary_name":"dexamethasone","nonproprietary_name":"dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7267-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":2400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-7267-61) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60219204401","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2044-1","proprietary_name":"dexamethasone","nonproprietary_name":"dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-2044-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"60505625501","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6255-1","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-6255-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":2400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (60505-6255-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687072901","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-729-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-729-01) / 1 TABLET in 1 BLISTER PACK (60687-729-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":2400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (60687-729-01) / 1 TABLET in 1 BLISTER PACK (60687-729-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687072911","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"69452027820","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-278-20","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Bionpharma Inc.,","package_description":"100 TABLET in 1 BOTTLE (69452-278-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"70954040410","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-404-10","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-404-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72578017201","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-172-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-172-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"72603019001","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-190-01","proprietary_name":"Dexamethasone","nonproprietary_name":"Dexamethasone","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-190-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":2400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (72603-190-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888024101","name":"DEXAMETHASONE 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-241-01","proprietary_name":"DEXAMETHASONE","nonproprietary_name":"DEXAMETHASONE","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-241-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.38175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexamethasone|Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00054317644","name":"DEXAMETHASONE INTENSOL 1 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3176-44","proprietary_name":"Dexamethasone Intensol","nonproprietary_name":"Dexamethasone Intensol","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"30 mL in 1 BOTTLE, GLASS (0054-3176-44)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.75082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J8540","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8540 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 mL in 1 BOTTLE, GLASS (0054-3176-44)) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64764017130","name":"DEXILANT DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-171-30","proprietary_name":"Dexilant","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64764-171-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.8526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.77267,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764017530","name":"DEXILANT DR 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-175-30","proprietary_name":"Dexilant","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64764-175-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.83942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764017590","name":"DEXILANT DR 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-175-90","proprietary_name":"Dexilant","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64764-175-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.83942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378208593","name":"DEXLANSOPRAZOLE DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2085-93","proprietary_name":"Dexlansoprazole","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2085-93)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.77267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"24979000106","name":"DEXLANSOPRAZOLE DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-001-06","proprietary_name":"Dexlansoprazole delayed release","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (24979-001-06)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.77267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"49884014711","name":"DEXLANSOPRAZOLE DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-147-11","proprietary_name":"Dexlansoprazole","nonproprietary_name":"Dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (49884-147-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.77267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"62332082330","name":"DEXLANSOPRAZOLE DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-823-30","proprietary_name":"Dexlansoprazole","nonproprietary_name":"Dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (62332-823-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.77267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"00378208677","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2086-77","proprietary_name":"Dexlansoprazole","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2086-77)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"00378208693","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2086-93","proprietary_name":"Dexlansoprazole","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2086-93)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"24979000206","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-002-06","proprietary_name":"Dexlansoprazole delayed release","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (24979-002-06)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"24979000207","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-002-07","proprietary_name":"Dexlansoprazole delayed release","nonproprietary_name":"dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (24979-002-07)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"49884014809","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-148-09","proprietary_name":"Dexlansoprazole","nonproprietary_name":"Dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Par Health USA, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (49884-148-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"49884014811","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-148-11","proprietary_name":"Dexlansoprazole","nonproprietary_name":"Dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (49884-148-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"62332082430","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-824-30","proprietary_name":"Dexlansoprazole","nonproprietary_name":"Dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (62332-824-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"62332082490","name":"DEXLANSOPRAZOLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-824-90","proprietary_name":"Dexlansoprazole","nonproprietary_name":"Dexlansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (62332-824-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.70686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexlansoprazole Dr|Dexlansoprazole","basis":"generic"},"part_b":null}, {"ndc":"10702010801","name":"DEXMETHYLPHENIDATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-108-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH, INC","package_description":"100 TABLET in 1 BOTTLE (10702-108-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.34138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"27808009301","name":"DEXMETHYLPHENIDATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-093-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (27808-093-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.34138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"57664037988","name":"DEXMETHYLPHENIDATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-379-88","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-379-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.34138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"67877065701","name":"DEXMETHYLPHENIDATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-657-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-657-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.34138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75834032801","name":"DEXMETHYLPHENIDATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-328-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-328-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.34138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"10702010601","name":"DEXMETHYLPHENIDATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-106-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"KVK-TECH, INC","package_description":"100 TABLET in 1 BOTTLE (10702-106-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.19002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"27808009101","name":"DEXMETHYLPHENIDATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-091-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (27808-091-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.19002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"57664037688","name":"DEXMETHYLPHENIDATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-376-88","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-376-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.19002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"67877065501","name":"DEXMETHYLPHENIDATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-655-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-655-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.19002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"10702010701","name":"DEXMETHYLPHENIDATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-107-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH, INC","package_description":"100 TABLET in 1 BOTTLE (10702-107-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"27808009201","name":"DEXMETHYLPHENIDATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-092-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (27808-092-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"57664037888","name":"DEXMETHYLPHENIDATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-378-88","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-378-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"67877065601","name":"DEXMETHYLPHENIDATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-656-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-656-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75834032701","name":"DEXMETHYLPHENIDATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-327-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-327-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093555101","name":"DEXMETHYLPHENIDATE ER 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5551-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5551-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115991901","name":"DEXMETHYLPHENIDATE ER 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9919-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-9919-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527810737","name":"DEXMETHYLPHENIDATE ER 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8107-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8107-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023001","name":"DEXMETHYLPHENIDATE ER 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-230-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-230-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884004901","name":"DEXMETHYLPHENIDATE ER 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-049-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-049-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010000501","name":"DEXMETHYLPHENIDATE ER 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-005-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-005-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093555201","name":"DEXMETHYLPHENIDATE ER 15 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5552-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5552-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115992001","name":"DEXMETHYLPHENIDATE ER 15 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9920-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-9920-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527810837","name":"DEXMETHYLPHENIDATE ER 15 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8108-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8108-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023101","name":"DEXMETHYLPHENIDATE ER 15 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-231-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-231-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884042801","name":"DEXMETHYLPHENIDATE ER 15 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-428-01","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-428-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010000601","name":"DEXMETHYLPHENIDATE ER 15 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-006-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-006-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093555301","name":"DEXMETHYLPHENIDATE ER 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5553-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5553-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115992101","name":"DEXMETHYLPHENIDATE ER 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9921-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-9921-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527810937","name":"DEXMETHYLPHENIDATE ER 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8109-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8109-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023201","name":"DEXMETHYLPHENIDATE ER 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-232-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-232-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884024801","name":"DEXMETHYLPHENIDATE ER 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-248-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-248-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010000701","name":"DEXMETHYLPHENIDATE ER 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-007-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-007-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093504501","name":"DEXMETHYLPHENIDATE ER 25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5045-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5045-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115170901","name":"DEXMETHYLPHENIDATE ER 25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1709-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-1709-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527811037","name":"DEXMETHYLPHENIDATE ER 25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8110-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8110-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023301","name":"DEXMETHYLPHENIDATE ER 25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-233-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-233-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884033301","name":"DEXMETHYLPHENIDATE ER 25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-333-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-333-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010000801","name":"DEXMETHYLPHENIDATE ER 25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-008-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-008-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093555401","name":"DEXMETHYLPHENIDATE ER 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5554-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5554-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115992201","name":"DEXMETHYLPHENIDATE ER 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9922-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-9922-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527811137","name":"DEXMETHYLPHENIDATE ER 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8111-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8111-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023401","name":"DEXMETHYLPHENIDATE ER 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-234-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-234-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884043001","name":"DEXMETHYLPHENIDATE ER 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-430-01","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-430-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010000901","name":"DEXMETHYLPHENIDATE ER 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-009-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-009-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093504601","name":"DEXMETHYLPHENIDATE ER 35 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5046-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5046-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115171001","name":"DEXMETHYLPHENIDATE ER 35 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1710-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-1710-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527811237","name":"DEXMETHYLPHENIDATE ER 35 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8112-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8112-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023501","name":"DEXMETHYLPHENIDATE ER 35 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-235-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-235-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884033901","name":"DEXMETHYLPHENIDATE ER 35 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-339-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-339-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010001001","name":"DEXMETHYLPHENIDATE ER 35 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-010-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-010-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093556201","name":"DEXMETHYLPHENIDATE ER 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5562-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5562-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527811337","name":"DEXMETHYLPHENIDATE ER 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8113-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8113-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722023601","name":"DEXMETHYLPHENIDATE ER 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-236-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-236-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884054601","name":"DEXMETHYLPHENIDATE ER 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-546-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-546-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010001101","name":"DEXMETHYLPHENIDATE ER 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-011-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-011-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00093555001","name":"DEXMETHYLPHENIDATE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5550-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-5550-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115991801","name":"DEXMETHYLPHENIDATE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9918-01","proprietary_name":"Dexmethylphenidate hydrochloride","nonproprietary_name":"Dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0115-9918-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527810637","name":"DEXMETHYLPHENIDATE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-8106-37","proprietary_name":"Dexmethylphenidate Hydrochloride Extended-Release","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-8106-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722022901","name":"DEXMETHYLPHENIDATE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-229-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-229-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"49884004801","name":"DEXMETHYLPHENIDATE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-048-01","proprietary_name":"Dexmethylphenidate Hydrochloride","nonproprietary_name":"Dexmethylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (49884-048-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010000401","name":"DEXMETHYLPHENIDATE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-004-01","proprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"DEXMETHYLPHENIDATE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-004-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dexmethylphenidate HCl ER|Dexmethylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115148701","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1487-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1487-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228305911","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3059-11","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-3059-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895201","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8952-01","proprietary_name":"Mixed Salts of a Single Entity Amphetamine Product XR","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8952-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527079137","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0791-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-0791-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722018601","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-186-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-186-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573046502","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-465-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (35573-465-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858061001","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-610-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate Extended-Release","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-610-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975027810","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-278-10","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-278-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850051101","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-511-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64850-511-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993059502","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-595-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-595-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010003001","name":"DEXTROAMP-AMPHET ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-030-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-030-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.53946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115148801","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1488-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1488-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228306311","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3063-11","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-3063-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895301","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8953-01","proprietary_name":"Mixed Salts of a Single Entity Amphetamine Product XR","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8953-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527079237","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0792-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-0792-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722018701","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-187-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-187-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573046602","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-466-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (35573-466-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858021501","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-215-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate Extended-Release","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-215-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975027910","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-279-10","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-279-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850051201","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-512-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64850-512-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993059602","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-596-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-596-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010003101","name":"DEXTROAMP-AMPHET ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-031-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-031-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.55748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115148901","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1489-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1489-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228306011","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3060-11","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-3060-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895401","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8954-01","proprietary_name":"Mixed Salts of a Single Entity Amphetamine Product XR","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8954-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527079337","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0793-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-0793-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722018801","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-188-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-188-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573046702","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-467-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (35573-467-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072001","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-720-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate Extended-Release","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-720-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975028010","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-280-10","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-280-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850051301","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-513-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64850-513-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993059702","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-597-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-597-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010003201","name":"DEXTROAMP-AMPHET ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-032-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-032-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.59656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115149001","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1490-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1490-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228306411","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3064-11","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-3064-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895501","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8955-01","proprietary_name":"Mixed Salts of a Single Entity Amphetamine Product XR","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8955-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527079437","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0794-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-0794-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722018901","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-189-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-189-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573046802","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-468-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (35573-468-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858032501","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-325-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate Extended-Release","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-325-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975028110","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-281-10","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-281-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850051401","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-514-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64850-514-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993059802","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-598-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-598-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010003301","name":"DEXTROAMP-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-033-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-033-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.48948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115149101","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1491-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1491-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228306111","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3061-11","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-3061-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895601","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8956-01","proprietary_name":"Mixed Salts of a Single Entity Amphetamine Product XR","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8956-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527079537","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0795-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-0795-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722019501","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-195-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-195-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573046902","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-469-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (35573-469-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858093001","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-930-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate Extended-Release","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-930-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975028210","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-282-10","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-282-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850051501","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-515-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64850-515-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993059902","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-599-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-599-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010003401","name":"DEXTROAMP-AMPHET ER 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-034-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-034-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.46559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115148601","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1486-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1486-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228306211","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3062-11","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-3062-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895101","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8951-01","proprietary_name":"Mixed Salts of a Single Entity Amphetamine Product XR","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8951-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527079037","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0790-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate and Amphetamine Aspartate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-0790-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722018501","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-185-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-185-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573046402","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-464-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (35573-464-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858005501","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-055-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate Extended-Release","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-055-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975027710","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-277-10","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-277-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850051001","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-510-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64850-510-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993059402","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-594-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-594-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010002901","name":"DEXTROAMP-AMPHET ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-029-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-029-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.49142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076337","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0763-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0763-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555077602","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0776-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0776-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019301","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-193-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-193-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714080501","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-805-01","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, Amphetamine aspartate, Dextroamphetamine sulfate, and Amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (16714-805-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722015801","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-158-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-158-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072401","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-724-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-724-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050301","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-503-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-503-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011401","name":"DEXTROAMP-AMPHETAM 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-114-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-114-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.35923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406888401","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8884-01","proprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8884-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076137","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0761-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0761-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555077502","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0775-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0775-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019101","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-191-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-191-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714094901","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-949-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-949-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722015601","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-156-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-156-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072201","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-722-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-722-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050101","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-501-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-501-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011201","name":"DEXTROAMP-AMPHETAM 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-112-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.875 mg/1; 1.875 mg/1; 1.875 mg/1; 1.875 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-112-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.27589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185084201","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0842-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-0842-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406889201","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8892-01","proprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8892-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076237","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0762-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0762-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555097202","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0972-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0972-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019201","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-192-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-192-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107007001","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-070-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-070-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714095001","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-950-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-950-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722015701","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-157-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-157-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806034101","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-341-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42806-341-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072301","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-723-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-723-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781017601","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-176-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,CII","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets, 10 mg,Cll","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Alvogen Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-176-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050201","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-502-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-502-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462064901","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-649-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-649-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011301","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-113-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-113-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001401","name":"DEXTROAMP-AMPHETAMIN 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-014-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 2.5 mg/1; 2.5 mg/1; 2.5 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72516-014-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406888501","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8885-01","proprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8885-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076437","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0764-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0764-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555077702","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0777-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0777-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019401","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-194-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-194-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107007201","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-072-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-072-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714095201","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-952-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-952-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722015901","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-159-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-159-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806034301","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-343-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42806-343-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072501","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-725-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-725-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781017801","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-178-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,CII","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets, 15 mg,Cll","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Alvogen Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-178-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050401","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-504-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-504-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065101","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-651-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-651-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011501","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-115-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-115-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001301","name":"DEXTROAMP-AMPHETAMIN 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-013-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"3.75 mg/1; 3.75 mg/1; 3.75 mg/1; 3.75 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72516-013-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185085301","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0853-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-0853-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406889301","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8893-01","proprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8893-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076537","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0765-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0765-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555097302","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0973-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0973-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019501","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-195-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-195-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107007301","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-073-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-073-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714095301","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-953-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-953-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722016301","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-163-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-163-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806034401","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-344-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42806-344-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072601","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-726-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-726-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781017901","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-179-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,CII","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets, 20 mg,Cll","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Alvogen Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-179-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050501","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-505-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-505-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065201","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-652-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-652-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011601","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-116-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-116-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001201","name":"DEXTROAMP-AMPHETAMIN 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-012-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 5 mg/1; 5 mg/1; 5 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72516-012-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185209901","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-2099-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-2099-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406889401","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8894-01","proprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8894-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076637","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0766-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0766-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555097402","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0974-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0974-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019601","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-196-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-196-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107007401","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-074-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-074-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714080801","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-808-01","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, Amphetamine aspartate, Dextroamphetamine sulfate, and Amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (16714-808-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722016401","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-164-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-164-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806034501","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-345-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42806-345-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072701","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-727-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-727-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781018001","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-180-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,CII","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets, 30 mg,Cll","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Alvogen Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-180-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050601","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-506-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-506-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065301","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-653-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-653-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011701","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-117-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-117-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001101","name":"DEXTROAMP-AMPHETAMIN 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-011-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 7.5 mg/1; 7.5 mg/1; 7.5 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72516-011-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.29556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185209801","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-2098-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-2098-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406889101","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8891-01","proprietary_name":"Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"dextroamphetamine saccharate and amphetamine aspartate and dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8891-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527076037","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0760-37","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-0760-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555097102","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0971-02","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0971-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534019001","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-190-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-190-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107006801","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-068-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-068-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714094801","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-948-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-948-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722015501","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-155-01","proprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AND AMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-155-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806033901","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-339-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42806-339-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858072101","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-721-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-721-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781017401","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-174-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,CII","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets, 5 mg,Cll","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Alvogen Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-174-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850050001","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-500-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-500-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462064701","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-647-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-647-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010011101","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-111-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-111-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001601","name":"DEXTROAMP-AMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-016-01","proprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate and Amphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1; 1.25 mg/1; 1.25 mg/1; 1.25 mg/1","labeler":"Oryza Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72516-016-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.26108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480368301","name":"DEXTROAMPH-AMPHET ER 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3683-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3683-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.43593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664095088","name":"DEXTROAMPH-AMPHET ER 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-950-88","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (57664-950-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.43593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406080301","name":"DEXTROAMPH-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0803-01","proprietary_name":"Mixed Salts of a Single-Entity Amphetamine Product","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-0803-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":7.92393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480368401","name":"DEXTROAMPH-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3684-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3684-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":7.92393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664095188","name":"DEXTROAMPH-AMPHET ER 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-951-88","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (57664-951-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":7.92393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406080701","name":"DEXTROAMPH-AMPHET ER 37.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0807-01","proprietary_name":"Mixed Salts of a Single-Entity Amphetamine Product","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"9.375 mg/1; 9.375 mg/1; 9.375 mg/1; 9.375 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-0807-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.65441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480368501","name":"DEXTROAMPH-AMPHET ER 37.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3685-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"9.375 mg/1; 9.375 mg/1; 9.375 mg/1; 9.375 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3685-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.65441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664095288","name":"DEXTROAMPH-AMPHET ER 37.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-952-88","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"9.375 mg/1; 9.375 mg/1; 9.375 mg/1; 9.375 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (57664-952-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.65441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406080401","name":"DEXTROAMPH-AMPHET ER 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0804-01","proprietary_name":"Mixed Salts of a Single-Entity Amphetamine Product","nonproprietary_name":"DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 12.5 mg/1; 12.5 mg/1; 12.5 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-0804-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.10719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480368601","name":"DEXTROAMPH-AMPHET ER 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3686-01","proprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","nonproprietary_name":"dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 12.5 mg/1; 12.5 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3686-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.10719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664095388","name":"DEXTROAMPH-AMPHET ER 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-953-88","proprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","nonproprietary_name":"Dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, amphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 12.5 mg/1; 12.5 mg/1; 12.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (57664-953-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":8.10719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406895901","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8959-01","proprietary_name":"DEXTROAMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8959-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00555095302","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0953-02","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0953-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"10702006601","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-066-01","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-066-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"11534018901","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-189-01","proprietary_name":"DEXTROAMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-189-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"13107003601","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-036-01","proprietary_name":"DEXTROAMPHETAMINE SULFATE","nonproprietary_name":"DEXTROAMPHETAMINE SULFATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-036-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536051001","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-510-01","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (52536-510-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536051003","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-510-03","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-510-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012310","name":"DEXTROAMPHETAMINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-123-10","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-123-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.37325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536051503","name":"DEXTROAMPHETAMINE 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-515-03","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-515-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.4497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012410","name":"DEXTROAMPHETAMINE 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-124-10","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-124-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.4497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012430","name":"DEXTROAMPHETAMINE 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-124-30","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Winder Laboratories LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (75826-124-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.4497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012010","name":"DEXTROAMPHETAMINE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-120-10","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-120-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.95113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012030","name":"DEXTROAMPHETAMINE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-120-30","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Winder Laboratories LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (75826-120-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.95113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536052003","name":"DEXTROAMPHETAMINE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-520-03","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-520-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.41457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012510","name":"DEXTROAMPHETAMINE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-125-10","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-125-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.41457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012530","name":"DEXTROAMPHETAMINE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-125-30","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Winder Laboratories LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (75826-125-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.41457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536053003","name":"DEXTROAMPHETAMINE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-530-03","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-530-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.48996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012610","name":"DEXTROAMPHETAMINE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-126-10","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-126-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.48996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012630","name":"DEXTROAMPHETAMINE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-126-30","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Winder Laboratories LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (75826-126-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.48996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406895801","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8958-01","proprietary_name":"DEXTROAMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8958-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00555095202","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0952-02","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0952-02)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"10702006501","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-065-01","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-065-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"11534018801","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-188-01","proprietary_name":"DEXTROAMPHETAMINE SULFATE","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-188-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"13107003501","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-035-01","proprietary_name":"DEXTROAMPHETAMINE SULFATE","nonproprietary_name":"DEXTROAMPHETAMINE SULFATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-035-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536050001","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-500-01","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (52536-500-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"52536050003","name":"DEXTROAMPHETAMINE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-500-03","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (52536-500-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.38361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"27808008501","name":"DEXTROAMPHETAMINE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-085-01","proprietary_name":"Dextroamphetamine","nonproprietary_name":"Dextroamphetamine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (27808-085-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.14342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993035957","name":"DEXTROAMPHETAMINE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-359-57","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Prasco Laboratories","package_description":"473 mL in 1 BOTTLE, PLASTIC (66993-359-57)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.14342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826012210","name":"DEXTROAMPHETAMINE 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-122-10","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-122-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.83093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"75826012230","name":"DEXTROAMPHETAMINE 7.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-122-30","proprietary_name":"Dextroamphetamine Sulfate","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Winder Laboratories LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (75826-122-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.83093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406896101","name":"DEXTROAMPHETAMINE ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8961-01","proprietary_name":"Dextroamphetamine Sulfate Extended-Release","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8961-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"45963030409","name":"DEXTROAMPHETAMINE ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-304-09","proprietary_name":"dextroamphetamine sulfate","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (45963-304-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406896201","name":"DEXTROAMPHETAMINE ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8962-01","proprietary_name":"Dextroamphetamine Sulfate Extended-Release","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8962-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.33772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"45963030509","name":"DEXTROAMPHETAMINE ER 15 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-305-09","proprietary_name":"dextroamphetamine sulfate","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (45963-305-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.33772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406896001","name":"DEXTROAMPHETAMINE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8960-01","proprietary_name":"Dextroamphetamine Sulfate Extended-Release","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0406-8960-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.10063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"45963030309","name":"DEXTROAMPHETAMINE ER 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-303-09","proprietary_name":"dextroamphetamine sulfate","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (45963-303-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.10063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dextroamphetamine Sulfate ER|Dextroamphetamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00536133434","name":"DEXTROMETHORPHAN 15 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1334-34","proprietary_name":"Dextromethorphan HBr 15 mg Liquid Gels","nonproprietary_name":"Dextromethorphan HBr","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"15 mg/1","labeler":"RUGBY LABORATORIES","package_description":"20 CAPSULE, LIQUID FILLED in 1 BOTTLE (0536-1334-34)","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.1217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802043321","name":"DEXTROMETHORPHAN ER 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-433-21","proprietary_name":"dextromethorphan polistirex extended release","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-433-21) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75854070101","name":"DHIVY 25-100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"75854-701-01","proprietary_name":"Dhivy","nonproprietary_name":"Carbidopa Levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Avion Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (75854-701-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.61409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dhivy|Carbidopa/Levodopa","basis":"brand"},"part_b":null}, {"ndc":"00096073708","name":"DHS TAR 0.5% SHAMPOO","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0096-0737-08","proprietary_name":"DHS TAR","nonproprietary_name":"coal tar","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".005 g/g","labeler":"Person and Covey","package_description":"250.08 g in 1 BOTTLE (0096-0737-08)"},"nadac":{"value":0.04106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00096073608","name":"DHS TAR GEL 0.5% SHAMPOO","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0096-0736-08","proprietary_name":"DHS tar gel","nonproprietary_name":"coal tar","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".005 g/g","labeler":"Person and Covey","package_description":"249.6 g in 1 BOTTLE (0096-0736-08)"},"nadac":{"value":0.04106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"10542001409","name":"DIALYVITE 3,000 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10542000909","name":"DIALYVITE SUPREME D TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10542-009-09","proprietary_name":"Dialyvite Supreme D","nonproprietary_name":"Ascorbic Acid, Cholecalciferol, Alpha-Tocopherol, Thiamine, Riboflavin, Niacinamide, Pyridoxine, Folic Acid, Cobalamin, Biotin, Pantothenic Acid, Zinc, Selenium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1; 2000 [iU]/1; 30 [iU]/1; 1.5 mg/1; 1.7 mg/1; 20 mg/1; 25 mg/1; 3 mg/1; 1 mg/1; 300 ug/1; 10 mg/1; 15 mg/1; 70 ug/1","labeler":"Hillestad Pharmaceuticals USA","package_description":"90 TABLET, COATED in 1 BOTTLE, PLASTIC (10542-009-09)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.34793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10542001010","name":"DIALYVITE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10542-010-10","proprietary_name":"Dialyvite","nonproprietary_name":"Ascorbic Acid, Thiamine, Riboflavin, Niacinamide, Pyridoxine, Folic Acid, Cobalamin, Biotin, Pantothenic Acid","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1; 1.5 mg/1; 1.7 mg/1; 20 mg/1; 10 mg/1; 1 mg/1; 6 ug/1; 300 ug/1; 10 mg/1","labeler":"Hillestad Pharmaceuticals USA","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (10542-010-10)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.16238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10542001210","name":"DIALYVITE WITH ZINC TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000046901","name":"DIAPER RASH 40% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0469-1","proprietary_name":"Zinc Oxide 40%","nonproprietary_name":"Diaper Rash Skin Protectent","dosage_form":"OINTMENT","route":"TOPICAL","strength":"40 g/100g","labeler":"Cardinal Health","package_description":"72 BOX in 1 CASE (70000-0469-1) / 1 TUBE in 1 BOX / 113 g in 1 TUBE"},"nadac":{"value":0.03389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70710207901","name":"DIAZEPAM 10 MG RECTAL GEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":208.71283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43386028001","name":"DIAZEPAM 10 MG RECTAL GEL (2PK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":208.71283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710207902","name":"DIAZEPAM 10 MG RECTAL GEL (2PK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2079-2","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"GEL","route":"RECTAL","strength":"10 mg/2mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"2 SYRINGE, PLASTIC in 1 PACKAGE (70710-2079-2) / 2 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":208.71283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43386028002","name":"DIAZEPAM 10 MG RECTAL GEL SYRG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-280-02","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"GEL","route":"RECTAL","strength":"10 mg/2g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 PACKAGE in 1 CARTON (43386-280-02) / 2 SYRINGE in 1 PACKAGE (43386-280-01) / 2 g in 1 SYRINGE (43386-280-03)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":208.71283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43386028003","name":"DIAZEPAM 10 MG RECTAL GEL SYRG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":208.71283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00172392760","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3927-60","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-3927-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00172392770","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3927-70","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0172-3927-70)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00172392780","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3927-80","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-3927-80)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00378047701","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0477-01","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0477-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00378047705","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0477-05","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0477-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"51079028601","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-286","inner_of":["51079-286-20"]},"part_b":null}, {"ndc":"51079028620","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-286-20","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-286-20) / 1 TABLET in 1 BLISTER PACK (51079-286-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065401","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-654-01","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-654-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065405","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-654-05","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-654-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065499","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-654-99","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-654-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"62135078890","name":"DIAZEPAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-788-90","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-788-90)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00172392560","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3925-60","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-3925-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00172392570","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3925-70","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0172-3925-70)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00378027101","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0271-01","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0271-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00378027105","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0271-05","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0271-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"51079028401","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-284","inner_of":["51079-284-20"]},"part_b":null}, {"ndc":"51079028420","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-284-20","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-284-20) / 1 TABLET in 1 BLISTER PACK (51079-284-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065201","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-652-01","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-652-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065205","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-652-05","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-652-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"62135078690","name":"DIAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-786-90","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-786-90)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"70710208001","name":"DIAZEPAM 20 MG RECTAL GEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":171.53691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43386028101","name":"DIAZEPAM 20 MG RECTAL GEL (2PK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":171.53691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710208002","name":"DIAZEPAM 20 MG RECTAL GEL (2PK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2080-2","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"GEL","route":"RECTAL","strength":"20 mg/4mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"2 SYRINGE, PLASTIC in 1 PACKAGE (70710-2080-2) / 4 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":171.53691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43386028103","name":"DIAZEPAM 20 MG RECTAL GEL SYRG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":171.53691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135076843","name":"DIAZEPAM 25 MG/5 ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-768-43","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam Oral Solution (Concentrate)","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/mL","labeler":"Chartwell RX, LLC","package_description":"30 mL in 1 BOTTLE (62135-768-43)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.06202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00172392660","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3926-60","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-3926-60)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00172392670","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3926-70","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0172-3926-70)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00172392680","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3926-80","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-3926-80)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00378034501","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0345-01","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0345-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00378034505","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0345-05","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0345-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"51079028501","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-285","inner_of":["51079-285-20"]},"part_b":null}, {"ndc":"51079028520","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-285-20","proprietary_name":"Diazepam","nonproprietary_name":"diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-285-20) / 1 TABLET in 1 BLISTER PACK (51079-285-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065301","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-653-01","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-653-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065305","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-653-05","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-653-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"59651065399","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-653-99","proprietary_name":"DIAZEPAM","nonproprietary_name":"DIAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-653-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"62135078790","name":"DIAZEPAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-787-90","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-787-90)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.02761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diazepam*|Diazepam","basis":"generic"},"part_b":null}, {"ndc":"00054318863","name":"DIAZEPAM 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3188-63","proprietary_name":"Diazepam","nonproprietary_name":"Diazepam","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE, PLASTIC (0054-3188-63)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.10708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054318544","name":"DIAZEPAM 5 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3185-44","proprietary_name":"Diazepam Intensol","nonproprietary_name":"Diazepam Intensol","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (0054-3185-44) / 30 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.06202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00254101019","name":"DIAZOXIDE 50 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-1010-19","proprietary_name":"Diazoxide","nonproprietary_name":"Diazoxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"50 mg/mL","labeler":"Par Health USA, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0254-1010-19) / 30 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":7.3764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diazoxide|Diazoxide","basis":"generic"},"part_b":null}, {"ndc":"13517010030","name":"DIAZOXIDE 50 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13517-100-30","proprietary_name":"Diazoxide","nonproprietary_name":"diazoxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"50 mg/mL","labeler":"e5 Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (13517-100-30) / 30 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":7.3764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diazoxide|Diazoxide","basis":"generic"},"part_b":null}, {"ndc":"00536121195","name":"DIBUCAINE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1211-95","proprietary_name":"Dibucaine Topical Anesthetic 1% Hemorrhoidal","nonproprietary_name":"DIBUCAINE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"10 mg/g","labeler":"Rugby Laboratories Inc.","package_description":"1 TUBE in 1 BOX (0536-1211-95) / 28 g in 1 TUBE","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Increased Histamine Release [PE]","Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.1492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"55494010010","name":"DICLEGIS DR 10-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55494-100-10","proprietary_name":"DICLEGIS","nonproprietary_name":"doxylamine succinate and pyridoxine hydrochloride","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Duchesnay USA, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (55494-100-10)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]"]},"nadac":{"value":1.67584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.09163,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208045705","name":"DICLOFENAC 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-457-05","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-457-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.69541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314001405","name":"DICLOFENAC 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-014-05","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-014-05) / 5 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.69541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314001425","name":"DICLOFENAC 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-014-25","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-014-25) / 2.5 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.7496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888015021","name":"DICLOFENAC 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-150-21","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-150-21) / 2.5 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.7496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888015022","name":"DICLOFENAC 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-150-22","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-150-22) / 5 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.69541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135802","name":"DICLOFENAC 1.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1358-2","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"16.05 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (51672-1358-2) / 150 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59088037210","name":"DICLOFENAC 1.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59088043510","name":"DICLOFENAC 1.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162091174","name":"DICLOFENAC 1.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-911-74","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac","dosage_form":"SOLUTION","route":"TOPICAL","strength":"16.05 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-911-74) / 150 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70512003805","name":"DICLOFENAC 1.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-038-05","proprietary_name":"Diclofenac Sodium 1.5%","nonproprietary_name":"Diclofenac Sodium Topical","dosage_form":"SOLUTION","route":"TOPICAL","strength":"16.05 mg/mL","labeler":"SOLA Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (70512-038-05) / 150 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70512081005","name":"DICLOFENAC 1.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-810-05","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"16.05 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 BOX (70512-810-05) / 150 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"13107026947","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-269-47","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Aurolife Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (13107-269-47) / 112 g in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922003316","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-033-16","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (21922-033-16) / 112 g in 1 BOTTLE, PUMP","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136908","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1369-8","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-1369-8) / 112 g in 1 BOTTLE, PUMP","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"60505040603","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0406-3","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-0406-3) / 112 g in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332048712","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-487-12","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (62332-487-12) / 112 g in 1 BOTTLE, PUMP","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162068312","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-683-12","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-683-12) / 112 g in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180053701","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-537-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (68180-537-01) / 112 g in 1 BOTTLE, PUMP","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70748033501","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603020701","name":"DICLOFENAC 2% SOLUTION PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-207-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/g","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (72603-207-01) / 112 g in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.42962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093372750","name":"DICLOFENAC EPOLAMINE 1.3% PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":4.70708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Epolamine|Diclofenac Epolamine","basis":"generic"},"part_b":null}, {"ndc":"00093372755","name":"DICLOFENAC EPOLAMINE 1.3% PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3727-55","proprietary_name":"diclofenac epolamine","nonproprietary_name":"diclofenac epolamine","dosage_form":"SYSTEM","route":"TOPICAL","strength":".013 g/1","labeler":"Teva Pharmaceuticals USA Inc.","package_description":"6 POUCH in 1 CARTON (0093-3727-55) / 5 SYSTEM in 1 POUCH (0093-3727-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.70708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Epolamine|Diclofenac Epolamine","basis":"generic"},"part_b":null}, {"ndc":"15370018530","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"15370-185-30","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"DICLOFENAC POTASSIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (15370-185-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"15370018560","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"15370-185-60","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"DICLOFENAC POTASSIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (15370-185-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"60290008801","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-088-01","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-088-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"69292054830","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-548-30","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amici Pharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69292-548-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"72888008630","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-086-30","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 TABLET, COATED in 1 BOTTLE (72888-086-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"73352008630","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-086-30","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Trifluent Pharma LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (73352-086-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"73352008660","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-086-60","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Trifluent Pharma LLC","package_description":"60 TABLET, COATED in 1 BOTTLE (73352-086-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"74157000760","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"74157-007-60","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"INA Pharmaceutics Inc","package_description":"60 TABLET, COATED in 1 BOTTLE (74157-007-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"74157001660","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"74157-016-60","proprietary_name":"DICLOFENAC POTASSIUM","nonproprietary_name":"diclofenac potassium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"INA Pharmaceutics Inc,","package_description":"60 TABLET in 1 BOTTLE (74157-016-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"75834033730","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-337-30","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (75834-337-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"75834033760","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-337-60","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (75834-337-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"87127080260","name":"DICLOFENAC POT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"87127-802-60","proprietary_name":"DICLOFENAC POTASSIUM","nonproprietary_name":"diclofenac potassium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Happy Robin, LLC","package_description":"60 TABLET in 1 BOTTLE (87127-802-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"13668067211","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"13668067264","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-672-64","proprietary_name":"DICLOFENAC POTASSIUM","nonproprietary_name":"DICLOFENAC POTASSIUM","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"9 PACKET in 1 CARTON (13668-672-64) / 1 POWDER, FOR SOLUTION in 1 PACKET (13668-672-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722004631","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-046-31","proprietary_name":"Diclofenac potassium","nonproprietary_name":"Diclofenac potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 POWDER, FOR SOLUTION in 1 PACKET (31722-046-31)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722004632","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-046-32","proprietary_name":"Diclofenac potassium","nonproprietary_name":"Diclofenac potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"9 POWDER, FOR SOLUTION in 1 CARTON (31722-046-32)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"49884090552","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"49884090564","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-905-64","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"9 POWDER, FOR SOLUTION in 1 CARTON (49884-905-64)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"51672424006","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4240-6","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"9 PACKET in 1 CARTON (51672-4240-6) / 1 POWDER, FOR SOLUTION in 1 PACKET (51672-4240-8)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"51672424008","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"67877077249","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"67877077258","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-772-58","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"9 PACKET in 1 CARTON (67877-772-58) / 1 POWDER, FOR SOLUTION in 1 PACKET (67877-772-49)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"69315050609","name":"DICLOFENAC POT 50 MG POWDR PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-506-09","proprietary_name":"DICLOFENAC POTASSIUM","nonproprietary_name":"DICLOFENAC POTASSIUM","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/1","labeler":"Leading Pharma, LLC","package_description":"9 PACKET in 1 CARTON (69315-506-09) / 1 POWDER, FOR SOLUTION in 1 PACKET","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":10.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"00093094801","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0948-01","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0948-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"00093094805","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0948-05","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-0948-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"50742027901","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-279-01","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50742-279-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"69292055001","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-550-01","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amici Pharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69292-550-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"69292055201","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-552-01","proprietary_name":"DICLOFENAC POTASSIUM","nonproprietary_name":"diclofenac potassium, film coated","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-552-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"70512075010","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-750-10","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70512-750-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"70512090030","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-900-30","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70512-900-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"70710183201","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1832-1","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1832-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"72819015110","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-151-10","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Archis Pharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72819-151-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"72888007301","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-073-01","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, COATED in 1 BOTTLE (72888-073-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"72888007305","name":"DICLOFENAC POT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-073-05","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, COATED in 1 BOTTLE (72888-073-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"00480943589","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9435-89","proprietary_name":"Diclofenac potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"TEVA PHARMACEUTICALS, INC.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (0480-9435-89)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"23155084012","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-840-12","proprietary_name":"diclofenac potassium","nonproprietary_name":"diclofenac potassium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (23155-840-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"59088013173","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59088-131-73","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium 25 mg","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"PureTek Corporation","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (59088-131-73)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"59651035308","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-353-08","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (59651-353-08)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"62135046912","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-469-12","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (62135-469-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"69315027520","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-275-20","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac Potassium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (69315-275-20)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"72336043212","name":"DICLOFENAC POTASSIUM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72336-432-12","proprietary_name":"Diclofenac Potassium","nonproprietary_name":"Diclofenac potassium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Lifsa Drugs LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (72336-432-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.80711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Potassium|Diclofenac Potassium","basis":"generic"},"part_b":null}, {"ndc":"61442010101","name":"DICLOFENAC SOD DR 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-101-01","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-101-01) / 100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.68438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001027900","name":"DICLOFENAC SOD DR 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-279-00","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-279-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.68438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603060001","name":"DICLOFENAC SOD DR 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-600-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-600-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.68438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888010901","name":"DICLOFENAC SOD DR 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-109-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-109-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.68438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084201","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-842-01","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-842-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084260","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-842-60","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-842-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084299","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-842-99","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-842-99)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010201","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-102-01","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-102-01) / 100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010210","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-102-10","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"12 BOTTLE, PLASTIC in 1 BOX (61442-102-10) / 1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010260","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-102-60","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-102-60) / 60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022601","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-226-01","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-226-01) / 100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022610","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-226-10","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"12 BOTTLE, PLASTIC in 1 BOX (61442-226-10) / 1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022660","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-226-60","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"24 BOTTLE, PLASTIC in 1 BOX (61442-226-60) / 60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028000","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-280-00","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-280-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028006","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-280-06","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-280-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028008","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-280-08","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-280-08)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603060101","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-601-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-601-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888011000","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-110-00","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-110-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888011001","name":"DICLOFENAC SOD DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-110-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-110-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084301","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-843-01","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-843-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084305","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-843-05","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-843-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084360","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-843-60","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-843-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084399","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-843-99","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-843-99)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687065801","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-658-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-658-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-658-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687065811","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010301","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-103-01","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-103-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010305","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-103-05","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-103-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010310","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-103-10","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-103-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442010360","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-103-60","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-103-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022701","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-227-01","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-227-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022705","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-227-05","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-227-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022710","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-227-10","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-227-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442022760","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-227-60","proprietary_name":"Diclofenac Sodium Delayed Release","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (61442-227-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028100","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-281-00","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-281-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028103","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-281-03","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-281-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028106","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-281-06","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-281-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001028108","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-281-08","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-281-08)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70512078460","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-784-60","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (70512-784-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603060401","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-604-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-604-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603060402","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-604-02","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-604-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603060403","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-604-03","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-604-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888011100","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-111-00","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-111-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888011101","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-111-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-111-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888011105","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-111-05","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-111-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888011160","name":"DICLOFENAC SOD DR 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-111-60","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Ltd","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-111-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020310","name":"DICLOFENAC SOD EC 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-203-10","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-203-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.68438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228255006","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2550-06","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (0228-2550-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228255011","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2550-11","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0228-2550-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228255096","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2550-96","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (0228-2550-96)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020206","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-202-06","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-202-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020210","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-202-10","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-202-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020211","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-202-11","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-202-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687060601","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-606-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-606-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-606-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687060611","name":"DICLOFENAC SOD EC 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228255106","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2551-06","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (0228-2551-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228255111","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2551-11","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0228-2551-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228255196","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2551-96","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (0228-2551-96)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020106","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-201-06","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (16571-201-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020110","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-201-10","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-201-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020111","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-201-11","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-201-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571020150","name":"DICLOFENAC SOD EC 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-201-50","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (16571-201-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527217037","name":"DICLOFENAC SOD ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.64639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Sodium ER|Diclofenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"42799095301","name":"DICLOFENAC SOD ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-953-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42799-953-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.64639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Sodium ER|Diclofenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"50742027801","name":"DICLOFENAC SOD ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-278-01","proprietary_name":"Diclofenac sodium","nonproprietary_name":"diclofenac sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50742-278-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.64639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Sodium ER|Diclofenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001061200","name":"DICLOFENAC SOD ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-612-00","proprietary_name":"Diclofenac sodium","nonproprietary_name":"diclofenac sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68001-612-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.64639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diclofenac Sodium ER|Diclofenac Sodium","basis":"generic"},"part_b":null}, {"ndc":"00536129434","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1294-34","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1294-34) / 50 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536129497","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1294-97","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1294-97) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922004409","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-044-09","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"diclofenac sodium topical gel, 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-044-09) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43598097710","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-977-10","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"diclofenac sodium topical gel, 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 TUBE in 1 CARTON (43598-977-10) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802095301","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-953-01","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-953-01) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001062145","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-621-45","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"Diclofenac Sodium Topical Gel, 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-621-45) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69097072044","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-720-44","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Cipla USA Inc.","package_description":"1 TUBE in 1 CARTON (69097-720-44) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238205301","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2053-1","proprietary_name":"Diclofenac sodium","nonproprietary_name":"Diclofenac","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-2053-1) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70512010610","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-106-10","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"SOLA Pharmaceuticals","package_description":"1 TUBE in 1 CARTON (70512-106-10) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"76282010339","name":"DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-103-39","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"1 TUBE in 1 CARTON (76282-103-39) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472178310","name":"DICLOFENAC SODIUM 3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-1783-10","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-1783-10) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.36795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802011101","name":"DICLOFENAC SODIUM 3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-111-01","proprietary_name":"diclofenac sodium","nonproprietary_name":"diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-111-01) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.36795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672136307","name":"DICLOFENAC SODIUM 3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1363-7","proprietary_name":"Diclofenac sodium","nonproprietary_name":"diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1363-7) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.36795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332058131","name":"DICLOFENAC SODIUM 3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-581-31","proprietary_name":"Diclofenac Sodium","nonproprietary_name":"Diclofenac Sodium Topical","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-581-31) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.36795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462035594","name":"DICLOFENAC SODIUM 3% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-355-94","proprietary_name":"DICLOFENAC SODIUM","nonproprietary_name":"diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 TUBE in 1 CARTON (68462-355-94) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.36795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591039719","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0397-19","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0591-0397-19)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591039760","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0397-60","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0591-0397-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571013360","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-133-60","proprietary_name":"Diclofenac Sodium/Misoprostol DICLOFENAC-SODIUM-MISOPROSTOL","nonproprietary_name":"Diclofenac Sodium/Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Micro Labs Limited","package_description":"60 TABLET in 1 BOTTLE (42571-133-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762002801","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0028-1","proprietary_name":"Diclofenac sodium and Misoprostol","nonproprietary_name":"Diclofenac sodium and Misoprostol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59762-0028-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762002802","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0028-2","proprietary_name":"Diclofenac sodium and Misoprostol","nonproprietary_name":"Diclofenac sodium and Misoprostol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59762-0028-2)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162043606","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-436-06","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (65162-436-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001023106","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-231-06","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-231-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834026460","name":"DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-264-60","proprietary_name":"Diclofenac Sodium Misoprostol","nonproprietary_name":"diclofenac sodium and misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1; 200 ug/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (75834-264-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.66455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591039860","name":"DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0398-60","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0591-0398-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571013460","name":"DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-134-60","proprietary_name":"Diclofenac Sodium/Misoprostol DICLOFENAC-SODIUM-MISOPROSTOL","nonproprietary_name":"Diclofenac Sodium/Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"Micro Labs Limited","package_description":"60 TABLET in 1 BOTTLE (42571-134-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762002901","name":"DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0029-1","proprietary_name":"Diclofenac sodium and Misoprostol","nonproprietary_name":"Diclofenac sodium and Misoprostol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59762-0029-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162043806","name":"DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-438-06","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (65162-438-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001023206","name":"DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-232-06","proprietary_name":"Diclofenac Sodium and Misoprostol","nonproprietary_name":"Diclofenac Sodium and Misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-232-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834026560","name":"DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-265-60","proprietary_name":"Diclofenac Sodium Misoprostol","nonproprietary_name":"diclofenac sodium and misoprostol","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"75 mg/1; 200 ug/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (75834-265-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.96624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093312301","name":"DICLOXACILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3123-01","proprietary_name":"Dicloxacillin Sodium","nonproprietary_name":"Dicloxacillin Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3123-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.59036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicloxacillin Sodium|Dicloxacillin Sodium","basis":"generic"},"part_b":null}, {"ndc":"59651056501","name":"DICLOXACILLIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-565-01","proprietary_name":"DICLOXACILLIN SODIUM","nonproprietary_name":"DICLOXACILLIN SODIUM","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-565-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.59036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicloxacillin Sodium|Dicloxacillin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093312501","name":"DICLOXACILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3125-01","proprietary_name":"Dicloxacillin Sodium","nonproprietary_name":"Dicloxacillin Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3125-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.92742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicloxacillin Sodium|Dicloxacillin Sodium","basis":"generic"},"part_b":null}, {"ndc":"59651056601","name":"DICLOXACILLIN 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-566-01","proprietary_name":"DICLOXACILLIN SODIUM","nonproprietary_name":"DICLOXACILLIN SODIUM","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-566-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.92742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicloxacillin Sodium|Dicloxacillin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00054074825","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0748-25","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0054-0748-25)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00054074831","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0748-31","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0054-0748-31)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527058601","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0586-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-0586-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527058610","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-0586-10","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, LLC","package_description":"1000 CAPSULE in 1 BOTTLE (0527-0586-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591079401","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0794-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-0794-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591079410","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0794-10","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0591-0794-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904698761","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6987-61","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6987-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571026001","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-260-01","proprietary_name":"DICYCLOMINE HYDROCHLORIDE","nonproprietary_name":"DICYCLOMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-260-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571026010","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-260-10","proprietary_name":"DICYCLOMINE HYDROCHLORIDE","nonproprietary_name":"DICYCLOMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (16571-260-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979020101","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-201-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (24979-201-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979020103","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-201-03","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 CAPSULE in 1 BOTTLE (24979-201-03)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722005201","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-052-01","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-052-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722005210","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-052-10","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (31722-052-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547063410","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-634-10","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-634-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547063411","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-634-11","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"1000 CAPSULE in 1 BOTTLE (43547-634-11)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268019911","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-199","inner_of":["50268-199-15"]},"part_b":null}, {"ndc":"50268019915","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-199-15","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-199-15) / 1 CAPSULE in 1 BLISTER PACK (50268-199-11)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651071901","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-719-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-719-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651071999","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-719-99","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (59651-719-99)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687036901","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-369-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-369-01) / 1 CAPSULE in 1 BLISTER PACK (60687-369-11)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687036911","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-369","inner_of":["60687-369-01"]},"part_b":null}, {"ndc":"62135071890","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-718-90","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-718-90)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"73473080001","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-800-01","proprietary_name":"DICYCLOMINE HYDROCHLORIDE","nonproprietary_name":"DICYCLOMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Solaris Pharma Corporation","package_description":"100 CAPSULE in 1 BOTTLE (73473-800-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"73473080010","name":"DICYCLOMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-800-10","proprietary_name":"DICYCLOMINE HYDROCHLORIDE","nonproprietary_name":"DICYCLOMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Solaris Pharma Corporation","package_description":"1000 CAPSULE in 1 BOTTLE (73473-800-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.07775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00054062263","name":"DICYCLOMINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0622-63","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"473 mL in 1 BOTTLE (0054-0622-63)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.17356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00603116158","name":"DICYCLOMINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-1161-58","proprietary_name":"dicyclomine hydrochloride","nonproprietary_name":"dicyclomine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Par Health USA, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (0603-1161-58)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.17356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954026110","name":"DICYCLOMINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-261-10","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Novitium Pharma LLC","package_description":"473 mL in 1 BOTTLE (70954-261-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.17356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143122701","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1227-01","proprietary_name":"Dicyclomine","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0143-1227-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00143122710","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1227-10","proprietary_name":"Dicyclomine","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0143-1227-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527128201","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1282-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, LLC","package_description":"100 TABLET in 1 BOTTLE (0527-1282-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527128210","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1282-10","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, LLC","package_description":"1000 TABLET in 1 BOTTLE (0527-1282-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591079501","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0795-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0795-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591079510","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0795-10","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0795-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904698861","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6988-61","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6988-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571025901","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-259-01","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-259-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571025910","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-259-10","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-259-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979020001","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-200-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (24979-200-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979020003","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-200-03","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (24979-200-03)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722007901","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-079-01","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-079-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722007910","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-079-10","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-079-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651072001","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-720-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-720-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651072099","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-720-99","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-720-99)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687038001","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-380-01","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-380-01) / 1 TABLET in 1 BLISTER PACK (60687-380-11)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687038011","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-380","inner_of":["60687-380-01"]},"part_b":null}, {"ndc":"62135042812","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-428-12","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-428-12)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452031120","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-311-20","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69452-311-20)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452031132","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-311-32","proprietary_name":"Dicyclomine Hydrochloride","nonproprietary_name":"Dicyclomine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Bionpharma Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69452-311-32)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011900","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-119-00","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"1000 TABLET in 1 BOTTLE (72888-119-00)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011901","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-119-01","proprietary_name":"Dicyclomine hydrochloride","nonproprietary_name":"Dicyclomine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"100 TABLET in 1 BOTTLE (72888-119-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"73473090201","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-902-01","proprietary_name":"DICYCLOMINE HYDROCHLORIDE","nonproprietary_name":"DICYCLOMINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solaris Pharma Corporation","package_description":"100 TABLET in 1 BOTTLE (73473-902-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"73473090210","name":"DICYCLOMINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-902-10","proprietary_name":"DICYCLOMINE HYDROCHLORIDE","nonproprietary_name":"DICYCLOMINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solaris Pharma Corporation","package_description":"1000 TABLET in 1 BOTTLE (73473-902-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dicyclomine HCl*|Dicyclomine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527147501","name":"DIETHYLPROPION 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1475-01","proprietary_name":"Diethylpropion Hydrochloride","nonproprietary_name":"Diethylpropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0527-1475-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.23804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702004401","name":"DIETHYLPROPION 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-044-01","proprietary_name":"DIETHYLPROPION HYDROCHLORIDE","nonproprietary_name":"DIETHYLPROPION HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"KVK-TECH, INC","package_description":"100 TABLET in 1 BOTTLE (10702-044-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.23804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135048890","name":"DIETHYLPROPION 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-488-90","proprietary_name":"Diethylpropion Hydrochloride","nonproprietary_name":"Diethylpropion Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET in 1 BOTTLE (62135-488-90)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.23804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527147701","name":"DIETHYLPROPION ER 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1477-01","proprietary_name":"Diethylpropion Hydrochloride ER","nonproprietary_name":"Diethylpropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0527-1477-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":1.91154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135048930","name":"DIETHYLPROPION ER 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-489-30","proprietary_name":"Diethylpropion Hydrochloride ER","nonproprietary_name":"Diethylpropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-489-30)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":1.91154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81665010910","name":"DIETHYLPROPION ER 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-109-10","proprietary_name":"Diethylpropion Hydrochloride ER","nonproprietary_name":"Diethylpropion Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (81665-109-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":1.91154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52015008001","name":"DIFICID 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52015-080-01","proprietary_name":"Dificid","nonproprietary_name":"fidaxomicin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1 BOTTLE in 1 CARTON (52015-080-01) / 20 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Macrolide Antibacterial [EPC]","Macrolides [CS]"]},"nadac":{"value":248.37854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":90.5046,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dificid|Fidaxomicin","basis":"brand"},"part_b":null}, {"ndc":"51672129602","name":"DIFLORASONE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1296-2","proprietary_name":"Diflorasone Diacetate","nonproprietary_name":"Diflorasone Diacetate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1296-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.6716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Diflorasone Diacetate|Diflorasone Diacetate","basis":"generic"},"part_b":null}, {"ndc":"51672129603","name":"DIFLORASONE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1296-3","proprietary_name":"Diflorasone Diacetate","nonproprietary_name":"Diflorasone Diacetate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1296-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.8927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Diflorasone Diacetate|Diflorasone Diacetate","basis":"generic"},"part_b":null}, {"ndc":"51672129502","name":"DIFLORASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1295-2","proprietary_name":"Diflorasone Diacetate","nonproprietary_name":"Diflorasone Diacetate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1295-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.25013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Diflorasone Diacetate|Diflorasone Diacetate","basis":"generic"},"part_b":null}, {"ndc":"51672129503","name":"DIFLORASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1295-3","proprietary_name":"Diflorasone Diacetate","nonproprietary_name":"Diflorasone Diacetate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1295-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.85141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Diflorasone Diacetate|Diflorasone Diacetate","basis":"generic"},"part_b":null}, {"ndc":"64980012403","name":"DIFLORASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64980-124-03","proprietary_name":"Diflorasone Diacetate","nonproprietary_name":"diflorasone diacetate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 TUBE in 1 CARTON (64980-124-03) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.25013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Diflorasone Diacetate|Diflorasone Diacetate","basis":"generic"},"part_b":null}, {"ndc":"64980012460","name":"DIFLORASONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-124-60","proprietary_name":"Diflorasone Diacetate","nonproprietary_name":"diflorasone diacetate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 TUBE in 1 CARTON (64980-124-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.85141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Diflorasone Diacetate|Diflorasone Diacetate","basis":"generic"},"part_b":null}, {"ndc":"00093922201","name":"DIFLUNISAL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9222-01","proprietary_name":"Diflunisal","nonproprietary_name":"Diflunisal","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-9222-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.06451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diflunisal|Diflunisal","basis":"generic"},"part_b":null}, {"ndc":"00093922205","name":"DIFLUNISAL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9222-05","proprietary_name":"Diflunisal","nonproprietary_name":"Diflunisal","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-9222-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.06451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diflunisal|Diflunisal","basis":"generic"},"part_b":null}, {"ndc":"00093922206","name":"DIFLUNISAL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9222-06","proprietary_name":"Diflunisal","nonproprietary_name":"Diflunisal","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0093-9222-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.06451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diflunisal|Diflunisal","basis":"generic"},"part_b":null}, {"ndc":"14539067301","name":"DIFLUNISAL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"14539-673-01","proprietary_name":"diflunisal","nonproprietary_name":"diflunisal","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (14539-673-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.06451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diflunisal|Diflunisal","basis":"generic"},"part_b":null}, {"ndc":"14539067306","name":"DIFLUNISAL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"14539-673-06","proprietary_name":"diflunisal","nonproprietary_name":"diflunisal","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (14539-673-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.06451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diflunisal|Diflunisal","basis":"generic"},"part_b":null}, {"ndc":"62135045660","name":"DIFLUNISAL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-456-60","proprietary_name":"Diflunisal","nonproprietary_name":"Diflunisal","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-456-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.06451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diflunisal|Diflunisal","basis":"generic"},"part_b":null}, {"ndc":"00378751835","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7518-35","proprietary_name":"Difluprednate","nonproprietary_name":"Difluprednate","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (0378-7518-35) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"00781600078","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6000-78","proprietary_name":"Difluprednate Ophthalmic","nonproprietary_name":"Difluprednate Ophthalmic","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (0781-6000-78) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"00832605405","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6054-05","proprietary_name":"Difluprednate","nonproprietary_name":"Difluprednate","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-6054-05) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"43598058811","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-588-11","proprietary_name":"Difluprednate Ophthalmic Emulsion","nonproprietary_name":"Difluprednate Ophthalmic","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-588-11) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"65145016101","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-161-01","proprietary_name":"Difluprednate","nonproprietary_name":"Difluprednate","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE in 1 CARTON (65145-161-01) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"69238138003","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1380-3","proprietary_name":"Difluprednate","nonproprietary_name":"Difluprednate ophthalmic","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1380-3) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"69315032905","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-329-05","proprietary_name":"DIFLUPREDNATE","nonproprietary_name":"DIFLUPREDNATE","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE in 1 CARTON (69315-329-05) / 5 mL in 1 BOTTLE"},"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"76282070850","name":"DIFLUPREDNATE 0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Difluprednate|Difluprednate","basis":"generic"},"part_b":null}, {"ndc":"59088015054","name":"DIGENYX 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59088-150-54","proprietary_name":"Digenyx","nonproprietary_name":"Hyoscyamine Sulfate 0.125 mg","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"PureTek Corporation","package_description":"30 TABLET in 1 BOTTLE (59088-150-54)"},"nadac":{"value":0.14589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyoscyamine Sulfate*|Hyoscyamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00054005746","name":"DIGOXIN 0.05 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0057-46","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"SOLUTION","route":"ORAL","strength":".05 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 mL in 1 BOTTLE (0054-0057-46)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":1.14686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66689032702","name":"DIGOXIN 0.05 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-327-02","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"SOLUTION","route":"ORAL","strength":".05 mg/mL","labeler":"VistaPharm, LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (66689-327-02) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":1.14686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69292060560","name":"DIGOXIN 0.05 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-605-60","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"SOLUTION","route":"ORAL","strength":".05 mg/mL","labeler":"Amici Pharma, Inc","package_description":"1 BOTTLE in 1 CARTON (69292-605-60) / 60 mL in 1 BOTTLE","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":1.14686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143124001","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1240-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0143-1240-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"00143124010","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1240-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0143-1240-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"00904592161","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5921-61","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5921-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"50268023811","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-238","inner_of":["50268-238-15"]},"part_b":null}, {"ndc":"50268023815","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-238-15","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-238-15) / 1 TABLET in 1 BLISTER PACK (50268-238-11)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"59651043701","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-437-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-437-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"59651043799","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-437-99","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-437-99)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"60687085801","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-858-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-858-01) / 1 TABLET in 1 BLISTER PACK (60687-858-11)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"60687085811","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-858","inner_of":["60687-858-01"]},"part_b":null}, {"ndc":"69238199101","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1991-1","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1991-1)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"69238199107","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1991-7","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE (69238-1991-7)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"70954020110","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-201-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-201-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"70954020120","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-201-20","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (70954-201-20)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"82685020101","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-201-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-201-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"82685020110","name":"DIGOXIN 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-201-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Oliva Therapeutics, LLC","package_description":"1000 TABLET in 1 BOTTLE (82685-201-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.1327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"00143124101","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1241-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0143-1241-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"00143124110","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1241-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0143-1241-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"00904592261","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5922-61","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5922-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"59651043801","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-438-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-438-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"59651043899","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-438-99","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-438-99)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"60687086901","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-869-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-869-01) / 1 TABLET in 1 BLISTER PACK (60687-869-11)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"60687086911","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-869","inner_of":["60687-869-01"]},"part_b":null}, {"ndc":"69238199201","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1992-1","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1992-1)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"69238199207","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1992-7","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE (69238-1992-7)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"70954020210","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-202-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-202-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"70954020220","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-202-20","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (70954-202-20)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"82685020201","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-202-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Oliva Therapeutics, LLC","package_description":"100 TABLET in 1 BOTTLE (82685-202-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"82685020210","name":"DIGOXIN 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-202-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Oliva Therapeutics, LLC","package_description":"1000 TABLET in 1 BOTTLE (82685-202-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":0.14843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"59651043601","name":"DIGOXIN 62.5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-436-01","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".0625 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-436-01)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":8.59432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"70954020010","name":"DIGOXIN 62.5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-200-10","proprietary_name":"Digoxin","nonproprietary_name":"Digoxin","dosage_form":"TABLET","route":"ORAL","strength":".0625 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-200-10)","pharm_classes":["Cardiac Glycoside [EPC]","Cardiac Glycosides [CS]"]},"nadac":{"value":8.59432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Digoxin*|Digoxin","basis":"generic"},"part_b":null}, {"ndc":"70069088001","name":"DIHYDROERGOTAMINE 4 MG/ML SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":49.63034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic","route_from":"fda_product","route":"NASAL","product_ndc":"70069-880","inner_of":["70069-880-08"]},"part_b":null}, {"ndc":"70069088008","name":"DIHYDROERGOTAMINE 4 MG/ML SPRY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-880-08","proprietary_name":"DIHYDROERGOTAMINE MESYLATE","nonproprietary_name":"DIHYDROERGOTAMINE MESYLATE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"4 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"8 CARTON in 1 KIT (70069-880-08) / 1 VIAL in 1 CARTON (70069-880-01) / 1 mL in 1 VIAL","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":29.43546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"24201046301","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":49.63034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic","route_from":"fda_product","route":"NASAL","product_ndc":"24201-463","inner_of":[]},"part_b":null}, {"ndc":"24201046308","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24201-463-08","proprietary_name":"Dihydroergotamine Mesylate","nonproprietary_name":"Dihydroergotamine Mesylate","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"8 VIAL in 1 CARTON (24201-463-08) / 1 mL in 1 VIAL","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":29.43546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"69097050327","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-503-27","proprietary_name":"Dihydroergotamine Mesylate Nasal","nonproprietary_name":"Dihydroergotamine Mesylate Nasal","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"4 mg/mL","labeler":"Cipla USA Inc.","package_description":"8 VIAL in 1 KIT (69097-503-27) / 1 mL in 1 VIAL","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":29.43546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69097050331","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-503-31","proprietary_name":"Dihydroergotamine Mesylate Nasal","nonproprietary_name":"Dihydroergotamine Mesylate Nasal","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"4 mg/mL","labeler":"Cipla USA Inc.","package_description":"1 VIAL in 1 KIT (69097-503-31) / 1 mL in 1 VIAL","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":49.63034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888009619","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-096-19","proprietary_name":"Dihydroergotamine mesylate","nonproprietary_name":"Dihydroergotamine mesylate","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"8 KIT in 1 KIT (72888-096-19) / 1 VIAL, GLASS in 1 KIT (72888-096-18) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":29.43546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"72888009634","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-096-34","proprietary_name":"Dihydroergotamine mesylate","nonproprietary_name":"Dihydroergotamine mesylate","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"1 VIAL, GLASS in 1 KIT (72888-096-34) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":49.63034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"73352009618","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":49.63034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic","route_from":"fda_product","route":"NASAL","product_ndc":"73352-096","inner_of":["73352-096-19"]},"part_b":null}, {"ndc":"73352009619","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-096-19","proprietary_name":"Dihydroergotamine mesylate","nonproprietary_name":"Dihydroergotamine mesylate","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/mL","labeler":"Trifluent Pharma, LLC","package_description":"8 KIT in 1 KIT (73352-096-19) / 1 VIAL, GLASS in 1 KIT (73352-096-18) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":29.43546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dihydroergotamine Mesylate*|Dihydroergotamine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"76282068043","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":49.63034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76282068044","name":"DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":29.43546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58151011001","name":"DILANTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-110-01","proprietary_name":"DILANTIN","nonproprietary_name":"Extended Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (58151-110-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151011010","name":"DILANTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-110-10","proprietary_name":"DILANTIN","nonproprietary_name":"Extended Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (58151-110-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151011032","name":"DILANTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151011088","name":"DILANTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-110-88","proprietary_name":"DILANTIN","nonproprietary_name":"Extended Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-110-88) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (58151-110-32)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.73861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151011801","name":"DILANTIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-118-01","proprietary_name":"DILANTIN","nonproprietary_name":"Extended Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (58151-118-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.49889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00071000724","name":"DILANTIN 50 MG INFATAB","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0071-0007-24","proprietary_name":"Dilantin Infatabs","nonproprietary_name":"Phenytoin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Parke-Davis Div of Pfizer Inc","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0071-0007-24)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.57665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505001406","name":"DILT XR 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0014-6","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-0014-6)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.31058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505001408","name":"DILT XR 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0014-8","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Apotex Corp.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-0014-8)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.31058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505001506","name":"DILT XR 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0015-6","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-0015-6)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.36629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505001508","name":"DILT XR 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0015-8","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Apotex Corp.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-0015-8)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.36629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505001606","name":"DILT XR 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0016-6","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-0016-6)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.48864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505001608","name":"DILT XR 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0016-8","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Apotex Corp.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (60505-0016-8)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.48864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093032101","name":"DILTIAZEM 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0321-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0321-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.09903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"42799013201","name":"DILTIAZEM 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228048401","name":"DILTIAZEM 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-484-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (50228-484-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.09903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62135033690","name":"DILTIAZEM 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-336-90","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-336-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.09903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332078431","name":"DILTIAZEM 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-784-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-784-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.09903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00378612001","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6120-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6120-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979018301","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-183-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-183-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742056601","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-566-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-566-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"51079092601","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"51079092620","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-926-20","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-926-20) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (51079-926-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"68462056201","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-562-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-562-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"75907004601","name":"DILTIAZEM 12HR ER 120 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-046-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (75907-046-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.97043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00378606001","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6060-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6060-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979018101","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-181-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-181-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742056401","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-564-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-564-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"51079092401","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"51079092420","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-924-20","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-924-20) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (51079-924-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"68462085001","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-850-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-850-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"75907004401","name":"DILTIAZEM 12HR ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-044-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (75907-044-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.42657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00378609001","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6090-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6090-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979018201","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-182-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-182-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742056501","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-565-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-565-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"51079092501","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"51079092520","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-925-20","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-925-20) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (51079-925-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"68462085101","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-851-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-851-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"75907004501","name":"DILTIAZEM 12HR ER 90 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-045-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (75907-045-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.66135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 12hr ER|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00904721761","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7217-61","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7217-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370082905","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370082909","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370082911","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002602","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-026-02","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-026-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002607","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-026-07","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-026-07)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742024830","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-248-30","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-248-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742024890","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-248-90","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-248-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687019501","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-195-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-195-01) / 1 CAPSULE, COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-195-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687019511","name":"DILTIAZEM 24H ER(CD) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00904721861","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7218-61","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7218-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083005","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083009","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083011","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002702","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-027-02","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-027-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002707","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-027-07","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-027-07)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742024930","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-249-30","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-249-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742024990","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-249-90","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-249-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687020601","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-206-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, COATED, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-206-01) / 1 CAPSULE, COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-206-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687020611","name":"DILTIAZEM 24H ER(CD) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00904721961","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7219-61","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7219-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083105","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083109","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083111","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002802","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-028-02","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-028-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002807","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-028-07","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-028-07)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742025030","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-250-30","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-250-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742025090","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-250-90","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-250-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687021701","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-217-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, COATED, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-217-01) / 1 CAPSULE, COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-217-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687021711","name":"DILTIAZEM 24H ER(CD) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00904722061","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7220-61","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7220-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083205","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083209","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"10370083211","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002902","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-029-02","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-029-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979002907","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-029-07","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-029-07)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742025130","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-251-30","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-251-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742025190","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-251-90","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-251-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687022801","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-228-01","proprietary_name":"Diltiazem Hydrochloride Extended-Release","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-228-01) / 1 CAPSULE, COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-228-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687022811","name":"DILTIAZEM 24H ER(CD) 300 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00228291809","name":"DILTIAZEM 24H ER(CD) 360 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2918-09","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2918-09)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.33265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"24979003007","name":"DILTIAZEM 24H ER(CD) 360 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-030-07","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (24979-030-07)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.33265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742025230","name":"DILTIAZEM 24H ER(CD) 360 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-252-30","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-252-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.33265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50742025290","name":"DILTIAZEM 24H ER(CD) 360 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-252-90","proprietary_name":"diltiazem hydrochloride","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (50742-252-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.33265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (Cd)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099202","name":"DILTIAZEM 24H ER(LA) 120 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-992-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Cipla USA, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-992-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.12264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099205","name":"DILTIAZEM 24H ER(LA) 120 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-992-05","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Cipla USA, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-992-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.12264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019504","name":"DILTIAZEM 24H ER(LA) 120 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-195-04","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-195-04)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.12264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099302","name":"DILTIAZEM 24H ER(LA) 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-993-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Cipla USA, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-993-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.03058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099305","name":"DILTIAZEM 24H ER(LA) 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-993-05","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Cipla USA, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-993-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.03058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019604","name":"DILTIAZEM 24H ER(LA) 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-196-04","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-196-04)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.03058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099402","name":"DILTIAZEM 24H ER(LA) 240 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-994-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Cipla USA, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-994-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.0087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099405","name":"DILTIAZEM 24H ER(LA) 240 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-994-05","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Cipla USA, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-994-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.0087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019704","name":"DILTIAZEM 24H ER(LA) 240 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-197-04","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-197-04)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.0087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099502","name":"DILTIAZEM 24H ER(LA) 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-995-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-995-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.92826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099505","name":"DILTIAZEM 24H ER(LA) 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-995-05","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-995-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.92826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019804","name":"DILTIAZEM 24H ER(LA) 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-198-04","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-198-04)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.92826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099602","name":"DILTIAZEM 24H ER(LA) 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-996-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Cipla USA, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-996-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.83372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099605","name":"DILTIAZEM 24H ER(LA) 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-996-05","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Cipla USA, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-996-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.83372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019904","name":"DILTIAZEM 24H ER(LA) 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-199-04","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-199-04)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.83372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099702","name":"DILTIAZEM 24H ER(LA) 420 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-997-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"420 mg/1","labeler":"Cipla USA, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-997-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":2.63186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"69097099705","name":"DILTIAZEM 24H ER(LA) 420 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-997-05","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"420 mg/1","labeler":"Cipla USA, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-997-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":2.63186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436020004","name":"DILTIAZEM 24H ER(LA) 420 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-200-04","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"420 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-200-04)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":2.63186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (La)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"16714052301","name":"DILTIAZEM 24H ER(XR) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-523-01","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-523-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.31058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"16714052302","name":"DILTIAZEM 24H ER(XR) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-523-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-523-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.31058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332081531","name":"DILTIAZEM 24H ER(XR) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-815-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-815-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.31058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019101","name":"DILTIAZEM 24H ER(XR) 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-191-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-191-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.31058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"16714052401","name":"DILTIAZEM 24H ER(XR) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-524-01","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-524-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.36629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"16714052402","name":"DILTIAZEM 24H ER(XR) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-524-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-524-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.36629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332081631","name":"DILTIAZEM 24H ER(XR) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-816-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-816-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.36629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019201","name":"DILTIAZEM 24H ER(XR) 180 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-192-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-192-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.36629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"16714052501","name":"DILTIAZEM 24H ER(XR) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-525-01","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-525-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.48864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"16714052502","name":"DILTIAZEM 24H ER(XR) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-525-02","proprietary_name":"DILTIAZEM HYDROCHLORIDE","nonproprietary_name":"DILTIAZEM HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-525-02)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.48864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332081731","name":"DILTIAZEM 24H ER(XR) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-817-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-817-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.48864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"70436019301","name":"DILTIAZEM 24H ER(XR) 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-193-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-193-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.48864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem 24hr ER (XR)|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00093031801","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0318-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0318-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00093031805","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0318-05","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-0318-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"42799012901","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799012902","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228048101","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-481-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (50228-481-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50228048105","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-481-05","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 TABLET in 1 BOTTLE (50228-481-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687071701","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-717-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-717-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-717-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687071711","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-717","inner_of":["60687-717-01"]},"part_b":null}, {"ndc":"62135033312","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-333-12","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-333-12)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332078131","name":"DILTIAZEM 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-781-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-781-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.04955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00093031901","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0319-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0319-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00093031905","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0319-05","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-0319-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"42799013001","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228048201","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-482-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (50228-482-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50228048205","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-482-05","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 TABLET in 1 BOTTLE (50228-482-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687072801","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-728-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-728-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-728-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"60687072811","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-728","inner_of":["60687-728-01"]},"part_b":null}, {"ndc":"62135033412","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-334-12","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-334-12)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332078231","name":"DILTIAZEM 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-782-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-782-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00093032001","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0320-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0320-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"42799013101","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799013102","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228048301","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-483-01","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (50228-483-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"50228048305","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-483-05","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 TABLET in 1 BOTTLE (50228-483-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62135033590","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-335-90","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-335-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"62332078331","name":"DILTIAZEM 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-783-31","proprietary_name":"Diltiazem Hydrochloride","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-783-31)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.0699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diltiazem HCl*|Diltiazem HCl","basis":"generic"},"part_b":null}, {"ndc":"00904646320","name":"DIMAPHEN DM ELIXIR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6463-20","proprietary_name":"dimaphen dm","nonproprietary_name":"Brompheniramine maleate, Dextromethorphan HBr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL; 5 mg/10mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6463-20) / 118 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237036701","name":"DIMETANE 25 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-367-01","proprietary_name":"Dimetane","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (57237-367-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237036799","name":"DIMETANE 25 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-367-99","proprietary_name":"Dimetane","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE, LIQUID FILLED in 1 BOTTLE (57237-367-99)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237036801","name":"DIMETANE 50 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-368-01","proprietary_name":"Dimetane","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (57237-368-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237036899","name":"DIMETANE 50 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-368-99","proprietary_name":"Dimetane","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE, LIQUID FILLED in 1 BOTTLE (57237-368-99)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979012721","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-127-21","proprietary_name":"dimethyl fumarate","nonproprietary_name":"dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"14 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (24979-127-21)"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722065731","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-657-31","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"DIMETHYL FUMARATE","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-657-31) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342034994","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-349-94","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"14 CAPSULE, DELAYED RELEASE in 1 BOTTLE (33342-349-94)"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547002414","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-024-14","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"14 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (43547-024-14)"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598042952","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-429-52","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-429-52) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651008314","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-083-14","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"14 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-083-14)"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877055514","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-555-14","proprietary_name":"Dimethyl fumarate","nonproprietary_name":"Dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"14 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (67877-555-14)"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097032289","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-322-89","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"DIMETHYL FUMARATE","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Cipla USA Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69097-322-89) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238131804","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1318-4","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1318-4) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70512085214","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-852-14","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (70512-852-14) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82249074514","name":"DIMETHYL FUMARATE DR 120 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-745-14","proprietary_name":"Dimethyl fumarate","nonproprietary_name":"Dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"CivicaScript LLC","package_description":"14 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (82249-745-14)"},"nadac":{"value":0.42839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979012804","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-128-04","proprietary_name":"dimethyl fumarate","nonproprietary_name":"dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (24979-128-04)"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722065832","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-658-32","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"DIMETHYL FUMARATE","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-658-32) / 60 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342035009","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-350-09","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (33342-350-09)"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547002506","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-025-06","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (43547-025-06)"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598043060","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-430-60","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-430-60) / 60 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651008460","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-084-60","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-084-60)"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877055660","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-556-60","proprietary_name":"Dimethyl fumarate","nonproprietary_name":"Dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (67877-556-60)"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097032303","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-323-03","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"DIMETHYL FUMARATE","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Cipla USA Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69097-323-03) / 60 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238131906","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1319-6","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1319-6) / 60 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70512085360","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-853-60","proprietary_name":"Dimethyl Fumarate","nonproprietary_name":"Dimethyl Fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (70512-853-60) / 60 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009013860","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-138-60","proprietary_name":"DIMETHYL FUMARATE","nonproprietary_name":"DIMETHYL FUMARATE","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1 BOTTLE in 1 CARTON (82009-138-60) / 60 CAPSULE, DELAYED RELEASE in 1 BOTTLE"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82249074760","name":"DIMETHYL FUMARATE DR 240 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-747-60","proprietary_name":"Dimethyl fumarate","nonproprietary_name":"Dimethyl fumarate","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"CivicaScript LLC","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (82249-747-60)"},"nadac":{"value":0.46717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00078035934","name":"DIOVAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0359-34","proprietary_name":"Diovan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"90 TABLET in 1 BOTTLE (0078-0359-34)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":10.03773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan|Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078036034","name":"DIOVAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0360-34","proprietary_name":"Diovan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"320 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"90 TABLET in 1 BOTTLE (0078-0360-34)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":12.67445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan|Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078042315","name":"DIOVAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0423-15","proprietary_name":"Diovan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 TABLET in 1 BOTTLE (0078-0423-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":7.81625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan|Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078035834","name":"DIOVAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0358-34","proprietary_name":"Diovan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"90 TABLET in 1 BOTTLE (0078-0358-34)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":9.32714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan|Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078031534","name":"DIOVAN HCT 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0315-34","proprietary_name":"Diovan HCT","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0078-0315-34)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":11.47643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan HCT|Valsartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"00078047234","name":"DIOVAN HCT 320-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0472-34","proprietary_name":"Diovan HCT","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0078-0472-34)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":16.37958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan HCT|Valsartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"00078031434","name":"DIOVAN HCT 80-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0314-34","proprietary_name":"Diovan HCT","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0078-0314-34)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":10.5648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diovan HCT|Valsartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"00037686010","name":"DIPENTUM 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0037-6860-10","proprietary_name":"Dipentum","nonproprietary_name":"olsalazine sodium","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"250 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE, PLASTIC (0037-6860-10)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":15.69625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipentum|Olsalazine Sodium","basis":"brand"},"part_b":null}, {"ndc":"24385037926","name":"DIPHEDRYL 12.5 MG/5 ML ELIXIR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-379-26","proprietary_name":"Good Neighbor Pharmacy Childrens Allergy","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-379-26) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904698516","name":"DIPHENHYDRAMINE 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6985-16","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"473 mL in 1 BOTTLE, PLASTIC (0904-6985-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904698520","name":"DIPHENHYDRAMINE 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6985-20","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"118 mL in 1 BOTTLE, PLASTIC (0904-6985-20)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237030512","name":"DIPHENHYDRAMINE 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-305-12","proprietary_name":"Diphenhydramine Oral Liquid","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118 mL in 1 BOTTLE (57237-305-12)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237030516","name":"DIPHENHYDRAMINE 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-305-16","proprietary_name":"Diphenhydramine Oral Liquid","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (57237-305-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81033002916","name":"DIPHENHYDRAMINE 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-029-16","proprietary_name":"Diphenhydramine HCl Oral Solution","nonproprietary_name":"Diphenhydramine HCl Oral Solution","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Kesin Pharma Corporation","package_description":"473 mL in 1 BOTTLE (81033-029-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83720050216","name":"DIPHENHYDRAMINE 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83720-502-16","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Oncor Pharmaceuticals","package_description":"473 mL in 1 BOTTLE (83720-502-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568000401","name":"DIPHENHYDRAMINE 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0004-1","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AARNA USA INC.","package_description":"100 CAPSULE in 1 BOTTLE (82568-0004-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000402","name":"DIPHENHYDRAMINE 25 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0004-2","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AARNA USA INC.","package_description":"1000 CAPSULE in 1 BOTTLE (82568-0004-2)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536121429","name":"DIPHENHYDRAMINE 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1214-29","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rugby Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0536-1214-29)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094001859","name":"DIPHENHYDRAMINE 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094001861","name":"DIPHENHYDRAMINE 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-018-61","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Precision Dose, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68094-018-61) / 10 TABLET in 1 BLISTER PACK (68094-018-59)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904205661","name":"DIPHENHYDRAMINE 50 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-2056-61","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX (0904-2056-61) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000501","name":"DIPHENHYDRAMINE 50 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0005-1","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AARNA USA INC.","package_description":"100 CAPSULE in 1 BOTTLE (82568-0005-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000502","name":"DIPHENHYDRAMINE 50 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0005-2","proprietary_name":"Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AARNA USA INC.","package_description":"1000 CAPSULE in 1 BOTTLE (82568-0005-2)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641037625","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0376-25","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"diphenhydramine hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 PACKAGE (0641-0376-25) / 1 mL in 1 VIAL (0641-0376-21)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 PACKAGE (0641-0376-25) / 1 mL in 1 VIAL (0641-0376-21)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641628225","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6282-25","proprietary_name":"Diphenhydramine hydrochloride","nonproprietary_name":"diphenhydramine hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 PACKAGE (0641-6282-25) / 1 mL in 1 VIAL (0641-6282-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 PACKAGE (0641-6282-25) / 1 mL in 1 VIAL (0641-6282-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155026441","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-264-41","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL, GLASS in 1 PACKAGE (23155-264-41) / 1 mL in 1 VIAL, GLASS (23155-264-31)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, GLASS in 1 PACKAGE (23155-264-41) / 1 mL in 1 VIAL, GLASS (23155-264-31)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021048101","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-481-01","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-481-01) / 1 mL in 1 VIAL","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-481-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42571033787","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-337-87","proprietary_name":"DIPHENHYDRAMINE","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Micro Labs Limited","package_description":"25 VIAL in 1 CARTON (42571-337-87) / 1 mL in 1 VIAL (42571-337-95)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (42571-337-87) / 1 mL in 1 VIAL (42571-337-95)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323066401","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-664-01","proprietary_name":"Diphenhydramine","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-664-01) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-664-00)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (63323-664-01) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-664-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323066416","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-664-16","proprietary_name":"Diphenhydramine","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-664-16) / 1 mL in 1 VIAL (63323-664-41)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-664-16) / 1 mL in 1 VIAL (63323-664-41)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485010105","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-101-05","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (72485-101-05) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-101-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.0542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, SINGLE-DOSE in 1 CARTON (72485-101-05) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-101-01)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485010125","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-101-25","proprietary_name":"Diphenhydramine Hydrochloride","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (72485-101-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-101-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (72485-101-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-101-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"83634078101","name":"DIPHENHYDRAMINE 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-781-01","proprietary_name":"Diphenhydramine","nonproprietary_name":"diphenhydramine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Avenacy, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (83634-781-01) / 1 mL in 1 VIAL, SINGLE-DOSE (83634-781-41)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.89801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Diphenhydramine HCl*|Diphenhydramine HCl","basis":"generic"},"part_b":{"hcpcs":"J1200","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1200 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (83634-781-01) / 1 mL in 1 VIAL, SINGLE-DOSE (83634-781-41)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00406123601","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1236-01","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"diphenoxylate hydrochloride and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-1236-01)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"00406123610","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1236-10","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"diphenoxylate hydrochloride and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"SpecGx LLC","package_description":"1000 TABLET in 1 BOTTLE (0406-1236-10)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"59762106101","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1061-1","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1061-1)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"60687089001","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-890-01","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"diphenoxylate hydrochloride and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-890-01) / 1 TABLET in 1 BLISTER PACK (60687-890-11)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"60687089011","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"62559049001","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-490-01","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-490-01)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"62559049010","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-490-10","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (62559-490-10)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"69315091001","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-910-01","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"diphenoxylate hydrochloride and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-910-01)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"69315091010","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-910-10","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"diphenoxylate hydrochloride and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-910-10)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"75826010700","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-107-00","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Winder Laboratories LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (75826-107-00)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"75826010703","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-107-03","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Winder Laboratories LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-107-03)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"75826010790","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-107-90","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Winder Laboratories LLC","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (75826-107-90)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"76385010701","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-107-01","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (76385-107-01)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"76385010710","name":"DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-107-10","proprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","nonproprietary_name":"Diphenoxylate Hydrochloride and Atropine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (76385-107-10)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Diphenoxylate-Atropine|Diphenoxylate HCl/Atropine","basis":"generic"},"part_b":null}, {"ndc":"00115107001","name":"DIPYRIDAMOLE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1070-01","proprietary_name":"Dipyridamole","nonproprietary_name":"DIPYRIDAMOLE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-1070-01)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"64980013301","name":"DIPYRIDAMOLE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"68382018701","name":"DIPYRIDAMOLE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-187-01","proprietary_name":"Dipyridamole","nonproprietary_name":"Dipyridamole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-187-01)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"69584018110","name":"DIPYRIDAMOLE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-181-10","proprietary_name":"Dipyridamole","nonproprietary_name":"Dipyridamole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69584-181-10)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.1359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"00115107101","name":"DIPYRIDAMOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1071-01","proprietary_name":"Dipyridamole","nonproprietary_name":"DIPYRIDAMOLE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-1071-01)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.35731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"64980013401","name":"DIPYRIDAMOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.35731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"68382018801","name":"DIPYRIDAMOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-188-01","proprietary_name":"Dipyridamole","nonproprietary_name":"Dipyridamole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-188-01)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.35731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"69584018210","name":"DIPYRIDAMOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-182-10","proprietary_name":"Dipyridamole","nonproprietary_name":"Dipyridamole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69584-182-10)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.35731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"00115107201","name":"DIPYRIDAMOLE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1072-01","proprietary_name":"Dipyridamole","nonproprietary_name":"DIPYRIDAMOLE","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-1072-01)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.23583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"64980013501","name":"DIPYRIDAMOLE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"68382018901","name":"DIPYRIDAMOLE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-189-01","proprietary_name":"Dipyridamole","nonproprietary_name":"Dipyridamole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-189-01)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.23583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"69584018310","name":"DIPYRIDAMOLE 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-183-10","proprietary_name":"Dipyridamole","nonproprietary_name":"Dipyridamole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69584-183-10)","pharm_classes":["Decreased Platelet Aggregation [PE]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.23583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dipyridamole|Dipyridamole","basis":"generic"},"part_b":null}, {"ndc":"00093312701","name":"DISOPYRAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3127-01","proprietary_name":"Disopyramide Phosphate","nonproprietary_name":"Disopyramide Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3127-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.80053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disopyramide Phosphate|Disopyramide Phosphate","basis":"generic"},"part_b":null}, {"ndc":"59762038601","name":"DISOPYRAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0386-1","proprietary_name":"Disopyramide Phosphate","nonproprietary_name":"disopyramide phosphate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (59762-0386-1)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.80053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disopyramide Phosphate|Disopyramide Phosphate","basis":"generic"},"part_b":null}, {"ndc":"75907002701","name":"DISOPYRAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-027-01","proprietary_name":"DISOPYRAMIDE PHOSPHATE","nonproprietary_name":"DISOPYRAMIDE PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE (75907-027-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.80053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disopyramide Phosphate|Disopyramide Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00093312901","name":"DISOPYRAMIDE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3129-01","proprietary_name":"Disopyramide Phosphate","nonproprietary_name":"Disopyramide Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-3129-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":1.53179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disopyramide Phosphate|Disopyramide Phosphate","basis":"generic"},"part_b":null}, {"ndc":"59762040001","name":"DISOPYRAMIDE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0400-1","proprietary_name":"Disopyramide Phosphate","nonproprietary_name":"disopyramide phosphate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"150 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (59762-0400-1)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":1.53179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disopyramide Phosphate|Disopyramide Phosphate","basis":"generic"},"part_b":null}, {"ndc":"75907002601","name":"DISOPYRAMIDE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-026-01","proprietary_name":"DISOPYRAMIDE PHOSPHATE","nonproprietary_name":"DISOPYRAMIDE PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE (75907-026-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":1.53179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disopyramide Phosphate|Disopyramide Phosphate","basis":"generic"},"part_b":null}, {"ndc":"42794002808","name":"DISULFIRAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-028-08","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (42794-028-08)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":1.82342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"47781060730","name":"DISULFIRAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-607-30","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Alvogen Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (47781-607-30)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":1.82342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"62135043130","name":"DISULFIRAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-431-30","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-431-30)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":1.82342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"62135043190","name":"DISULFIRAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-431-90","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-431-90)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":1.82342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"42794002908","name":"DISULFIRAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-029-08","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (42794-029-08)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":13.31433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"62135043230","name":"DISULFIRAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-432-30","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-432-30)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":13.31433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"62135043290","name":"DISULFIRAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-432-90","proprietary_name":"Disulfiram","nonproprietary_name":"Disulfiram","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-432-90)","pharm_classes":["Acetyl Aldehyde Dehydrogenase Inhibitors [MoA]","Aldehyde Dehydrogenase Inhibitor [EPC]"]},"nadac":{"value":13.31433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Disulfiram|Disulfiram","basis":"generic"},"part_b":null}, {"ndc":"00904661561","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6615-61","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6615-61) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011501","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-115-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE, COATED PELLETS in 1 BOTTLE (27241-115-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011505","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-115-05","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 CAPSULE, COATED PELLETS in 1 BOTTLE (27241-115-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011510","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-115-10","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE, COATED PELLETS in 1 BOTTLE (27241-115-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111053201","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-532-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Dr. Reddy's Laboratories Ltd","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-532-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111053205","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-532-05","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Dr. Reddy's Laboratories Ltd","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-532-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084031301","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-313-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-313-01) / 1 CAPSULE, COATED PELLETS in 1 BLISTER PACK (68084-313-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084031311","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084031365","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-313-65","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-313-65) / 1 CAPSULE, COATED PELLETS in 1 BLISTER PACK (68084-313-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382010601","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-106-01","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, COATED PELLETS in 1 BOTTLE (68382-106-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382010610","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-106-10","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, COATED PELLETS in 1 BOTTLE (68382-106-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756044711","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-447-11","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE, COATED PELLETS in 1 BOTTLE (70756-447-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756044712","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-447-12","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"125 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 CAPSULE, COATED PELLETS in 1 BOTTLE (70756-447-12)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603026001","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-260-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (72603-260-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603026002","name":"DIVALPROEX DR 125 MG CAP SPRNK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-260-02","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (72603-260-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.20079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712211","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7122-11","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0832-7122-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300013801","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-138-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (29300-138-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300013805","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-138-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (29300-138-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237010601","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-106-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-106-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237010605","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-106-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-106-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085711","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085721","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-857-21","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-857-21) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-857-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756079613","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-796-13","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (62756-796-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756079688","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-796-88","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (62756-796-88)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001047200","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-472-00","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-472-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001047203","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-472-03","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-472-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452043320","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-433-20","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-433-20)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452043330","name":"DIVALPROEX SOD DR 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-433-30","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"125 mg/1","labeler":"Bionpharma Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-433-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.05494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712301","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7123-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-7123-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (0832-7123-89)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712311","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7123-11","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0832-7123-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712315","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7123-15","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (0832-7123-15)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712389","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904686061","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6860-61","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6860-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300013901","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-139-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (29300-139-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300013905","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-139-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (29300-139-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004701","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-047-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-047-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004705","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-047-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-047-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086801","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-868-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-868-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-868-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086811","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756079713","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-797-13","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (62756-797-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756079788","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-797-88","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (62756-797-88)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001047300","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-473-00","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-473-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001047303","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-473-03","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-473-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452043420","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-434-20","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-434-20)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452043430","name":"DIVALPROEX SOD DR 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-434-30","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-434-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.08564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712401","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7124-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-7124-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (0832-7124-89)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712411","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7124-11","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0832-7124-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712415","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-7124-15","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (0832-7124-15)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832712489","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904686161","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6861-61","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6861-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904686190","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6861-90","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"90 BLISTER PACK in 1 CARTON (0904-6861-90) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300014001","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-140-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (29300-140-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300014005","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-140-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (29300-140-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004801","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-048-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-048-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004805","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-048-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (57237-048-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687087911","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687087961","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-879-61","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"90 BLISTER PACK in 1 CARTON (60687-879-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-879-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756079813","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-798-13","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (62756-798-13)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756079888","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-798-88","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (62756-798-88)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001047400","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-474-00","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-474-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001047403","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-474-03","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (68001-474-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452043520","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-435-20","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-435-20)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452043530","name":"DIVALPROEX SOD DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-435-30","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Bionpharma Inc.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-435-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.16081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378047201","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0472-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-0472-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378047205","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0472-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-0472-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904636345","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6363-45","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6363-45) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904636361","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6363-61","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6363-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714048401","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-484-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-484-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714048402","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-484-02","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-484-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300038001","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-380-01","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (29300-380-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300038005","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-380-05","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (29300-380-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722002101","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-021-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-021-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722002105","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-021-05","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-021-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268025911","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268025915","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-259-15","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-259-15) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-259-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079076601","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079076608","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-766-08","proprietary_name":"Divalproex Sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Mylan Institutional Inc.","package_description":"80 BLISTER PACK in 1 CARTON (51079-766-08) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (51079-766-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111053301","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-533-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Dr. Reddy's Laboratories Ltd","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-533-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111053305","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-533-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Dr. Reddy's Laboratories Ltd","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-533-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687090401","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-904-01","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-904-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-904-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687090411","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162075510","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-755-10","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-755-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162075550","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-755-50","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-755-50)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862059401","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-594-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-594-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862059499","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-594-99","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-594-99)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001010500","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-105-00","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-105-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001010503","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-105-03","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-105-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001064600","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-646-00","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-646-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001064603","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-646-03","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-646-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084031001","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-310-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-310-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-310-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084031011","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180026001","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-260-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-260-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180026002","name":"DIVALPROEX SOD ER 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-260-02","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-260-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.12984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378047301","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0473-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-0473-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378047305","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0473-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-0473-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904718245","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7182-45","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-7182-45) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904718261","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7182-61","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7182-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714048501","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-485-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-485-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714048502","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-485-02","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-485-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300038101","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-381-01","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (29300-381-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300038105","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-381-05","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (29300-381-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722002201","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-022-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-022-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722002205","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-022-05","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-022-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268026011","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268026013","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-260-13","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-260-13) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-260-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079076701","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079076708","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-767-08","proprietary_name":"Divalproex Sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Institutional Inc.","package_description":"80 BLISTER PACK in 1 CARTON (51079-767-08) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (51079-767-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111053401","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-534-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Dr. Reddy's Laboratories Ltd","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-534-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111053405","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-534-05","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Dr. Reddy's Laboratories Ltd","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-534-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687091501","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-915-01","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-915-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-915-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687091502","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-915-02","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 CARTON (60687-915-02) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-915-93)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687091511","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687091593","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162075710","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-757-10","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-757-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162075750","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-757-50","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-757-50)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862059501","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-595-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-595-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862059505","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-595-05","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-595-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001010600","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-106-00","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-106-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001010603","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-106-03","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-106-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001064700","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-647-00","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-647-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001064703","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-647-03","proprietary_name":"divalproex sodium","nonproprietary_name":"divalproex sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-647-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084041501","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-415-01","proprietary_name":"Divalproex Sodium","nonproprietary_name":"Divalproex Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-415-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-415-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084041511","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180026101","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-261-01","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-261-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180026102","name":"DIVALPROEX SOD ER 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-261-02","proprietary_name":"Divalproex sodium","nonproprietary_name":"Divalproex sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-261-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.19434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Divalproex Sodium ER|Divalproex Sodium","basis":"generic"},"part_b":null}, {"ndc":"68025006530","name":"DIVIGEL 0.25 MG GEL PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-065-30","proprietary_name":"DIVIGEL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 PACKET in 1 CARTON (68025-065-30) / .25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025006630","name":"DIVIGEL 0.5 MG GEL PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-066-30","proprietary_name":"DIVIGEL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 PACKET in 1 CARTON (68025-066-30) / .5 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.39183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025008330","name":"DIVIGEL 0.75 MG GEL PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-083-30","proprietary_name":"DIVIGEL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 PACKET in 1 CARTON (68025-083-30) / .75 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.40611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025006730","name":"DIVIGEL 1 MG GEL PACKET","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-067-30","proprietary_name":"DIVIGEL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 PACKET in 1 CARTON (68025-067-30) / 1 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.38098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68025008630","name":"DIVIGEL 1.25 MG GEL PACKET","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-086-30","proprietary_name":"DIVIGEL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 PACKET in 1 CARTON (68025-086-30) / 1.25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":4.29397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367018408","name":"DM-GUAIF-PE 18-200-10 MG/15 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-184-08","proprietary_name":"DEXTROMETHORPHAN HYDROBROMIDE, Guaifenesin, and PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"DEXTROMETHORPHAN HYDROBROMIDE, Guaifenesin, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"18 mg/15mL; 200 mg/15mL; 10 mg/15mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"240 mL in 1 BOTTLE (69367-184-08)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.072,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536142704","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1427-04","proprietary_name":"DOCOSANOL","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 PACKAGE (0536-1427-04) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713035302","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0353-02","proprietary_name":"DOCOSANOL","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0353-02) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713035362","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0353-62","proprietary_name":"DOCOSANOL","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0713-0353-62) / 2 g in 1 BOTTLE, PUMP"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672140602","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1406-2","proprietary_name":"Docosanol","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"2 TUBE in 1 PACKAGE (51672-1406-2) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672140603","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1406-3","proprietary_name":"Docosanol","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 PACKAGE (51672-1406-3) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269088135","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-881-35","proprietary_name":"DOCOSANOL","nonproprietary_name":"DOCOSANOL","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"H2-Pharma, LLC","package_description":"2 g in 1 TUBE (61269-881-35)"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269098135","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269098937","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-989-37","proprietary_name":"DOCOSANOL","nonproprietary_name":"DOCOSANOL","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"H2-Pharma, LLC","package_description":"1 BOTTLE, PUMP in 1 PACKAGE (61269-989-37) / 2 g in 1 BOTTLE, PUMP"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000051701","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000067201","name":"DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0672-1","proprietary_name":"Docosanol","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Leader/ Cardinal Health 110, Inc.","package_description":"1 TUBE in 1 PACKAGE (70000-0672-1) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904718361","name":"DOCUSATE SODIUM 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7183-61","proprietary_name":"Docusate Sodium - Stool Softener Laxative","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-7183-61) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904728060","name":"DOCUSATE SODIUM 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7280-60","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0904-7280-60)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904728080","name":"DOCUSATE SODIUM 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7280-80","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0904-7280-80)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24689013001","name":"DOCUSATE SODIUM 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-130-01","proprietary_name":"Docusate sodium","nonproprietary_name":"Docusate sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (24689-130-01)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687012901","name":"DOCUSATE SODIUM 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-129-01","proprietary_name":"Docusate Sodium","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-129-01) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (60687-129-11)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687012911","name":"DOCUSATE SODIUM 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904728160","name":"DOCUSATE SODIUM 250 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7281-60","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0904-7281-60)"},"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904728180","name":"DOCUSATE SODIUM 250 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7281-80","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0904-7281-80)"},"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268026811","name":"DOCUSATE SODIUM 250 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268026815","name":"DOCUSATE SODIUM 250 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-268-15","proprietary_name":"Docusate Sodium","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-268-15) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (50268-268-11)"},"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536130485","name":"DOCUSATE SODIUM 50 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1304-85","proprietary_name":"Docusate Sodium Liquid","nonproprietary_name":"Docusate Sodium","dosage_form":"LIQUID","route":"ORAL","strength":"50 mg/5mL","labeler":"RUGBY LABORATORIES","package_description":"473 mL in 1 BOTTLE (0536-1304-85)"},"nadac":{"value":0.02007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54859081316","name":"DOCUSATE SODIUM 50 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-813-16","proprietary_name":"Docusate Sodium Liquid","nonproprietary_name":"Docusate Sodium","dosage_form":"LIQUID","route":"ORAL","strength":"50 mg/5mL","labeler":"LLORENS PHARMACEUTICALS INTERNATIONAL DIVISION","package_description":"473 mL in 1 BOTTLE (54859-813-16)"},"nadac":{"value":0.02007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904692093","name":"DOCUSATE SODIUM MINI ENEMA","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6920-93","proprietary_name":"Docusate Mini Enema","nonproprietary_name":"docusate sodium","dosage_form":"LIQUID","route":"RECTAL","strength":"283 mg/5mL","labeler":"Major Pharmaceuticals","package_description":"30 TUBE in 1 JAR (0904-6920-93) / 5 mL in 1 TUBE"},"nadac":{"value":0.46116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904752208","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7522-08","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-7522-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"42794004410","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-044-10","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":"125 ug/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (42794-044-10)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"47335006186","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-061-86","proprietary_name":"DOFETILIDE","nonproprietary_name":"DOFETILIDE","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (47335-061-86)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"59651011860","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-118-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-118-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"69452013117","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-131-17","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"Bionpharma Inc.","package_description":"60 CAPSULE in 1 BOTTLE (69452-131-17)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"72205003960","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-039-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72205-039-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"72603013001","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-130-01","proprietary_name":"DOFETILIDE","nonproprietary_name":"DOFETILIDE","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"NorthStar RxLLC","package_description":"60 CAPSULE in 1 BOTTLE (72603-130-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"75907005660","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-056-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (75907-056-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"76282075560","name":"DOFETILIDE 125 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-755-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".125 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"60 CAPSULE in 1 BOTTLE (76282-755-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"00904752308","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7523-08","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-7523-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"42794004510","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-045-10","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 ug/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (42794-045-10)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"59651011960","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-119-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-119-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"69452013217","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-132-17","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"Bionpharma Inc.","package_description":"60 CAPSULE in 1 BOTTLE (69452-132-17)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"72205004060","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-040-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72205-040-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"72603013101","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-131-01","proprietary_name":"DOFETILIDE","nonproprietary_name":"DOFETILIDE","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"NorthStar RxLLC","package_description":"60 CAPSULE in 1 BOTTLE (72603-131-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"75907005560","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-055-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (75907-055-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"76282075660","name":"DOFETILIDE 250 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-756-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".25 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"60 CAPSULE in 1 BOTTLE (76282-756-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"00904752408","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7524-08","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-7524-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"42794004610","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-046-10","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":"500 ug/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (42794-046-10)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"59651012060","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-120-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-120-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"69452013317","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-133-17","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Bionpharma Inc.","package_description":"60 CAPSULE in 1 BOTTLE (69452-133-17)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"72205004160","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-041-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72205-041-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"72603013201","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-132-01","proprietary_name":"DOFETILIDE","nonproprietary_name":"DOFETILIDE","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar RxLLC","package_description":"60 CAPSULE in 1 BOTTLE (72603-132-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"75907005460","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-054-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (75907-054-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"76282075760","name":"DOFETILIDE 500 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-757-60","proprietary_name":"Dofetilide","nonproprietary_name":"Dofetilide","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"60 CAPSULE in 1 BOTTLE (76282-757-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.19291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dofetilide|Dofetilide","basis":"generic"},"part_b":null}, {"ndc":"00904675060","name":"DOK 100 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6750-60","proprietary_name":"DOK","nonproprietary_name":"docusate sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"100 TABLET in 1 BOTTLE (0904-6750-60)"},"nadac":{"value":0.03896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742065928","name":"DOLISHALE 90-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-659-28","proprietary_name":"Dolishale","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"90 ug/1; 20 ug/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1 BLISTER PACK in 1 CARTON (50742-659-28) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":1.13572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dolishale|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50742065984","name":"DOLISHALE 90-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-659-84","proprietary_name":"Dolishale","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"90 ug/1; 20 ug/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"3 BLISTER PACK in 1 CARTON (50742-659-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":1.13572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dolishale|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00904647861","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6478-61","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6478-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"13668010310","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-103-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13668-103-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"13668010330","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-103-30","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-103-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"13668010390","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-103-90","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13668-103-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077903","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-779-03","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16571-779-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077909","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-779-09","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16571-779-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077910","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-779-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-779-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077950","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-779-50","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-779-50)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"31722073805","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-738-05","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-738-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"31722073830","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-738-30","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-738-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"31722073890","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-738-90","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-738-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002807","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-028-07","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-028-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002810","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-028-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-028-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002815","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-028-15","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-028-15)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027603","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-276-03","proprietary_name":"donepezil hydrochloride","nonproprietary_name":"donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-276-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027609","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-276-09","proprietary_name":"donepezil hydrochloride","nonproprietary_name":"donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-276-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027611","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-276-11","proprietary_name":"donepezil hydrochloride","nonproprietary_name":"donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-276-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"60687030301","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-303-01","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-303-01) / 1 TABLET in 1 BLISTER PACK (60687-303-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"60687030311","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332009330","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-093-30","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-093-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332009390","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-093-90","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-093-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332009391","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-093-91","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-093-91)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012801","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012803","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012805","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012806","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"82009012005","name":"DONEPEZIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-120-05","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-120-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"24979000406","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-004-06","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24979-004-06)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"24979000407","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-004-07","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (24979-004-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342006107","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-061-07","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-061-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342006110","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-061-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-061-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"42799095401","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-954-01","proprietary_name":"Donepezil hydrochloride","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42799-954-01)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"42799095402","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-954-02","proprietary_name":"Donepezil hydrochloride","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42799-954-02)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"55111030230","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-302-30","proprietary_name":"Donepezil hydrochloride","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-302-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"55111030290","name":"DONEPEZIL HCL 23 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-302-90","proprietary_name":"Donepezil hydrochloride","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"23 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55111-302-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.73542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"00904647761","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6477-61","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6477-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"13668010210","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-102-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13668-102-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"13668010230","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-102-30","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-102-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"13668010290","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-102-90","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13668-102-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077803","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-778-03","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16571-778-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077809","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-778-09","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16571-778-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077810","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-778-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-778-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"16571077850","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-778-50","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-778-50)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"31722073705","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-737-05","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-737-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"31722073730","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-737-30","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-737-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"31722073790","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-737-90","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-737-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002707","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-027-07","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-027-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002710","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-027-10","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-027-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002715","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-027-15","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-027-15)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027503","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-275-03","proprietary_name":"donepezil hydrochloride","nonproprietary_name":"donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-275-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027509","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-275-09","proprietary_name":"donepezil hydrochloride","nonproprietary_name":"donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-275-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027511","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-275-11","proprietary_name":"donepezil hydrochloride","nonproprietary_name":"donepezil hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-275-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"60687029201","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-292-01","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-292-01) / 1 TABLET in 1 BLISTER PACK (60687-292-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"60687029211","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332009230","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-092-30","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-092-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332009290","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-092-90","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-092-90)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332009291","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-092-91","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-092-91)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012701","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012703","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012705","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"71093012706","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"82009011905","name":"DONEPEZIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-119-05","proprietary_name":"Donepezil","nonproprietary_name":"Donepezil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-119-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.04395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342003007","name":"DONEPEZIL HCL ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-030-07","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (33342-030-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.29119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl ODT|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342002907","name":"DONEPEZIL HCL ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-029-07","proprietary_name":"Donepezil Hydrochloride","nonproprietary_name":"Donepezil Hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (33342-029-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.28066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Donepezil HCl ODT|Donepezil HCl","basis":"generic"},"part_b":null}, {"ndc":"51862056060","name":"DORYX MPC DR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51862-560-60","proprietary_name":"DORYX MPC","nonproprietary_name":"doxycycline hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Mayne Pharma Commercial LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (51862-560-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":18.1822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208048510","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-485-10","proprietary_name":"Dorzolamide HCl","nonproprietary_name":"Dorzolamide HCl","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-485-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"25021000610","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-006-10","proprietary_name":"Dorzolamide Hydrochloride","nonproprietary_name":"Dorzolamide Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (25021-006-10) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"42571014126","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-141-26","proprietary_name":"Dorzolamide Hydrochloride Ophthalmic Solution","nonproprietary_name":"Dorzolamide Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-141-26) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"61314001910","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-019-10","proprietary_name":"DORZOLAMIDE HYDROCHLORIDE","nonproprietary_name":"dorzolamide hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Sandoz Inc","package_description":"10 mL in 1 BOTTLE (61314-019-10)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"62332051910","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-519-10","proprietary_name":"Dorzolamide Hydrochloride","nonproprietary_name":"Dorzolamide Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-519-10) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"69315030410","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-304-10","proprietary_name":"Dorzolamide hydrochloride","nonproprietary_name":"Dorzolamide hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE in 1 CARTON (69315-304-10) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"70069050101","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-501-01","proprietary_name":"Dorzolamide Hydrochloride","nonproprietary_name":"Dorzolamide Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-501-01) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"70377008111","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"71921040010","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-400-10","proprietary_name":"Dorzolamide Hydrochloride Ophthalmic","nonproprietary_name":"Dorzolamide Hydrochloride Ophthalmic","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"10 mL in 1 BOTTLE (71921-400-10)","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72266019701","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-197-01","proprietary_name":"Dorzolamide Hydrochloride","nonproprietary_name":"Dorzolamide Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"FOSUN PHARMA USA INC","package_description":"1 BOTTLE in 1 CARTON (72266-197-01) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72888007715","name":"DORZOLAMIDE HCL 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-077-15","proprietary_name":"DORZOLAMIDE HYDROCHLORIDE","nonproprietary_name":"dorzolamide hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Advagen Pharma Ltd.","package_description":"1 BOTTLE in 1 CARTON (72888-077-15) / 10 mL in 1 BOTTLE","pharm_classes":["Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]"]},"nadac":{"value":0.83485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide HCl|Dorzolamide HCl","basis":"generic"},"part_b":null}, {"ndc":"42571038273","name":"DORZOLAMIDE-TIMOLOL 2-0.5%(PF)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-382-73","proprietary_name":"DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE","nonproprietary_name":"DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE PRESERVATIVE FREE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Micro Labs Limited","package_description":"4 POUCH in 1 CARTON (42571-382-73) / 15 VIAL, SINGLE-USE in 1 POUCH (42571-382-71) / .2 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.09395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742032360","name":"DORZOLAMIDE-TIMOLOL 2-0.5%(PF)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-323-60","proprietary_name":"Dorzolamide hydrochloride and timolol maleate","nonproprietary_name":"Dorzolamide hydrochloride and timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"12 POUCH in 1 CARTON (50742-323-60) / 5 VIAL in 1 POUCH (50742-323-05) / .2 mL in 1 VIAL","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.09395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862094760","name":"DORZOLAMIDE-TIMOLOL 2-0.5%(PF)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-947-60","proprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate Preservative Free","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate Preservative Free","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"4 POUCH in 1 CARTON (65862-947-60) / 15 VIAL, SINGLE-USE in 1 POUCH (65862-947-15) / .2 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.09395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208048610","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-486-10","proprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-486-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"42571014726","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-147-26","proprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate ophthalmic Solution","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"22.3 mg/mL; 6.8 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-147-26) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"61314003002","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-030-02","proprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Sandoz Inc","package_description":"10 mL in 1 BOTTLE (61314-030-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"62332055310","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-553-10","proprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate Ophthalmic Solution","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-553-10) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"65862094601","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-946-01","proprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65862-946-01) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"69315030510","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-305-10","proprietary_name":"Dorzolamide and Timolol","nonproprietary_name":"Dorzolamide Hydrochloride and Timolol Maleate Ophthalmic Solution","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69315-305-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"70069005101","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-051-01","proprietary_name":"DORZOLAMIDE HYDROCHLORIDE and TIMOLOL MALEATE","nonproprietary_name":"DORZOLAMIDE HYDROCHLORIDE and TIMOLOL MALEATE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-051-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Dorzolamide-Timolol|Dorzolamide HCl/Timolol Maleat","basis":"generic"},"part_b":null}, {"ndc":"70377008211","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71921022610","name":"DORZOLAMIDE-TIMOLOL EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-226-10","proprietary_name":"DORZOLAMIDE HYDROCHLORIDE TIMOLOL MALEATE","nonproprietary_name":"dorzolamide hydrochloride timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL; 5 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE, DISPENSING in 1 CARTON (71921-226-10) / 10 mL in 1 BOTTLE, DISPENSING","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.89267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162098904","name":"DOTTI 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162098908","name":"DOTTI 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-989-08","proprietary_name":"DOTTI","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-989-08) / 1 d in 1 POUCH (65162-989-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099204","name":"DOTTI 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099208","name":"DOTTI 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-992-08","proprietary_name":"DOTTI","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-992-08) / 1 d in 1 POUCH (65162-992-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099304","name":"DOTTI 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099308","name":"DOTTI 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-993-08","proprietary_name":"DOTTI","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-993-08) / 1 d in 1 POUCH (65162-993-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099504","name":"DOTTI 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099508","name":"DOTTI 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-995-08","proprietary_name":"DOTTI","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-995-08) / 1 d in 1 POUCH (65162-995-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099704","name":"DOTTI 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162099708","name":"DOTTI 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-997-08","proprietary_name":"DOTTI","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-997-08) / 1 d in 1 POUCH (65162-997-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dotti|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"51672204402","name":"DOUBLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2044-2","proprietary_name":"Double Antibiotic","nonproprietary_name":"Bacitracin Zinc and Polymyxin B Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g; 10000 [USP'U]/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2044-2) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.1148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49702024613","name":"DOVATO 50-300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49702-246-13","proprietary_name":"Dovato","nonproprietary_name":"dolutegravir sodium and lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 300 mg/1","labeler":"ViiV Healthcare Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49702-246-13)","pharm_classes":["HIV Integrase Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":105.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dovato|Dolutegravir Sodium/Lamivudine","basis":"brand"},"part_b":null}, {"ndc":"49702024633","name":"DOVATO 50-300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49702-246-33","proprietary_name":"Dovato","nonproprietary_name":"dolutegravir sodium and lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 300 mg/1","labeler":"ViiV Healthcare Company","package_description":"1 BLISTER PACK in 1 CARTON (49702-246-33) / 30 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["HIV Integrase Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":105.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dovato|Dolutegravir Sodium/Lamivudine","basis":"brand"},"part_b":null}, {"ndc":"00093207001","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2070-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2070-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00832035611","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0356-11","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0356-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904552261","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5522-61","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5522-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"16571016501","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-165-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-165-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"23155009201","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-092-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-092-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035101","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-351-01","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-351-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035110","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-351-10","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-351-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022211","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022215","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-222-15","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-222-15) / 1 TABLET in 1 BLISTER PACK (50268-222-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089201","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-892-01","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-892-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089299","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-892-99","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-892-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59762138807","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1388-7","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1388-7)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009300","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0093-0","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0093-0)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009301","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0093-1","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0093-1)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135005190","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-051-90","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"Doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-051-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084083601","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-836-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-836-01) / 1 TABLET in 1 BLISTER PACK (68084-836-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084083611","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084083625","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-836-25","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-836-25) / 1 TABLET in 1 BLISTER PACK (68084-836-95)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084083695","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078301","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-783-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-783-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078310","name":"DOXAZOSIN MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-783-10","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-783-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00093206901","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2069-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2069-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00832035711","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0357-11","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0357-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904552361","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5523-61","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5523-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"16571016601","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-166-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-166-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"23155009301","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-093-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-093-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035201","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-352-01","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-352-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035210","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-352-10","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-352-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022311","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022315","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-223-15","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-223-15) / 1 TABLET in 1 BLISTER PACK (50268-223-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089301","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-893-01","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-893-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089399","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-893-99","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-893-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59762242007","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2420-7","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-2420-7)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009400","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0094-0","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0094-0)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009401","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0094-1","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0094-1)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135005290","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-052-90","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"Doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-052-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084085101","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-851-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-851-01) / 1 TABLET in 1 BLISTER PACK (68084-851-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084085111","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084085125","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-851-25","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-851-25) / 1 TABLET in 1 BLISTER PACK (68084-851-95)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084085195","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078401","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-784-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-784-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078410","name":"DOXAZOSIN MESYLATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-784-10","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-784-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.06355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00093206801","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2068-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2068-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00832135811","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1358-11","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1358-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904552461","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5524-61","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5524-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"16571016701","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-167-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-167-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"23155009401","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-094-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-094-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035301","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-353-01","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-353-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035310","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-353-10","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-353-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022411","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022415","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-224-15","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-224-15) / 1 TABLET in 1 BLISTER PACK (50268-224-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089401","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-894-01","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-894-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59762139007","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1390-7","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1390-7)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59762244007","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2440-7","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-2440-7)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009500","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0095-0","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0095-0)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009501","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0095-1","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0095-1)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135005390","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-053-90","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"Doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-053-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084086201","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-862-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-862-01) / 1 TABLET in 1 BLISTER PACK (68084-862-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084086211","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084086225","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-862-25","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-862-25) / 1 TABLET in 1 BLISTER PACK (68084-862-95)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68084086295","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078501","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-785-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-785-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078510","name":"DOXAZOSIN MESYLATE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-785-10","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-785-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00093206701","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2067-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2067-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00832135911","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1359-11","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1359-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"16571016801","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-168-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-168-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"23155009501","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-095-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-095-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035401","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-354-01","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-354-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"29300035410","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-354-10","proprietary_name":"Doxazosin Mesylate","nonproprietary_name":"Doxazosin Mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-354-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022511","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"50268022515","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-225-15","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-225-15) / 1 TABLET in 1 BLISTER PACK (50268-225-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089501","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-895-01","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-895-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651089599","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-895-99","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-895-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59762139107","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1391-7","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1391-7)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59762248007","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2480-7","proprietary_name":"Doxazosin","nonproprietary_name":"doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-2480-7)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009600","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0096-0","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0096-0)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505009601","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0096-1","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0096-1)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135005490","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-054-90","proprietary_name":"Doxazosin mesylate","nonproprietary_name":"Doxazosin mesylate","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-054-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078601","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-786-01","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-786-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68382078610","name":"DOXAZOSIN MESYLATE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-786-10","proprietary_name":"Doxazosin","nonproprietary_name":"Doxazosin","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-786-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxazosin Mesylate|Doxazosin Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378104901","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1049-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-1049-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378104910","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1049-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-1049-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904705261","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7052-61","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7052-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155079401","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-794-01","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-794-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079301","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-793-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"100 CAPSULE in 1 BOTTLE (24658-793-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079310","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-793-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 CAPSULE in 1 BOTTLE (24658-793-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016701","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-167-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-167-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016710","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-167-10","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (27241-167-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079043601","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-436","inner_of":["51079-436-20"]},"part_b":null}, {"ndc":"51079043620","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-436-20","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-436-20) / 1 CAPSULE in 1 BLISTER PACK (51079-436-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651017301","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-173-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-173-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135056090","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-560-90","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-560-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332063731","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-637-31","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-637-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64980059401","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-594-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-594-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"69238116609","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1166-9","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1166-9)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042411","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-424-11","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-424-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205008891","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-088-91","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (72205-088-91)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603039001","name":"DOXEPIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-390-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-390-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.07787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"54838051240","name":"DOXEPIN 10 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-512-40","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Lannett Company, LLC","package_description":"120 mL in 1 BOTTLE, PLASTIC (54838-512-40)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.83884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378641001","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6410-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-6410-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378641010","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6410-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-6410-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904705561","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7055-61","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7055-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155079801","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-798-01","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-798-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079701","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-797-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"100 CAPSULE in 1 BOTTLE (24658-797-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079705","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-797-05","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"500 CAPSULE in 1 BOTTLE (24658-797-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079710","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-797-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 CAPSULE in 1 BOTTLE (24658-797-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241017101","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-171-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-171-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241017110","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-171-10","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (27241-171-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079065101","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-651","inner_of":["51079-651-20"]},"part_b":null}, {"ndc":"51079065120","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-651-20","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-651-20) / 1 CAPSULE in 1 BLISTER PACK (51079-651-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651017701","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-177-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-177-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135056490","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-564-90","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-564-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332064031","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-640-31","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-640-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64980059801","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-598-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-598-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"69238117309","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1173-9","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1173-9)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042811","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-428-11","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-428-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205009291","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-092-91","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (72205-092-91)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603039401","name":"DOXEPIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-394-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-394-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.29013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"42799093501","name":"DOXEPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799093502","name":"DOXEPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799093550","name":"DOXEPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884022201","name":"DOXEPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884022203","name":"DOXEPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884022205","name":"DOXEPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378312501","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3125-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-3125-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378312510","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3125-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-3125-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904705361","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7053-61","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7053-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155079501","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-795-01","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-795-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079401","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-794-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"100 CAPSULE in 1 BOTTLE (24658-794-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079410","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-794-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 CAPSULE in 1 BOTTLE (24658-794-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016801","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-168-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-168-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016810","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-168-10","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (27241-168-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079043701","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-437","inner_of":["51079-437-20"]},"part_b":null}, {"ndc":"51079043720","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-437-20","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-437-20) / 1 CAPSULE in 1 BLISTER PACK (51079-437-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651017401","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-174-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-174-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135056190","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-561-90","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-561-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332063831","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-638-31","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-638-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64980059501","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-595-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-595-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"69238117009","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1170-9","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1170-9)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042511","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-425-11","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-425-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205008991","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-089-91","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (72205-089-91)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603039101","name":"DOXEPIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-391-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-391-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.14151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093960995","name":"DOXEPIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9609-95","proprietary_name":"doxepin hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-9609-95) / 45 g in 1 TUBE","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":7.11754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378811745","name":"DOXEPIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8117-45","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8117-45) / 45 g in 1 TUBE","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":7.11754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238173306","name":"DOXEPIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1733-6","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-1733-6) / 45 g in 1 TUBE","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":7.11754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378425001","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4250-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-4250-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378425010","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4250-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-4250-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904705461","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7054-61","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7054-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155079601","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-796-01","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-796-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079501","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-795-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"100 CAPSULE in 1 BOTTLE (24658-795-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079510","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-795-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 CAPSULE in 1 BOTTLE (24658-795-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016901","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-169-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-169-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016910","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-169-10","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (27241-169-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079043801","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-438","inner_of":["51079-438-20"]},"part_b":null}, {"ndc":"51079043820","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-438-20","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-438-20) / 1 CAPSULE in 1 BLISTER PACK (51079-438-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651017501","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-175-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-175-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135056290","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-562-90","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-562-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332064531","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-645-31","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-645-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64980059601","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-596-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-596-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"69238117109","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1171-9","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1171-9)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042611","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-426-11","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-426-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205009091","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-090-91","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (72205-090-91)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603039201","name":"DOXEPIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-392-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-392-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378537501","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5375-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-5375-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378537510","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5375-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-5375-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155079701","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-797-01","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-797-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079601","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-796-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"100 CAPSULE in 1 BOTTLE (24658-796-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"24658079610","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-796-10","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 CAPSULE in 1 BOTTLE (24658-796-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241017001","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-170-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-170-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241017010","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-170-10","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (27241-170-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651017601","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-176-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-176-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135056390","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-563-90","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-563-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332063931","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-639-31","proprietary_name":"DOXEPIN HYDROCHLORIDE","nonproprietary_name":"DOXEPIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-639-31)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64980059701","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-597-01","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-597-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"69238117209","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1172-9","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1172-9)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042711","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-427-11","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-427-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205009191","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-091-91","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"Doxepin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (72205-091-91)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603039301","name":"DOXEPIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-393-01","proprietary_name":"Doxepin Hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-393-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.19659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00228331503","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3315-03","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0228-3315-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241028030","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-280-30","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-280-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"51672424602","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4246-2","proprietary_name":"doxepin hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4246-2)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084430","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-844-30","proprietary_name":"DOXEPIN","nonproprietary_name":"DOXEPIN","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-844-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64380020301","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-203-01","proprietary_name":"Doxepin","nonproprietary_name":"doxepin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (64380-203-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205005230","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-052-30","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-052-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72578018106","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-181-06","proprietary_name":"doxepin","nonproprietary_name":"doxepin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-181-06)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603022201","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-222-01","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"North Star Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-222-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72819016103","name":"DOXEPIN HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-161-03","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Archis Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72819-161-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.33336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"00228331603","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3316-03","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0228-3316-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241028130","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-281-30","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-281-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"51672424702","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4247-2","proprietary_name":"doxepin hydrochloride","nonproprietary_name":"doxepin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4247-2)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084530","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-845-30","proprietary_name":"DOXEPIN","nonproprietary_name":"DOXEPIN","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-845-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"64380020401","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-204-01","proprietary_name":"Doxepin","nonproprietary_name":"doxepin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (64380-204-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205005330","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-053-30","proprietary_name":"Doxepin hydrochloride","nonproprietary_name":"Doxepin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-053-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72578018206","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-182-06","proprietary_name":"doxepin","nonproprietary_name":"doxepin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-182-06)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603022301","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-223-01","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6 mg/1","labeler":"North Star Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-223-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"72819016203","name":"DOXEPIN HCL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-162-03","proprietary_name":"Doxepin","nonproprietary_name":"Doxepin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6 mg/1","labeler":"Archis Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72819-162-03)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":1.3716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxepin HCl*|Doxepin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135041746","name":"DOXYCYCLINE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-417-46","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Chartwell RX LLC","package_description":"60 mL in 1 BOTTLE, GLASS (62135-417-46)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.23041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135087746","name":"DOXYCYCLINE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-877-46","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Chartwell RX LLC","package_description":"60 mL in 1 BOTTLE, GLASS (62135-877-46)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.23041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180065701","name":"DOXYCYCLINE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-657-01","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"DOXYCYCLINE","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 mL in 1 BOTTLE (68180-657-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.23041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135062560","name":"DOXYCYCLINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-625-60","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-625-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.69979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332049960","name":"DOXYCYCLINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-499-60","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-499-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.69979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"64380022501","name":"DOXYCYCLINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-225-01","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET in 1 BOTTLE (64380-225-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.69979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00228289611","name":"DOXYCYCLINE HYC DR 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.18358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155014201","name":"DOXYCYCLINE HYC DR 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-142-01","proprietary_name":"DOXYCYCLINE HYCLATE DELAYED RELEASE","nonproprietary_name":"doxycycline hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (23155-142-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.18358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332048231","name":"DOXYCYCLINE HYC DR 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-482-31","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (62332-482-31)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.18358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591457560","name":"DOXYCYCLINE HYC DR 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4575-60","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (0591-4575-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":5.17223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155061106","name":"DOXYCYCLINE HYC DR 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-611-06","proprietary_name":"DOXYCYCLINE HYCLATE DELAYED RELEASE","nonproprietary_name":"doxycycline hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (23155-611-06)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":5.17223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547032506","name":"DOXYCYCLINE HYC DR 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-325-06","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare US LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (43547-325-06)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":5.17223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332048460","name":"DOXYCYCLINE HYC DR 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-484-60","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (62332-484-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":5.17223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68308071630","name":"DOXYCYCLINE HYC DR 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-716-30","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Mayne Pharma Commercial LLC","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (68308-716-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":5.17223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591455022","name":"DOXYCYCLINE HYC DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0591-4550-22","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (0591-4550-22)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":1.56942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547046212","name":"DOXYCYCLINE HYC DR 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43547-462-12","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (43547-462-12)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":1.56942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143314250","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143980305","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9803-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (0143-9803-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00143980350","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9803-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 CAPSULE in 1 BOTTLE, PLASTIC (0143-9803-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00904042804","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0428-04","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-0428-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00904042806","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0428-06","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-0428-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"27808023301","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-233-01","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"50 CAPSULE in 1 BOTTLE (27808-233-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"27808023302","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-233-02","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (27808-233-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"50268027811","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-278","inner_of":["50268-278-15"]},"part_b":null}, {"ndc":"50268027815","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-278-15","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-278-15) / 1 CAPSULE in 1 BLISTER PACK (50268-278-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"53489011902","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-119-02","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"50 CAPSULE in 1 BOTTLE, PLASTIC (53489-119-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"53489011905","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-119-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (53489-119-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"60687051311","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-513","inner_of":["60687-513-65"]},"part_b":null}, {"ndc":"60687051365","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-513-65","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-513-65) / 1 CAPSULE in 1 BLISTER PACK (60687-513-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135098505","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-985-05","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"500 CAPSULE in 1 BOTTLE (62135-985-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135098550","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-985-50","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"50 CAPSULE in 1 BOTTLE (62135-985-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332036350","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-363-50","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"50 CAPSULE in 1 BOTTLE (62332-363-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332036371","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-363-71","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (62332-363-71)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"69238110002","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1100-2","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"50 CAPSULE in 1 BOTTLE (69238-1100-2)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"69238110005","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1100-5","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 CAPSULE in 1 BOTTLE (69238-1100-5)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"72578005505","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-055-05","proprietary_name":"Doxycycline hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (72578-055-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"72578005518","name":"DOXYCYCLINE HYCLATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-055-18","proprietary_name":"Doxycycline hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"50 CAPSULE in 1 BOTTLE (72578-055-18)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.1049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00143211205","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-2112-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (0143-2112-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00143211250","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-2112-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 TABLET, COATED in 1 BOTTLE (0143-2112-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00591555305","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5553-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-5553-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00591555350","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5553-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"50 TABLET in 1 BOTTLE, PLASTIC (0591-5553-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00904043004","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0430-04","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-0430-04) / 1 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00904043006","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0430-06","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-0430-06) / 1 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00904043095","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0430-95","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 TABLET, COATED in 1 BOTTLE (0904-0430-95)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031001","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-01","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (24658-310-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031005","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (24658-310-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031007","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-07","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"300 TABLET, FILM COATED in 1 BOTTLE (24658-310-07)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031008","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-08","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"400 TABLET, FILM COATED in 1 BOTTLE (24658-310-08)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031010","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-10","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (24658-310-10)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031020","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-20","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (24658-310-20)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031021","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-21","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"210 TABLET, FILM COATED in 1 BOTTLE (24658-310-21)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031030","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-30","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24658-310-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031050","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-310-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (24658-310-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"24658031201","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658031205","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658031210","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658031220","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658031250","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27808023401","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-234-01","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"50 TABLET in 1 BOTTLE (27808-234-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"27808023402","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-234-02","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (27808-234-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"42192050105","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-501-05","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (42192-501-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"42806031005","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-310-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42806-310-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"42806031050","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-310-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (42806-310-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"50268027911","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-279","inner_of":["50268-279-15"]},"part_b":null}, {"ndc":"50268027915","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-279-15","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-279-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-279-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"53489012002","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-120-02","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (53489-120-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"53489012005","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-120-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (53489-120-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135062601","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-626-01","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62135-626-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135062605","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-626-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62135-626-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135062610","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-626-10","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62135-626-10)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135062650","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-626-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (62135-626-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135062696","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-626-96","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX LLC","package_description":"2000 TABLET, FILM COATED in 1 BOTTLE (62135-626-96)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62584069311","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"62584-693","inner_of":["62584-693-21"]},"part_b":null}, {"ndc":"62584069321","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-693-21","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (62584-693-21) / 1 TABLET, COATED in 1 BLISTER PACK (62584-693-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"72578000105","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-001-05","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-001-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"72578000118","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-001-18","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"50 TABLET in 1 BOTTLE (72578-001-18)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"85477050105","name":"DOXYCYCLINE HYCLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241015402","name":"DOXYCYCLINE HYCLATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-154-02","proprietary_name":"Doxycycline hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-154-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.72427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135090820","name":"DOXYCYCLINE HYCLATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-908-20","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (62135-908-20)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.72427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332038860","name":"DOXYCYCLINE HYCLATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-388-60","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-388-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.72427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"68180065407","name":"DOXYCYCLINE HYCLATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-654-07","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxyclycline hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (68180-654-07)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.72427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806036201","name":"DOXYCYCLINE HYCLATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-362-01","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-362-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.09837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"53489064701","name":"DOXYCYCLINE HYCLATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-647-01","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (53489-647-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.09837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135062390","name":"DOXYCYCLINE HYCLATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-623-90","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-623-90)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.09837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332035231","name":"DOXYCYCLINE HYCLATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-352-31","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-352-31)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.09837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"68047071460","name":"DOXYCYCLINE HYCLATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-714-60","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Larken Laboratories, Inc.","package_description":"60 TABLET in 1 BOTTLE (68047-714-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.09837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"00143980250","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9802-50","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 CAPSULE in 1 BOTTLE, PLASTIC (0143-9802-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"50268027711","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-277","inner_of":["50268-277-15"]},"part_b":null}, {"ndc":"50268027715","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-277-15","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-277-15) / 1 CAPSULE in 1 BLISTER PACK (50268-277-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"53489011802","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-118-02","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"50 CAPSULE in 1 BOTTLE, PLASTIC (53489-118-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135098405","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-984-05","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX LLC","package_description":"500 CAPSULE in 1 BOTTLE (62135-984-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135098450","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-984-50","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX LLC","package_description":"50 CAPSULE in 1 BOTTLE (62135-984-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332036250","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-362-50","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"50 CAPSULE in 1 BOTTLE (62332-362-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"72578005418","name":"DOXYCYCLINE HYCLATE 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-054-18","proprietary_name":"Doxycycline hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"50 CAPSULE in 1 BOTTLE (72578-054-18)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.14441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"27241015302","name":"DOXYCYCLINE HYCLATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-153-02","proprietary_name":"Doxycycline hyclate","nonproprietary_name":"Doxycycline hyclate","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-153-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.54817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62135090720","name":"DOXYCYCLINE HYCLATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-907-20","proprietary_name":"Doxycycline Hyclate","nonproprietary_name":"Doxycycline Hyclate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (62135-907-20)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.54817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"62332038760","name":"DOXYCYCLINE HYCLATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-387-60","proprietary_name":"DOXYCYCLINE HYCLATE","nonproprietary_name":"DOXYCYCLINE HYCLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-387-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.54817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Hyclate*|Doxycycline Hyclate","basis":"generic"},"part_b":null}, {"ndc":"68180065307","name":"DOXYCYCLINE HYCLATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-653-07","proprietary_name":"doxycycline hyclate","nonproprietary_name":"doxyclycline hyclate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"75 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (68180-653-07)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.54817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788013430","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-134-30","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"DOXYCYCLINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (11788-134-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"43547059003","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-590-03","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"30 CAPSULE in 1 BOTTLE (43547-590-03)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"43598045730","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-457-30","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE in 1 BOTTLE (43598-457-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"60505477503","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4775-3","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-4775-3)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"62332078530","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-785-30","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"DOXYCYCLINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-785-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"68308066830","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-668-30","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"DOXYCYCLINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Mayne Pharma Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68308-668-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"70748030806","name":"DOXYCYCLINE IR-DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-308-06","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70748-308-06)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Ir-Dr|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"00713057250","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713057293","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268028111","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268028115","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-281-15","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-281-15) / 1 CAPSULE in 1 BLISTER PACK (50268-281-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071611","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071621","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-716-21","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-716-21) / 1 CAPSULE in 1 BLISTER PACK (60687-716-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687094311","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687094321","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-943-21","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-943-21) / 1 CAPSULE in 1 BLISTER PACK (60687-943-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135026225","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-262-25","proprietary_name":"Doxycycline Monohydrate","nonproprietary_name":"Doxycycline Monohydrate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC.","package_description":"250 CAPSULE in 1 BOTTLE (62135-262-25)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Monohydrate|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"62135026250","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-262-50","proprietary_name":"Doxycycline Monohydrate","nonproprietary_name":"Doxycycline Monohydrate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC.","package_description":"50 CAPSULE in 1 BOTTLE (62135-262-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Monohydrate|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"62135026260","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-262-60","proprietary_name":"Doxycycline Monohydrate","nonproprietary_name":"Doxycycline Monohydrate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 CAPSULE in 1 BOTTLE (62135-262-60)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Monohydrate|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"62332025050","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-250-50","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"50 CAPSULE in 1 BOTTLE (62332-250-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380018001","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-180-01","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"50 CAPSULE in 1 BOTTLE (64380-180-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380018002","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-180-02","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"250 CAPSULE in 1 BOTTLE (64380-180-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380092201","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-922-01","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"50 CAPSULE in 1 BOTTLE (64380-922-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380092202","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-922-02","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"250 CAPSULE in 1 BOTTLE (64380-922-02)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180065208","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-652-08","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"DOXYCYCLINE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (68180-652-08)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382070718","name":"DOXYCYCLINE MONO 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-707-18","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"50 CAPSULE in 1 BOTTLE (68382-707-18)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.22669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527133825","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1338-25","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lannett Company, Inc.","package_description":"250 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1338-25)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527133850","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1338-50","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lannett Company, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1338-50)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155013505","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-135-05","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-135-05)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155013525","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-135-25","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"50 TABLET in 1 BOTTLE (23155-135-25)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687034425","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-344-25","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-344-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-344-95)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687034495","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135072620","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-726-20","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET in 1 BOTTLE (62135-726-20)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710112307","name":"DOXYCYCLINE MONO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1123-7","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (70710-1123-7)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24891,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155013603","name":"DOXYCYCLINE MONO 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-136-03","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (23155-136-03)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.63368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380020801","name":"DOXYCYCLINE MONO 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-208-01","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET in 1 BOTTLE (64380-208-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.63368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710112403","name":"DOXYCYCLINE MONO 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1124-3","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1124-3)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.63368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713057001","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268028011","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268028015","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-280-15","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-280-15) / 1 CAPSULE in 1 BLISTER PACK (50268-280-11)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135026001","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-260-01","proprietary_name":"Doxycycline Monohydrate","nonproprietary_name":"Doxycycline Monohydrate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 CAPSULE in 1 BOTTLE (62135-260-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Doxycycline Monohydrate|Doxycycline Monohydrate","basis":"generic"},"part_b":null}, {"ndc":"64380017901","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-179-01","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE (64380-179-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380092001","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-920-01","proprietary_name":"Doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE (64380-920-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180065001","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-650-01","proprietary_name":"DOXYCYCLINE","nonproprietary_name":"DOXYCYCLINE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-650-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382078201","name":"DOXYCYCLINE MONO 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-782-01","proprietary_name":"doxycycline","nonproprietary_name":"doxycycline","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-782-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.15166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527133501","name":"DOXYCYCLINE MONO 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1335-01","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1335-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.16036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155013301","name":"DOXYCYCLINE MONO 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-133-01","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-133-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.16036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135072520","name":"DOXYCYCLINE MONO 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-725-20","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET in 1 BOTTLE (62135-725-20)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.16036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710112101","name":"DOXYCYCLINE MONO 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1121-1","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1121-1)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.16036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155013401","name":"DOXYCYCLINE MONO 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-134-01","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-134-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.3024,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710112201","name":"DOXYCYCLINE MONO 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1122-1","proprietary_name":"Doxycycline","nonproprietary_name":"Doxycycline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1122-1)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.3024,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591213201","name":"DOXYLAMINE-PYRIDOXINE 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2132-01","proprietary_name":"Doxylamine succinate and pyridoxine hydrochloride","nonproprietary_name":"Doxylamine succinate and pyridoxine hydrochloride","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (0591-2132-01)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]"]},"nadac":{"value":1.09163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884018601","name":"DOXYLAMINE-PYRIDOXINE 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-186-01","proprietary_name":"Doxylamine Succinate and Pyridoxine Hydrochloride","nonproprietary_name":"Doxylamine Succinate and Pyridoxine Hydrochloride, Delayed release Tablets 10 mg/10 mg","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (49884-186-01)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]"]},"nadac":{"value":1.09163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452020620","name":"DOXYLAMINE-PYRIDOXINE 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-206-20","proprietary_name":"Doxylamine succinate and Pyridoxine hydrochloride","nonproprietary_name":"Doxylamine succinate and Pyridoxine hydrochloride","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Bionpharma Inc.,","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (69452-206-20)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]"]},"nadac":{"value":1.09163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70505010010","name":"DOXYLAMINE-PYRIDOXINE 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70505-100-10","proprietary_name":"Doxylamine succinate and pyridoxine hydrochloride","nonproprietary_name":"Doxylamine succinate and pyridoxine hydrochloride","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Analog Pharma","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (70505-100-10)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]"]},"nadac":{"value":1.09163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904205112","name":"DRIMINATE 50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-2051-12","proprietary_name":"Driminate","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-2051-12) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904205159","name":"DRIMINATE 50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-2051-59","proprietary_name":"Driminate","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-2051-59) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904677212","name":"DRIMINATE 50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6772-12","proprietary_name":"Dimenhydrinate","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (0904-6772-12) / 12 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335061630","name":"DRIZALMA SPRINKLE DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-616-30","proprietary_name":"DRIZALMA SPRINKLE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (47335-616-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":7.04433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335061730","name":"DRIZALMA SPRINKLE DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-617-30","proprietary_name":"DRIZALMA SPRINKLE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (47335-617-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":7.23088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335061830","name":"DRIZALMA SPRINKLE DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-618-30","proprietary_name":"DRIZALMA SPRINKLE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (47335-618-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":7.16995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335061930","name":"DRIZALMA SPRINKLE DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-619-30","proprietary_name":"DRIZALMA SPRINKLE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (47335-619-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":7.15216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904714504","name":"DRONABINOL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7145-04","proprietary_name":"Dronabinol","nonproprietary_name":"Dronabinol","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7145-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cannabinoid [EPC]","Cannabinoids [CS]"]},"nadac":{"value":3.3535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dronabinol|Dronabinol","basis":"generic"},"part_b":{"hcpcs":"Q0167","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0167 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0904-7145-04) / 1 CAPSULE in 1 BLISTER PACK) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722096160","name":"DRONABINOL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-961-60","proprietary_name":"DRONABINOL","nonproprietary_name":"dronabinol","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"60 CAPSULE in 1 BOTTLE (31722-961-60)","pharm_classes":["Cannabinoid [EPC]","Cannabinoids [CS]"]},"nadac":{"value":3.3535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dronabinol|Dronabinol","basis":"generic"},"part_b":null}, {"ndc":"42858086806","name":"DRONABINOL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.3535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dronabinol|Dronabinol","basis":"generic"},"part_b":null}, {"ndc":"67877075460","name":"DRONABINOL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-754-60","proprietary_name":"Dronabinol","nonproprietary_name":"Dronabinol","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE (67877-754-60)","pharm_classes":["Cannabinoid [EPC]","Cannabinoids [CS]"]},"nadac":{"value":3.3535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dronabinol|Dronabinol","basis":"generic"},"part_b":{"hcpcs":"Q0167","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0167 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 CAPSULE in 1 BOTTLE (67877-754-60)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781407515","name":"DROSP-EE-LEVOMEF 3-0.02-0.451","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-4075-15","proprietary_name":"Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium","nonproprietary_name":"Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sandoz Inc","package_description":"3 BLISTER PACK in 1 CARTON (0781-4075-15) / 1 KIT in 1 BLISTER PACK (0781-4075-52)"},"nadac":{"value":1.38228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781407552","name":"DROSP-EE-LEVOMEF 3-0.02-0.451","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.38228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180089471","name":"DROSP-EE-LEVOMEF 3-0.02-0.451","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.38228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180089473","name":"DROSP-EE-LEVOMEF 3-0.02-0.451","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-894-73","proprietary_name":"drospirenone, ethinyl estradiol and levomefolate calcium and levomefolate calcium","nonproprietary_name":"drospirenone, ethinyl estradiol and levomefolate calcium and levomefolate calcium","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-894-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":1.38228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781410315","name":"DROSP-EE-LEVOMEF 3-0.03-0.451","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-4103-15","proprietary_name":"Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium","nonproprietary_name":"Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sandoz Inc","package_description":"3 BLISTER PACK in 1 PACKAGE (0781-4103-15) / 1 KIT in 1 BLISTER PACK (0781-4103-52)"},"nadac":{"value":2.95972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781410352","name":"DROSP-EE-LEVOMEF 3-0.03-0.451","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":2.95972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722093431","name":"DROSPIRENONE-EE 3-0.02 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-934-31","proprietary_name":"Drospirenone and ethinyl estradiol","nonproprietary_name":"Drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (31722-934-31) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"31722093432","name":"DROSPIRENONE-EE 3-0.02 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-934-32","proprietary_name":"Drospirenone and ethinyl estradiol","nonproprietary_name":"Drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Camber Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (31722-934-32) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"68462072029","name":"DROSPIRENONE-EE 3-0.02 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-720-29","proprietary_name":"drospirenone and ethinyl estradiol","nonproprietary_name":"drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-720-29) / 1 KIT in 1 BLISTER PACK (68462-720-84)"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"68462072084","name":"DROSPIRENONE-EE 3-0.02 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"72603087501","name":"DROSPIRENONE-EE 3-0.02 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"72603087503","name":"DROSPIRENONE-EE 3-0.02 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-875-03","proprietary_name":"Drospirenone and Ethinyl Estradiol","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"NorthStar Rx LLC","package_description":"3 POUCH in 1 CARTON (72603-875-03) / 1 BLISTER PACK in 1 POUCH (72603-875-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"31722094528","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"31722094531","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-945-31","proprietary_name":"Drospirenone and Ethinyl Estradiol","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Camber Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (31722-945-31) / 1 KIT in 1 BLISTER PACK (31722-945-28)"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"31722094532","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-945-32","proprietary_name":"Drospirenone and Ethinyl Estradiol","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (31722-945-32) / 1 KIT in 1 BLISTER PACK (31722-945-28)"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"60505489702","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"60505489708","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4897-8","proprietary_name":"DROSPIRENONE AND ETHINYL ESTRADIOL","nonproprietary_name":"DROSPIRENONE AND ETHINYL ESTRADIOL","dosage_form":"KIT","route":null,"strength":null,"labeler":"Apotex Corp.","package_description":"3 BLISTER PACK in 1 POUCH (60505-4897-8) / 1 KIT in 1 BLISTER PACK (60505-4897-2) * 7 TABLET in 1 BLISTER PACK * 21 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"68180086871","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"68180086873","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-868-73","proprietary_name":"DROSPIRENONE AND ETHINYL ESTRADIOL","nonproprietary_name":"DROSPIRENONE AND ETHINYL ESTRADIOL","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-868-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK * 7 TABLET in 1 BLISTER PACK (68180-913-74) * 21 TABLET in 1 BLISTER PACK (68180-912-74)"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"68462073329","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-733-29","proprietary_name":"drospirenone and ethinyl estradiol","nonproprietary_name":"drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-733-29) / 1 KIT in 1 BLISTER PACK (68462-733-84)"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"68462073384","name":"DROSPIRENONE-EE 3-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Drospirenone-Ethinyl Estradiol|Ethinyl Estradiol/Drospirenone","basis":"generic"},"part_b":null}, {"ndc":"00904739289","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7392-89","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"90 CAPSULE in 1 BOTTLE (0904-7392-89)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"31722001490","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-014-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-014-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"50228042990","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-429-90","proprietary_name":"Droxidopa","nonproprietary_name":"droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-429-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"67877070490","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-704-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-704-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"70710138909","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1389-9","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (70710-1389-9)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"72205007290","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-072-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-072-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"82249055190","name":"DROXIDOPA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-551-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"CivicaScript LLC","package_description":"90 CAPSULE in 1 BOTTLE (82249-551-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.47244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"00904739389","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7393-89","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"90 CAPSULE in 1 BOTTLE (0904-7393-89)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"31722001590","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-015-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-015-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"50228043090","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-430-90","proprietary_name":"Droxidopa","nonproprietary_name":"droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-430-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"67877070590","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-705-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-705-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"70710139009","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1390-9","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (70710-1390-9)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"72205007390","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-073-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-073-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"82249055290","name":"DROXIDOPA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-552-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"CivicaScript LLC","package_description":"90 CAPSULE in 1 BOTTLE (82249-552-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":0.9008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"00904739489","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7394-89","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"90 CAPSULE in 1 BOTTLE (0904-7394-89)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"31722001090","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-010-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-010-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"50228043190","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-431-90","proprietary_name":"Droxidopa","nonproprietary_name":"droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-431-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"67877070690","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-706-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-706-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"70710139109","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1391-9","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (70710-1391-9)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"72205007490","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-074-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-074-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"82249055490","name":"DROXIDOPA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-554-90","proprietary_name":"Droxidopa","nonproprietary_name":"Droxidopa","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"CivicaScript LLC","package_description":"90 CAPSULE in 1 BOTTLE (82249-554-90)","pharm_classes":["Catecholamines [CS]","Increased Blood Pressure [PE]"]},"nadac":{"value":1.84448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Droxidopa|Droxidopa","basis":"generic"},"part_b":null}, {"ndc":"70000050201","name":"DRY EYE RELIEF EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0502-1","proprietary_name":"Leader Dry Eye Relief Eye Drops","nonproprietary_name":"Glycerin, Hypromellose, Polyethylene glycol 400","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".2 g/100mL; .2 g/100mL; 1 g/100mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0502-1) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.16867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000062201","name":"DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0622-1","proprietary_name":"Acetaminophen and Ibuprofen","nonproprietary_name":"Acetaminophen and Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"18 TABLET in 1 BOTTLE (70000-0622-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000073701","name":"DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0737-1","proprietary_name":"Leader Dual Action Pain Reliever","nonproprietary_name":"Acetaminophen, Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0737-1) / 18 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008112312","name":"DUAVEE 0.45-20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1123-12","proprietary_name":"Duavee","nonproprietary_name":"conjugated estrogens/bazedoxifene","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".45 mg/1; 20 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 POUCH in 1 CARTON (0008-1123-12) / 2 BLISTER PACK in 1 POUCH / 15 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":6.47948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duavee|Estrogens,Conj/Bazedoxifene","basis":"brand"},"part_b":null}, {"ndc":"78206012701","name":"DULERA 100 MCG-5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-127-01","proprietary_name":"Dulera","nonproprietary_name":"mometasone furoate and formoterol fumarate dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 5 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-127-01) / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.19157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dulera|Mometasone/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"78206012702","name":"DULERA 100 MCG-5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-127-02","proprietary_name":"Dulera","nonproprietary_name":"mometasone furoate and formoterol fumarate dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 5 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-127-02) / 60 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.24577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dulera|Mometasone/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"78206012601","name":"DULERA 200 MCG-5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-126-01","proprietary_name":"Dulera","nonproprietary_name":"mometasone furoate and formoterol fumarate dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 5 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-126-01) / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.18275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dulera|Mometasone/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"78206012602","name":"DULERA 200 MCG-5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-126-02","proprietary_name":"Dulera","nonproprietary_name":"mometasone furoate and formoterol fumarate dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 5 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-126-02) / 60 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.26136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dulera|Mometasone/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"78206012501","name":"DULERA 50 MCG-5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-125-01","proprietary_name":"Dulera","nonproprietary_name":"mometasone furoate and formoterol fumarate dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 5 ug/1","labeler":"Organon LLC","package_description":"1 CANISTER in 1 CARTON (78206-125-01) / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.19279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dulera|Mometasone/Formoterol","basis":"brand"},"part_b":null}, {"ndc":"00228289006","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2890-06","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0228-2890-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009706","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-097-06","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-097-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009710","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-097-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-097-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722016860","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-168-60","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-168-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547037906","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-379-06","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-379-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547037909","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-379-09","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-379-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991074605","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-746-05","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-746-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991074690","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-746-90","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-746-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237001760","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877026360","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-263-60","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-263-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001059406","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-594-06","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-594-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029407","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-294-07","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-294-07)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009002905","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-029-05","proprietary_name":"Duloxetine","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health, LLC","package_description":"500 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (82009-029-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009017010","name":"DULOXETINE HCL DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-170-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-170-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228289103","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2891-03","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0228-2891-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228289150","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2891-50","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0228-2891-50)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009803","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-098-03","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-098-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009809","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-098-09","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-098-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009810","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-098-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-098-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722016930","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-169-30","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-169-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547038003","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-380-03","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-380-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547038009","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-380-09","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-380-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547038011","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-380-11","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-380-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991074710","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-747-10","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-747-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991074790","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-747-90","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-747-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237001830","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237001890","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237001899","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877026410","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-264-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-264-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877026430","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-264-30","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-264-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877026490","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-264-90","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-264-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001059504","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-595-04","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-595-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001059505","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-595-05","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-595-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001059508","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-595-08","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-595-08)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029503","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-295-03","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-295-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029506","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-295-06","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-295-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029509","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-295-09","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-295-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009003010","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-030-10","proprietary_name":"Duloxetine","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Quallent Pharmaceuticals Health, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (82009-030-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009017110","name":"DULOXETINE HCL DR 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-171-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-171-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241016430","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-164-30","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-164-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991075033","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-750-33","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-750-33)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991075090","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-750-90","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-750-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001057004","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-570-04","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-570-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029706","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-297-06","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-297-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009003130","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009003190","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-031-90","proprietary_name":"Duloxetine","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health, LLC","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (82009-031-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009017230","name":"DULOXETINE HCL DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-172-30","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-172-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.24391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228289203","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2892-03","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0228-2892-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228289296","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2892-96","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (0228-2892-96)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009903","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-099-03","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-099-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241009990","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-099-90","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (27241-099-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722017030","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-170-30","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-170-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547038103","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-381-03","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-381-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547038109","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-381-09","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-381-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547038111","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-381-11","proprietary_name":"DULOXETINE","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-381-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991074810","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-748-10","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-748-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991074890","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-748-90","proprietary_name":"Duloxetine Delayed-Release","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (51991-748-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237001930","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237001990","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237001999","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877026510","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-265-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-265-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877026530","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-265-30","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-265-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877026590","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-265-90","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-265-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001059604","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-596-04","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-596-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001059608","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-596-08","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-596-08)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029603","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-296-03","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-296-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029606","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-296-06","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-296-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180029609","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-296-09","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68180-296-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009003210","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-032-10","proprietary_name":"Duloxetine","nonproprietary_name":"DULOXETINE HYDROCHLORIDE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"60 mg/1","labeler":"Quallent Pharmaceuticals Health, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (82009-032-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009017310","name":"DULOXETINE HCL DR 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-173-10","proprietary_name":"Duloxetine","nonproprietary_name":"Duloxetine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-173-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.13493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Duloxetine HCl|Duloxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00024591902","name":"DUPIXENT 200 MG/1.14 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5919-02","proprietary_name":"Dupixent","nonproprietary_name":"Dupilumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 mg/1.14mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE, GLASS in 1 CARTON (0024-5919-02) / 1.14 mL in 1 SYRINGE, GLASS (0024-5919-00)","pharm_classes":["Antibodies, Monoclonal [CS]","Interleukin 4 Receptor alpha Antagonists [MoA]","Interleukin-4 Receptor alpha Antagonist [EPC]"]},"nadac":{"value":1778.85887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024591801","name":"DUPIXENT 200 MG/1.14 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5918-01","proprietary_name":"Dupixent","nonproprietary_name":"Dupilumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 mg/1.14mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE, GLASS in 1 CARTON (0024-5918-01) / 1.14 mL in 1 SYRINGE, GLASS (0024-5918-00)","pharm_classes":["Antibodies, Monoclonal [CS]","Interleukin 4 Receptor alpha Antagonists [MoA]","Interleukin-4 Receptor alpha Antagonist [EPC]"]},"nadac":{"value":1773.73509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024591502","name":"DUPIXENT 300 MG/2 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5915-02","proprietary_name":"Dupixent","nonproprietary_name":"Dupilumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"300 mg/2mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE, GLASS in 1 CARTON (0024-5915-02) / 2 mL in 1 SYRINGE, GLASS (0024-5915-00)","pharm_classes":["Antibodies, Monoclonal [CS]","Interleukin 4 Receptor alpha Antagonists [MoA]","Interleukin-4 Receptor alpha Antagonist [EPC]"]},"nadac":{"value":1009.5592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024591401","name":"DUPIXENT 300 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5914-01","proprietary_name":"Dupixent","nonproprietary_name":"Dupilumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"300 mg/2mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE, GLASS in 1 CARTON (0024-5914-01) / 2 mL in 1 SYRINGE, GLASS (0024-5914-00)","pharm_classes":["Antibodies, Monoclonal [CS]","Interleukin 4 Receptor alpha Antagonists [MoA]","Interleukin-4 Receptor alpha Antagonist [EPC]"]},"nadac":{"value":1010.59551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50991053501","name":"DURAFLU 325-20-200-60 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50991-535-01","proprietary_name":"Duraflu","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HBr, GUAIFENESIN, PSEUDOEPHEDRINE HCl","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1; 325 mg/1; 20 mg/1; 200 mg/1","labeler":"Poly Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50991-535-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.90411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66758008675","name":"DUREZOL 0.05% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-086-75","proprietary_name":"DUREZOL","nonproprietary_name":"difluprednate","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (66758-086-75) / 5 mL in 1 BOTTLE"},"nadac":{"value":42.24913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":9.68661,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Durezol|Difluprednate","basis":"brand"},"part_b":null}, {"ndc":"31722013130","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-131-30","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (31722-131-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"31722013190","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-131-90","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, LIQUID FILLED in 1 BOTTLE (31722-131-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"42806054909","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-549-09","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 CAPSULE, LIQUID FILLED in 1 BOTTLE (42806-549-09)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"42806054930","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-549-30","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 mg/1","labeler":"Epic Pharma, LLC","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (42806-549-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"59651002130","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-021-30","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (59651-021-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"59651002190","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-021-90","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, LIQUID FILLED in 1 BOTTLE (59651-021-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"65162075009","name":"DUTASTERIDE 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-750-09","proprietary_name":"Dutasteride","nonproprietary_name":"Dutasteride","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-750-09)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.15702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride|Dutasteride","basis":"generic"},"part_b":null}, {"ndc":"10370028009","name":"DUTASTERIDE-TAMSULOSIN 0.5-0.4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"10370028011","name":"DUTASTERIDE-TAMSULOSIN 0.5-0.4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651006330","name":"DUTASTERIDE-TAMSULOSIN 0.5-0.4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-063-30","proprietary_name":"Dutasteride and Tamsulosin Hydrochloride","nonproprietary_name":"Dutasteride and Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1; .4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-063-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]","Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651006390","name":"DUTASTERIDE-TAMSULOSIN 0.5-0.4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-063-90","proprietary_name":"Dutasteride and Tamsulosin Hydrochloride","nonproprietary_name":"Dutasteride and Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1; .4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (59651-063-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]","Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382064006","name":"DUTASTERIDE-TAMSULOSIN 0.5-0.4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-640-06","proprietary_name":"Dutasteride and tamsulosin hydrochloride","nonproprietary_name":"Dutasteride and tamsulosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1; .4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68382-640-06)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]","Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382064016","name":"DUTASTERIDE-TAMSULOSIN 0.5-0.4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-640-16","proprietary_name":"Dutasteride and tamsulosin hydrochloride","nonproprietary_name":"Dutasteride and tamsulosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1; .4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68382-640-16)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]","Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Dutasteride-Tamsulosin|Dutasteride/Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24478010801","name":"DYANAVEL XR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-108-01","proprietary_name":"DYANAVEL XR","nonproprietary_name":"amphetamine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (24478-108-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.77832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24478010901","name":"DYANAVEL XR 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-109-01","proprietary_name":"DYANAVEL XR","nonproprietary_name":"amphetamine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (24478-109-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.80648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24478010201","name":"DYANAVEL XR 2.5 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-102-01","proprietary_name":"Dyanavel XR","nonproprietary_name":"amphetamine","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (24478-102-01) / 464 mL in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.76739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24478010202","name":"DYANAVEL XR 2.5 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-102-02","proprietary_name":"Dyanavel XR","nonproprietary_name":"amphetamine","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (24478-102-02) / 60 mL in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.75749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24478011001","name":"DYANAVEL XR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-110-01","proprietary_name":"DYANAVEL XR","nonproprietary_name":"amphetamine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (24478-110-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":14.78945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24478010601","name":"DYANAVEL XR 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-106-01","proprietary_name":"DYANAVEL XR","nonproprietary_name":"amphetamine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (24478-106-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":7.8534,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00037024523","name":"DYMISTA NASAL SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-0245-23","proprietary_name":"DYMISTA","nonproprietary_name":"Azelastine Hydrochloride and Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"137 ug/1; 50 ug/1","labeler":"Viatris Specialty LLC","package_description":"1 BOTTLE, SPRAY in 1 BOX (0037-0245-23) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":9.13987,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":2.021,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Dymista|Azelastine/Fluticasone","basis":"brand"},"part_b":null}, {"ndc":"00116102104","name":"DYNA-HEX 2% SOLUTION","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-1021-04","proprietary_name":"DYNA-HEX 2","nonproprietary_name":"Chlorhexidine Gluconate","dosage_form":"LIQUID","route":"TOPICAL","strength":"2 g/100mL","labeler":"Xttrium Laboratories, Inc.","package_description":"118 mL in 1 BOTTLE, PLASTIC (0116-1021-04)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116106104","name":"DYNA-HEX 4% LIQUID","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-1061-04","proprietary_name":"ANTISEPTIC SKIN CLEANSER","nonproprietary_name":"Chlorhexidine Gluconate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"4 g/100mL","labeler":"Xttrium Laboratories, Inc.","package_description":"118 mL in 1 BOTTLE, PLASTIC (0116-1061-04)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.03992,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116106108","name":"DYNA-HEX 4% LIQUID","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-1061-08","proprietary_name":"ANTISEPTIC SKIN CLEANSER","nonproprietary_name":"CHLORHEXIDINE GLUCONATE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"4 g/100mL","labeler":"Xttrium Laboratories, Inc.","package_description":"237 mL in 1 BOTTLE, PLASTIC (0116-1061-08)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.03664,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116106116","name":"DYNA-HEX 4% LIQUID","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-1061-16","proprietary_name":"ANTISEPTIC SKIN CLEANSER","nonproprietary_name":"CHLORHEXIDINE GLUCONATE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"4 g/100mL","labeler":"Xttrium Laboratories, Inc.","package_description":"437 mL in 1 BOTTLE, PLASTIC (0116-1061-16)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.02199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.01776,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116106140","name":"DYNA-HEX 4% LIQUID","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-1061-40","proprietary_name":"ANTISEPTIC SKIN CLEANSER","nonproprietary_name":"CHLORHEXIDINE GLUCONATE","dosage_form":"SOLUTION","route":"TOPICAL","strength":"4 g/100mL","labeler":"Xttrium Laboratories, Inc.","package_description":"118 mL in 1 BOTTLE (0116-1061-40)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.03992,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000047801","name":"EAR DROPS FOR SWIMMERS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0478-1","proprietary_name":"LEADER Ear Drops for Swimmers","nonproprietary_name":"LEADER Ear Drops for Swimmers","dosage_form":"LIQUID","route":"AURICULAR (OTIC)","strength":"950 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"30 mL in 1 CONTAINER (70000-0478-1)"},"nadac":{"value":0.08353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904747835","name":"EAR WAX REMOVAL 6.5% DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7478-35","proprietary_name":"Major Earwax Removal Drops Earwax Removal Aid","nonproprietary_name":"CARBAMIDE PEROXIDE","dosage_form":"SOLUTION/ DROPS","route":"TOPICAL","strength":"65 mg/mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 BOX (0904-7478-35) / 15 mL in 1 BOTTLE"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11527014351","name":"EAR WAX REMOVAL 6.5% DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-143-51","proprietary_name":"Ear Wax Removal Drops","nonproprietary_name":"Carbamide Peroxide - 6.5%","dosage_form":"SOLUTION/ DROPS","route":"TOPICAL","strength":"65 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11527-143-51) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122055705","name":"EAR WAX REMOVAL 6.5% DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-557-05","proprietary_name":"Good Neighbor Pharmacy Earwax Removal Drops","nonproprietary_name":"CARBAMIDE PEROXIDE","dosage_form":"LIQUID","route":"TOPICAL","strength":"65 mg/mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, DISPENSING in 1 CARTON (46122-557-05) / 15 mL in 1 BOTTLE, DISPENSING"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000068801","name":"EAR WAX REMOVAL 6.5% DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0688-1","proprietary_name":"Leader Earwax Removal Drops Earwax Removal Aid","nonproprietary_name":"CARBAMIDE PEROXIDE","dosage_form":"SOLUTION/ DROPS","route":"TOPICAL","strength":"65 mg/mL","labeler":"Cardinal Health, Inc.","package_description":"1 BOTTLE in 1 BOX (70000-0688-1) / 15 mL in 1 BOTTLE"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122055605","name":"EAR WAX REMOVAL 6.5% KIT","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-556-05","proprietary_name":"Good Neighbor Pharmacy Earwax Removal","nonproprietary_name":"CARBAMIDE PEROXIDE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Amerisource Bergen","package_description":"1 KIT in 1 KIT (46122-556-05) * 1 BOTTLE, DISPENSING in 1 CARTON / 15 mL in 1 BOTTLE, DISPENSING"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002777201","name":"EBGLYSS 250 MG/2 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1783.52375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ebglyss Pen|Lebrikizumab-Lbkz","basis":"brand"},"part_b":null}, {"ndc":"00002777211","name":"EBGLYSS 250 MG/2 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7772-11","proprietary_name":"EBGLYSS","nonproprietary_name":"lebrikizumab-lbkz","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 mg/2mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-7772-11) / 2 mL in 1 SYRINGE (0002-7772-01)","pharm_classes":["Interleukin-13 Antagonist [EPC]","Interleukin-13 Antagonists [MoA]"]},"nadac":{"value":1783.52375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ebglyss Pen|Lebrikizumab-Lbkz","basis":"brand"},"part_b":null}, {"ndc":"45802046611","name":"ECONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-466-11","proprietary_name":"Econazole Nitrate","nonproprietary_name":"Econazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-466-11) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.35094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Econazole Nitrate|Econazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"45802046635","name":"ECONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-466-35","proprietary_name":"Econazole Nitrate","nonproprietary_name":"Econazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-466-35) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.39726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Econazole Nitrate|Econazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"45802046653","name":"ECONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-466-53","proprietary_name":"Econazole Nitrate","nonproprietary_name":"Econazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-466-53) / 85 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.21159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Econazole Nitrate|Econazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"51672130301","name":"ECONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1303-1","proprietary_name":"Econazole Nitrate","nonproprietary_name":"Econazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1303-1) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.39726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Econazole Nitrate|Econazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"51672130302","name":"ECONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1303-2","proprietary_name":"Econazole Nitrate","nonproprietary_name":"Econazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1303-2) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.35094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Econazole Nitrate|Econazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"51672130308","name":"ECONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1303-8","proprietary_name":"Econazole Nitrate","nonproprietary_name":"Econazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1303-8) / 85 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.21159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Econazole Nitrate|Econazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"50102021101","name":"ECONTRA ONE-STEP 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50102021111","name":"ECONTRA ONE-STEP 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50102021113","name":"ECONTRA ONE-STEP 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-211-13","proprietary_name":"EContra One-Step","nonproprietary_name":"Levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Afaxys Pharma, LLC","package_description":"3 CARTON in 1 PACKAGE (50102-211-13) / 1 BLISTER PACK in 1 CARTON (50102-211-11) / 1 TABLET in 1 BLISTER PACK (50102-211-01)","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50102021116","name":"ECONTRA ONE-STEP 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00485024001","name":"ED A-HIST DM TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0240-01","proprietary_name":"ED-A-HIST DM","nonproprietary_name":"CHLORPHENIRAMINE MALEATE, DEXTROMETHORPHAN HYDROBROMIDE, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"4 mg/1; 10 mg/1; 10 mg/1","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (0485-0240-01)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.43527,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00485025401","name":"ED-A-HIST 4 MG-10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0485-0254-01","proprietary_name":"ED A-HIST","nonproprietary_name":"CHLORPHENIRAMINE MALEATE and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"4 mg/1; 10 mg/1","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (0485-0254-01)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00485017116","name":"ED-A-HIST DM LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0171-16","proprietary_name":"ED A-HIST DM","nonproprietary_name":"DEXTROMETHORPHAN HYDROBROMIDE, CHLORPHENIRAMINE MALEATE, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"15 mg/5mL; 4 mg/5mL; 10 mg/5mL","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"473 mL in 1 BOTTLE, PLASTIC (0485-0171-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00485008201","name":"ED-SPAZ 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60631004030","name":"EDARBI 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60631-040-30","proprietary_name":"Edarbi","nonproprietary_name":"Azilsartan kamedoxomil","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (60631-040-30)","pharm_classes":["Angiotensin 2 Receptor Blocker [EPC]","Angiotensin 2 Type 1 Receptor Antagonists [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":8.28484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.46667,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edarbi|Azilsartan Medoxomil","basis":"brand"},"part_b":null}, {"ndc":"60631008030","name":"EDARBI 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60631-080-30","proprietary_name":"Edarbi","nonproprietary_name":"Azilsartan kamedoxomil","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (60631-080-30)","pharm_classes":["Angiotensin 2 Receptor Blocker [EPC]","Angiotensin 2 Type 1 Receptor Antagonists [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":9.00912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.81043,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edarbi|Azilsartan Medoxomil","basis":"brand"},"part_b":null}, {"ndc":"60631041230","name":"EDARBYCLOR 40-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60631-412-30","proprietary_name":"Edarbyclor","nonproprietary_name":"Azilsartan kamedoxomil and chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Azurity Pharmaceuticals, Inc. (formerly Arbor Pharmaceuticals)","package_description":"30 TABLET in 1 BOTTLE (60631-412-30)","pharm_classes":["Angiotensin 2 Receptor Blocker [EPC]","Angiotensin 2 Type 1 Receptor Antagonists [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":8.49444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edarbyclor|Azilsartan Med/Chlorthalidone","basis":"brand"},"part_b":null}, {"ndc":"60631042530","name":"EDARBYCLOR 40-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60631-425-30","proprietary_name":"Edarbyclor","nonproprietary_name":"Azilsartan kamedoxomil and chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Azurity Pharmaceuticals, Inc. (formerly Arbor Pharmaceuticals)","package_description":"30 TABLET in 1 BOTTLE (60631-425-30)","pharm_classes":["Angiotensin 2 Receptor Blocker [EPC]","Angiotensin 2 Type 1 Receptor Antagonists [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":8.49019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edarbyclor|Azilsartan Med/Chlorthalidone","basis":"brand"},"part_b":null}, {"ndc":"52244001002","name":"EDEX 10 MCG CARTRIDGE 2-PK KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52244-010-02","proprietary_name":"Edex","nonproprietary_name":"alprostadil","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRACAVERNOUS","strength":"10 ug/mL","labeler":"Endo USA, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (52244-010-02) / 1 CARTRIDGE in 1 BLISTER PACK / 1 mL in 1 CARTRIDGE","pharm_classes":["Genitourinary Arterial Vasodilation [PE]","Prostaglandin Analog [EPC]","Prostaglandin E1 Agonist [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]","Venous Vasodilation [PE]"]},"nadac":{"value":182.91666,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52244002002","name":"EDEX 20 MCG CARTRIDGE 2-PK KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52244-020-02","proprietary_name":"Edex","nonproprietary_name":"alprostadil","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRACAVERNOUS","strength":"20 ug/mL","labeler":"Endo USA, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (52244-020-02) / 1 CARTRIDGE in 1 BLISTER PACK / 1 mL in 1 CARTRIDGE","pharm_classes":["Genitourinary Arterial Vasodilation [PE]","Prostaglandin Analog [EPC]","Prostaglandin E1 Agonist [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]","Venous Vasodilation [PE]"]},"nadac":{"value":237.372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00037601035","name":"EDLUAR 10 MG SL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.48392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edluar|Zolpidem Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00037601093","name":"EDLUAR 10 MG SL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-6010-93","proprietary_name":"Edluar","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Viatris Specialty LLC","package_description":"5 BLISTER PACK in 1 CARTON (0037-6010-93) / 6 TABLET in 1 BLISTER PACK (0037-6010-35)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":15.48392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edluar|Zolpidem Tartrate","basis":"brand"},"part_b":null}, {"ndc":"59676027801","name":"EDURANT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-278-01","proprietary_name":"EDURANT","nonproprietary_name":"rilpivirine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Janssen Products, LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59676-278-01)","pharm_classes":["Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":48.04095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Edurant|Rilpivirine HCl","basis":"brand"},"part_b":null}, {"ndc":"31722050430","name":"EFAVIRENZ 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-504-30","proprietary_name":"Efavirenz","nonproprietary_name":"Efavirenz","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-504-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.27584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Efavirenz|Efavirenz","basis":"generic"},"part_b":null}, {"ndc":"42543088904","name":"EFAVIRENZ 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.27584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Efavirenz|Efavirenz","basis":"generic"},"part_b":null}, {"ndc":"65862004930","name":"EFAVIRENZ 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-049-30","proprietary_name":"Efavirenz","nonproprietary_name":"Efavirenz","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-049-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.27584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Efavirenz|Efavirenz","basis":"generic"},"part_b":null}, {"ndc":"69097030102","name":"EFAVIRENZ 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-301-02","proprietary_name":"Efavirenz","nonproprietary_name":"Efavirenz","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-301-02)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.27584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Efavirenz|Efavirenz","basis":"generic"},"part_b":null}, {"ndc":"00093523456","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5234-56","proprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 200 mg/1; 300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5234-56)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722073630","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-736-30","proprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 200 mg/1; 300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-736-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342013807","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-138-07","proprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 200 mg/1; 300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-138-07)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42385091530","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-915-30","proprietary_name":"Efavirenz, emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"Efavirenz, emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 200 mg/1; 300 mg/1","labeler":"Laurus Labs Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42385-915-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862049730","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-497-30","proprietary_name":"Efavirenz, Emtricitabine And Tenofovir Disoproxil Fumarate","nonproprietary_name":"Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 200 mg/1; 300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-497-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097021002","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-210-02","proprietary_name":"efavirenz, emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"efavirenz, emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 200 mg/1; 300 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-210-02)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282067830","name":"EFAVIRENZ-EMTRICITABINE-TENOFOV DISOP FUM 600-200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.12492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51801001330","name":"EFFER-K 10 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-013-30","proprietary_name":"Effer-K 10 mEq Unflavored","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"391 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-013-30) / 1 TABLET, EFFERVESCENT in 1 POUCH","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.4545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801001430","name":"EFFER-K 10 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-014-30","proprietary_name":"Effer-K 10 mEq Cherry Vanilla","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"391 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-014-30) / 1 TABLET, EFFERVESCENT in 1 POUCH","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.4545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801001130","name":"EFFER-K 20 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-011-30","proprietary_name":"Effer-K 20 mEq Unflavored","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"782 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-011-30) / 1 TABLET, EFFERVESCENT in 1 POUCH","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801001230","name":"EFFER-K 20 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-012-30","proprietary_name":"Effer-K 20 mEq Orange Cream","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"782 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-012-30) / 1 TABLET, EFFERVESCENT in 1 POUCH","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000101","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.35667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000130","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-001-30","proprietary_name":"Effer-K Orange","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"977.5 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-001-30) / 1 TABLET, EFFERVESCENT in 1 POUCH"},"nadac":{"value":0.35667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000140","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-001-40","proprietary_name":"Effer-K Orange","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"977.5 mg/1","labeler":"Nomax Inc.","package_description":"100 POUCH in 1 CARTON (51801-001-40) / 1 TABLET, EFFERVESCENT in 1 POUCH"},"nadac":{"value":0.35667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000501","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.85942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000530","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-005-30","proprietary_name":"Effer-K Lemon Citrus","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"977.5 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-005-30) / 1 TABLET, EFFERVESCENT in 1 POUCH"},"nadac":{"value":0.35667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000601","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.85942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000630","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-006-30","proprietary_name":"Effer-K Cherry Berry","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"977.5 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-006-30) / 1 TABLET, EFFERVESCENT in 1 POUCH"},"nadac":{"value":0.35667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000701","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.85942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"51801000730","name":"EFFER-K 25 MEQ TABLET EFF","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51801-007-30","proprietary_name":"Effer-K Unflavored","nonproprietary_name":"POTASSIUM BICARBONATE","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"977.5 mg/1","labeler":"Nomax Inc.","package_description":"30 POUCH in 1 CARTON (51801-007-30) / 1 TABLET, EFFERVESCENT in 1 POUCH"},"nadac":{"value":0.35667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effer-K|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"58151012777","name":"EFFEXOR XR 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-127-77","proprietary_name":"Effexor XR","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (58151-127-77)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":21.62193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effexor XR|Venlafaxine HCl","basis":"brand"},"part_b":null}, {"ndc":"58151012793","name":"EFFEXOR XR 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-127-93","proprietary_name":"Effexor XR","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (58151-127-93)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":21.62193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effexor XR|Venlafaxine HCl","basis":"brand"},"part_b":null}, {"ndc":"58151012577","name":"EFFEXOR XR 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-125-77","proprietary_name":"Effexor XR","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (58151-125-77)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":17.70418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effexor XR|Venlafaxine HCl","basis":"brand"},"part_b":null}, {"ndc":"58151012593","name":"EFFEXOR XR 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-125-93","proprietary_name":"Effexor XR","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (58151-125-93)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":17.70418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effexor XR|Venlafaxine HCl","basis":"brand"},"part_b":null}, {"ndc":"58151012677","name":"EFFEXOR XR 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-126-77","proprietary_name":"Effexor XR","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (58151-126-77)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":19.81997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effexor XR|Venlafaxine HCl","basis":"brand"},"part_b":null}, {"ndc":"58151012693","name":"EFFEXOR XR 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-126-93","proprietary_name":"Effexor XR","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (58151-126-93)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":19.81997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Effexor XR|Venlafaxine HCl","basis":"brand"},"part_b":null}, {"ndc":"00037480170","name":"ELESTRIN 0.06% GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-4801-70","proprietary_name":"ELESTRIN","nonproprietary_name":"ESTRADIOL","dosage_form":"GEL, METERED","route":"TOPICAL","strength":".52 mg/.87g","labeler":"Viatris Specialty LLC","package_description":"2 BOTTLE, PUMP in 1 CARTON (0037-4801-70) / 35 g in 1 BOTTLE, PUMP (0037-4801-35)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":3.60934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Elestrin|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093831018","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8310-18","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"Eletriptan Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0093-8310-18) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0093-8310-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00093831019","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378428732","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378428785","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4287-85","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0378-4287-85) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-4287-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"27241003968","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"31722044331","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-443-31","proprietary_name":"Eletriptan hydrobromide","nonproprietary_name":"Eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (31722-443-31) / 6 TABLET, FILM COATED in 1 BLISTER PACK (31722-443-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"59651010406","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"59651010469","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-104-69","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"Eletriptan Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (59651-104-69) / 6 TABLET, FILM COATED in 1 BLISTER PACK (59651-104-06)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"68382092286","name":"ELETRIPTAN HBR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-922-86","proprietary_name":"Eletriptan hydrobromide","nonproprietary_name":"Eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68382-922-86) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00093831118","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8311-18","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"Eletriptan Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0093-8311-18) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0093-8311-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00093831119","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378428808","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4288-08","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 BLISTER PACK in 1 CARTON (0378-4288-08) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-4288-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378428832","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"00378428885","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4288-85","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0378-4288-85) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-4288-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"27241004068","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"31722044431","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-444-31","proprietary_name":"Eletriptan hydrobromide","nonproprietary_name":"Eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (31722-444-31) / 6 TABLET, FILM COATED in 1 BLISTER PACK (31722-444-32)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"59651010506","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"59651010569","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-105-69","proprietary_name":"Eletriptan Hydrobromide","nonproprietary_name":"Eletriptan Hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (59651-105-69) / 6 TABLET, FILM COATED in 1 BLISTER PACK (59651-105-06)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"68382092386","name":"ELETRIPTAN HBR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-923-86","proprietary_name":"Eletriptan hydrobromide","nonproprietary_name":"Eletriptan hydrobromide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68382-923-86) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eletriptan HBr|Eletriptan Hydrobromide","basis":"generic"},"part_b":null}, {"ndc":"16714036501","name":"ELINEST-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-365-01","proprietary_name":"Elinest","nonproprietary_name":"Norgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-365-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Elinest|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714036504","name":"ELINEST-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-365-04","proprietary_name":"Elinest","nonproprietary_name":"Norgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-365-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Elinest|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00003089321","name":"ELIQUIS 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0893-21","proprietary_name":"ELIQUIS","nonproprietary_name":"apixaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0003-0893-21)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":5.51282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eliquis|Apixaban","basis":"brand"},"part_b":null}, {"ndc":"00003089331","name":"ELIQUIS 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0893-31","proprietary_name":"ELIQUIS","nonproprietary_name":"apixaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"10 BLISTER PACK in 1 CARTON (0003-0893-31) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":5.51282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eliquis|Apixaban","basis":"brand"},"part_b":null}, {"ndc":"00003089421","name":"ELIQUIS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0894-21","proprietary_name":"ELIQUIS","nonproprietary_name":"apixaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0003-0894-21)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":5.52114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eliquis|Apixaban","basis":"brand"},"part_b":null}, {"ndc":"00003089431","name":"ELIQUIS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0894-31","proprietary_name":"ELIQUIS","nonproprietary_name":"apixaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"10 BLISTER PACK in 1 CARTON (0003-0894-31) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":5.52114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eliquis|Apixaban","basis":"brand"},"part_b":null}, {"ndc":"00003089470","name":"ELIQUIS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0894-70","proprietary_name":"ELIQUIS","nonproprietary_name":"apixaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"74 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0003-0894-70)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":5.52114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eliquis|Apixaban","basis":"brand"},"part_b":null}, {"ndc":"00003376474","name":"ELIQUIS DVT-PE TREATMENT 30-DAY STARTER 5 MG PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-3764-74","proprietary_name":"ELIQUIS 30-Day Starter Pack","nonproprietary_name":"apixaban","dosage_form":"KIT","route":null,"strength":null,"labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 KIT in 1 CARTON (0003-3764-74) * 32 TABLET, COATED in 1 BLISTER PACK * 42 TABLET, COATED in 1 BLISTER PACK"},"nadac":{"value":5.50766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eliquis|Apixaban","basis":"brand"},"part_b":null}, {"ndc":"73302045601","name":"ELLA 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73302-456-01","proprietary_name":"Ella","nonproprietary_name":"ulipristal acetate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"PMI Branded Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (73302-456-01) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Agonist/Antagonist [EPC]","Selective Progesterone Receptor Modulators [MoA]"]},"nadac":{"value":37.09804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458009801","name":"ELMIRON 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-098-01","proprietary_name":"ELMIRON","nonproprietary_name":"PENTOSAN POLYSULFATE SODIUM","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"100 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (50458-098-01)","pharm_classes":["Glycosaminoglycan [EPC]","Glycosaminoglycans [CS]"]},"nadac":{"value":12.09644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Elmiron|Pentosan Polysulfate Sodium","basis":"brand"},"part_b":null}, {"ndc":"00054096413","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0964-13","proprietary_name":"Eltrombopag","nonproprietary_name":"Eltrombopag Olamine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0964-13)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722084330","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-843-30","proprietary_name":"ELTROMBOPAG","nonproprietary_name":"ELTROMBOPAG","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-843-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598073130","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-731-30","proprietary_name":"eltrombopag","nonproprietary_name":"eltrombopag","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.,","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-731-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219141503","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1415-3","proprietary_name":"Eltrombopag Olamine","nonproprietary_name":"Eltrombopag","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60219-1415-3)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069083901","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-839-01","proprietary_name":"Eltrombopag olamine","nonproprietary_name":"Eltrombopag olamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70069-839-01)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710139703","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1397-3","proprietary_name":"ELTROMBOPAG","nonproprietary_name":"eltrombopag","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1397-3)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205015830","name":"ELTROMBOPAG 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-158-30","proprietary_name":"eltrombopag","nonproprietary_name":"eltrombopag olamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-158-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Increased Megakaryocyte Maturation [PE]","Increased Platelet Production [PE]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Thrombopoietin Receptor Agonist [EPC]","Thrombopoietin Receptor Agonists [MoA]","UGT1A1 Inhibitors [MoA]","UGT1A3 Inhibitors [MoA]","UGT1A4 Inhibitors [MoA]","UGT1A6 Inhibitors [MoA]","UGT1A9 Inhibitors [MoA]","UGT2B15 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":25.849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162046932","name":"ELURYNG VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eluryng|Etonogestrel/Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162046935","name":"ELURYNG VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-469-35","proprietary_name":"EluRyng","nonproprietary_name":"Etonogestrel and Ethinyl Estradiol","dosage_form":"RING","route":"VAGINAL","strength":".12 mg/d; .015 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"3 POUCH in 1 CARTON (65162-469-35) / 21 d in 1 POUCH (65162-469-32)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eluryng|Etonogestrel/Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"69557033301","name":"ELYXYB 120 MG/4.8 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69557-333-01","proprietary_name":"ELYXYB - celecoxib","nonproprietary_name":"celecoxib","dosage_form":"LIQUID","route":"ORAL","strength":"120 mg/4.8mL","labeler":"SCILEX PHARMACEUTICALS INC.","package_description":"6 BOTTLE in 1 CARTON (69557-333-01) / 4.8 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":30.53807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Elyxyb|Celecoxib","basis":"brand"},"part_b":null}, {"ndc":"00006306601","name":"EMEND 125 MG POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":327.384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00006306603","name":"EMEND 125 MG POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-3066-03","proprietary_name":"EMEND","nonproprietary_name":"aprepitant","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"125 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1 POUCH in 1 CARTON (0006-3066-03) / 1 POWDER, FOR SUSPENSION in 1 POUCH (0006-3066-01)","pharm_classes":["Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Neurokinin 1 Antagonists [MoA]","Substance P/Neurokinin-1 Receptor Antagonist [EPC]"]},"nadac":{"value":327.384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8501","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8501 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0006-3066-03) / 1 POWDER, FOR SUSPENSION in 1 POUCH (0006-3066-01)) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00002143601","name":"EMGALITY 120 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":734.28328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002143611","name":"EMGALITY 120 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1436-11","proprietary_name":"EMGALITY","nonproprietary_name":"galcanezumab-gnlm","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"120 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-1436-11) / 1 mL in 1 SYRINGE (0002-1436-01)"},"nadac":{"value":734.28328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002237701","name":"EMGALITY 120 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":734.42083,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002237711","name":"EMGALITY 120 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2377-11","proprietary_name":"EMGALITY","nonproprietary_name":"galcanezumab-gnlm","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"120 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-2377-11) / 1 mL in 1 SYRINGE (0002-2377-01)"},"nadac":{"value":734.42083,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002311509","name":"EMGALITY 300 MG DOSE (100 MG/ML X 3 SYRINGES)","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3115-09","proprietary_name":"EMGALITY","nonproprietary_name":"galcanezumab-gnlm","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Eli Lilly and Company","package_description":"3 SYRINGE in 1 CARTON (0002-3115-09) / 1 mL in 1 SYRINGE (0002-3115-01)"},"nadac":{"value":612.51644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49502090201","name":"EMSAM 12 MG/24 HOURS PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":75.39812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emsam|Selegiline","basis":"brand"},"part_b":null}, {"ndc":"49502090230","name":"EMSAM 12 MG/24 HOURS PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49502-902-30","proprietary_name":"EMSAM","nonproprietary_name":"selegiline","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"12 mg/24h","labeler":"Viatris Specialty LLC","package_description":"30 POUCH in 1 CARTON (49502-902-30) / 1 PATCH in 1 POUCH (49502-902-01) / 24 h in 1 PATCH","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":75.39812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emsam|Selegiline","basis":"brand"},"part_b":null}, {"ndc":"49502090001","name":"EMSAM 6 MG/24 HOURS PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":74.99706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emsam|Selegiline","basis":"brand"},"part_b":null}, {"ndc":"49502090030","name":"EMSAM 6 MG/24 HOURS PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49502-900-30","proprietary_name":"EMSAM","nonproprietary_name":"selegiline","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"6 mg/24h","labeler":"Viatris Specialty LLC","package_description":"30 POUCH in 1 CARTON (49502-900-30) / 1 PATCH in 1 POUCH (49502-900-01) / 24 h in 1 PATCH","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":74.99706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emsam|Selegiline","basis":"brand"},"part_b":null}, {"ndc":"49502090101","name":"EMSAM 9 MG/24 HOURS PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":75.17807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emsam|Selegiline","basis":"brand"},"part_b":null}, {"ndc":"49502090130","name":"EMSAM 9 MG/24 HOURS PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49502-901-30","proprietary_name":"EMSAM","nonproprietary_name":"selegiline","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"9 mg/24h","labeler":"Viatris Specialty LLC","package_description":"30 POUCH in 1 CARTON (49502-901-30) / 1 PATCH in 1 POUCH (49502-901-01) / 24 h in 1 PATCH","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":75.17807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emsam|Selegiline","basis":"brand"},"part_b":null}, {"ndc":"65862030130","name":"EMTRICITABINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-301-30","proprietary_name":"Emtricitabine","nonproprietary_name":"Emtricitabine","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (65862-301-30)","pharm_classes":["Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":12.68669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emtricitabine|Emtricitabine","basis":"generic"},"part_b":null}, {"ndc":"69097064202","name":"EMTRICITABINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-642-02","proprietary_name":"emtricitabine","nonproprietary_name":"emtricitabine","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (69097-642-02)","pharm_classes":["Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":12.68669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emtricitabine|Emtricitabine","basis":"generic"},"part_b":null}, {"ndc":"00378544093","name":"EMTRICITABINE-RILPIVIRINE-TENOFOVIR DIS FUM 200-25-300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5440-93","proprietary_name":"Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 25 mg/1; 300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5440-93)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":114.503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42385080130","name":"EMTRICITABINE-RILPIVIRINE-TENOFOVIR DIS FUM 200-25-300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-801-30","proprietary_name":"emtricitabine, rilpivirine and tenofovir disoproxil fumarate","nonproprietary_name":"emtricitabine, rilpivirine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 25 mg/1; 300 mg/1","labeler":"Laurus Labs Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42385-801-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":114.503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651016530","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 100-150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-165-30","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-165-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":10.19448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238209203","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 100-150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69238-2092-3","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 150 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-2092-3)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":10.19448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710136403","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 100-150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1364-3","proprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1364-3)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":10.19448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093770456","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7704-56","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7704-56)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904717207","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7172-07","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7172-07) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714053401","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-534-01","proprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-534-01)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722056030","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-560-30","proprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-560-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342010607","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-106-07","proprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-106-07)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42385095330","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-953-30","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Laurus Labs Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42385-953-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862035430","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-354-30","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-354-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238209503","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2095-3","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-2095-3)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710136703","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1367-3","proprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","nonproprietary_name":"Emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1367-3)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009010930","name":"EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE 200-300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-109-30","proprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","nonproprietary_name":"Emtricitabine and Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82009-109-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61958060101","name":"EMTRIVA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61958-0601-1","proprietary_name":"Emtriva","nonproprietary_name":"EMTRICITABINE","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (61958-0601-1)","pharm_classes":["Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":17.44593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":12.68669,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emtriva|Emtricitabine","basis":"brand"},"part_b":null}, {"ndc":"64896066930","name":"EMVERM 100 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":712.46855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Emverm|Mebendazole","basis":"brand"},"part_b":null}, {"ndc":"59651013628","name":"EMZAHH 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-136-28","proprietary_name":"Emzahh","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (59651-136-28) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"59651013688","name":"EMZAHH 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-136-88","proprietary_name":"Emzahh","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (59651-136-88) / 1 TABLET in 1 POUCH","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"31722002015","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-020-15","proprietary_name":"Enalapril maleate oral solution","nonproprietary_name":"Enalapril maleate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-020-15) / 150 mL in 1 BOTTLE","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536040101","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-401-01","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52536-401-01) / 150 mL in 1 BOTTLE","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651052955","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-529-55","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-529-55) / 150 mL in 1 BOTTLE","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238172907","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1729-7","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1729-7) / 150 mL in 1 BOTTLE","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238214107","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452023746","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-237-46","proprietary_name":"Enalapril maleate oral solution","nonproprietary_name":"Enalapril maleate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Bionpharma Inc.","package_description":"1 BOTTLE in 1 CARTON (69452-237-46) / 150 mL in 1 BOTTLE","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603024701","name":"ENALAPRIL 1 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-247-01","proprietary_name":"Enalapril maleate oral solution","nonproprietary_name":"Enalapril maleate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-247-01) / 150 mL in 1 BOTTLE","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904731161","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7311-61","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7311-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"16714044401","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-444-01","proprietary_name":"Enalapril Maleate","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-444-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155077201","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-772-01","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-772-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155077210","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-772-10","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-772-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054710","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-547-10","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-547-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054711","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-547-11","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-547-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228023001","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-230-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-230-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228023010","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-230-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-230-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672424501","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4245-1","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4245-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672424503","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4245-3","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4245-3)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135059190","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-591-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-591-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068701","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-687-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-687-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068710","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-687-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-687-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"68645045690","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"68645060690","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-606-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-606-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054401","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-544-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-544-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054410","name":"ENALAPRIL MALEATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-544-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amici Pharma, Inc","package_description":"1000 TABLET in 1 BOTTLE (69292-544-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"00904730961","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7309-61","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7309-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155070401","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-704-01","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-704-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155070410","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-704-10","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-704-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054510","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-545-10","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-545-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054511","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-545-11","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-545-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228022801","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-228-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-228-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228022810","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-228-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-228-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672403701","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4037-1","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4037-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672403703","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4037-3","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4037-3)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135058990","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-589-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-589-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068501","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-685-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-685-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068510","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-685-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-685-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054001","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-540-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-540-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054010","name":"ENALAPRIL MALEATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-540-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Amici Pharma, Inc","package_description":"1000 TABLET in 1 BOTTLE (69292-540-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.06251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"00904731261","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7312-61","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7312-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"16714044501","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-445-01","proprietary_name":"Enalapril Maleate","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-445-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"16714044502","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-445-02","proprietary_name":"Enalapril Maleate","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Northstar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (16714-445-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155077301","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-773-01","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-773-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155077310","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-773-10","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-773-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054810","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-548-10","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-548-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054811","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-548-11","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-548-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228023101","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-231-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-231-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228023110","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-231-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-231-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672404001","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4040-1","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4040-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672404003","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4040-3","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4040-3)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135059290","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-592-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-592-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068801","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-688-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-688-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068810","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-688-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-688-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"68645045790","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"68645060790","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-607-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-607-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054601","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-546-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-546-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054610","name":"ENALAPRIL MALEATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-546-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amici Pharma, Inc","package_description":"1000 TABLET in 1 BOTTLE (69292-546-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.09526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"00904731061","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7310-61","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7310-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"16714044301","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-443-01","proprietary_name":"Enalapril Maleate","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-443-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155070501","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-705-01","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-705-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"23155070510","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-705-10","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-705-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054610","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-546-10","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-546-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"43547054611","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-546-11","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-546-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228022901","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-229-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-229-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"50228022910","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-229-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-229-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672403801","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4038-1","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4038-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672403803","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4038-3","proprietary_name":"Enalapril Maleate","nonproprietary_name":"Enalapril Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4038-3)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135059090","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-590-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-590-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068601","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-686-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-686-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"64980068610","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-686-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"ENALAPRIL MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-686-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"68645045590","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"68645060590","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-605-90","proprietary_name":"Enalapril maleate","nonproprietary_name":"Enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-605-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054201","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-542-01","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-542-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"69292054210","name":"ENALAPRIL MALEATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-542-10","proprietary_name":"ENALAPRIL MALEATE","nonproprietary_name":"enalapril maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amici Pharma, Inc","package_description":"1000 TABLET in 1 BOTTLE (69292-542-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":0.0724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril Maleate|Enalapril Maleate","basis":"generic"},"part_b":null}, {"ndc":"51672404601","name":"ENALAPRIL-HYDROCHLOROTHIAZIDE 10-25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4046-1","proprietary_name":"Enalapril Maleate and Hydrochlorothiazide","nonproprietary_name":"Enalapril Maleate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4046-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril-Hydrochlorothiazide|Enalapril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"51672404501","name":"ENALAPRIL-HYDROCHLOROTHIAZIDE 5-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4045-1","proprietary_name":"Enalapril Maleate and Hydrochlorothiazide","nonproprietary_name":"Enalapril Maleate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 12.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4045-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enalapril-Hydrochlorothiazide|Enalapril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"64661065030","name":"ENBRACE HR SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64661-650-30","proprietary_name":"EnBrace HR","nonproprietary_name":"LEVOMEFOLATE MAGNESIUM, LEUCOVORIN, FOLIC ACID, FERROUS CYSTEINE GLYCINATE, MAGNESIUM ASCORBATE, ZINC ASCORBATE, COCARBOXYLASE, FLAVIN ADENINE DINUCLEOTIDE, NADH, PYRIDOXAL PHOSPHATE ANHYDROUS, COBAMAMIDE, BETAINE, MAGNESIUM L-THREONATE, 1,2-DOCOSAHEXANOYL-SN-GLYCERO-3-PHOSPHOSERINE CALCIUM, 1,2-ICOSAPENTOYL-SN-GLYCERO-3-PHOSPHOSERINE CALCIUM, and PHOSPHATIDYL SERINE","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"5.23 mg/1; 2.5 mg/1; 1 mg/1; 13.6 mg/1; 24 mg/1; 1 mg/1; 25 ug/1; 25 ug/1; 25 ug/1; 25 ug/1; 50 ug/1; 500 ug/1; 1 mg/1; 6.4 mg/1; 800 ug/1; 12 mg/1","labeler":"Jaymac Pharmaceuticals, LLC","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (64661-650-30)","pharm_classes":["Ascorbic Acid [CS]","Folate Analog [EPC]","Folic Acid [CS]","Methylating Activity [MoA]","Methylating Agent [EPC]","Vitamin C [EPC]"]},"nadac":{"value":4.47914,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58406001004","name":"ENBREL 25 MG/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58406-010-04","proprietary_name":"ENBREL","nonproprietary_name":"etanercept","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"25 mg/.5mL","labeler":"Immunex Corporation","package_description":"4 SYRINGE in 1 CARTON (58406-010-04) / .5 mL in 1 SYRINGE (58406-010-01)","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":2084.14429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enbrel|Etanercept","basis":"brand"},"part_b":null}, {"ndc":"58406004404","name":"ENBREL 50 MG/ML MINI CARTRIDGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58406-044-04","proprietary_name":"ENBREL","nonproprietary_name":"etanercept","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"50 mg/mL","labeler":"Immunex Corporation","package_description":"4 CARTRIDGE in 1 CARTON (58406-044-04) / 1 mL in 1 CARTRIDGE (58406-044-01)","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":2080.995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enbrel Mini|Etanercept","basis":"brand"},"part_b":null}, {"ndc":"58406003204","name":"ENBREL 50 MG/ML SURECLICK","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58406-032-04","proprietary_name":"ENBREL","nonproprietary_name":"etanercept","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"50 mg/mL","labeler":"Immunex Corporation","package_description":"4 SYRINGE in 1 CARTON (58406-032-04) / 1 mL in 1 SYRINGE (58406-032-01)","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":2083.47839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enbrel Sureclick|Etanercept","basis":"brand"},"part_b":null}, {"ndc":"58406002104","name":"ENBREL 50 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58406-021-04","proprietary_name":"ENBREL","nonproprietary_name":"etanercept","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"50 mg/mL","labeler":"Immunex Corporation","package_description":"4 SYRINGE in 1 CARTON (58406-021-04) / 1 mL in 1 SYRINGE (58406-021-01)","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":2080.59222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enbrel|Etanercept","basis":"brand"},"part_b":null}, {"ndc":"68047014316","name":"ENDACOF-DM LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-143-16","proprietary_name":"EndaCof DM","nonproprietary_name":"Brompheniramine Maleate, Dextromethorphan Hydrobromide and Phenylephrine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/5mL; 5 mg/5mL; 2.5 mg/5mL","labeler":"Larken Laboratories, Inc.","package_description":"473 mL in 1 BOTTLE (68047-143-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05121,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60951071270","name":"ENDOCET 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60951-712-70","proprietary_name":"ENDOCET","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (60951-712-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"60951070170","name":"ENDOCET 2.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60951-701-70","proprietary_name":"ENDOCET","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 325 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60951-701-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.76157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"60951060270","name":"ENDOCET 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60951-602-70","proprietary_name":"ENDOCET","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (60951-602-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"60951060285","name":"ENDOCET 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60951-602-85","proprietary_name":"ENDOCET","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE (60951-602-85)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"60951070070","name":"ENDOCET 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60951-700-70","proprietary_name":"ENDOCET","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (60951-700-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"55566650001","name":"ENDOMETRIN 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.15184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endometrin|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"55566650002","name":"ENDOMETRIN 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.15184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endometrin|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"55566650003","name":"ENDOMETRIN 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55566-6500-3","proprietary_name":"ENDOMETRIN","nonproprietary_name":"Progesterone","dosage_form":"INSERT","route":"VAGINAL","strength":"100 mg/1","labeler":"Ferring Pharmaceuticals Inc.","package_description":"1 CARTON in 1 CARTON (55566-6500-3) / 21 BLISTER PACK in 1 CARTON (55566-6500-2) / 1 INSERT in 1 BLISTER PACK (55566-6500-1)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":15.15184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Endometrin|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"00904632078","name":"ENEMA READY TO USE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6320-78","proprietary_name":"Saline Laxative","nonproprietary_name":"Saline Laxative","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/133mL; 19 g/133mL","labeler":"Major Pharmaceuticals","package_description":"133 mL in 1 BOTTLE (0904-6320-78)"},"nadac":{"value":0.0067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"17433987603","name":"ENEMEEZ MINI ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17433-9876-3","proprietary_name":"ENEMEEZ","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"LIQUID","route":"RECTAL","strength":"283 mg/5mL","labeler":"Quest Products, LLC","package_description":"30 TUBE in 1 CONTAINER (17433-9876-3) / 5 mL in 1 TUBE (17433-9876-0)"},"nadac":{"value":0.36647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.46116,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"17433987605","name":"ENEMEEZ MINI ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17433-9876-5","proprietary_name":"ENEMEEZ","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"LIQUID","route":"RECTAL","strength":"283 mg/5mL","labeler":"Quest Products, LLC","package_description":"5 TUBE in 1 CONTAINER (17433-9876-5) / 5 mL in 1 TUBE (17433-9876-0)"},"nadac":{"value":0.40789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"17433987703","name":"ENEMEEZ PLUS MINI ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17433-9877-3","proprietary_name":"ENEMEEZ Plus","nonproprietary_name":"docusate sodium and benzocaine","dosage_form":"LIQUID","route":"RECTAL","strength":"20 mg/5mL; 283 mg/5mL","labeler":"Quest Products, LLC","package_description":"30 TUBE in 1 CONTAINER (17433-9877-3) / 5 mL in 1 TUBE (17433-9877-0)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Increased Histamine Release [PE]","Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.36838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700015611","name":"ENILLORING VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enilloring|Etonogestrel/Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700015691","name":"ENILLORING VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-156-91","proprietary_name":"EnilloRing","nonproprietary_name":"Etonogestrel and Ethinyl Estradiol Vaginal","dosage_form":"RING","route":"VAGINAL","strength":".015 mg/d; .12 mg/d","labeler":"Xiromed, LLC","package_description":"3 POUCH in 1 CARTON (70700-156-91) / 21 d in 1 POUCH (70700-156-11)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enilloring|Etonogestrel/Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"64661071130","name":"ENLYTE SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.90041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00548560500","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5605-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5605-00) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5605-00) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781326869","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3268-69","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3268-69) / 1 mL in 1 SYRINGE (0781-3268-05)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3268-69) / 1 mL in 1 SYRINGE (0781-3268-05)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955101010","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1010-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1010-10) / 1 SYRINGE in 1 CELLO PACK (0955-1010-01) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1010-10) / 1 SYRINGE in 1 CELLO PACK (0955-1010-01) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714004610","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-046-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-046-10) / 1 mL in 1 SYRINGE (16714-046-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-046-10) / 1 mL in 1 SYRINGE (16714-046-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041071","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-410-71","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-410-71) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-410-71) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323058665","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-586-65","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-586-65) / 1 SYRINGE in 1 BLISTER PACK (63323-586-63) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-586-65) / 1 SYRINGE in 1 BLISTER PACK (63323-586-63) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323058696","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-586-96","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-586-96) / 1 SYRINGE in 1 BLISTER PACK (63323-586-21) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-586-96) / 1 SYRINGE in 1 BLISTER PACK (63323-586-21) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323060584","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-605-84","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 CELLO PACK in 1 CARTON (63323-605-84) / 1 SYRINGE in 1 CELLO PACK (63323-605-01) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (63323-605-84) / 1 SYRINGE in 1 CELLO PACK (63323-605-01) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063742","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-637-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-637-42) / 1 mL in 1 SYRINGE (68001-637-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-637-42) / 1 mL in 1 SYRINGE (68001-637-43)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710176106","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1761-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1761-6) / 1 mL in 1 SYRINGE (70710-1761-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":null}, {"ndc":"71288043689","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-436-89","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-436-89) / 1 mL in 1 SYRINGE (71288-436-88)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-436-89) / 1 mL in 1 SYRINGE (71288-436-88)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043692","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-436-92","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-436-92) / 1 mL in 1 SYRINGE (71288-436-91)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-436-92) / 1 mL in 1 SYRINGE (71288-436-91)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839011310","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-113-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-113-10) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-113-10) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952013006","name":"ENOXAPARIN 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-130-06","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-130-06) / 1 mL in 1 SYRINGE (81952-130-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.45169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-130-06) / 1 mL in 1 SYRINGE (81952-130-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560600","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5606-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5606-00) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5606-00) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781329868","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3298-68","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3298-68) / .8 mL in 1 SYRINGE (0781-3298-04)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3298-68) / .8 mL in 1 SYRINGE (0781-3298-04)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955101210","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1012-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"120 mg/.8mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1012-10) / 1 SYRINGE in 1 CELLO PACK (0955-1012-01) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1012-10) / 1 SYRINGE in 1 CELLO PACK (0955-1012-01) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714005610","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-056-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-056-10) / .8 mL in 1 SYRINGE (16714-056-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-056-10) / .8 mL in 1 SYRINGE (16714-056-01)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041170","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-411-70","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-411-70) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-411-70) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323065599","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-655-99","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"120 mg/.8mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-655-99) / 1 SYRINGE in 1 BLISTER PACK (63323-655-21) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-655-99) / 1 SYRINGE in 1 BLISTER PACK (63323-655-21) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063842","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-638-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-638-42) / .8 mL in 1 SYRINGE (68001-638-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-638-42) / .8 mL in 1 SYRINGE (68001-638-43)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710176206","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1762-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"120 mg/.8mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1762-6) / .8 mL in 1 SYRINGE (70710-1762-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (70710-1762-6) / .8 mL in 1 SYRINGE (70710-1762-2)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288041181","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"71288043792","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-437-92","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-437-92) / .8 mL in 1 SYRINGE (71288-437-91)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-437-92) / .8 mL in 1 SYRINGE (71288-437-91)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043794","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-437-94","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-437-94) / .8 mL in 1 SYRINGE (71288-437-93)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-437-94) / .8 mL in 1 SYRINGE (71288-437-93)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839011510","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-115-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"120 mg/.8mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-115-10) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-115-10) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952013228","name":"ENOXAPARIN 120 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-132-28","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"120 mg/.8mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-132-28) / .8 mL in 1 SYRINGE (81952-132-18)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":10.41734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-132-28) / .8 mL in 1 SYRINGE (81952-132-18)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560700","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5607-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5607-00) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5607-00) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781329969","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3299-69","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3299-69) / 1 mL in 1 SYRINGE (0781-3299-05)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3299-69) / 1 mL in 1 SYRINGE (0781-3299-05)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955101510","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1015-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1015-10) / 1 SYRINGE in 1 CELLO PACK (0955-1015-01) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1015-10) / 1 SYRINGE in 1 CELLO PACK (0955-1015-01) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714006610","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-066-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-066-10) / 1 mL in 1 SYRINGE (16714-066-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-066-10) / 1 mL in 1 SYRINGE (16714-066-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041171","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-411-71","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-411-71) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-411-71) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323058994","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-589-94","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-589-94) / 1 SYRINGE in 1 BLISTER PACK (63323-589-21) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-589-94) / 1 SYRINGE in 1 BLISTER PACK (63323-589-21) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063942","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-639-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-639-42) / 1 mL in 1 SYRINGE (68001-639-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-639-42) / 1 mL in 1 SYRINGE (68001-639-43)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710176306","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1763-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1763-6) / 1 mL in 1 SYRINGE (70710-1763-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":null}, {"ndc":"71288043894","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-438-94","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-438-94) / 1 mL in 1 SYRINGE (71288-438-93)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-438-94) / 1 mL in 1 SYRINGE (71288-438-93)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043896","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-438-96","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-438-96) / 1 mL in 1 SYRINGE (71288-438-95)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-438-96) / 1 mL in 1 SYRINGE (71288-438-95)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839011610","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-116-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-116-10) / 1 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-116-10) / 1 mL in 1 SYRINGE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952013506","name":"ENOXAPARIN 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-135-06","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-135-06) / 1 mL in 1 SYRINGE (81952-135-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":8.90376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-135-06) / 1 mL in 1 SYRINGE (81952-135-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560100","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5601-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5601-00) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5601-00) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781323863","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3238-63","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3238-63) / .3 mL in 1 SYRINGE (0781-3238-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3238-63) / .3 mL in 1 SYRINGE (0781-3238-01)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955100310","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1003-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1003-10) / 1 SYRINGE in 1 CELLO PACK (0955-1003-01) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1003-10) / 1 SYRINGE in 1 CELLO PACK (0955-1003-01) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714000610","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-006-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-006-10) / .3 mL in 1 SYRINGE (16714-006-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-006-10) / .3 mL in 1 SYRINGE (16714-006-01)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041070","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-410-70","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-410-70) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-410-70) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323053383","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-533-83","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 CELLO PACK in 1 CARTON (63323-533-83) / 1 SYRINGE in 1 CELLO PACK (63323-533-01) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (63323-533-83) / 1 SYRINGE in 1 CELLO PACK (63323-533-01) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323055965","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-559-65","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-559-65) / 1 SYRINGE in 1 BLISTER PACK (63323-559-63) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-559-65) / 1 SYRINGE in 1 BLISTER PACK (63323-559-63) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323055993","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-559-93","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-559-93) / 1 SYRINGE in 1 BLISTER PACK (63323-559-21) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-559-93) / 1 SYRINGE in 1 BLISTER PACK (63323-559-21) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001045742","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-457-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-457-42) / .3 mL in 1 SYRINGE (68001-457-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-457-42) / .3 mL in 1 SYRINGE (68001-457-43)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063342","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-633-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-633-42) / .3 mL in 1 SYRINGE (68001-633-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-633-42) / .3 mL in 1 SYRINGE (68001-633-43)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710175706","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1757-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1757-6) / .3 mL in 1 SYRINGE (70710-1757-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (70710-1757-6) / .3 mL in 1 SYRINGE (70710-1757-2)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043281","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-432-81","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-432-81) / .3 mL in 1 SYRINGE (71288-432-80)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-432-81) / .3 mL in 1 SYRINGE (71288-432-80)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043292","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-432-92","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-432-92) / .3 mL in 1 SYRINGE (71288-432-91)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-432-92) / .3 mL in 1 SYRINGE (71288-432-91)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839010910","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-109-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-109-10) / .3 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-109-10) / .3 mL in 1 SYRINGE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952012323","name":"ENOXAPARIN 30 MG/0.3 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-123-23","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"30 mg/.3mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-123-23) / .3 mL in 1 SYRINGE (81952-123-13)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.12683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-123-23) / .3 mL in 1 SYRINGE (81952-123-13)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560800","name":"ENOXAPARIN 300 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5608-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 mg/3mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 VIAL in 1 CARTON (0548-5608-00) / 3 mL in 1 VIAL","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.87241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0548-5608-00) / 3 mL in 1 VIAL) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955101601","name":"ENOXAPARIN 300 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1016-01","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"300 mg/3mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0955-1016-01) / 3 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.87241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0955-1016-01) / 3 mL in 1 VIAL, MULTI-DOSE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323053903","name":"ENOXAPARIN 300 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-539-03","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 mg/3mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (63323-539-03) / 3 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.87241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (63323-539-03) / 3 mL in 1 VIAL, MULTI-DOSE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001064141","name":"ENOXAPARIN 300 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-641-41","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 mg/3mL","labeler":"BluePoint Laboratories","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (68001-641-41) / 3 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.87241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (68001-641-41) / 3 mL in 1 VIAL, MULTI-DOSE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288042603","name":"ENOXAPARIN 300 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-426-03","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 mg/3mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (71288-426-03) / 3 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.87241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (71288-426-03) / 3 mL in 1 VIAL, MULTI-DOSE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288042691","name":"ENOXAPARIN 300 MG/3 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-426-91","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 mg/3mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (71288-426-91) / 3 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":9.87241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (71288-426-91) / 3 mL in 1 VIAL, MULTI-DOSE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560200","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5602-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5602-00) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5602-00) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781324664","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3246-64","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3246-64) / .4 mL in 1 SYRINGE (0781-3246-02)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3246-64) / .4 mL in 1 SYRINGE (0781-3246-02)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955100410","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1004-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1004-10) / 1 SYRINGE in 1 CELLO PACK (0955-1004-01) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1004-10) / 1 SYRINGE in 1 CELLO PACK (0955-1004-01) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714001610","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-016-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-016-10) / .4 mL in 1 SYRINGE (16714-016-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-016-10) / .4 mL in 1 SYRINGE (16714-016-01)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041076","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-410-76","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-410-76) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-410-76) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323053587","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-535-87","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 CELLO PACK in 1 CARTON (63323-535-87) / 1 SYRINGE in 1 CELLO PACK (63323-535-01) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (63323-535-87) / 1 SYRINGE in 1 CELLO PACK (63323-535-01) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323056465","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-564-65","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-564-65) / 1 SYRINGE in 1 BLISTER PACK (63323-564-63) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-564-65) / 1 SYRINGE in 1 BLISTER PACK (63323-564-63) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323056497","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-564-97","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-564-97) / 1 SYRINGE in 1 BLISTER PACK (63323-564-21) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-564-97) / 1 SYRINGE in 1 BLISTER PACK (63323-564-21) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001045842","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-458-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-458-42) / .4 mL in 1 SYRINGE (68001-458-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-458-42) / .4 mL in 1 SYRINGE (68001-458-43)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063442","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-634-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-634-42) / .4 mL in 1 SYRINGE (68001-634-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-634-42) / .4 mL in 1 SYRINGE (68001-634-43)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710175806","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1758-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1758-6) / .4 mL in 1 SYRINGE (70710-1758-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":null}, {"ndc":"71288043383","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-433-83","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-433-83) / .4 mL in 1 SYRINGE (71288-433-82)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-433-83) / .4 mL in 1 SYRINGE (71288-433-82)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043392","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-433-92","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-433-92) / .4 mL in 1 SYRINGE (71288-433-91)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-433-92) / .4 mL in 1 SYRINGE (71288-433-91)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839011010","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-110-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-110-10) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-110-10) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952012424","name":"ENOXAPARIN 40 MG/0.4 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-124-24","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-124-24) / .4 mL in 1 SYRINGE (81952-124-14)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-124-24) / .4 mL in 1 SYRINGE (81952-124-14)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560300","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5603-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5603-00) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5603-00) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781325666","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3256-66","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3256-66) / .6 mL in 1 SYRINGE (0781-3256-03)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3256-66) / .6 mL in 1 SYRINGE (0781-3256-03)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955100610","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1006-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1006-10) / 1 SYRINGE in 1 CELLO PACK (0955-1006-01) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1006-10) / 1 SYRINGE in 1 CELLO PACK (0955-1006-01) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714002610","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-026-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-026-10) / .6 mL in 1 SYRINGE (16714-026-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-026-10) / .6 mL in 1 SYRINGE (16714-026-01)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041077","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-410-77","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-410-77) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-410-77) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323056665","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-566-65","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-566-65) / 1 SYRINGE in 1 BLISTER PACK (63323-566-63) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-566-65) / 1 SYRINGE in 1 BLISTER PACK (63323-566-63) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323056698","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-566-98","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-566-98) / 1 SYRINGE in 1 BLISTER PACK (63323-566-21) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-566-98) / 1 SYRINGE in 1 BLISTER PACK (63323-566-21) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323060788","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-607-88","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 CELLO PACK in 1 CARTON (63323-607-88) / 1 SYRINGE in 1 CELLO PACK (63323-607-01) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (63323-607-88) / 1 SYRINGE in 1 CELLO PACK (63323-607-01) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001045942","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-459-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-459-42) / .6 mL in 1 SYRINGE (68001-459-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-459-42) / .6 mL in 1 SYRINGE (68001-459-43)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063542","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-635-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-635-42) / .6 mL in 1 SYRINGE (68001-635-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-635-42) / .6 mL in 1 SYRINGE (68001-635-43)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710175906","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1759-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1759-6) / .6 mL in 1 SYRINGE (70710-1759-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":null}, {"ndc":"71288043485","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-434-85","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-434-85) / .6 mL in 1 SYRINGE (71288-434-84)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-434-85) / .6 mL in 1 SYRINGE (71288-434-84)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043492","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-434-92","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-434-92) / .6 mL in 1 SYRINGE (71288-434-91)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-434-92) / .6 mL in 1 SYRINGE (71288-434-91)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839011110","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-111-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-111-10) / .6 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-111-10) / .6 mL in 1 SYRINGE) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952012626","name":"ENOXAPARIN 60 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-126-26","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"60 mg/.6mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-126-26) / .6 mL in 1 SYRINGE (81952-126-16)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":7.45223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-126-26) / .6 mL in 1 SYRINGE (81952-126-16)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00548560400","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5604-00","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"10 SYRINGE in 1 CARTON (0548-5604-00) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0548-5604-00) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781326268","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3262-68","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sandoz Inc","package_description":"10 SYRINGE in 1 CARTON (0781-3262-68) / .8 mL in 1 SYRINGE (0781-3262-04)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3262-68) / .8 mL in 1 SYRINGE (0781-3262-04)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00955100810","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-1008-10","proprietary_name":"Enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0955-1008-10) / 1 SYRINGE in 1 CELLO PACK (0955-1008-01) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0955-1008-10) / 1 SYRINGE in 1 CELLO PACK (0955-1008-01) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714003610","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-036-10","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"10 SYRINGE in 1 CARTON (16714-036-10) / .8 mL in 1 SYRINGE (16714-036-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (16714-036-10) / .8 mL in 1 SYRINGE (16714-036-01)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021041078","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-410-78","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-410-78) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (25021-410-78) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323053190","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-531-90","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 CELLO PACK in 1 CARTON (63323-531-90) / 1 SYRINGE in 1 CELLO PACK (63323-531-01) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (63323-531-90) / 1 SYRINGE in 1 CELLO PACK (63323-531-01) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323058465","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-584-65","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-584-65) / 1 SYRINGE in 1 BLISTER PACK (63323-584-63) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-584-65) / 1 SYRINGE in 1 BLISTER PACK (63323-584-63) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323058499","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-584-99","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 BLISTER PACK in 1 CARTON (63323-584-99) / 1 SYRINGE in 1 BLISTER PACK (63323-584-21) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 BLISTER PACK in 1 CARTON (63323-584-99) / 1 SYRINGE in 1 BLISTER PACK (63323-584-21) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001063642","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-636-42","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"10 SYRINGE in 1 CARTON (68001-636-42) / .8 mL in 1 SYRINGE (68001-636-43)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (68001-636-42) / .8 mL in 1 SYRINGE (68001-636-43)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710176006","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1760-6","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (70710-1760-6) / .8 mL in 1 SYRINGE (70710-1760-2)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":null}, {"ndc":"71288043587","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-435-87","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-435-87) / .8 mL in 1 SYRINGE (71288-435-86)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-435-87) / .8 mL in 1 SYRINGE (71288-435-86)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288043592","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-435-92","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71288-435-92) / .8 mL in 1 SYRINGE (71288-435-91)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71288-435-92) / .8 mL in 1 SYRINGE (71288-435-91)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839011210","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-112-10","proprietary_name":"enoxaparin sodium","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 SYRINGE in 1 CARTON (71839-112-10) / .8 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (71839-112-10) / .8 mL in 1 SYRINGE) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952012828","name":"ENOXAPARIN 80 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-128-28","proprietary_name":"Enoxaparin Sodium","nonproprietary_name":"Enoxaparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"80 mg/.8mL","labeler":"Hepalink USA Inc.","package_description":"10 SYRINGE in 1 CARTON (81952-128-28) / .8 mL in 1 SYRINGE (81952-128-18)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.68676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enoxaparin Sodium|Enoxaparin Sodium","basis":"generic"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (81952-128-28) / .8 mL in 1 SYRINGE (81952-128-18)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00555904758","name":"ENPRESSE-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180073971","name":"ENSKYCE 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enskyce|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180073973","name":"ENSKYCE 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-739-73","proprietary_name":"ENSKYCE","nonproprietary_name":"desogestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-739-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK * 21 TABLET, FILM COATED in 1 BLISTER PACK (68180-787-74) * 7 TABLET in 1 BLISTER PACK (68180-794-74)"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Enskyce|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50222030260","name":"ENSTILAR 0.005%-0.064% FOAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50222-302-60","proprietary_name":"ENSTILAR","nonproprietary_name":"calcipotriene and betamethasone dipropionate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"50 ug/g; .5 mg/g","labeler":"LEO Pharma Inc.","package_description":"1 CAN in 1 CARTON (50222-302-60) / 60 g in 1 CAN","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":21.8397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Enstilar|Calcipotriene/Betamethasone","basis":"brand"},"part_b":null}, {"ndc":"00527183037","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1830-37","proprietary_name":"Entacapone","nonproprietary_name":"entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1830-37)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00781557801","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5578-01","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5578-01)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"00904682207","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6822-07","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6822-07) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"27241004910","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-049-10","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-049-10)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"33342026011","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-260-11","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-260-11)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"50268029511","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"50268029515","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-295-15","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-295-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-295-11)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"60687018811","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"60687018821","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-188-21","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-188-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-188-11)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"62332047831","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-478-31","proprietary_name":"ENTACAPONE","nonproprietary_name":"ENTACAPONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-478-31)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"65862065401","name":"ENTACAPONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-654-01","proprietary_name":"Entacapone","nonproprietary_name":"Entacapone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-654-01)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":0.32457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entacapone|Entacapone","basis":"generic"},"part_b":null}, {"ndc":"16714071701","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-717-01","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16714-717-01)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"31722083330","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-833-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-833-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"31722083390","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-833-90","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-833-90)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"42494045730","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-457-30","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR ANHYDROUS","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Cameron Pharmaceuticals","package_description":"30 TABLET in 1 BOTTLE (42494-457-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"42806065830","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-658-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (42806-658-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"42806066730","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-667-30","proprietary_name":"Entecavir","nonproprietary_name":"entecavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Epic Pharma, LLC","package_description":"1 BOTTLE in 1 CARTON (42806-667-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"43547043603","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-436-03","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-436-03)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"60687021625","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-216-25","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-216-25) / 1 TABLET in 1 BLISTER PACK (60687-216-95)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"60687021695","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"61442031130","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-311-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61442-311-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"65862084130","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-841-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-841-30) / 30 TABLET in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"68382092006","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-920-06","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-920-06)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"69097042602","name":"ENTECAVIR 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-426-02","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69097-426-02)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"16714071801","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-718-01","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16714-718-01)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"31722083430","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-834-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-834-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"42494045830","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-458-30","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR ANHYDROUS","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Cameron Pharmaceuticals","package_description":"30 TABLET in 1 BOTTLE (42494-458-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"42806065930","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-659-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (42806-659-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"42806066830","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-668-30","proprietary_name":"Entecavir","nonproprietary_name":"entecavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Epic Pharma, LLC","package_description":"1 BOTTLE in 1 CARTON (42806-668-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"43547043703","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-437-03","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-437-03)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"65862084230","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-842-30","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-842-30) / 30 TABLET in 1 BOTTLE","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"68382092106","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-921-06","proprietary_name":"Entecavir","nonproprietary_name":"Entecavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-921-06)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"69097042502","name":"ENTECAVIR 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-425-02","proprietary_name":"ENTECAVIR","nonproprietary_name":"ENTECAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69097-425-02)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Analog [EXT]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.36844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entecavir|Entecavir","basis":"generic"},"part_b":null}, {"ndc":"00078065920","name":"ENTRESTO 24 MG-26 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0659-20","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0078-0659-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.5927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entresto|Sacubitril/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078065967","name":"ENTRESTO 24 MG-26 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0659-67","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0078-0659-67)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.5927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entresto|Sacubitril/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078077720","name":"ENTRESTO 49 MG-51 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0777-20","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0078-0777-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.56059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entresto|Sacubitril/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078077767","name":"ENTRESTO 49 MG-51 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0777-67","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0078-0777-67)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.56059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entresto|Sacubitril/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078069620","name":"ENTRESTO 97 MG-103 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0696-20","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0078-0696-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.58867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entresto|Sacubitril/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078069667","name":"ENTRESTO 97 MG-103 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0696-67","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0078-0696-67)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.58867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Entresto|Sacubitril/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078123820","name":"ENTRESTO SPRINKLE 15-16 MG PLT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-1238-20","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"PELLET","route":"ORAL","strength":"15 mg/1; 16 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"60 PELLET in 1 BOTTLE (0078-1238-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.60672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00078123120","name":"ENTRESTO SPRINKLE 6-6 MG PELLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-1231-20","proprietary_name":"ENTRESTO","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"PELLET","route":"ORAL","strength":"6 mg/1; 6 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"60 PELLET in 1 BOTTLE (0078-1231-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":11.6248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45963043864","name":"ENULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-438-64","proprietary_name":"Enulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"Actavis Pharma, Inc.","package_description":"473 mL in 1 BOTTLE (45963-438-64)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Enulose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"64764010560","name":"EOHILIA 2 MG/10 ML PACKET","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64764-105-60","proprietary_name":"Eohilia","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"ORAL","strength":"2 mg/10mL","labeler":"TAKEDA PHARMACEUTICALS AMERICA, INC.","package_description":"60 POUCH in 1 CARTON (64764-105-60) / 10 mL in 1 POUCH (64764-105-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.28718,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-31","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Eohilia|Budesonide","basis":"brand"},"part_b":null}, {"ndc":"52652400101","name":"EPANED 1 MG/ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-4001-1","proprietary_name":"Epaned","nonproprietary_name":"enalapril maleate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"150 mL in 1 BOTTLE (52652-4001-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Decreased Blood Pressure [PE]"]},"nadac":{"value":4.47849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.7946,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epaned|Enalapril Maleate","basis":"brand"},"part_b":null}, {"ndc":"61958220101","name":"EPCLUSA 400 MG-100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2201-1","proprietary_name":"Epclusa","nonproprietary_name":"Velpatasvir and Sofosbuvir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 400 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"28 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (61958-2201-1)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Hepatitis C Virus NS5A Inhibitor [EPC]","Hepatitis C Virus Nucleotide Analog NS5B Polymerase Inhibitor [EPC]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 2B1 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","RNA Replicase Inhibitors [MoA]"]},"nadac":{"value":865.89214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":278.02579,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epclusa|Sofosbuvir/Velpatasvir","basis":"brand"},"part_b":null}, {"ndc":"00299590645","name":"EPIDUO FORTE 0.3-2.5% GEL PUMP","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0299-5906-45","proprietary_name":"epiduo forte","nonproprietary_name":"adapalene and benzoyl peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"3 mg/g; 25 mg/g","labeler":"Galderma Laboratories, L.P.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0299-5906-45) / 45 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":14.9672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.62604,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Epiduo Forte|Adapalene/Benzoyl Peroxide","basis":"brand"},"part_b":null}, {"ndc":"00037682410","name":"EPIFOAM FOAM","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0037-6824-10","proprietary_name":"EPIFOAM","nonproprietary_name":"pramoxine hydrochloride and hydrocortisone acetate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"100 mg/10g; 100 mg/10g","labeler":"Viatris Specialty LLC","package_description":"1 CANISTER in 1 CARTON (0037-6824-10) / 10 g in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.99953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Epifoam|Hydrocortisone/Pramoxine","basis":"brand"},"part_b":null}, {"ndc":"70069000801","name":"EPINASTINE HCL 0.05% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-008-01","proprietary_name":"EPINASTINE HYDROCHLORIDE","nonproprietary_name":"EPINASTINE HYDROCHLORIDE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-008-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic Agonists [MoA]","Adrenergic Receptor Agonist [EPC]","Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":14.32952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epinastine HCl|Epinastine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093598519","name":"EPINEPHRINE 0.15 MG AUTO-INJCT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":129.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00093598527","name":"EPINEPHRINE 0.15 MG AUTO-INJCT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5985-27","proprietary_name":"Epinephrine","nonproprietary_name":"Epinephrine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":".15 mg/.3mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 CONTAINER in 1 CARTON (0093-5985-27) / 1 SYRINGE in 1 CONTAINER (0093-5985-19) / .3 mL in 1 SYRINGE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":129.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00115169530","name":"EPINEPHRINE 0.15 MG AUTO-INJCT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1695-30","proprietary_name":"epinephrine","nonproprietary_name":"epinephrine","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":".15 mg/.15mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 CASE in 1 CARTON (0115-1695-30) / 1 SYRINGE, GLASS in 1 CASE / .15 mL in 1 SYRINGE, GLASS","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":117.96603,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00115169549","name":"EPINEPHRINE 0.15 MG AUTO-INJCT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1695-49","proprietary_name":"epinephrine","nonproprietary_name":"epinephrine","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":".15 mg/.15mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"2 CASE in 1 CARTON (0115-1695-49) / 1 SYRINGE, GLASS in 1 CASE / .15 mL in 1 SYRINGE, GLASS","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":117.96603,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"49502010101","name":"EPINEPHRINE 0.15 MG AUTO-INJCT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":141.88177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"49502010102","name":"EPINEPHRINE 0.15 MG AUTO-INJCT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49502-101-02","proprietary_name":"Epinephrine","nonproprietary_name":"Epinephrine","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":".15 mg/.3mL","labeler":"Viatris Specialty LLC","package_description":"2 CONTAINER in 1 CARTON (49502-101-02) / 1 SYRINGE, GLASS in 1 CONTAINER (49502-101-01) / .3 mL in 1 SYRINGE, GLASS","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":141.88177,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00093598619","name":"EPINEPHRINE 0.3 MG AUTO-INJECT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":133.59659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00093598627","name":"EPINEPHRINE 0.3 MG AUTO-INJECT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5986-27","proprietary_name":"Epinephrine","nonproprietary_name":"Epinephrine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":".3 mg/.3mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 CONTAINER in 1 CARTON (0093-5986-27) / 1 SYRINGE in 1 CONTAINER (0093-5986-19) / .3 mL in 1 SYRINGE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":133.59659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00115169430","name":"EPINEPHRINE 0.3 MG AUTO-INJECT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1694-30","proprietary_name":"epinephrine","nonproprietary_name":"epinephrine","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":".3 mg/.3mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 CASE in 1 CARTON (0115-1694-30) / 1 SYRINGE, GLASS in 1 CASE / .3 mL in 1 SYRINGE, GLASS","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":111.99764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"00115169449","name":"EPINEPHRINE 0.3 MG AUTO-INJECT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1694-49","proprietary_name":"epinephrine","nonproprietary_name":"epinephrine","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":".3 mg/.3mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"2 CASE in 1 CARTON (0115-1694-49) / 1 SYRINGE, GLASS in 1 CASE / .3 mL in 1 SYRINGE, GLASS","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":111.99764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"49502010201","name":"EPINEPHRINE 0.3 MG AUTO-INJECT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":141.27567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"49502010202","name":"EPINEPHRINE 0.3 MG AUTO-INJECT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49502-102-02","proprietary_name":"Epinephrine","nonproprietary_name":"Epinephrine","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":".3 mg/.3mL","labeler":"Viatris Specialty LLC","package_description":"2 CONTAINER in 1 CARTON (49502-102-02) / 1 SYRINGE, GLASS in 1 CONTAINER (49502-102-01) / .3 mL in 1 SYRINGE, GLASS","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":141.27567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Epinephrine|Epinephrine","basis":"generic"},"part_b":null}, {"ndc":"76329331801","name":"EPINEPHRINE 1 MG/10 ML LUERJET","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76329-3318-1","proprietary_name":"Epinephrine","nonproprietary_name":"Epinephrine","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":".1 mg/mL","labeler":"International Medication Systems, Limited","package_description":"10 CARTON in 1 PACKAGE (76329-3318-1) / 1 SYRINGE in 1 CARTON / 10 mL in 1 SYRINGE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.23804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571017303","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-173-03","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (16571-173-03)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16571017309","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-173-09","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-173-09)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16729029310","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-293-10","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-293-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16729029315","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-293-15","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16729-293-15)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"31722004930","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-049-30","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-049-30)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"31722004990","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-049-90","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-049-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"51991087733","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-877-33","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51991-877-33)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"51991087790","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-877-90","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (51991-877-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"59762110702","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1107-2","proprietary_name":"Eplerenone","nonproprietary_name":"eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59762-1107-2)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"59762110703","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1107-3","proprietary_name":"Eplerenone","nonproprietary_name":"eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59762-1107-3)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"59762171003","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"60687045111","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"60687045121","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-451-21","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-451-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-451-11)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"69367030709","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-307-09","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-307-09)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"69367030730","name":"EPLERENONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-307-30","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-307-30)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.30799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16571017403","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-174-03","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (16571-174-03)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16571017409","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-174-09","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-174-09)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16729029410","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-294-10","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-294-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"16729029415","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-294-15","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16729-294-15)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"31722005030","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-050-30","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-050-30)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"31722005090","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-050-90","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-050-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"51991087833","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-878-33","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51991-878-33)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"51991087890","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-878-90","proprietary_name":"EPLERENONE","nonproprietary_name":"EPLERENONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (51991-878-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"59762110801","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1108-1","proprietary_name":"Eplerenone","nonproprietary_name":"eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59762-1108-1)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"59762110802","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1108-2","proprietary_name":"Eplerenone","nonproprietary_name":"eplerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59762-1108-2)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"59762172002","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"69367030809","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-308-09","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-308-09)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"69367030830","name":"EPLERENONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-308-30","proprietary_name":"Eplerenone","nonproprietary_name":"Eplerenone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-308-30)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.45044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eplerenone|Eplerenone","basis":"generic"},"part_b":null}, {"ndc":"55513014410","name":"EPOGEN 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-144-10","proprietary_name":"EPOGEN","nonproprietary_name":"epoetin alfa","dosage_form":"SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [iU]/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-144-10) / 1 mL in 1 VIAL (55513-144-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":161.80013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epogen|Epoetin Alfa","basis":"brand"},"part_b":null}, {"ndc":"55513014420","name":"EPOGEN 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-144-20","proprietary_name":"EPOGEN","nonproprietary_name":"epoetin alfa","dosage_form":"SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [iU]/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-144-20) / 1 mL in 1 VIAL (55513-144-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":161.80013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epogen|Epoetin Alfa","basis":"brand"},"part_b":null}, {"ndc":"55513012610","name":"EPOGEN 2,000 UNITS/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-126-10","proprietary_name":"EPOGEN","nonproprietary_name":"epoetin alfa","dosage_form":"SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"2000 [iU]/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-126-10) / 1 mL in 1 VIAL (55513-126-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":32.26688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epogen|Epoetin Alfa","basis":"brand"},"part_b":null}, {"ndc":"55513012620","name":"EPOGEN 2,000 UNITS/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-126-20","proprietary_name":"EPOGEN","nonproprietary_name":"epoetin alfa","dosage_form":"SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"2000 [iU]/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-126-20) / 1 mL in 1 VIAL (55513-126-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":32.26688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epogen|Epoetin Alfa","basis":"brand"},"part_b":null}, {"ndc":"55513014810","name":"EPOGEN 4,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-148-10","proprietary_name":"EPOGEN","nonproprietary_name":"epoetin alfa","dosage_form":"SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4000 [iU]/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-148-10) / 1 mL in 1 VIAL (55513-148-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":64.3638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Epogen|Epoetin Alfa","basis":"brand"},"part_b":null}, {"ndc":"52652900101","name":"EPRONTIA 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-9001-1","proprietary_name":"Eprontia","nonproprietary_name":"Topiramate","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (52652-9001-1)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.58252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.08239,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Eprontia|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"52652900102","name":"EPRONTIA 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52652-9001-2","proprietary_name":"Eprontia","nonproprietary_name":"Topiramate","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52652-9001-2) / 240 mL in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.55454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Eprontia|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"52652900103","name":"EPRONTIA 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-9001-3","proprietary_name":"Eprontia","nonproprietary_name":"Topiramate","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52652-9001-3) / 120 mL in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.7158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":2.08667,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Eprontia|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"70000002101","name":"EPSOM SALT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0021-1","proprietary_name":"Epsom Salt","nonproprietary_name":"MAGNESIUM SULFATE","dosage_form":"CRYSTAL","route":"ORAL; TOPICAL","strength":"1 g/g","labeler":"Cardinal Health, 110 dba Leader","package_description":"454 g in 1 POUCH (70000-0021-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122046143","name":"EPSOM SALT GRANULES","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-461-43","proprietary_name":"Epsom Salt","nonproprietary_name":"Epsom Salt","dosage_form":"GRANULE","route":"ORAL; TOPICAL","strength":"1 g/g","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"454 g in 1 POUCH (46122-461-43)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"30698041912","name":"EQUETRO 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-419-12","proprietary_name":"EQUETRO","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Validus Pharmaceuticals LLC","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (30698-419-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":3.65288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Equetro|Carbamazepine","basis":"brand"},"part_b":null}, {"ndc":"30698042112","name":"EQUETRO 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-421-12","proprietary_name":"EQUETRO","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Validus Pharmaceuticals LLC","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (30698-421-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":4.18424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Equetro|Carbamazepine","basis":"brand"},"part_b":null}, {"ndc":"30698042312","name":"EQUETRO 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-423-12","proprietary_name":"EQUETRO","nonproprietary_name":"Carbamazepine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Validus Pharmaceuticals LLC","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (30698-423-12)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":4.70075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Equetro|Carbamazepine","basis":"brand"},"part_b":null}, {"ndc":"13668075701","name":"ERGOCALCIFEROL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-757-01","proprietary_name":"ERGOCALCIFEROL","nonproprietary_name":"ergocalciferol","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-757-01)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81279010420","name":"ERGOMAR 2 MG TABLET SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81279-104-20","proprietary_name":"Ergomar Sublingual","nonproprietary_name":"Ergotamine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Pangea Pharmaceuticals LLC","package_description":"2 BLISTER PACK in 1 CARTON (81279-104-20) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Ergotamine Derivative [EPC]","Ergotamines [CS]"]},"nadac":{"value":43.46114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ergomar|Ergotamine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"75907007528","name":"ERRIN 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Errin|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"75907007532","name":"ERRIN 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-075-32","proprietary_name":"ERRIN","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (75907-075-32) / 28 TABLET in 1 BLISTER PACK (75907-075-28)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Errin|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"00143939810","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9398-10","proprietary_name":"ertapenem sodium","nonproprietary_name":"ertapenem sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Hikma Pharmaceuticals USA, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0143-9398-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (0143-9398-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0143-9398-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (0143-9398-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409351022","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3510-22","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-3510-22) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (0409-3510-21)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0409-3510-22) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (0409-3510-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16714088910","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-889-10","proprietary_name":"ERTAPENEM SODIUM","nonproprietary_name":"Ertapenem","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"NorthStar RxLLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (16714-889-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (16714-889-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (16714-889-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (16714-889-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"42023022110","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-221-10","proprietary_name":"ERTAPENEM","nonproprietary_name":"ertapenem sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"ENDO USA, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 PACKAGE (42023-221-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (42023-221-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 PACKAGE (42023-221-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (42023-221-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"42023022185","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-221-85","proprietary_name":"ERTAPENEM","nonproprietary_name":"ertapenem sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"ENDO USA, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 PACKAGE (42023-221-85) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (42023-221-89)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 PACKAGE (42023-221-85) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (42023-221-89)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"43598090158","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-901-58","proprietary_name":"ERTAPENEM SODIUM","nonproprietary_name":"Ertapenem","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Dr.Reddys Laboratories Inc.,","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (43598-901-58) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (43598-901-11)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (43598-901-58) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (43598-901-11)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567082010","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-820-10","proprietary_name":"ertapenem","nonproprietary_name":"ertapenem","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (44567-820-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (44567-820-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (44567-820-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (44567-820-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55150028209","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-282-09","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-282-09) / 1 INJECTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (55150-282-09) / 1 INJECTION in 1 VIAL, SINGLE-DOSE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55150028220","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-282-20","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-282-20) / 1 INJECTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (55150-282-20) / 1 INJECTION in 1 VIAL, SINGLE-DOSE) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505619604","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6196-4","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem Sodium","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/20mL","labeler":"Apotex Corp","package_description":"10 VIAL in 1 CARTON (60505-6196-4) / 20 mL in 1 VIAL (60505-6196-0)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (60505-6196-4) / 20 mL in 1 VIAL (60505-6196-0)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323082320","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-823-20","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (63323-823-20) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (63323-823-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (63323-823-20) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (63323-823-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001040831","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-408-31","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem Sodium","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/20mL","labeler":"BluePoint Laboratories","package_description":"10 VIAL in 1 CARTON (68001-408-31) / 20 mL in 1 VIAL (68001-408-29)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (68001-408-31) / 20 mL in 1 VIAL (68001-408-29)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72266015905","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-159-05","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Fosun Pharma USA Inc","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (72266-159-05) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (72266-159-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":47.2056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, SINGLE-DOSE in 1 CARTON (72266-159-05) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (72266-159-01)) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72266015910","name":"ERTAPENEM 1 GRAM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-159-10","proprietary_name":"Ertapenem","nonproprietary_name":"Ertapenem Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 g/1","labeler":"Fosun Pharma USA Inc","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72266-159-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (72266-159-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":26.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ertapenem|Ertapenem Sodium","basis":"generic"},"part_b":{"hcpcs":"J1335","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1335 (500 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72266-159-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (72266-159-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"45802096272","name":"ERY 2% PADS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-962-72","proprietary_name":"Ery","nonproprietary_name":"Erythromycin","dosage_form":"SWAB","route":"TOPICAL","strength":"20 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 APPLICATOR in 1 JAR (45802-962-72) / .8 mL in 1 APPLICATOR","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.23477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ery|Erythromycin Base In Ethanol","basis":"brand"},"part_b":null}, {"ndc":"24338012203","name":"ERY-TAB DR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-122-03","proprietary_name":"ERY-TAB","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Arbor Pharmaceuticals, Inc.","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (24338-122-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.92505,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24338012403","name":"ERY-TAB DR 333 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-124-03","proprietary_name":"ERY-TAB","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Arbor Pharmaceuticals, Inc.","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (24338-124-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.25776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24338012603","name":"ERY-TAB DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-126-03","proprietary_name":"ERY-TAB","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Arbor Pharmaceuticals, Inc.","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (24338-126-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.11442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574402435","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.82657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574402450","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":6.83399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208091019","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-910-19","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"50 TUBE in 1 BOX (24208-910-19) / 1 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":6.83399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208091055","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-910-55","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-910-55) / 3.5 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.82657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70244003101","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-031-01","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Sentiss Pharmaceuticals LLC","package_description":"50 TUBE in 1 CARTON (70244-031-01) / 1 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":6.83399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70244003102","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-031-02","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Sentiss Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (70244-031-02) / 3.5 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.82657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72485067031","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-670-31","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"50 TUBE in 1 CARTON (72485-670-31) / 1 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":6.83399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72485067035","name":"ERYTHROMYCIN 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-670-35","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 TUBE in 1 CARTON (72485-670-35) / 3.5 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.82657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802096694","name":"ERYTHROMYCIN 2% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-966-94","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"GEL","route":"TOPICAL","strength":"20 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-966-94) / 30 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.67256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802096696","name":"ERYTHROMYCIN 2% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-966-96","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"GEL","route":"TOPICAL","strength":"20 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-966-96) / 60 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.6827,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42571038425","name":"ERYTHROMYCIN 2% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.35204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802003846","name":"ERYTHROMYCIN 2% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-038-46","proprietary_name":"erythromycin","nonproprietary_name":"erythromycin","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-038-46) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.35204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656003060","name":"ERYTHROMYCIN 2% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-030-60","proprietary_name":"erythromycin topical solution 2%","nonproprietary_name":"erythromycin topical solution 2%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC LLC","package_description":"1 BOTTLE in 1 CARTON (71656-030-60) / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.35204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536013213","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-132-13","proprietary_name":"ERYTHROMYCIN ETHYLSUCCINATE","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Wilshire Pharmaceuticals","package_description":"100 mL in 1 BOTTLE (52536-132-13)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.91229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536013413","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-134-13","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Wilshire Pharmaceuticals Inc.","package_description":"100 mL in 1 BOTTLE (52536-134-13)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.91229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536013613","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-136-13","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Wilshire Pharmaceuticals Inc.","package_description":"200 mL in 1 BOTTLE (52536-136-13)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.52026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219150301","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1503-1","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 mL in 1 BOTTLE (60219-1503-1)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.91229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559044002","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-440-02","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"200 mL in 1 BOTTLE (62559-440-02)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.52026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559063001","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-630-01","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (62559-630-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.91229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238150301","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1503-1","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 mL in 1 BOTTLE (69238-1503-1)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.91229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75834029501","name":"ERYTHROMYCIN 200 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-295-01","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (75834-295-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":0.91229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093557101","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5571-01","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5571-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093557156","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5571-56","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5571-56)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668060601","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-606-01","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"250 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, COATED in 1 BOTTLE (13668-606-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668060630","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-606-30","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"250 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (13668-606-30)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24338010203","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-102-03","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Arbor Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24338-102-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536010303","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-103-03","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Wilshire Pharmaceuticals","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (52536-103-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710104701","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1047-1","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1047-1)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710104703","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1047-3","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1047-3)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834024201","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834024230","name":"ERYTHROMYCIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.95521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536013013","name":"ERYTHROMYCIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-130-13","proprietary_name":"ERYTHROMYCIN ETHYLSUCCINATE","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Wilshire Pharmaceuticals","package_description":"100 mL in 1 BOTTLE (52536-130-13)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.74359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219150402","name":"ERYTHROMYCIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1504-2","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 mL in 1 BOTTLE (60219-1504-2)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.74359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559063101","name":"ERYTHROMYCIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-631-01","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (62559-631-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.74359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238150402","name":"ERYTHROMYCIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1504-2","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 mL in 1 BOTTLE (69238-1504-2)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.74359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75834029401","name":"ERYTHROMYCIN 400 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-294-01","proprietary_name":"Erythromycin Ethylsuccinate","nonproprietary_name":"Erythromycin Ethylsuccinate","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (75834-294-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.74359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093557201","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5572-01","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5572-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093557256","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5572-56","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5572-56)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668060701","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-607-01","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, COATED in 1 BOTTLE (13668-607-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668060730","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-607-30","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (13668-607-30)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536010503","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-105-03","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Wilshire Pharmaceuticals","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (52536-105-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710104801","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1048-1","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1048-1)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710104803","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1048-3","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1048-3)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834024301","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834024330","name":"ERYTHROMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.51038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907007601","name":"ERYTHROMYCIN DR 250 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"75907-076-01","proprietary_name":"erythromycin","nonproprietary_name":"erythromycin","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"250 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (75907-076-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":5.95998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668058601","name":"ERYTHROMYCIN DR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-586-01","proprietary_name":"ERYTHROMYCIN","nonproprietary_name":"ERYTHROMYCIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-586-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.92505,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668058630","name":"ERYTHROMYCIN DR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-586-30","proprietary_name":"ERYTHROMYCIN","nonproprietary_name":"ERYTHROMYCIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-586-30)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.92505,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536018003","name":"ERYTHROMYCIN DR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-180-03","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Wilshire Pharmaceuticals","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (52536-180-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.92505,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238147103","name":"ERYTHROMYCIN DR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1471-3","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (69238-1471-3)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.92505,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668058730","name":"ERYTHROMYCIN DR 333 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-587-30","proprietary_name":"ERYTHROMYCIN","nonproprietary_name":"ERYTHROMYCIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-587-30)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.25776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536018303","name":"ERYTHROMYCIN DR 333 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-183-03","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Wilshire Pharmaceuticals","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (52536-183-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.25776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238147203","name":"ERYTHROMYCIN DR 333 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1472-3","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"333 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (69238-1472-3)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.25776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668058801","name":"ERYTHROMYCIN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-588-01","proprietary_name":"ERYTHROMYCIN","nonproprietary_name":"ERYTHROMYCIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-588-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.11442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668058830","name":"ERYTHROMYCIN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-588-30","proprietary_name":"ERYTHROMYCIN","nonproprietary_name":"ERYTHROMYCIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-588-30)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.11442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536018603","name":"ERYTHROMYCIN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-186-03","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Wilshire Pharmaceuticals","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (52536-186-03)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.11442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238147303","name":"ERYTHROMYCIN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1473-3","proprietary_name":"Erythromycin","nonproprietary_name":"Erythromycin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (69238-1473-3)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":3.11442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980032801","name":"ERYTHROMYCIN-BENZOYL GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-328-01","proprietary_name":"Erythromycin and Benzoyl Peroxide","nonproprietary_name":"Erythromycin and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g; 50 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"23.3 g in 1 JAR (64980-328-01)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.5991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Erythromycin-Benzoyl Peroxide|Erythromycin/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"64980032802","name":"ERYTHROMYCIN-BENZOYL GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-328-02","proprietary_name":"Erythromycin and Benzoyl Peroxide","nonproprietary_name":"Erythromycin and Benzoyl Peroxide","dosage_form":"GEL","route":"TOPICAL","strength":"30 mg/g; 50 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"46.6 g in 1 JAR (64980-328-02)","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Macrolide Antimicrobial [EPC]","Macrolide [EPC]","Macrolides [CS]"]},"nadac":{"value":1.03321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Erythromycin-Benzoyl Peroxide|Erythromycin/Benzoyl Peroxide","basis":"generic"},"part_b":null}, {"ndc":"00904642661","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6426-61","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6426-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013601","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-136-01","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-136-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013605","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-136-05","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-136-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013610","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-136-10","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13668-136-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571075601","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-756-01","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-756-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571075610","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-756-10","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-756-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"43547028110","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-281-10","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43547-281-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"43547028111","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-281-11","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-281-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"65862037401","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-374-01","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-374-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"65862037405","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-374-05","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-374-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68001059200","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-592-00","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-592-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68001059208","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-592-08","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68001-592-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68084061701","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-617-01","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-617-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-617-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68084061711","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68645051954","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-519-54","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68645-519-54)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"69097084805","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-848-05","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69097-848-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"69097084815","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-848-15","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69097-848-15)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"72603015001","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-150-01","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/21","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-150-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282025010","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-250-10","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (76282-250-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282025030","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-250-30","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-250-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282025090","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-250-90","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-250-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"82009003610","name":"ESCITALOPRAM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-036-10","proprietary_name":"escitalopram oxalate","nonproprietary_name":"escitalopram oxalate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-036-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"52427079530","name":"ESCITALOPRAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-795-30","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE in 1 BOTTLE (52427-795-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":5.45324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"00904642761","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6427-61","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6427-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013701","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-137-01","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-137-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013705","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-137-05","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-137-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013710","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-137-10","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13668-137-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571075701","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-757-01","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-757-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571075710","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-757-10","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-757-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"43547028210","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-282-10","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43547-282-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"43547028211","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-282-11","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-282-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"59746028190","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-281-90","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59746-281-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"65862037501","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-375-01","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-375-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"65862037505","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-375-05","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-375-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68001059300","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-593-00","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-593-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68001059308","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-593-08","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68001-593-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68084061801","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-618-01","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-618-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-618-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68084061811","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68645052054","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-520-54","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68645-520-54)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"69097084905","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-849-05","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69097-849-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"69097084915","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-849-15","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69097-849-15)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"72603015101","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-151-01","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/21","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-151-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282025110","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-251-10","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (76282-251-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282025130","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-251-30","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-251-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282025190","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-251-90","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-251-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"82009003710","name":"ESCITALOPRAM 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-037-10","proprietary_name":"escitalopram oxalate","nonproprietary_name":"escitalopram oxalate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-037-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013501","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-135-01","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-135-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013505","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-135-05","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13668-135-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"13668013510","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-135-10","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13668-135-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571075501","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-755-01","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-755-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571075510","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-755-10","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-755-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"43547028010","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-280-10","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43547-280-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"43547028011","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-280-11","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-280-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"60687086501","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-865-01","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-865-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-865-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"60687086511","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"65862037301","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-373-01","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-373-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"65862037305","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-373-05","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-373-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"68001059100","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-591-00","proprietary_name":"Escitalopram","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-591-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"69097084705","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-847-05","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69097-847-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"69097084715","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-847-15","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69097-847-15)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"72603014901","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-149-01","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-149-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282024910","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-249-10","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (76282-249-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282024930","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-249-30","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-249-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"76282024990","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-249-90","proprietary_name":"Escitalopram oxalate","nonproprietary_name":"escitalopram","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-249-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"82009003510","name":"ESCITALOPRAM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-035-10","proprietary_name":"escitalopram oxalate","nonproprietary_name":"escitalopram oxalate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-035-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Escitalopram Oxalate|Escitalopram Oxalate","basis":"generic"},"part_b":null}, {"ndc":"16571076924","name":"ESCITALOPRAM OXALATE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-769-24","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"240 mL in 1 BOTTLE (16571-769-24)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.14255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722056924","name":"ESCITALOPRAM OXALATE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-569-24","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram Oxalate","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"240 mL in 1 BOTTLE (31722-569-24)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.14255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"33342005328","name":"ESCITALOPRAM OXALATE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-053-28","proprietary_name":"escitalopram","nonproprietary_name":"escitalopram","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Macleods Pharmaceuticals Limited","package_description":"240 mL in 1 BOTTLE (33342-053-28)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.14255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135072937","name":"ESCITALOPRAM OXALATE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-729-37","proprietary_name":"Escitalopram Oral Solution","nonproprietary_name":"Escitalopram Oral","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"240 mL in 1 BOTTLE (62135-729-37)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.14255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162070588","name":"ESCITALOPRAM OXALATE 5 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-705-88","proprietary_name":"Escitalopram Oxalate","nonproprietary_name":"Escitalopram","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"240 mL in 1 BOTTLE (65162-705-88)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.14255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"13668053830","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-538-30","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-538-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722042830","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-428-30","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-428-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598068430","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-684-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-684-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651053330","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-533-30","proprietary_name":"ESLICARBAZEPINE ACETATE","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-533-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746071730","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-717-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-717-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505465803","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4658-3","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4658-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877058530","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-585-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-585-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180029006","name":"ESLICARBAZEPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-290-06","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-290-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.67576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668053930","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-539-30","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-539-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722042930","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-429-30","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-429-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598068530","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-685-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-685-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651053430","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-534-30","proprietary_name":"ESLICARBAZEPINE ACETATE","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-534-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746071830","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-718-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-718-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505465903","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4659-3","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4659-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877058630","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-586-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-586-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180029106","name":"ESLICARBAZEPINE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-291-06","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-291-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.85082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668054060","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-540-60","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-540-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722043060","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-430-60","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-430-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598068660","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-686-60","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 TABLET in 1 BOTTLE (43598-686-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651053560","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-535-60","proprietary_name":"ESLICARBAZEPINE ACETATE","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (59651-535-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746071960","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-719-60","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (59746-719-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505466006","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4660-6","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4660-6)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877058760","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-587-60","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET in 1 BOTTLE (67877-587-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180029207","name":"ESLICARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-292-07","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (68180-292-07)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.32378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668054130","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-541-30","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-541-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722043130","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-431-30","proprietary_name":"Eslicarbazepine acetate","nonproprietary_name":"Eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-431-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598068730","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-687-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-687-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651053630","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-536-30","proprietary_name":"ESLICARBAZEPINE ACETATE","nonproprietary_name":"ESLICARBAZEPINE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-536-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746072030","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-720-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"eslicarbazepine acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-720-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505466103","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4661-3","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4661-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877058830","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-588-30","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-588-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180029306","name":"ESLICARBAZEPINE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-293-06","proprietary_name":"Eslicarbazepine Acetate","nonproprietary_name":"Eslicarbazepine Acetate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-293-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.72576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668054894","name":"ESOMEPRAZOLE DR 10 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-548-94","proprietary_name":"Esomeprazole Magnesium for delayed-release oral suspension","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (13668-548-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.96363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651080330","name":"ESOMEPRAZOLE DR 10 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-803-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (59651-803-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.96363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097052734","name":"ESOMEPRAZOLE DR 10 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-527-34","proprietary_name":"ESOMEPRAZOLE MAGNESIUM","nonproprietary_name":"ESOMEPRAZOLE MAGNESIUM","dosage_form":"GRANULE, FOR SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"30 GRANULE, FOR SUSPENSION, EXTENDED RELEASE in 1 CARTON (69097-527-34)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.96363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668054694","name":"ESOMEPRAZOLE DR 2.5 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-546-94","proprietary_name":"Esomeprazole Magnesium for delayed-release oral suspension","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (13668-546-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":5.49156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097050731","name":"ESOMEPRAZOLE DR 2.5 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-507-31","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"2.5 mg/1","labeler":"Cipla USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (69097-507-31)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":5.49156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668054994","name":"ESOMEPRAZOLE DR 20 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-549-94","proprietary_name":"Esomeprazole Magnesium for delayed-release oral suspension","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (13668-549-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.00136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651080430","name":"ESOMEPRAZOLE DR 20 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-804-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (59651-804-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.00136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382084894","name":"ESOMEPRAZOLE DR 20 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-848-94","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (68382-848-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.00136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097052834","name":"ESOMEPRAZOLE DR 20 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-528-34","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (69097-528-34)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.00136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668055094","name":"ESOMEPRAZOLE DR 40 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-550-94","proprietary_name":"Esomeprazole Magnesium for delayed-release oral suspension","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (13668-550-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.17167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651080530","name":"ESOMEPRAZOLE DR 40 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-805-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (59651-805-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.17167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382084994","name":"ESOMEPRAZOLE DR 40 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-849-94","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (68382-849-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.17167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097052934","name":"ESOMEPRAZOLE DR 40 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-529-34","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/1","labeler":"Cipla USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (69097-529-34)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":4.17167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668054794","name":"ESOMEPRAZOLE DR 5 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-547-94","proprietary_name":"Esomeprazole Magnesium for delayed-release oral suspension","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (13668-547-94)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":5.00536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651080230","name":"ESOMEPRAZOLE DR 5 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-802-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (59651-802-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":5.00536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097050831","name":"ESOMEPRAZOLE DR 5 MG PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-508-31","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (69097-508-31)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":5.00536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378235077","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2350-77","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2350-77)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378235093","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2350-93","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2350-93)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571088041","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571088042","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-880-42","proprietary_name":"ESOMEPRAZOLE MAGNESIUM","nonproprietary_name":"ESOMEPRAZOLE MAGNESIUM","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BOTTLE in 1 CARTON (16571-880-42) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714097901","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-979-01","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-979-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714097902","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-979-02","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-979-02)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722066410","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-664-10","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-664-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722066430","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-664-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-664-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722066490","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-664-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-664-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547000103","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-001-03","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-001-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598040733","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-407-33","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"3 BOTTLE in 1 CARTON (43598-407-33) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598050910","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-509-10","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43598-509-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598050930","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-509-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43598-509-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598050990","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-509-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43598-509-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660002727","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-027-27","proprietary_name":"Esomeprazole","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"2 BOTTLE in 1 CARTON (51660-027-27) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660002744","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-027-44","proprietary_name":"Esomeprazole","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"3 BOTTLE in 1 CARTON (51660-027-44) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111049230","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651056130","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-561-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-561-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687093411","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687093421","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-934-21","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-934-21) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (60687-934-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62175082032","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-820-32","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (62175-820-32)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62175082046","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-820-46","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (62175-820-46)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304073410","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-734-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (63304-734-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980063203","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-632-03","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64980-632-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980063209","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-632-09","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64980-632-09)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980063210","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-632-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64980-632-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862078330","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-783-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (65862-783-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862078390","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-783-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (65862-783-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877047810","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-478-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-478-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877047830","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-478-30","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-478-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877047890","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-478-90","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-478-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877057130","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-571-30","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium delayed release capsules","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-571-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877057190","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-571-90","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium delayed release capsules","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-571-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382044106","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-441-06","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-441-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382044110","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-441-10","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-441-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382044116","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-441-16","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-441-16)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032014","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032031","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-320-31","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-320-31) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032032","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-320-32","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"2 BOTTLE in 1 CARTON (69230-320-32) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032033","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-320-33","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"3 BOTTLE in 1 CARTON (69230-320-33) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072701","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0727-1","proprietary_name":"leader esomeprazole magnesium","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"3 BOTTLE in 1 CARTON (70000-0727-1) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072702","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0727-2","proprietary_name":"leader esomeprazole magnesium","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0727-2) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000073101","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0731-1","proprietary_name":"ESOMEPRAZOLE MAGNESIUM","nonproprietary_name":"ESOMEPRAZOLE MAGNESIUM","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"LEADER/ CARDINAL HEALTH 110, INC.","package_description":"2 BOTTLE in 1 CARTON (70000-0731-1) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70000-0731-2)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013309","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-133-09","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70010-133-09)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013310","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-133-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70010-133-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069081410","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-814-10","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70069-814-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069081430","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-814-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70069-814-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069081490","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-814-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70069-814-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005511","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-055-11","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.,","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70377-055-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005512","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-055-12","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.,","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70377-055-12)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005513","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-055-13","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.,","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70377-055-13)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009003310","name":"ESOMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-033-10","proprietary_name":"ESOMEPRAZOLE MAGNESIUM","nonproprietary_name":"ESOMEPRAZOLE MAGNESIUM","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-033-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378235177","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2351-77","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2351-77)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378235193","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2351-93","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-2351-93)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904658168","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6581-68","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"60 BLISTER PACK in 1 CARTON (0904-6581-68) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714098001","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-980-01","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-980-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714098002","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-980-02","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-980-02)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714098003","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-980-03","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-980-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722066510","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-665-10","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-665-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722066530","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-665-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-665-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722066590","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-665-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-665-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547000203","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-002-03","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-002-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547000209","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-002-09","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-002-09)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547000211","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-002-11","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43547-002-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598051010","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-510-10","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43598-510-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598051030","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-510-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43598-510-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598051090","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-510-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (43598-510-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268027211","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268027213","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-272-13","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-272-13) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (50268-272-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111049330","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651056230","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-562-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-562-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651056290","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-562-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-562-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62175084032","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-840-32","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE (62175-840-32)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304073510","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-735-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (63304-735-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980063303","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-633-03","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64980-633-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980063309","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-633-09","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64980-633-09)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980063310","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-633-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64980-633-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862078430","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-784-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (65862-784-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862078490","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-784-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (65862-784-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877047910","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-479-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-479-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877047930","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-479-30","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-479-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877047990","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-479-90","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-479-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877057210","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-572-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium delayed release capsules","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-572-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877057230","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-572-30","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium delayed release capsules","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-572-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877057290","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-572-90","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium delayed release capsules","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-572-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382044206","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-442-06","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-442-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382044210","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-442-10","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-442-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382044216","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-442-16","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-442-16)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013403","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-134-03","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70010-134-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013409","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-134-09","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70010-134-09)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013410","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-134-10","proprietary_name":"Esomeprazole magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70010-134-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069081510","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-815-10","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70069-815-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069081530","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-815-30","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70069-815-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069081590","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-815-90","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70069-815-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005611","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-056-11","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.,","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70377-056-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005612","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-056-12","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.,","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70377-056-12)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005613","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-056-13","proprietary_name":"esomeprazole magnesium","nonproprietary_name":"esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.,","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70377-056-13)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009003410","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-034-10","proprietary_name":"ESOMEPRAZOLE MAGNESIUM","nonproprietary_name":"ESOMEPRAZOLE MAGNESIUM","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-034-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009003490","name":"ESOMEPRAZOLE MAG DR 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-034-90","proprietary_name":"ESOMEPRAZOLE MAGNESIUM","nonproprietary_name":"ESOMEPRAZOLE MAGNESIUM","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-034-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700011984","name":"ESTARYLLA 0.25-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estarylla|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700011985","name":"ESTARYLLA 0.25-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-119-85","proprietary_name":"Estarylla","nonproprietary_name":"Norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-119-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estarylla|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00591074401","name":"ESTAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0744-01","proprietary_name":"Estazolam","nonproprietary_name":"Estazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0744-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.88416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estazolam|Estazolam","basis":"generic"},"part_b":null}, {"ndc":"70954048010","name":"ESTAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-480-10","proprietary_name":"Estazolam","nonproprietary_name":"Estazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-480-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.88416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estazolam|Estazolam","basis":"generic"},"part_b":null}, {"ndc":"75907002801","name":"ESTAZOLAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-028-01","proprietary_name":"Estazolam","nonproprietary_name":"Estazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75907-028-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.88416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estazolam|Estazolam","basis":"generic"},"part_b":null}, {"ndc":"00591074501","name":"ESTAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0745-01","proprietary_name":"Estazolam","nonproprietary_name":"Estazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0745-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estazolam|Estazolam","basis":"generic"},"part_b":null}, {"ndc":"70954048110","name":"ESTAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-481-10","proprietary_name":"Estazolam","nonproprietary_name":"Estazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-481-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estazolam|Estazolam","basis":"generic"},"part_b":null}, {"ndc":"75907002901","name":"ESTAZOLAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-029-01","proprietary_name":"Estazolam","nonproprietary_name":"Estazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75907-029-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estazolam|Estazolam","basis":"generic"},"part_b":null}, {"ndc":"00430375414","name":"ESTRACE 0.01% CREAM","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0430-3754-14","proprietary_name":"ESTRACE","nonproprietary_name":"estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Allergan, Inc.","package_description":"36 CARTON in 1 CASE (0430-3754-14) / 1 TUBE, WITH APPLICATOR in 1 CARTON / 42.5 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.76131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Estrace*|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093354143","name":"ESTRADIOL 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3541-43","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0093-3541-43) / 42.5 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378877035","name":"ESTRADIOL 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8770-35","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8770-35) / 42.5 g in 1 TUBE","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922008506","name":"ESTRADIOL 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-085-06","proprietary_name":"ESTRADIOL VAGINAL","nonproprietary_name":"Estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-085-06) / 42.5 g in 1 TUBE","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802009735","name":"ESTRADIOL 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-097-35","proprietary_name":"Estradiol Vaginal","nonproprietary_name":"Estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-097-35) / 42.5 g in 1 TUBE","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"47781010444","name":"ESTRADIOL 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-104-44","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Alvogen Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (47781-104-44) / 42.5 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993000210","name":"ESTRADIOL 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-002-10","proprietary_name":"Estradiol Vaginal Cream","nonproprietary_name":"estradiol","dosage_form":"CREAM","route":"VAGINAL","strength":".1 mg/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-002-10) / 42.5 g in 1 TUBE","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.46452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378334916","name":"ESTRADIOL 0.025 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.75493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378334999","name":"ESTRADIOL 0.025 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3349-99","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-3349-99) / 1 PATCH in 1 POUCH (0378-3349-16) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.75493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781711954","name":"ESTRADIOL 0.025 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7119-54","proprietary_name":"Estradiol Transdermal System","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Sandoz Inc","package_description":"4 PATCH in 1 CARTON (0781-7119-54) / 7 d in 1 PATCH (0781-7119-58)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.75493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781711958","name":"ESTRADIOL 0.025 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":11.75493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378461916","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378461926","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4619-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4619-26) / 1 PATCH in 1 POUCH (0378-4619-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464416","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464426","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4644-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4644-26) / 1 PATCH in 1 POUCH (0378-4644-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781712958","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781712983","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7129-83","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 CARTON (0781-7129-83) / 1 PATCH in 1 POUCH (0781-7129-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968342501","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968342508","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-3425-8","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-3425-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119101","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119108","name":"ESTRADIOL 0.025 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1191-8","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"8 POUCH in 1 BOX (70710-1191-8) / 1 PATCH in 1 POUCH (70710-1191-1) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378336016","name":"ESTRADIOL 0.0375 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.93041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378336099","name":"ESTRADIOL 0.0375 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3360-99","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-3360-99) / 1 PATCH in 1 POUCH (0378-3360-16) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.93041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781712254","name":"ESTRADIOL 0.0375 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7122-54","proprietary_name":"Estradiol Transdermal System","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Sandoz Inc","package_description":"4 PATCH in 1 CARTON (0781-7122-54) / 7 d in 1 PATCH (0781-7122-58)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.93041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781712258","name":"ESTRADIOL 0.0375 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":11.93041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462016","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462026","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4620-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4620-26) / 1 PATCH in 1 POUCH (0378-4620-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464316","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464326","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4643-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4643-26) / 1 PATCH in 1 POUCH (0378-4643-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713858","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713883","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7138-83","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 CARTON (0781-7138-83) / 1 PATCH in 1 POUCH (0781-7138-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968343701","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968343708","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-3437-8","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-3437-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119201","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119208","name":"ESTRADIOL 0.0375 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1192-8","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"8 POUCH in 1 BOX (70710-1192-8) / 1 PATCH in 1 POUCH (70710-1192-1) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378335016","name":"ESTRADIOL 0.05 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.28267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378335099","name":"ESTRADIOL 0.05 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3350-99","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-3350-99) / 1 PATCH in 1 POUCH (0378-3350-16) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.28267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713354","name":"ESTRADIOL 0.05 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7133-54","proprietary_name":"Estradiol Transdermal System","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Sandoz Inc","package_description":"4 PATCH in 1 CARTON (0781-7133-54) / 7 d in 1 PATCH (0781-7133-58)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.28267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713358","name":"ESTRADIOL 0.05 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":11.28267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462116","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462126","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4621-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4621-26) / 1 PATCH in 1 POUCH (0378-4621-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464216","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464226","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4642-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4642-26) / 1 PATCH in 1 POUCH (0378-4642-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781714458","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781714483","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7144-83","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 CARTON (0781-7144-83) / 1 PATCH in 1 POUCH (0781-7144-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968345001","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968345008","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-3450-8","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-3450-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119301","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119308","name":"ESTRADIOL 0.05 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1193-8","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"8 POUCH in 1 BOX (70710-1193-8) / 1 PATCH in 1 POUCH (70710-1193-1) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378336116","name":"ESTRADIOL 0.06 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.25248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378336199","name":"ESTRADIOL 0.06 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3361-99","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".06 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-3361-99) / 1 PATCH in 1 POUCH (0378-3361-16) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":12.25248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713454","name":"ESTRADIOL 0.06 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7134-54","proprietary_name":"Estradiol Transdermal System","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".06 mg/d","labeler":"Sandoz Inc","package_description":"4 PATCH in 1 CARTON (0781-7134-54) / 7 d in 1 PATCH (0781-7134-58)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":12.25248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713458","name":"ESTRADIOL 0.06 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":12.25248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954064610","name":"ESTRADIOL 0.06% 1.25G GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-646-10","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL, METERED","route":"TOPICAL","strength":".75 mg/1.25g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"50 g in 1 BOTTLE, PUMP (70954-646-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":3.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"73473030850","name":"ESTRADIOL 0.06% 1.25G GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-308-50","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/1.25g","labeler":"Solaris Pharma Corporation","package_description":"1 BOTTLE, PUMP in 1 CARTON (73473-308-50) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":3.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378335116","name":"ESTRADIOL 0.075 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":13.05876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378335199","name":"ESTRADIOL 0.075 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3351-99","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-3351-99) / 1 PATCH in 1 POUCH (0378-3351-16) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":13.05876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713654","name":"ESTRADIOL 0.075 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7136-54","proprietary_name":"Estradiol Transdermal System","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Sandoz Inc","package_description":"4 PATCH in 1 CARTON (0781-7136-54) / 7 d in 1 PATCH (0781-7136-58)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":13.05876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781713658","name":"ESTRADIOL 0.075 MG PATCH(1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":13.05876,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462216","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462226","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4622-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4622-26) / 1 PATCH in 1 POUCH (0378-4622-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464116","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464126","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4641-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4641-26) / 1 PATCH in 1 POUCH (0378-4641-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781715658","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781715683","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7156-83","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 CARTON (0781-7156-83) / 1 PATCH in 1 POUCH (0781-7156-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968347501","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968347508","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-3475-8","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-3475-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119401","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119408","name":"ESTRADIOL 0.075 MG PATCH(2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1194-8","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"8 POUCH in 1 BOX (70710-1194-8) / 1 PATCH in 1 POUCH (70710-1194-1) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378335216","name":"ESTRADIOL 0.1 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.76731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378335299","name":"ESTRADIOL 0.1 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3352-99","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-3352-99) / 1 PATCH in 1 POUCH (0378-3352-16) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":12.76731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781710454","name":"ESTRADIOL 0.1 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7104-54","proprietary_name":"Estradiol Transdermal System","nonproprietary_name":"Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Sandoz Inc","package_description":"4 PATCH in 1 CARTON (0781-7104-54) / 7 d in 1 PATCH (0781-7104-58)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":12.76731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781710458","name":"ESTRADIOL 0.1 MG PATCH (1/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":12.76731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462316","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378462326","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4623-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4623-26) / 1 PATCH in 1 POUCH (0378-4623-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464016","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378464026","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4640-26","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"8 POUCH in 1 CARTON (0378-4640-26) / 1 PATCH in 1 POUCH (0378-4640-16) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781716758","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781716783","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7167-83","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 CARTON (0781-7167-83) / 1 PATCH in 1 POUCH (0781-7167-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968341001","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968341008","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-3410-8","proprietary_name":"Estradiol","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 CARTON (68968-3410-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119501","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119508","name":"ESTRADIOL 0.1 MG PATCH (2/WK)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1195-8","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"8 POUCH in 1 BOX (70710-1195-8) / 1 PATCH in 1 POUCH (70710-1195-1) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811009032","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-090-32","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"Trigen Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (13811-090-32) / .25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"21922008652","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-086-52","proprietary_name":"Estradiol Gel","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-086-52) / .25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802013430","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-134-30","proprietary_name":"ESTRADIOL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-134-30) / .25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238245203","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2452-3","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Transdermal","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 PACKET in 1 CARTON (69238-2452-3) / .25 g in 1 PACKET (69238-2452-1)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700014335","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-143-35","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Gel 0.1%","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"Xiromed, LLC","package_description":"30 PACKET in 1 CARTON (70700-143-35) / .25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954053120","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-531-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-531-20) / .25 g in 1 PACKET (70954-531-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603024130","name":"ESTRADIOL 0.1% (0.25 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-241-30","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/.25g","labeler":"NorthStar Rx LLC","package_description":"30 PACKET in 1 CARTON (72603-241-30) / .25 g in 1 PACKET (72603-241-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.75703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811009132","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-091-32","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"Trigen Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (13811-091-32) / .5 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"21922008752","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-087-52","proprietary_name":"Estradiol Gel","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-087-52) / .5 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802020230","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-202-30","proprietary_name":"ESTRADIOL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-202-30) / .5 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238245103","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2451-3","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Transdermal","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 PACKET in 1 CARTON (69238-2451-3) / .5 g in 1 PACKET (69238-2451-1)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700014435","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-144-35","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Gel 0.1%","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"Xiromed, LLC","package_description":"30 PACKET in 1 CARTON (70700-144-35) / .5 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954053020","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-530-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-530-20) / .5 g in 1 PACKET (70954-530-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603024230","name":"ESTRADIOL 0.1% (0.5 MG) GEL PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-242-30","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/.5g","labeler":"NorthStar Rx LLC","package_description":"30 PACKET in 1 CARTON (72603-242-30) / .5 g in 1 PACKET (72603-242-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.95477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811009232","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-092-32","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"Trigen Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (13811-092-32) / .75 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"21922008852","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-088-52","proprietary_name":"Estradiol Gel","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-088-52) / .75 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802031030","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-310-30","proprietary_name":"ESTRADIOL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-310-30) / .75 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238245003","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2450-3","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Transdermal","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 PACKET in 1 CARTON (69238-2450-3) / .75 g in 1 PACKET (69238-2450-1)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700019435","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-194-35","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Gel 0.1%","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"Xiromed, LLC","package_description":"30 PACKET in 1 CARTON (70700-194-35) / .75 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954053220","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-532-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-532-20) / .75 g in 1 PACKET (70954-532-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603024330","name":"ESTRADIOL 0.1% (0.75 MG) GEL PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-243-30","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":".75 mg/.75g","labeler":"NorthStar Rx LLC","package_description":"30 PACKET in 1 CARTON (72603-243-30) / .75 g in 1 PACKET (72603-243-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.59192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811009332","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-093-32","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Trigen Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (13811-093-32) / 1 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922008952","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-089-52","proprietary_name":"Estradiol Gel","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-089-52) / 1 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802045230","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-452-30","proprietary_name":"ESTRADIOL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-452-30) / 1 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238244903","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2449-3","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Transdermal","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 PACKET in 1 CARTON (69238-2449-3) / 1 g in 1 PACKET (69238-2449-1)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700014535","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-145-35","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Gel 0.1%","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Xiromed, LLC","package_description":"30 PACKET in 1 CARTON (70700-145-35) / 1 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70954053320","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-533-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-533-20) / 1 g in 1 PACKET (70954-533-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603024430","name":"ESTRADIOL 0.1% (1 MG) GEL PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-244-30","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar Rx LLC","package_description":"30 PACKET in 1 CARTON (72603-244-30) / 1 g in 1 PACKET (72603-244-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.96726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13811009432","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-094-32","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"Trigen Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (13811-094-32) / 1.25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922009052","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-090-52","proprietary_name":"Estradiol Gel","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-090-52) / 1.25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802057330","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-573-30","proprietary_name":"ESTRADIOL","nonproprietary_name":"estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-573-30) / 1.25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238244803","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2448-3","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Transdermal","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 PACKET in 1 CARTON (69238-2448-3) / 1.25 g in 1 PACKET (69238-2448-1)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700019535","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-195-35","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol Gel 0.1%","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"Xiromed, LLC","package_description":"30 PACKET in 1 CARTON (70700-195-35) / 1.25 g in 1 PACKET","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70954053420","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-534-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-534-20) / 1.25 g in 1 PACKET (70954-534-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603024530","name":"ESTRADIOL 0.1% (1.25 MG) GEL PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-245-30","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"GEL","route":"TOPICAL","strength":"1.25 mg/1.25g","labeler":"NorthStar Rx LLC","package_description":"30 PACKET in 1 CARTON (72603-245-30) / 1.25 g in 1 PACKET (72603-245-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.73351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00555089902","name":"ESTRADIOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0899-02","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0899-02)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658070201","name":"ESTRADIOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-702-01","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"PURACAP LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE (24658-702-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806008701","name":"ESTRADIOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-087-01","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-087-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806008705","name":"ESTRADIOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-087-05","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"500 TABLET in 1 BOTTLE (42806-087-05)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954056410","name":"ESTRADIOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-564-10","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-564-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027301","name":"ESTRADIOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-273-01","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-273-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555088602","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0886-02","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0886-02)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555088604","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0886-04","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0555-0886-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658070301","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-703-01","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"PURACAP LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE (24658-703-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658070305","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-703-05","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"PURACAP LABORATORIES, LLC","package_description":"500 TABLET in 1 BOTTLE (24658-703-05)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806008801","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-088-01","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-088-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806008805","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-088-05","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"500 TABLET in 1 BOTTLE (42806-088-05)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687087611","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687087665","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-876-65","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-876-65) / 1 TABLET in 1 BLISTER PACK (60687-876-11)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954056510","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-565-10","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-565-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954056520","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-565-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (70954-565-20)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027401","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-274-01","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-274-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027402","name":"ESTRADIOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-274-02","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-274-02)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.06347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093322308","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3223-08","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"INSERT","route":"VAGINAL","strength":"10 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"8 BLISTER PACK in 1 CARTON (0093-3223-08) / 1 APPLICATOR in 1 BLISTER PACK / 1 INSERT in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093322319","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093322397","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3223-97","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"INSERT","route":"VAGINAL","strength":"10 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"18 BLISTER PACK in 1 CARTON (0093-3223-97) / 1 APPLICATOR in 1 BLISTER PACK (0093-3223-19) / 1 INSERT in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651043904","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651043906","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651043908","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-439-08","proprietary_name":"ESTRADIOL VAGINAL INSERTS","nonproprietary_name":"Estradiol","dosage_form":"TABLET, FILM COATED","route":"VAGINAL","strength":"10 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"8 APPLICATOR in 1 CARTON (59651-439-08) / 1 TABLET, FILM COATED in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651043918","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-439-18","proprietary_name":"ESTRADIOL VAGINAL INSERTS","nonproprietary_name":"Estradiol","dosage_form":"TABLET, FILM COATED","route":"VAGINAL","strength":"10 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"18 APPLICATOR in 1 CARTON (59651-439-18) / 1 TABLET, FILM COATED in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462071171","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-711-71","proprietary_name":"ESTRADIOL VAGINAL INSERTS","nonproprietary_name":"estradiol","dosage_form":"TABLET, FILM COATED","route":"VAGINAL","strength":"10 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"8 APPLICATOR in 1 CARTON (68462-711-71) / 1 TABLET, FILM COATED in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462071176","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462071182","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462071188","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-711-88","proprietary_name":"ESTRADIOL VAGINAL INSERTS","nonproprietary_name":"estradiol","dosage_form":"TABLET, FILM COATED","route":"VAGINAL","strength":"10 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"18 APPLICATOR in 1 CARTON (68462-711-88) / 1 TABLET, FILM COATED in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603087408","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-874-08","proprietary_name":"ESTRADIOL VAGINAL INSERTS","nonproprietary_name":"Estradiol","dosage_form":"TABLET, FILM COATED","route":"VAGINAL","strength":"10 ug/1","labeler":"NorthStar Rx LLC","package_description":"8 APPLICATOR in 1 CARTON (72603-874-08) / 1 TABLET, FILM COATED in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603087418","name":"ESTRADIOL 10 MCG VAGINAL INSRT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-874-18","proprietary_name":"ESTRADIOL VAGINAL INSERTS","nonproprietary_name":"Estradiol","dosage_form":"TABLET, FILM COATED","route":"VAGINAL","strength":"10 ug/1","labeler":"NorthStar Rx LLC","package_description":"18 APPLICATOR in 1 CARTON (72603-874-18) / 1 TABLET, FILM COATED in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555088702","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0887-02","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0887-02)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555088704","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0887-04","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0555-0887-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658070401","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-704-01","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"PURACAP LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE (24658-704-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658070405","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-704-05","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"PURACAP LABORATORIES, LLC","package_description":"500 TABLET in 1 BOTTLE (24658-704-05)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806008901","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-089-01","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-089-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806008905","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-089-05","proprietary_name":"ESTRADIOL","nonproprietary_name":"ESTRADIOL","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"500 TABLET in 1 BOTTLE (42806-089-05)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954056610","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-566-10","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-566-10)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954056620","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-566-20","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (70954-566-20)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027501","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-275-01","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-275-01)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027502","name":"ESTRADIOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-275-02","proprietary_name":"Estradiol","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-275-02)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":0.07959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143929001","name":"ESTRADIOL VALERATE 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9290-01","proprietary_name":"Estradiol Valerate","nonproprietary_name":"Estradiol Valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9290-01) / 5 mL in 1 VIAL","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":22.64523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9290-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517042001","name":"ESTRADIOL VALERATE 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0420-01","proprietary_name":"ESTRADIOL VALERATE","nonproprietary_name":"ESTRADIOL VALERATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0517-0420-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":22.64523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0517-0420-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700027422","name":"ESTRADIOL VALERATE 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-274-22","proprietary_name":"Estradiol valerate","nonproprietary_name":"Estradiol valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Xiromed, LLC","package_description":"5 mL in 1 VIAL, MULTI-DOSE (70700-274-22)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":22.64523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, MULTI-DOSE (70700-274-22)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143929101","name":"ESTRADIOL VALERATE 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9291-01","proprietary_name":"Estradiol Valerate","nonproprietary_name":"Estradiol Valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9291-01) / 5 mL in 1 VIAL","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":36.82787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9291-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517044001","name":"ESTRADIOL VALERATE 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0440-01","proprietary_name":"ESTRADIOL VALERATE","nonproprietary_name":"ESTRADIOL VALERATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"40 mg/mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0517-0440-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":36.82787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0517-0440-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700027522","name":"ESTRADIOL VALERATE 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-275-22","proprietary_name":"Estradiol valerate","nonproprietary_name":"Estradiol valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Xiromed, LLC","package_description":"5 mL in 1 VIAL, MULTI-DOSE (70700-275-22)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":36.82787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, MULTI-DOSE (70700-275-22)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143928901","name":"ESTRADIOL VALERATE 50 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9289-01","proprietary_name":"Estradiol Valerate","nonproprietary_name":"Estradiol Valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9289-01) / 5 mL in 1 VIAL","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.29878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9289-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700027322","name":"ESTRADIOL VALERATE 50 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-273-22","proprietary_name":"Estradiol valerate","nonproprietary_name":"Estradiol valerate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"10 mg/mL","labeler":"Xiromed, LLC","package_description":"5 mL in 1 VIAL, MULTI-DOSE (70700-273-22)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.29878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Estradiol Valerate|Estradiol Valerate","basis":"generic"},"part_b":{"hcpcs":"J1380","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1380 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, MULTI-DOSE (70700-273-22)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50742065828","name":"ESTRADIOL-NORETH 0.5-0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-658-28","proprietary_name":"Estradiol and Norethindrone Acetate","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1; .1 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1 BLISTER PACK in 1 CARTON (50742-658-28) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"50742065884","name":"ESTRADIOL-NORETH 0.5-0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-658-84","proprietary_name":"Estradiol and Norethindrone Acetate","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1; .1 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"3 BLISTER PACK in 1 CARTON (50742-658-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"51991062328","name":"ESTRADIOL-NORETH 0.5-0.1 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-623-28","proprietary_name":"Estradiol / Norethindrone Acetate","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1; .1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51991-623-28) / 28 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"50742065728","name":"ESTRADIOL-NORETH 1-0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-657-28","proprietary_name":"Estradiol and Norethindrone Acetate","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1 BLISTER PACK in 1 CARTON (50742-657-28) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"50742065784","name":"ESTRADIOL-NORETH 1-0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-657-84","proprietary_name":"Estradiol and Norethindrone Acetate","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"3 BLISTER PACK in 1 CARTON (50742-657-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"51991047428","name":"ESTRADIOL-NORETH 1-0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-474-28","proprietary_name":"Estradiol / Norethindrone Acetate","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51991-474-28) / 28 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estradiol-Norethindrone Acetat|Estradiol/Norethindrone Acet","basis":"generic"},"part_b":null}, {"ndc":"00013104201","name":"ESTRING 7.5 MCG/DAY (2 MG) RING","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0013-1042-01","proprietary_name":"Estring","nonproprietary_name":"estradiol","dosage_form":"SYSTEM","route":"VAGINAL","strength":"2 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 POUCH in 1 CARTON (0013-1042-01) / 1 SYSTEM in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":551.31736,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Estring|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093553756","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5537-56","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5537-56)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"00378527001","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5270-01","proprietary_name":"Eszopiclone","nonproprietary_name":"eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5270-01)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"31722085501","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-855-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-855-01)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"31722085530","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-855-30","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-855-30)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"33342029907","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-299-07","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-299-07)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"55111062930","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-629-30","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (55111-629-30)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"65862096701","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-967-01","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-967-01)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"65862096730","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-967-30","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-967-30)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"68462038201","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-382-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-382-01)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"69452034713","name":"ESZOPICLONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-347-13","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-347-13)"},"nadac":{"value":0.0993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"00093553801","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5538-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5538-01)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"00378527101","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5271-01","proprietary_name":"Eszopiclone","nonproprietary_name":"eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5271-01)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"31722085601","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-856-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-856-01)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"31722085630","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-856-30","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-856-30)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"33342030011","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-300-11","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (33342-300-11)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"55111061901","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-619-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, COATED in 1 BOTTLE (55111-619-01)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"65862096801","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-968-01","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-968-01)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"68462038301","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-383-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-383-01)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"69452034820","name":"ESZOPICLONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-348-20","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-348-20)"},"nadac":{"value":0.09096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"00093553901","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5539-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5539-01)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"00378527201","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5272-01","proprietary_name":"Eszopiclone","nonproprietary_name":"eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5272-01)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"31722085701","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-857-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-857-01)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"31722085730","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-857-30","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-857-30)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"33342030111","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-301-11","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (33342-301-11)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"55111061701","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-617-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"3 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, COATED in 1 BOTTLE (55111-617-01)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"65862096901","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-969-01","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-969-01)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"68462038401","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-384-01","proprietary_name":"Eszopiclone","nonproprietary_name":"Eszopiclone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-384-01)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"69452034920","name":"ESZOPICLONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-349-20","proprietary_name":"ESZOPICLONE","nonproprietary_name":"ESZOPICLONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-349-20)"},"nadac":{"value":0.0877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Eszopiclone|Eszopiclone","basis":"generic"},"part_b":null}, {"ndc":"42799040501","name":"ETHACRYNIC ACID 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-405-01","proprietary_name":"Ethacrynic Acid","nonproprietary_name":"Ethacrynic Acid","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-405-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.80656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethacrynic Acid|Ethacrynic Acid","basis":"generic"},"part_b":null}, {"ndc":"50228033410","name":"ETHACRYNIC ACID 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-334-10","proprietary_name":"Ethacrynic Acid","nonproprietary_name":"Ethacrynic Acid","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-334-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.80656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethacrynic Acid|Ethacrynic Acid","basis":"generic"},"part_b":null}, {"ndc":"68180015901","name":"ETHACRYNIC ACID 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-159-01","proprietary_name":"Ethacrynic Acid","nonproprietary_name":"Ethacrynic Acid","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-159-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.80656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethacrynic Acid|Ethacrynic Acid","basis":"generic"},"part_b":null}, {"ndc":"69238112601","name":"ETHACRYNIC ACID 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1126-1","proprietary_name":"Ethacrynic Acid","nonproprietary_name":"Ethacrynic Acid","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1126-1)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.80656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethacrynic Acid|Ethacrynic Acid","basis":"generic"},"part_b":null}, {"ndc":"42806010101","name":"ETHAMBUTOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-101-01","proprietary_name":"ETHAMBUTOL HYDROCHLORIDE","nonproprietary_name":"ETHAMBUTOL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42806-101-01)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":0.30403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethambutol HCl|Ethambutol HCl","basis":"generic"},"part_b":null}, {"ndc":"68180028001","name":"ETHAMBUTOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-280-01","proprietary_name":"Ethambutol Hydrochloride","nonproprietary_name":"Ethambutol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-280-01)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":0.30403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethambutol HCl|Ethambutol HCl","basis":"generic"},"part_b":null}, {"ndc":"42806010201","name":"ETHAMBUTOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-102-01","proprietary_name":"ETHAMBUTOL HYDROCHLORIDE","nonproprietary_name":"ETHAMBUTOL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42806-102-01)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":0.458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethambutol HCl|Ethambutol HCl","basis":"generic"},"part_b":null}, {"ndc":"68084028001","name":"ETHAMBUTOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-280-01","proprietary_name":"Ethambutol Hydrochloride","nonproprietary_name":"Ethambutol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-280-01) / 1 TABLET in 1 BLISTER PACK (68084-280-11)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":0.458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethambutol HCl|Ethambutol HCl","basis":"generic"},"part_b":null}, {"ndc":"68084028011","name":"ETHAMBUTOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethambutol HCl|Ethambutol HCl","basis":"generic"},"part_b":null}, {"ndc":"68180028101","name":"ETHAMBUTOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-281-01","proprietary_name":"Ethambutol Hydrochloride","nonproprietary_name":"Ethambutol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-281-01)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":0.458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ethambutol HCl|Ethambutol HCl","basis":"generic"},"part_b":null}, {"ndc":"23155053201","name":"ETHOSUXIMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806070801","name":"ETHOSUXIMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-708-01","proprietary_name":"Ethosuximide","nonproprietary_name":"Ethosuximide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-708-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135079012","name":"ETHOSUXIMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-790-12","proprietary_name":"ETHOSUXIMIDE","nonproprietary_name":"ETHOSUXIMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE in 1 BOTTLE (62135-790-12)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380087806","name":"ETHOSUXIMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-878-06","proprietary_name":"ETHOSUXIMIDE","nonproprietary_name":"ETHOSUXIMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE (64380-878-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452015220","name":"ETHOSUXIMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-152-20","proprietary_name":"Ethosuximide","nonproprietary_name":"Ethosuximide","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69452-152-20)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121067016","name":"ETHOSUXIMIDE 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0670-16","proprietary_name":"ETHOSUXIMIDE","nonproprietary_name":"ETHOSUXIMIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0670-16)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762235007","name":"ETHOSUXIMIDE 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2350-7","proprietary_name":"Ethosuximide","nonproprietary_name":"Ethosuximide","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (59762-2350-7) / 474 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672401601","name":"ETODOLAC 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4016-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (51672-4016-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.29637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"60505003901","name":"ETODOLAC 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0039-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-0039-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.29637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"62559025001","name":"ETODOLAC 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-250-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-250-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.29637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"83980003101","name":"ETODOLAC 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-031-01","proprietary_name":"etodolac","nonproprietary_name":"etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (83980-031-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.29637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672401701","name":"ETODOLAC 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4017-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (51672-4017-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.41563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"60505004001","name":"ETODOLAC 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0040-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-0040-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.41563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"62559025101","name":"ETODOLAC 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-251-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-251-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.41563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"83980003201","name":"ETODOLAC 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-032-01","proprietary_name":"etodolac","nonproprietary_name":"etodolac","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 CAPSULE in 1 BOTTLE (83980-032-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.41563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"42799011101","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-111-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42799-111-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672401801","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4018-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51672-4018-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"60505004101","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0041-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0041-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"62135091060","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-910-60","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-910-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"69238134201","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1342-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1342-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"76385011801","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-118-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76385-118-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"83980002901","name":"ETODOLAC 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-029-01","proprietary_name":"etodolac","nonproprietary_name":"etodolac","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-029-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.26236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"42799011201","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-112-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42799-112-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672403601","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4036-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51672-4036-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"60505010201","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0102-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0102-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"62135091160","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-911-60","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-911-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"69238134301","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1343-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1343-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"76385011901","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-119-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76385-119-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"83980003001","name":"ETODOLAC 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-030-01","proprietary_name":"etodolac","nonproprietary_name":"etodolac","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-030-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.28517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"00093112201","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1122-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0093-1122-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"16714049701","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-497-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-497-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"16714049702","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-497-02","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-497-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672405101","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4051-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"TaSun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4051-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672405104","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4051-4","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"TaSun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4051-4)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"68382027101","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-271-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-271-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"68382027114","name":"ETODOLAC ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-271-14","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-271-14)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.61584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"00093717201","name":"ETODOLAC ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7172-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0093-7172-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"16714049802","name":"ETODOLAC ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-498-02","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-498-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672405201","name":"ETODOLAC ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4052-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TaSun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4052-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672405204","name":"ETODOLAC ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4052-4","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TaSun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4052-4)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"68382027201","name":"ETODOLAC ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-272-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-272-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"00093111801","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1118-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0093-1118-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"16714049901","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-499-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-499-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"16714049902","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-499-02","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-499-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672405301","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4053-1","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"TaSun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4053-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"51672405304","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4053-4","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"TaSun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (51672-4053-4)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"68382027301","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-273-01","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-273-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"68382027314","name":"ETODOLAC ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-273-14","proprietary_name":"Etodolac","nonproprietary_name":"Etodolac","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-273-14)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.07277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etodolac ER|Etodolac","basis":"generic"},"part_b":null}, {"ndc":"00093767901","name":"ETONOGESTREL-EE VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093767902","name":"ETONOGESTREL-EE VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7679-02","proprietary_name":"Etonogestrel and Ethinyl Estradiol","nonproprietary_name":"Etonogestrel and Ethinyl Estradiol","dosage_form":"INSERT, EXTENDED RELEASE","route":"VAGINAL","strength":".12 mg/d; .015 mg/d","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0093-7679-02) / 21 d in 1 POUCH (0093-7679-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714002901","name":"ETONOGESTREL-EE VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714002903","name":"ETONOGESTREL-EE VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-029-03","proprietary_name":"Etonogestrel and Ethinyl Estradiol Vaginal Ring","nonproprietary_name":"Etonogestrel and Ethinyl Estradiol Vaginal Ring","dosage_form":"RING","route":"VAGINAL","strength":".015 mg/d; .12 mg/d","labeler":"Northstar Rx LLC","package_description":"3 POUCH in 1 CARTON (16714-029-03) / 21 d in 1 POUCH (16714-029-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993060536","name":"ETONOGESTREL-EE VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-605-36","proprietary_name":"Etonogestrel/Ethinyl Estradiol","nonproprietary_name":"etonogestrel and ethinyl estradiol","dosage_form":"INSERT, EXTENDED RELEASE","route":"VAGINAL","strength":".12 mg/d; .015 mg/d","labeler":"Prasco Laboratories","package_description":"3 POUCH in 1 BOX (66993-605-36) / 21 d in 1 POUCH (66993-605-81)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993060581","name":"ETONOGESTREL-EE VAGINAL RING","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10147057001","name":"ETRAVIRINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10147-0570-1","proprietary_name":"Etravirine","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Patriot Pharmaceuticals","package_description":"120 TABLET in 1 BOTTLE, PLASTIC (10147-0570-1)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.76708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"60219172107","name":"ETRAVIRINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60219-1721-7","proprietary_name":"etravirine","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"120 TABLET in 1 BOTTLE, PLASTIC (60219-1721-7)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.76708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"69315028520","name":"ETRAVIRINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69315-285-20","proprietary_name":"ETRAVIRINE","nonproprietary_name":"ETRAVIRINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Leading Pharma, LLC","package_description":"120 TABLET in 1 BOTTLE (69315-285-20)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.76708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"69452025422","name":"ETRAVIRINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69452-254-22","proprietary_name":"etravirine","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"120 TABLET in 1 BOTTLE, PLASTIC (69452-254-22)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.76708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"10147057101","name":"ETRAVIRINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10147-0571-1","proprietary_name":"Etravirine","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Patriot Pharmaceuticals","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (10147-0571-1)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":9.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"60219172206","name":"ETRAVIRINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1722-6","proprietary_name":"etravirine","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (60219-1722-6)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":9.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"69315028606","name":"ETRAVIRINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-286-06","proprietary_name":"ETRAVIRINE","nonproprietary_name":"ETRAVIRINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Leading Pharma, LLC","package_description":"60 TABLET in 1 BOTTLE (69315-286-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":9.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"69452025517","name":"ETRAVIRINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-255-17","proprietary_name":"etravirine","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (69452-255-17)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":9.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Etravirine|Etravirine","basis":"generic"},"part_b":null}, {"ndc":"55724021111","name":"EUCRISA 2% OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55724-211-11","proprietary_name":"Eucrisa","nonproprietary_name":"crisaborole","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 TUBE in 1 CARTON (55724-211-11) / 100 g in 1 TUBE","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":10.7089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Eucrisa|Crisaborole","basis":"brand"},"part_b":null}, {"ndc":"55724021121","name":"EUCRISA 2% OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55724-211-21","proprietary_name":"Eucrisa","nonproprietary_name":"crisaborole","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 TUBE in 1 CARTON (55724-211-21) / 60 g in 1 TUBE","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":12.64647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Eucrisa|Crisaborole","basis":"brand"},"part_b":null}, {"ndc":"00574206727","name":"EVAMIST 1.53 MG/SPRAY","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2067-27","proprietary_name":"Evamist","nonproprietary_name":"Estradiol","dosage_form":"SPRAY","route":"TRANSDERMAL","strength":"1.53 mg/1","labeler":"Padagis US LLC","package_description":"56 SPRAY in 1 VIAL, MULTI-DOSE (0574-2067-27)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.21945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Evamist|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00054047021","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0470-21","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0470-21)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (0054-0470-21)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"49884015802","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"49884015852","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991037906","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-379-06","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-379-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (51991-379-06)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51991037960","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-379-60","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (51991-379-60) / 10 TABLET in 1 BLISTER PACK (51991-379-99)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"51991037999","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"67877071831","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-718-31","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"6 BLISTER PACK in 1 CARTON (67877-718-31) / 10 TABLET in 1 BLISTER PACK (67877-718-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (67877-718-31) / 10 TABLET in 1 BLISTER PACK (67877-718-33)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877071833","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377006911","name":"EVEROLIMUS 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-069-11","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET in 1 BOTTLE (70377-069-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":1.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (70377-069-11)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054047121","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0471-21","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0471-21)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (0054-0471-21)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"49884015902","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-159-02","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"6 BLISTER PACK in 1 CARTON (49884-159-02) / 10 TABLET in 1 BLISTER PACK (49884-159-52)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (49884-159-02) / 10 TABLET in 1 BLISTER PACK (49884-159-52)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"49884015952","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991038006","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-380-06","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-380-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (51991-380-06)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51991038060","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-380-60","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (51991-380-60) / 10 TABLET in 1 BLISTER PACK (51991-380-99)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"51991038099","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"59651093260","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-932-60","proprietary_name":"everolimus","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (59651-932-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"67877071931","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-719-31","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"6 BLISTER PACK in 1 CARTON (67877-719-31) / 10 TABLET in 1 BLISTER PACK (67877-719-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (67877-719-31) / 10 TABLET in 1 BLISTER PACK (67877-719-33)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877071933","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377007011","name":"EVEROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-070-11","proprietary_name":"Everolimus","nonproprietary_name":"EVEROLIMUS","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET in 1 BOTTLE (70377-070-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":3.52462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (70377-070-11)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054047221","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0472-21","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0472-21)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (0054-0472-21)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"49884016002","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"49884016052","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991038106","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-381-06","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-381-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (51991-381-06)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51991038160","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-381-60","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (51991-381-60) / 10 TABLET in 1 BLISTER PACK (51991-381-99)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"51991038199","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"67877072031","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-720-31","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"6 BLISTER PACK in 1 CARTON (67877-720-31) / 10 TABLET in 1 BLISTER PACK (67877-720-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (67877-720-31) / 10 TABLET in 1 BLISTER PACK (67877-720-33)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877072033","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377007111","name":"EVEROLIMUS 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-071-11","proprietary_name":"Everolimus","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET in 1 BOTTLE (70377-071-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.18252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (70377-071-11)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054060421","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0604-21","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0604-21)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"49884028302","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-283-02","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"6 BLISTER PACK in 1 CARTON (49884-283-02) / 10 TABLET in 1 BLISTER PACK (49884-283-52)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (49884-283-02) / 10 TABLET in 1 BLISTER PACK (49884-283-52)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"49884028352","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991098506","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-985-06","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-985-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (51991-985-06)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51991098560","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"51991098599","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-985-99","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus tablets","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 BLISTER PACK in 1 CARTON (51991-985-99) / 10 TABLET in 1 BLISTER PACK (51991-985-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"59651093460","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-934-60","proprietary_name":"everolimus","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (59651-934-60)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"67877072131","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-721-31","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"6 BLISTER PACK in 1 CARTON (67877-721-31) / 10 TABLET in 1 BLISTER PACK (67877-721-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 BLISTER PACK in 1 CARTON (67877-721-31) / 10 TABLET in 1 BLISTER PACK (67877-721-33)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877072133","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377011211","name":"EVEROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-112-11","proprietary_name":"Everolimus","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET in 1 BOTTLE (70377-112-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":5.25295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":{"hcpcs":"J7527","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7527 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 TABLET in 1 BOTTLE (70377-112-11)) gives 60 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054048213","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0054-0482-13","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0482-13)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991082428","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51991-824-28","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (51991-824-28) / 7 TABLET in 1 BLISTER PACK (51991-824-99)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991082433","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51991-824-33","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (51991-824-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991082499","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377001311","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-013-11","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET in 1 BOTTLE (70377-013-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377001322","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-013-22","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"4 BLISTER PACK in 1 CARTON (70377-013-22) / 7 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377001323","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-013-23","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"4 BLISTER PACK in 1 CARTON (70377-013-23) / 7 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"72603025701","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-257-01","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-257-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"82293003320","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"82293003321","name":"EVEROLIMUS 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82293-033-21","proprietary_name":"everolimus","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novugen Pharma (USA) LLC.","package_description":"4 BLISTER PACK in 1 CARTON (82293-033-21) / 7 TABLET in 1 BLISTER PACK (82293-033-20)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-03","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"00054048113","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0054-0481-13","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-0481-13)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991082228","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51991-822-28","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (51991-822-28) / 7 TABLET in 1 BLISTER PACK (51991-822-99)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991082233","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51991-822-33","proprietary_name":"Everolimus","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (51991-822-33)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"51991082299","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377001111","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-011-11","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET in 1 BOTTLE (70377-011-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377001122","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-011-22","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"4 BLISTER PACK in 1 CARTON (70377-011-22) / 7 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"70377001123","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-011-23","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"4 BLISTER PACK in 1 CARTON (70377-011-23) / 7 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"72603025501","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-255-01","proprietary_name":"EVEROLIMUS","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-255-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"82293003120","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"82293003121","name":"EVEROLIMUS 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82293-031-21","proprietary_name":"everolimus","nonproprietary_name":"everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novugen Pharma (USA) LLC.","package_description":"4 BLISTER PACK in 1 CARTON (82293-031-21) / 7 TABLET in 1 BLISTER PACK (82293-031-20)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"73352069910","name":"EVEXITHROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-699-10","proprietary_name":"EvexiTHROID","nonproprietary_name":"LEVOTHYROXINE and LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"76 ug/1; 18 ug/1","labeler":"Trifluent Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (73352-699-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352069310","name":"EVEXITHROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-693-10","proprietary_name":"EvexiTHROID","nonproprietary_name":"LEVOTHYROXINE and LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"9.5 ug/1; 2.25 ug/1","labeler":"Trifluent Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (73352-693-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352069410","name":"EVEXITHROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-694-10","proprietary_name":"EvexiTHROID","nonproprietary_name":"LEVOTHYROXINE and LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"19 ug/1; 4.5 ug/1","labeler":"Trifluent Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (73352-694-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352069610","name":"EVEXITHROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-696-10","proprietary_name":"EvexiTHROID","nonproprietary_name":"LEVOTHYROXINE and LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"38 ug/1; 9 ug/1","labeler":"Trifluent Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (73352-696-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352069810","name":"EVEXITHROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-698-10","proprietary_name":"EvexiTHROID","nonproprietary_name":"LEVOTHYROXINE and LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"57 ug/1; 13.5 ug/1","labeler":"Trifluent Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (73352-698-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002418430","name":"EVISTA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4184-30","proprietary_name":"Evista","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Eli Lilly and Company","package_description":"30 TABLET in 1 BOTTLE (0002-4184-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":6.34306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Evista|Raloxifene HCl","basis":"brand"},"part_b":null}, {"ndc":"00003364111","name":"EVOTAZ 300 MG-150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-3641-11","proprietary_name":"EVOTAZ","nonproprietary_name":"atazanavir and cobicistat","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 150 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"30 TABLET in 1 BOTTLE (0003-3641-11)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":52.0479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Evotaz|Atazanavir Sulfate/Cobicistat","basis":"brand"},"part_b":null}, {"ndc":"00713088301","name":"EVOXAC 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0883-01","proprietary_name":"Evoxac","nonproprietary_name":"cevimeline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0713-0883-01)","pharm_classes":["Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":8.59086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.72894,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Evoxac|Cevimeline HCl","basis":"brand"},"part_b":null}, {"ndc":"00078050115","name":"EXELON 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0501-15","proprietary_name":"Exelon","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 PATCH in 1 CARTON (0078-0501-15) / 24 h in 1 PATCH (0078-0501-61)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":21.87205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"00078050161","name":"EXELON 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.87205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"66758014231","name":"EXELON 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-142-31","proprietary_name":"Exelon","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Sandoz Inc","package_description":"30 PATCH in 1 CARTON (66758-142-31) / 24 h in 1 PATCH (66758-142-58)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":21.87205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"66758014258","name":"EXELON 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.87205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"00078050215","name":"EXELON 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0502-15","proprietary_name":"Exelon","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 PATCH in 1 CARTON (0078-0502-15) / 24 h in 1 PATCH (0078-0502-61)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":21.80833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"00078050261","name":"EXELON 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.80833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"66758014331","name":"EXELON 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-143-31","proprietary_name":"Exelon","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Sandoz Inc","package_description":"30 PATCH in 1 CARTON (66758-143-31) / 24 h in 1 PATCH (66758-143-58)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":21.80833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"66758014358","name":"EXELON 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.80833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exelon|Rivastigmine","basis":"brand"},"part_b":null}, {"ndc":"00054008013","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"00832059530","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0595-30","proprietary_name":"Exemestane","nonproprietary_name":"Exemestane","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, Inc.","package_description":"30 TABLET in 1 BOTTLE (0832-0595-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"51991000590","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-005-90","proprietary_name":"Exemestane","nonproprietary_name":"Exemestane","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (51991-005-90)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"59651051630","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-516-30","proprietary_name":"Exemestane","nonproprietary_name":"Exemestane","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-516-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"59762285801","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-2858-1","proprietary_name":"EXEMESTANE","nonproprietary_name":"Exemestane","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, SUGAR COATED in 1 BOTTLE (59762-2858-1)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"68382038306","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-383-06","proprietary_name":"Exemestane","nonproprietary_name":"Exemestane","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (68382-383-06)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"69097031602","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-316-02","proprietary_name":"EXEMESTANE","nonproprietary_name":"exemestane","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-316-02)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"71921019033","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-190-33","proprietary_name":"Exemestane","nonproprietary_name":"Exemestane","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (71921-190-33)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"72603032901","name":"EXEMESTANE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-329-01","proprietary_name":"Exemestane","nonproprietary_name":"Exemestane","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-329-01)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.74782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exemestane|Exemestane","basis":"generic"},"part_b":null}, {"ndc":"70121168601","name":"EXENATIDE 10 MCG DOSE PEN INJ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70121-1686-1","proprietary_name":"Exenatide","nonproprietary_name":"Exenatide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 CARTRIDGE in 1 CARTON (70121-1686-1) / 2.4 mL in 1 CARTRIDGE","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":300.1675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078049115","name":"EXFORGE 10-320 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0491-15","proprietary_name":"Exforge","nonproprietary_name":"amlodipine besylate and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0078-0491-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":15.39419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.43177,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exforge|Amlodipine Besylate/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078048815","name":"EXFORGE 5-160 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0488-15","proprietary_name":"Exforge","nonproprietary_name":"amlodipine besylate and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 160 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0078-0488-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":10.65075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26403,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exforge|Amlodipine Besylate/Valsartan","basis":"brand"},"part_b":null}, {"ndc":"00078056315","name":"EXFORGE HCT 10-320-25 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0563-15","proprietary_name":"Exforge HCT","nonproprietary_name":"amlodipine valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 320 mg/1; 25 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0078-0563-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":15.44773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.44347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Exforge HCT|Amlodipine/Valsartan/HCThiazid","basis":"brand"},"part_b":null}, {"ndc":"23594015032","name":"EXXUA ER 18.2 MG TAB (TITRATN)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23594-150-32","proprietary_name":"EXXUA","nonproprietary_name":"gepirone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18.2 mg/1","labeler":"Aytu Therapeutics, LLC","package_description":"32 TABLET, EXTENDED RELEASE in 1 BOTTLE (23594-150-32)"},"nadac":{"value":57.47091,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23594015230","name":"EXXUA ER 54.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23594-152-30","proprietary_name":"EXXUA","nonproprietary_name":"gepirone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54.5 mg/1","labeler":"Aytu Therapeutics, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (23594-152-30)"},"nadac":{"value":56.57319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385007505","name":"EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.09689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385007705","name":"EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000045601","name":"EYE DROPS ADVANCED RELIEF","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0456-1","proprietary_name":"Leader Advanced Relief Eye Drops","nonproprietary_name":"DEXTRAN 70, POLYETHYLENE GLYCOL 400, POVIDONE, TETRAHYDROZOLINE HCl","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/100mL; 1000 mg/100mL; 1000 mg/100mL; 50 mg/100mL","labeler":"Cardinal Health","package_description":"1 BOTTLE, DROPPER in 1 BOX (70000-0456-1) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Increased Intravascular Volume [PE]","Osmotic Activity [MoA]","Plasma Volume Expander [EPC]"]},"nadac":{"value":0.152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536125240","name":"EYE ITCH RELIEF 0.025% DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1252-40","proprietary_name":"Ketotifen Fumarate","nonproprietary_name":"Ketotifen Fumarate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0536-1252-40) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":1.29403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000052201","name":"EYE ITCH RELIEF 0.025% DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0522-1","proprietary_name":"Eye Itch Relief","nonproprietary_name":"ketotifen fumarate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Cardinal Health","package_description":"1 BOTTLE in 1 CARTON (70000-0522-1) / 5 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":1.29403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000001801","name":"EYE WASH IRRIGATING SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0018-1","proprietary_name":"Leader Eye Wash","nonproprietary_name":"purified water","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"99.05 g/100mL","labeler":"Cardinal Health","package_description":"1 BOTTLE, DROPPER in 1 BOX (70000-0018-1) / 118 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.02879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536122497","name":"EYE WASH SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1224-97","proprietary_name":"Rugby Eye Wash","nonproprietary_name":"Water, purified","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"99.05 g/100mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, DROPPER in 1 BOX (0536-1224-97) / 118 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.02879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71571033383","name":"EYSUVIS 0.25% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71571-333-83","proprietary_name":"Eysuvis","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"ALCON LABORATORIES, INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (71571-333-83) / 8.3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":61.51166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Eysuvis|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"00904710304","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7103-04","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7103-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"00904710310","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7103-10","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7103-10) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"16714081301","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-813-01","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-813-01)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"16714081302","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-813-02","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET in 1 BOTTLE (16714-813-02)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"16714081303","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-813-03","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (16714-813-03)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"31722062805","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-628-05","proprietary_name":"EZETIMIBE","nonproprietary_name":"EZETIMIBE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-628-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"31722062830","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-628-30","proprietary_name":"EZETIMIBE","nonproprietary_name":"EZETIMIBE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-628-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"31722062890","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-628-90","proprietary_name":"EZETIMIBE","nonproprietary_name":"EZETIMIBE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-628-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"50228037905","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-379-05","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-379-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"50228037930","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-379-30","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (50228-379-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"50228037990","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-379-90","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (50228-379-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"50268029811","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"50268029812","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-298-12","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-298-12) / 1 TABLET in 1 BLISTER PACK (50268-298-11)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"51660020005","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-200-05","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"500 TABLET in 1 BOTTLE (51660-200-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"51660020030","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-200-30","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"30 TABLET in 1 BOTTLE (51660-200-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"51660020090","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-200-90","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"90 TABLET in 1 BOTTLE (51660-200-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"59651005205","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-052-05","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-052-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"59651005230","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-052-30","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-052-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"59651005290","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-052-90","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (59651-052-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"60687037311","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"60687037321","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-373-21","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-373-21) / 1 TABLET in 1 BLISTER PACK (60687-373-11)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"67877049005","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-490-05","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-490-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"67877049030","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-490-30","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-490-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"67877049090","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-490-90","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-490-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"68382077305","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-773-05","proprietary_name":"ezetimibe","nonproprietary_name":"ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-773-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"68382077306","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-773-06","proprietary_name":"ezetimibe","nonproprietary_name":"ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (68382-773-06)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"68382077316","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-773-16","proprietary_name":"ezetimibe","nonproprietary_name":"ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-773-16)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"68462022605","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-226-05","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-226-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"68462022630","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-226-30","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-226-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"68462022690","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-226-90","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-226-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"69238115403","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1154-3","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET in 1 BOTTLE (69238-1154-3)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"69238115409","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1154-9","proprietary_name":"Ezetimibe","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 TABLET in 1 BOTTLE (69238-1154-9)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"82009002405","name":"EZETIMIBE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-024-05","proprietary_name":"ezetimibe","nonproprietary_name":"ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-024-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe|Ezetimibe","basis":"generic"},"part_b":null}, {"ndc":"43598074210","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-742-10","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (43598-742-10)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074230","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-742-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-742-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074290","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-742-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-742-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877050730","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-507-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-507-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877050790","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-507-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-507-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032130","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-321-30","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-321-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032190","name":"EZETIMIBE-SIMVASTATIN 10-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-321-90","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-321-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.27376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074410","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-744-10","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"1000 TABLET in 1 BOTTLE (43598-744-10)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074430","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-744-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-744-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074490","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-744-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-744-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877050830","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-508-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-508-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877050890","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-508-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-508-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032230","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-322-30","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-322-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032290","name":"EZETIMIBE-SIMVASTATIN 10-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-322-90","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-322-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714078001","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-780-01","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"30 TABLET in 1 BOTTLE (16714-780-01)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714078002","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-780-02","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"90 TABLET in 1 BOTTLE (16714-780-02)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074330","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-743-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-743-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074390","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-743-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-743-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877050930","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-509-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-509-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877050990","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-509-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-509-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032330","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-323-30","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-323-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032390","name":"EZETIMIBE-SIMVASTATIN 10-40 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-323-90","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-323-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714078101","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-781-01","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"30 TABLET in 1 BOTTLE (16714-781-01)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714078102","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-781-02","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"90 TABLET in 1 BOTTLE (16714-781-02)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074505","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-745-05","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"500 TABLET in 1 BOTTLE (43598-745-05)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074530","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-745-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET in 1 BOTTLE (43598-745-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"43598074590","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-745-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 TABLET in 1 BOTTLE (43598-745-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877051030","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-510-30","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-510-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"67877051090","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-510-90","proprietary_name":"Ezetimibe and Simvastatin","nonproprietary_name":"Ezetimibe and Simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-510-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032430","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-324-30","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-324-30)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68462032490","name":"EZETIMIBE-SIMVASTATIN 10-80 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-324-90","proprietary_name":"ezetimibe and simvastatin","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-324-90)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ezetimibe-Simvastatin|Ezetimibe/Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"51862029510","name":"FABIOR 0.1% FOAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51862-295-10","proprietary_name":"FABIOR","nonproprietary_name":"tazarotene","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Mayne Pharma","package_description":"1 CAN in 1 CARTON (51862-295-10) / 100 g in 1 CAN","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":12.32276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Fabior|Tazarotene","basis":"brand"},"part_b":null}, {"ndc":"16714035901","name":"FALMINA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-359-01","proprietary_name":"Falmina","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-359-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Falmina|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714035903","name":"FALMINA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-359-03","proprietary_name":"Falmina","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-359-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Falmina|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714035904","name":"FALMINA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-359-04","proprietary_name":"Falmina","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-359-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Falmina|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093811756","name":"FAMCICLOVIR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8117-56","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-8117-56)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.21439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"31722070630","name":"FAMCICLOVIR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-706-30","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-706-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.21439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"33342002407","name":"FAMCICLOVIR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-024-07","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-024-07)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.21439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"60505324503","name":"FAMCICLOVIR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"64980034903","name":"FAMCICLOVIR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-349-03","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64980-349-03)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.21439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"65862046530","name":"FAMCICLOVIR 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-465-30","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-465-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.21439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"00093811856","name":"FAMCICLOVIR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8118-56","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-8118-56)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.44249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"31722070730","name":"FAMCICLOVIR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-707-30","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-707-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.44249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"33342002507","name":"FAMCICLOVIR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-025-07","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-025-07)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.44249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"60505324603","name":"FAMCICLOVIR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"64980035003","name":"FAMCICLOVIR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-350-03","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64980-350-03)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.44249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"65862046630","name":"FAMCICLOVIR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-466-30","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-466-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.44249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"00093811956","name":"FAMCICLOVIR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8119-56","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-8119-56)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.7878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"31722070830","name":"FAMCICLOVIR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-708-30","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-708-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.7878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"33342002607","name":"FAMCICLOVIR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-026-07","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-026-07)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.7878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"60505324703","name":"FAMCICLOVIR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.7878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"64980035103","name":"FAMCICLOVIR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-351-03","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64980-351-03)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.7878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"65862046730","name":"FAMCICLOVIR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-467-30","proprietary_name":"Famciclovir","nonproprietary_name":"Famciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-467-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.7878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Famciclovir|Famciclovir","basis":"generic"},"part_b":null}, {"ndc":"55111011890","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-118-90","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddys Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-118-90) / 90 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001049404","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-494-04","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-494-04) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001049406","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-494-06","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-494-06) / 60 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032601","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-326-01","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-326-01) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032605","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-326-05","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-326-05) / 500 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032610","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-326-10","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-326-10) / 1000 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032630","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-326-30","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-326-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032660","name":"FAMOTIDINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-326-60","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-326-60) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00172572860","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-5728-60","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0172-5728-60)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00172572870","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-5728-70","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0172-5728-70)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00172572880","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-5728-80","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0172-5728-80)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536129801","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1298-01","proprietary_name":"Rugby Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1298-01) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904719306","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7193-06","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7193-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904719361","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7193-61","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7193-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001701","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-017-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-017-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001710","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-017-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-017-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268029911","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268029915","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-299-15","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-299-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-299-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111011901","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-119-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (55111-119-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111011910","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-119-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (55111-119-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039601","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-396-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddys Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-396-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687059501","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-595-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-595-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-595-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687059511","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442012101","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-121-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Carlsbad Technology, Inc","package_description":"24 BOTTLE in 1 BOX (61442-121-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442012110","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-121-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Carlsbad Technology, Inc","package_description":"12 BOTTLE in 1 BOX (61442-121-10) / 1000 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135080790","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-807-90","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-807-90)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332000131","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-001-31","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-001-31)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332000191","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-001-91","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-001-91)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062301","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-623-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-623-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062310","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-623-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (64980-623-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062350","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-623-50","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64980-623-50)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862085901","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-859-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-859-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862085999","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-859-99","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-859-99)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877084201","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-842-01","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-842-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877084205","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-842-05","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-842-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877084210","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-842-10","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-842-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001039700","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-397-00","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-397-00)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001039708","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-397-08","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68001-397-08)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094005459","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094005465","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-054-65","proprietary_name":"Famotidine","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Precision Dose, Inc.","package_description":"20 BLISTER PACK in 1 CARTON (68094-054-65) / 10 TABLET, FILM COATED in 1 BLISTER PACK (68094-054-59)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68645014059","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68645059459","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-594-59","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68645-594-59)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032701","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-327-01","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-327-01) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032705","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-327-05","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-327-05) / 500 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032710","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-327-10","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-327-10) / 1000 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032730","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-327-30","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-327-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032750","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-327-50","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-327-50) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367040010","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-400-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-400-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710168300","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1683-0","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70710-1683-0)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710168301","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1683-1","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1683-1)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756005111","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-051-11","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-051-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756005112","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-051-12","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-051-12)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014505","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-145-05","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-145-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014530","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-145-30","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-145-30)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014591","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-145-91","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72205-145-91)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014599","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-145-99","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-145-99)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.02886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011625","name":"FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-116-25","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chain Drug Marketing Association INC","package_description":"1 BOTTLE in 1 CARTON (83324-116-25) / 25 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641602225","name":"FAMOTIDINE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6022-25","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6022-25) / 2 mL in 1 VIAL (0641-6022-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.30272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1308","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1308 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6022-25) / 2 mL in 1 VIAL (0641-6022-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021075302","name":"FAMOTIDINE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-753-02","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-753-02) / 2 mL in 1 VIAL","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.30272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1308","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1308 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-753-02) / 2 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323073912","name":"FAMOTIDINE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-739-12","proprietary_name":"Famotidine","nonproprietary_name":"FAMOTIDINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-739-12) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-739-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.30272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1308","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1308 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (63323-739-12) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-739-11)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323073916","name":"FAMOTIDINE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-739-16","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-USE in 1 TRAY (63323-739-16) / 2 mL in 1 VIAL, SINGLE-USE (63323-739-41)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.30272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1308","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1308 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 TRAY (63323-739-16) / 2 mL in 1 VIAL, SINGLE-USE (63323-739-41)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457043322","name":"FAMOTIDINE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-433-22","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL in 1 CARTON (67457-433-22) / 2 mL in 1 VIAL (67457-433-00)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.30272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1308","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1308 (0.25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (67457-433-22) / 2 mL in 1 VIAL (67457-433-00)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00172572960","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-5729-60","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0172-5729-60)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00172572970","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-5729-70","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0172-5729-70)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001801","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-018-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-018-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001805","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-018-05","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-018-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001810","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-018-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-018-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268030411","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268030415","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-304-15","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-304-15) / 1 TABLET in 1 BLISTER PACK (50268-304-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442012201","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-122-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Carlsbad Technology, Inc","package_description":"24 BOTTLE in 1 BOX (61442-122-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442012210","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-122-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Carlsbad Technology, Inc","package_description":"12 BOTTLE in 1 BOX (61442-122-10) / 1000 TABLET in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135080890","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-808-90","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-808-90)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332000231","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-002-31","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-002-31)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332000271","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-002-71","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-002-71)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332000291","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-002-91","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-002-91)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062401","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-624-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-624-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062410","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-624-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (64980-624-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062450","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-624-50","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64980-624-50)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862086001","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-860-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-860-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862086099","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-860-99","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-860-99)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877084301","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-843-01","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-843-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877084305","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-843-05","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-843-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877088901","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-889-01","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-889-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877088905","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-889-05","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-889-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001039800","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-398-00","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-398-00)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001039803","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-398-03","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-398-03)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367040110","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-401-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-401-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710168400","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1684-0","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70710-1684-0)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710168401","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1684-1","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1684-1)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710168405","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1684-5","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70710-1684-5)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756005211","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-052-11","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-052-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756005212","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-052-12","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-052-12)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014605","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-146-05","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72205-146-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014630","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-146-30","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-146-30)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014691","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-146-91","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72205-146-91)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205014699","name":"FAMOTIDINE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-146-99","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-146-99)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832604510","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0832-6045-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 mL in 1 BOTTLE (0832-6045-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.4942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832604550","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6045-50","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"50 mL in 1 BOTTLE (0832-6045-50)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27241024949","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-249-49","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Ajanta Pharma USA Inc.","package_description":"50 mL in 1 BOTTLE (27241-249-49)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722006331","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-063-31","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"50 mL in 1 BOTTLE (31722-063-31)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571043345","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-433-45","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Micro Labs Limited","package_description":"50 mL in 1 BOTTLE (42571-433-45)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651070150","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-701-50","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"50 mL in 1 BOTTLE (59651-701-50)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219209004","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2090-4","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"50 mL in 1 BOTTLE (60219-2090-4)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877077589","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-775-89","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"50 mL in 1 BOTTLE (67877-775-89)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180015001","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-150-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"50 mL in 1 BOTTLE (68180-150-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68382044405","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-444-05","proprietary_name":"FAMOTIDINE","nonproprietary_name":"famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"50 mL in 1 BOTTLE, PLASTIC (68382-444-05)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238209004","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2090-4","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"50 mL in 1 BOTTLE (69238-2090-4)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70377011311","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-113-11","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Biocon Pharma Inc.","package_description":"50 mL in 1 BOTTLE (70377-113-11)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954031610","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-316-10","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"50 mL in 1 BOTTLE (70954-316-10)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205023384","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-233-84","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"55 mL in 1 BOTTLE (72205-233-84)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603017101","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-171-01","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"50 mL in 1 BOTTLE (72603-171-01)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"80005011916","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-119-16","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Carnegie Pharmaceuticals LLC","package_description":"50 mL in 1 BOTTLE (80005-119-16)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81033002350","name":"FAMOTIDINE 40 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-023-50","proprietary_name":"FAMOTIDINE","nonproprietary_name":"FAMOTIDINE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/5mL","labeler":"Kesin Pharma Corporation","package_description":"50 mL in 1 BOTTLE (81033-023-50)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43068010102","name":"FANAPT 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-101-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-101-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":30.49846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"43068011002","name":"FANAPT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-110-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-110-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":60.28658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"43068011202","name":"FANAPT 12 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-112-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"12 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-112-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":60.00994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"43068010202","name":"FANAPT 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-102-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-102-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":30.73767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"43068010402","name":"FANAPT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-104-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-104-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":30.53019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"43068010602","name":"FANAPT 6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-106-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-106-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":37.61441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"43068010802","name":"FANAPT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43068-108-02","proprietary_name":"FANAPT","nonproprietary_name":"ILOPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Vanda Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (43068-108-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":37.4823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fanapt|Iloperidone","basis":"brand"},"part_b":null}, {"ndc":"00310621030","name":"FARXIGA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6210-30","proprietary_name":"FARXIGA","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0310-6210-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.07703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Farxiga|Dapagliflozin Propanediol","basis":"brand"},"part_b":null}, {"ndc":"00310621039","name":"FARXIGA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6210-39","proprietary_name":"FARXIGA","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"3 BLISTER PACK in 1 CARTON (0310-6210-39) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.07703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Farxiga|Dapagliflozin Propanediol","basis":"brand"},"part_b":null}, {"ndc":"00310621090","name":"FARXIGA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6210-90","proprietary_name":"FARXIGA","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0310-6210-90)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.07703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18391,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Farxiga|Dapagliflozin Propanediol","basis":"brand"},"part_b":null}, {"ndc":"00310620530","name":"FARXIGA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6205-30","proprietary_name":"FARXIGA","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0310-6205-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.07577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Farxiga|Dapagliflozin Propanediol","basis":"brand"},"part_b":null}, {"ndc":"00310620590","name":"FARXIGA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6205-90","proprietary_name":"FARXIGA","nonproprietary_name":"DAPAGLIFLOZIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0310-6205-90)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.07577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16272,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Farxiga|Dapagliflozin Propanediol","basis":"brand"},"part_b":null}, {"ndc":"00054041313","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0413-13","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 TABLET in 1 BOTTLE (0054-0413-13)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"00527224432","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2244-32","proprietary_name":"FEBUXOSTAT","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (0527-2244-32)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"00904739546","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7395-46","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7395-46)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"16714005901","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-059-01","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-059-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"27808020601","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-206-01","proprietary_name":"Febuxostat","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Tris Pharma Inc","package_description":"30 TABLET in 1 BOTTLE (27808-206-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"33342027407","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-274-07","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat tablets 40 mg","dosage_form":"FILM","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 FILM in 1 BOTTLE (33342-274-07)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"43547029503","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-295-03","proprietary_name":"FEBUXOSTAT","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US LLC","package_description":"30 TABLET in 1 BOTTLE (43547-295-03)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"47335072183","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-721-83","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (47335-721-83)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"59651011330","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-113-30","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-113-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"60687053811","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"60687053821","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-538-21","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-538-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-538-11)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"62332019030","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-190-30","proprietary_name":"Febuxostat","nonproprietary_name":"febuxostat","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-190-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"72205002830","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-028-30","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-028-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"72578013606","name":"FEBUXOSTAT 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-136-06","proprietary_name":"febuxostat","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-136-06)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"00054041413","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0414-13","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 TABLET in 1 BOTTLE (0054-0414-13)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"00527224832","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2248-32","proprietary_name":"FEBUXOSTAT","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (0527-2248-32)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"00904739646","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7396-46","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7396-46)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"16714006001","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-060-01","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-060-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"27808020701","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-207-01","proprietary_name":"Febuxostat","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Tris Pharma Inc","package_description":"30 TABLET in 1 BOTTLE (27808-207-01)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"33342027507","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-275-07","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat tablets 80 mg","dosage_form":"FILM","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 FILM in 1 BOTTLE (33342-275-07)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"43547029603","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-296-03","proprietary_name":"FEBUXOSTAT","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Solco Healthcare US LLC","package_description":"30 TABLET in 1 BOTTLE (43547-296-03)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"47335072283","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-722-83","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (47335-722-83)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"59651011430","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-114-30","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-114-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"62332019130","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-191-30","proprietary_name":"Febuxostat","nonproprietary_name":"febuxostat","dosage_form":"TABLET, COATED","route":"ORAL","strength":"80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-191-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"72205002930","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-029-30","proprietary_name":"Febuxostat","nonproprietary_name":"Febuxostat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-029-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"72578013706","name":"FEBUXOSTAT 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-137-06","proprietary_name":"febuxostat","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-137-06)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Febuxostat|Febuxostat","basis":"generic"},"part_b":null}, {"ndc":"70700030784","name":"FEIRZA 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030785","name":"FEIRZA 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-307-85","proprietary_name":"FEIRZA 1/20","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol Tablets USP, 1 mg/0.02 mg and Ferrous Fumarate Tablets, 75 mg","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-307-85) / 1 BLISTER PACK in 1 POUCH (70700-307-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030984","name":"FEIRZA 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030985","name":"FEIRZA 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-309-85","proprietary_name":"FEIRZA 1.5/30 TM","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol Tablets USP, 1.5 mg/30 mcg and Ferrous Fumarate Tablets, 75 mg","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-309-85) / 1 BLISTER PACK in 1 POUCH (70700-309-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672418501","name":"FELBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4185-1","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4185-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746073490","name":"FELBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-734-90","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 TABLET in 1 BOTTLE (53746-734-90)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559073001","name":"FELBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-730-01","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-730-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162073409","name":"FELBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-734-09","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-734-09)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578005601","name":"FELBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-056-01","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-056-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578005616","name":"FELBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-056-16","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (72578-056-16)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672418601","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4186-1","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4186-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746073518","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-735-18","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"180 TABLET in 1 BOTTLE (53746-735-18)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746073590","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-735-90","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 TABLET in 1 BOTTLE (53746-735-90)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559073101","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-731-01","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-731-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162073509","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-735-09","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-735-09)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162073518","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-735-18","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"180 TABLET in 1 BOTTLE (65162-735-18)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578005701","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-057-01","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-057-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578005716","name":"FELBAMATE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-057-16","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (72578-057-16)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714077501","name":"FELBAMATE 600 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-775-01","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL","labeler":"NORTHSTAR RX LLC","package_description":"237 mL in 1 BOTTLE (16714-775-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.35611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672417201","name":"FELBAMATE 600 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4172-1","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"237 mL in 1 BOTTLE (51672-4172-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.35611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954005110","name":"FELBAMATE 600 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-051-10","proprietary_name":"Felbamate","nonproprietary_name":"Felbamate","dosage_form":"SUSPENSION","route":"ORAL","strength":"600 mg/5mL","labeler":"Novitium Pharma LLC","package_description":"237 mL in 1 BOTTLE (70954-051-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.35611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00037043001","name":"FELBATOL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-0430-01","proprietary_name":"Felbatol","nonproprietary_name":"felbamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0037-0430-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":14.68507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.79783,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felbatol|Felbamate","basis":"brand"},"part_b":null}, {"ndc":"00037043101","name":"FELBATOL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-0431-01","proprietary_name":"Felbatol","nonproprietary_name":"felbamate","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0037-0431-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":16.82196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.0016,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felbatol|Felbamate","basis":"brand"},"part_b":null}, {"ndc":"00603358321","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-3583-21","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0603-3583-21)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"00603358328","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-3583-28","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0603-3583-28)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013401","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-134-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-134-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013405","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-134-05","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-134-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013410","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-134-10","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-134-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"23155005001","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-050-01","proprietary_name":"FELODIPINE","nonproprietary_name":"FELODIPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (23155-050-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"57237011001","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-110-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (57237-110-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"61442043305","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-433-05","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (61442-433-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"62135064890","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-648-90","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-648-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"68462023501","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-235-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-235-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"69367026601","name":"FELODIPINE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-266-01","proprietary_name":"Felopdipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-266-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"00603358121","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-3581-21","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0603-3581-21)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"00603358128","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-3581-28","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0603-3581-28)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013201","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-132-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-132-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013205","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-132-05","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-132-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013210","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-132-10","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-132-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"23155004801","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-048-01","proprietary_name":"FELODIPINE","nonproprietary_name":"FELODIPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (23155-048-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"57237010801","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-108-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (57237-108-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"61442043105","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-431-05","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (61442-431-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"62135064690","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-646-90","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-646-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"68462023301","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-233-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-233-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"69367026401","name":"FELODIPINE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-264-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-264-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"00603358221","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-3582-21","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0603-3582-21)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"00603358228","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-3582-28","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0603-3582-28)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013301","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-133-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-133-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013305","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-133-05","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-133-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"13668013310","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-133-10","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-133-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"23155004901","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-049-01","proprietary_name":"FELODIPINE","nonproprietary_name":"FELODIPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (23155-049-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"57237010901","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-109-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (57237-109-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"61442043205","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-432-05","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (61442-432-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"62135064790","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-647-90","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-647-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"68462023401","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-234-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-234-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"69367026501","name":"FELODIPINE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-265-01","proprietary_name":"Felodipine","nonproprietary_name":"Felodipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-265-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.12262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Felodipine ER|Felodipine","basis":"generic"},"part_b":null}, {"ndc":"00078024915","name":"FEMARA 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0249-15","proprietary_name":"Femara","nonproprietary_name":"letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0078-0249-15)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":27.11602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Femara|Letrozole","basis":"brand"},"part_b":null}, {"ndc":"72495060184","name":"FEMLYV 1 MG-0.02 MG ODT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72495-601-84","proprietary_name":"FEMLYV","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Millicent US, Inc.","package_description":"3 POUCH in 1 CARTON (72495-601-84) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":7.04096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72495020105","name":"FEMRING 0.05 MG/DAY VAG RING","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72495-201-05","proprietary_name":"Femring","nonproprietary_name":"estradiol acetate","dosage_form":"RING","route":"VAGINAL","strength":".05 mg/d","labeler":"Millicent US, Inc.","package_description":"1 POUCH in 1 CARTON (72495-201-05) / 90 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":866.06935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Femring|Estradiol Acetate","basis":"brand"},"part_b":null}, {"ndc":"72495020210","name":"FEMRING 0.10 MG/DAY VAG RING","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72495-202-10","proprietary_name":"Femring","nonproprietary_name":"estradiol acetate","dosage_form":"RING","route":"VAGINAL","strength":".1 mg/d","labeler":"Millicent US, Inc.","package_description":"1 POUCH in 1 CARTON (72495-202-10) / 90 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":925.63063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Femring|Estradiol Acetate","basis":"brand"},"part_b":null}, {"ndc":"00378439177","name":"FENOFIBRATE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4391-77","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-4391-77)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":16.75499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352010201","name":"FENOFIBRATE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-102-01","proprietary_name":"FENOFIBRATE","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Trifluent Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (73352-102-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":16.75499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505312103","name":"FENOFIBRATE 130 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3121-3","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"130 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-3121-3)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.70221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505312109","name":"FENOFIBRATE 130 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3121-9","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"130 mg/1","labeler":"Apotex Corp.","package_description":"90 CAPSULE in 1 BOTTLE (60505-3121-9)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.70221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180013106","name":"FENOFIBRATE 130 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-131-06","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"130 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-131-06)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.70221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668043901","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-439-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-439-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011904","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-119-04","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-119-04)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858013401","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975030510","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-305-10","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (43975-305-10)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651020201","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-202-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-202-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089490","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-894-90","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-894-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332008531","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-085-31","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-085-31)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462058101","name":"FENOFIBRATE 134 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-581-01","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"134 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-581-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378306605","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3066-05","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"145 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3066-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378306677","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3066-77","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"145 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3066-77)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904716161","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7161-61","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7161-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904748004","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7480-04","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7480-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904748061","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7480-61","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7480-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722059690","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-596-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"145 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-596-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547043109","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-431-09","proprietary_name":"FENOFIBRATE","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-431-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079060801","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079060820","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-608-20","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"145 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-608-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-608-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062901","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-629-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-629-01) / 1 TABLET in 1 BLISTER PACK (60687-629-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062911","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062921","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-629-21","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-629-21) / 1 TABLET in 1 BLISTER PACK (60687-629-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036171","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-361-71","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"145 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62332-361-71)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332036190","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-361-90","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"145 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-361-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862076990","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-769-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"145 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, COATED in 1 BOTTLE (65862-769-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180038902","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-389-02","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-389-02)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180038909","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-389-09","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-389-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097045805","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-458-05","proprietary_name":"Fenofibrate","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"145 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-458-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009006090","name":"FENOFIBRATE 145 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-060-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"145 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (82009-060-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559046190","name":"FENOFIBRATE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-461-90","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62559-461-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":5.30292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115552202","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-5522-02","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (0115-5522-02)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115552210","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-5522-10","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 TABLET in 1 BOTTLE (0115-5522-10)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904753904","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7539-04","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7539-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011703","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-117-03","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-117-03)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011705","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-117-05","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-117-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858066045","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-660-45","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42858-660-45)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268031311","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268031315","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-313-15","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-313-15) / 1 TABLET in 1 BLISTER PACK (50268-313-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651057690","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-576-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-576-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219552205","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-5522-5","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (60219-5522-5)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219552209","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-5522-9","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (60219-5522-9)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086411","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687086421","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-864-21","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-864-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-864-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135083890","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-838-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-838-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055590","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-555-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-555-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055591","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-555-91","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-555-91)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367025405","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367025409","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-254-09","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-254-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756021551","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-215-51","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70756-215-51)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756021590","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-215-90","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (70756-215-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603084101","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-841-01","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-841-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603084102","name":"FENOFIBRATE 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-841-02","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (72603-841-02)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.1033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668043801","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-438-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-438-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241012004","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-120-04","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-120-04)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858020001","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975030610","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-306-10","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (43975-306-10)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651020301","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-203-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-203-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071311","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071321","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-713-21","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-713-21) / 1 CAPSULE in 1 BLISTER PACK (60687-713-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089990","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-899-90","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-899-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332008631","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-086-31","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-086-31)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462058201","name":"FENOFIBRATE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-582-01","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-582-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378439077","name":"FENOFIBRATE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4390-77","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-4390-77)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":5.53539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352010101","name":"FENOFIBRATE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-101-01","proprietary_name":"FENOFIBRATE","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Trifluent Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (73352-101-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":5.53539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505312003","name":"FENOFIBRATE 43 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3120-3","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"43 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-3120-3)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.38364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180013006","name":"FENOFIBRATE 43 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-130-06","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"43 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-130-06)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.38364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378306577","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3065-77","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"48 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3065-77)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722059590","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-595-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"48 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-595-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547043009","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-430-09","proprietary_name":"FENOFIBRATE","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"48 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-430-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268033811","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268033812","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-338-12","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"48 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-338-12) / 1 TABLET in 1 BLISTER PACK (50268-338-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079059901","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079059920","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-599-20","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"48 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-599-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-599-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687061811","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687061821","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-618-21","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"48 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-618-21) / 1 TABLET in 1 BLISTER PACK (60687-618-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862076890","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-768-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"48 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, COATED in 1 BOTTLE (65862-768-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180038809","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-388-09","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"48 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-388-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097045905","name":"FENOFIBRATE 48 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-459-05","proprietary_name":"Fenofibrate","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"48 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-459-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559046090","name":"FENOFIBRATE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-460-90","proprietary_name":"Fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62559-460-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":2.55969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115551110","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-5511-10","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 TABLET in 1 BOTTLE (0115-5511-10)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011603","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-116-03","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-116-03)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858045445","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-454-45","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"54 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42858-454-45)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268031211","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268031215","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-312-15","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-312-15) / 1 TABLET in 1 BLISTER PACK (50268-312-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651057590","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-575-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"54 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-575-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219551109","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-5511-9","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (60219-5511-9)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085311","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085321","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-853-21","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"54 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-853-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-853-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135083790","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-837-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"54 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-837-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055490","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-554-90","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"54 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-554-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180023109","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-231-09","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-231-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756021451","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-214-51","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70756-214-51)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756021490","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-214-90","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (70756-214-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603084001","name":"FENOFIBRATE 54 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-840-01","proprietary_name":"FENOFIBRATE","nonproprietary_name":"FENOFIBRATE","dosage_form":"TABLET","route":"ORAL","strength":"54 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-840-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668044001","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-440-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-440-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241011804","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-118-04","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-118-04)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858006701","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43975044410","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-444-10","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (43975-444-10)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651020101","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-201-01","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-201-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089390","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-893-90","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-893-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332008431","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-084-31","proprietary_name":"Fenofibrate","nonproprietary_name":"Fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-084-31)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462058001","name":"FENOFIBRATE 67 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-580-01","proprietary_name":"fenofibrate","nonproprietary_name":"fenofibrate","dosage_form":"CAPSULE","route":"ORAL","strength":"67 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-580-01)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.09197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115132510","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1325-10","proprietary_name":"Fenofibric Acid","nonproprietary_name":"FENOFIBRIC ACID","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"135 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0115-1325-10)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115155510","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42385094590","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571034890","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651021790","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-217-90","proprietary_name":"FENOFIBRIC ACID","nonproprietary_name":"FENOFIBRIC ACID","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"135 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-217-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332024590","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-245-90","proprietary_name":"Fenofibric Acid","nonproprietary_name":"Fenofibric Acid","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"135 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (62332-245-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315028209","name":"FENOFIBRIC ACID DR 135 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-282-09","proprietary_name":"FENOFIBRIC ACID","nonproprietary_name":"FENOFIBRIC ACID","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"135 mg/1","labeler":"Leading Pharma, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (69315-282-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.2863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42385094490","name":"FENOFIBRIC ACID DR 45 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571034790","name":"FENOFIBRIC ACID DR 45 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651021690","name":"FENOFIBRIC ACID DR 45 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-216-90","proprietary_name":"FENOFIBRIC ACID","nonproprietary_name":"FENOFIBRIC ACID","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"45 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-216-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332024490","name":"FENOFIBRIC ACID DR 45 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-244-90","proprietary_name":"Fenofibric Acid","nonproprietary_name":"Fenofibric Acid","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"45 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (62332-244-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315028109","name":"FENOFIBRIC ACID DR 45 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-281-09","proprietary_name":"FENOFIBRIC ACID","nonproprietary_name":"FENOFIBRIC ACID","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"45 mg/1","labeler":"Leading Pharma, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (69315-281-09)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]"]},"nadac":{"value":0.16106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409909422","name":"FENTANYL 100 MCG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-9094-22","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"FENTANYL CITRATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-9094-22) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-9094-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-9094-22) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-9094-12)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641602725","name":"FENTANYL 100 MCG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6027-25","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6027-25) / 2 mL in 1 VIAL (0641-6027-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6027-25) / 2 mL in 1 VIAL (0641-6027-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323080602","name":"FENTANYL 100 MCG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-806-02","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".05 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (63323-806-02) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-806-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (63323-806-02) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-806-12)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572017025","name":"FENTANYL 100 MCG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-170-25","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-170-25) / 2 mL in 1 VIAL (72572-170-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-170-25) / 2 mL in 1 VIAL (72572-170-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81565020502","name":"FENTANYL 100 MCG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81565-205-02","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Phlow Corp.","package_description":"25 VIAL in 1 CARTON (81565-205-02) / 2 mL in 1 VIAL (81565-205-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (81565-205-02) / 2 mL in 1 VIAL (81565-205-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378912416","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378912498","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9124-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"100 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9124-98) / 1 PATCH in 1 POUCH (0378-9124-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406910076","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9100-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"100 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9100-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781042811","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"47781042847","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-428-47","proprietary_name":"Fentanyl system","nonproprietary_name":"Fentanyl","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"100 ug/1","labeler":"ALVOGEN","package_description":"5 POUCH in 1 CARTON (47781-428-47) / 1 PATCH in 1 POUCH (47781-428-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"50742055601","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055605","name":"FENTANYL 100 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-556-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"100 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-556-05) / 1 PATCH in 1 POUCH (50742-556-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":18.35787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378911916","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378911998","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9119-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"12 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9119-98) / 1 PATCH in 1 POUCH (0378-9119-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406911276","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9112-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"12.5 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9112-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781042311","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"47781042347","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-423-47","proprietary_name":"Fentanyl system","nonproprietary_name":"Fentanyl","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"12.5 ug/1","labeler":"ALVOGEN","package_description":"5 POUCH in 1 CARTON (47781-423-47) / 1 PATCH in 1 POUCH (47781-423-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"50742054901","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742054905","name":"FENTANYL 12 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-549-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"12 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-549-05) / 1 PATCH in 1 POUCH (50742-549-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.98903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409909441","name":"FENTANYL 2,500 MCG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409909444","name":"FENTANYL 2,500 MCG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409909455","name":"FENTANYL 2,500 MCG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-9094-55","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"FENTANYL CITRATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Hospira, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0409-9094-55) / 50 mL in 1 VIAL, SINGLE-DOSE (0409-9094-44)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00641603001","name":"FENTANYL 2,500 MCG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6030-01","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"50 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 mL in 1 VIAL (0641-6030-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 mL in 1 VIAL (0641-6030-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323080650","name":"FENTANYL 2,500 MCG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-806-50","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".05 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (63323-806-50) / 50 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (63323-806-50) / 50 mL in 1 VIAL, SINGLE-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572017201","name":"FENTANYL 2,500 MCG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-172-01","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"50 ug/mL","labeler":"Civica, Inc.","package_description":"1 VIAL in 1 CARTON (72572-172-01) / 50 mL in 1 VIAL","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (72572-172-01) / 50 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378912116","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378912198","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9121-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"25 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9121-98) / 1 PATCH in 1 POUCH (0378-9121-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406912576","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9125-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"25 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9125-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781042411","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"47781042447","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-424-47","proprietary_name":"Fentanyl system","nonproprietary_name":"Fentanyl","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"25 ug/1","labeler":"ALVOGEN","package_description":"5 POUCH in 1 CARTON (47781-424-47) / 1 PATCH in 1 POUCH (47781-424-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"50742055001","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055005","name":"FENTANYL 25 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-550-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"25 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-550-05) / 1 PATCH in 1 POUCH (50742-550-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":6.01448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641602810","name":"FENTANYL 250 MCG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6028-10","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0641-6028-10) / 5 mL in 1 VIAL (0641-6028-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0641-6028-10) / 5 mL in 1 VIAL (0641-6028-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572017110","name":"FENTANYL 250 MCG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-171-10","proprietary_name":"Fentanyl Citrate","nonproprietary_name":"Fentanyl Citrate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 ug/mL","labeler":"Civica, Inc.","package_description":"10 VIAL in 1 CARTON (72572-171-10) / 5 mL in 1 VIAL (72572-171-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.78639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3010","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3010 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (72572-171-10) / 5 mL in 1 VIAL (72572-171-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378912516","name":"FENTANYL 37.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":35.02694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378912598","name":"FENTANYL 37.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9125-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"37.5 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9125-98) / 1 PATCH in 1 POUCH (0378-9125-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":35.02694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406903776","name":"FENTANYL 37.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9037-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"37.5 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9037-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":35.02694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055101","name":"FENTANYL 37.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":35.02694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055105","name":"FENTANYL 37.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-551-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"37.5 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-551-05) / 1 PATCH in 1 POUCH (50742-551-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":35.02694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378912216","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378912298","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9122-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"50 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9122-98) / 1 PATCH in 1 POUCH (0378-9122-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406915076","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9150-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"50 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9150-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781042611","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"47781042647","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-426-47","proprietary_name":"Fentanyl system","nonproprietary_name":"Fentanyl","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"50 ug/1","labeler":"ALVOGEN","package_description":"5 POUCH in 1 CARTON (47781-426-47) / 1 PATCH in 1 POUCH (47781-426-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"50742055201","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055205","name":"FENTANYL 50 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-552-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"50 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-552-05) / 1 PATCH in 1 POUCH (50742-552-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":9.07,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378912616","name":"FENTANYL 62.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":57.686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378912698","name":"FENTANYL 62.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9126-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"62.5 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9126-98) / 1 PATCH in 1 POUCH (0378-9126-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":57.686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406906276","name":"FENTANYL 62.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9062-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"62.5 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9062-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":57.686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055301","name":"FENTANYL 62.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":57.686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055305","name":"FENTANYL 62.5 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-553-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"62.5 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-553-05) / 1 PATCH in 1 POUCH (50742-553-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":57.686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378912316","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00378912398","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9123-98","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"75 ug/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"5 POUCH in 1 CARTON (0378-9123-98) / 1 PATCH in 1 POUCH (0378-9123-16) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"00406917576","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9175-76","proprietary_name":"FENTANYL TRANSDERMAL","nonproprietary_name":"fentanyl transdermal","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"75 ug/h","labeler":"SpecGx LLC","package_description":"5 POUCH in 1 CARTON (0406-9175-76) / 1 PATCH in 1 POUCH / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781042711","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"47781042747","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-427-47","proprietary_name":"Fentanyl system","nonproprietary_name":"Fentanyl","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"75 ug/1","labeler":"ALVOGEN","package_description":"5 POUCH in 1 CARTON (47781-427-47) / 1 PATCH in 1 POUCH (47781-427-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fentanyl|Fentanyl","basis":"generic"},"part_b":null}, {"ndc":"50742055401","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742055405","name":"FENTANYL 75 MCG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-554-05","proprietary_name":"FENTANYL","nonproprietary_name":"FENTANYL","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"75 ug/h","labeler":"INGENUS PHARMACEUTICALS, LLC","package_description":"5 POUCH in 1 CARTON (50742-554-05) / 1 PATCH in 1 POUCH (50742-554-01) / 72 h in 1 PATCH","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":15.87124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00178008990","name":"FERRALET 90 TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0178-0089-90","proprietary_name":"Ferralet 90","nonproprietary_name":"iron, folic acid, cyanocobalamin, ascorbic acid, and docusate sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1; 1 mg/1; 12 ug/1; 120 mg/1; 50 mg/1","labeler":"Mission Pharmacal Company","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0178-0089-90)","pharm_classes":["Ascorbic Acid [CS]","Vitamin B 12 [CS]","Vitamin B12 [EPC]","Vitamin C [EPC]"]},"nadac":{"value":2.18464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378289520","name":"FERRIC CITRATE 210 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2895-20","proprietary_name":"Ferric Citrate","nonproprietary_name":"Ferric Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"210 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"200 TABLET, FILM COATED in 1 BOTTLE (0378-2895-20)","pharm_classes":["Iron [CS]","Parenteral Iron Replacement [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":6.27508,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480299697","name":"FERRIC CITRATE 210 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2996-97","proprietary_name":"Ferric Citrate","nonproprietary_name":"Ferric Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"210 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"200 TABLET, FILM COATED in 1 BOTTLE (0480-2996-97)","pharm_classes":["Iron [CS]","Parenteral Iron Replacement [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":6.27508,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722003330","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-033-30","proprietary_name":"FESOTERODINE FUMARATE","nonproprietary_name":"FESOTERODINE FUMARATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-033-30)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43598024730","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-247-30","proprietary_name":"Fesoterodine fumarate","nonproprietary_name":"Fesoterodine fumarate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Dr.Reddy's Laboratories Inc.,","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-247-30)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62332017530","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-175-30","proprietary_name":"Fesoterodine Fumarate","nonproprietary_name":"Fesoterodine Fumarate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-175-30)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862076630","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-766-30","proprietary_name":"FESOTERODINE FUMARATE","nonproprietary_name":"FESOTERODINE FUMARATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-766-30)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877006430","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-064-30","proprietary_name":"Fesoterodine Fumarate","nonproprietary_name":"Fesoterodine Fumarate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-064-30)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68382047906","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-479-06","proprietary_name":"fesoterodine fumarate","nonproprietary_name":"fesoterodine fumarate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-479-06)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72603041301","name":"FESOTERODINE ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-413-01","proprietary_name":"FESOTERODINE FUMARATE","nonproprietary_name":"FESOTERODINE FUMARATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-413-01)"},"nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722003430","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-034-30","proprietary_name":"FESOTERODINE FUMARATE","nonproprietary_name":"FESOTERODINE FUMARATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-034-30)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43598024830","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-248-30","proprietary_name":"Fesoterodine fumarate","nonproprietary_name":"Fesoterodine fumarate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Dr.Reddy's Laboratories Inc.,","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-248-30)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62332017630","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-176-30","proprietary_name":"Fesoterodine Fumarate","nonproprietary_name":"Fesoterodine Fumarate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-176-30)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862076730","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-767-30","proprietary_name":"FESOTERODINE FUMARATE","nonproprietary_name":"FESOTERODINE FUMARATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-767-30)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877006830","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-068-30","proprietary_name":"Fesoterodine Fumarate","nonproprietary_name":"Fesoterodine Fumarate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-068-30)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68382048006","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-480-06","proprietary_name":"fesoterodine fumarate","nonproprietary_name":"fesoterodine fumarate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-480-06)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"72603041401","name":"FESOTERODINE ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-414-01","proprietary_name":"FESOTERODINE FUMARATE","nonproprietary_name":"FESOTERODINE FUMARATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-414-01)"},"nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fesoterodine Fumarate ER|Fesoterodine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00456220228","name":"FETZIMA 20-40 MG TITRATION PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0456-2202-28","proprietary_name":"Fetzima","nonproprietary_name":"LEVOMILNACIPRAN HYDROCHLORIDE","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Allergan, Inc.","package_description":"1 KIT in 1 BLISTER PACK (0456-2202-28)"},"nadac":{"value":17.60658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fetzima|Levomilnacipran HCl","basis":"brand"},"part_b":null}, {"ndc":"00456221230","name":"FETZIMA ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2212-30","proprietary_name":"Fetzima","nonproprietary_name":"LEVOMILNACIPRAN HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0456-2212-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":17.58708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00456222030","name":"FETZIMA ER 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2220-30","proprietary_name":"Fetzima","nonproprietary_name":"LEVOMILNACIPRAN HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0456-2220-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":17.59735,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00456224030","name":"FETZIMA ER 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2240-30","proprietary_name":"Fetzima","nonproprietary_name":"LEVOMILNACIPRAN HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0456-2240-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":17.61125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00456228030","name":"FETZIMA ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2280-30","proprietary_name":"Fetzima","nonproprietary_name":"LEVOMILNACIPRAN HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0456-2280-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":17.5875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672211500","name":"FEVERALL 120 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.92739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24417,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672211502","name":"FEVERALL 120 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2115-2","proprietary_name":"Feverall Childrens","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"120 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (51672-2115-2) / 1 SUPPOSITORY in 1 BLISTER PACK (51672-2115-0)"},"nadac":{"value":0.92739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24417,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672211600","name":"FEVERALL 325 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.95583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672211602","name":"FEVERALL 325 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2116-2","proprietary_name":"Feverall Jr. Strength","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"325 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (51672-2116-2) / 1 SUPPOSITORY in 1 BLISTER PACK (51672-2116-0)"},"nadac":{"value":0.95583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672211400","name":"FEVERALL 80 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672211402","name":"FEVERALL 80 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2114-2","proprietary_name":"Feverall Infants","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"80 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (51672-2114-2) / 1 SUPPOSITORY in 1 BLISTER PACK (51672-2114-0)"},"nadac":{"value":0.91544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980070501","name":"FEXMID 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-705-01","proprietary_name":"Fexmid","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-705-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.26288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Cyclobenzaprine HCl|Cyclobenzaprine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904705040","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7050-40","proprietary_name":"Fexofenadine Hydrochloride","nonproprietary_name":"Fexofenadine HCl","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0904-7050-40)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904705060","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7050-60","proprietary_name":"Fexofenadine Hydrochloride","nonproprietary_name":"Fexofenadine HCl","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0904-7050-60)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904748602","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7486-02","proprietary_name":"fexofenadine hcl","nonproprietary_name":"fexofenadine hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7486-02)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904748640","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7486-40","proprietary_name":"fexofenadine hcl","nonproprietary_name":"fexofenadine hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0904-7486-40)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904748660","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7486-60","proprietary_name":"fexofenadine hcl","nonproprietary_name":"fexofenadine hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0904-7486-60)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714089901","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-899-01","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (16714-899-01) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714089902","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-899-02","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (16714-899-02) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660099830","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-998-30","proprietary_name":"FEXOFENADINE HYDROCHLORIDE","nonproprietary_name":"FEXOFENADINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"1 BOTTLE in 1 CARTON (51660-998-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660099855","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-998-55","proprietary_name":"FEXOFENADINE HYDROCHLORIDE","nonproprietary_name":"FEXOFENADINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"1 BOTTLE in 1 CARTON (51660-998-55) / 150 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111078401","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-784-01","proprietary_name":"Fexofenadine hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-784-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111078430","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-784-30","proprietary_name":"Fexofenadine hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-784-30) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001044000","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-440-00","proprietary_name":"Fexofenadine hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-440-00) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001044004","name":"FEXOFENADINE HCL 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-440-04","proprietary_name":"Fexofenadine hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-440-04) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904719204","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7192-04","proprietary_name":"fexofenadine hcl","nonproprietary_name":"fexofenadine hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0904-7192-04)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904719240","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7192-40","proprietary_name":"fexofenadine hcl","nonproprietary_name":"fexofenadine hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0904-7192-40)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904719260","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7192-60","proprietary_name":"fexofenadine hcl","nonproprietary_name":"fexofenadine hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0904-7192-60)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111078301","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-783-01","proprietary_name":"Fexofenadine hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-783-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043900","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-439-00","proprietary_name":"Fexofenadine hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-439-00) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230020101","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-201-01","proprietary_name":"Fexofenadine HCl","nonproprietary_name":"Fexofenadine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Camber Consumer Care","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69230-201-01)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230020105","name":"FEXOFENADINE HCL 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-201-05","proprietary_name":"Fexofenadine HCl","nonproprietary_name":"Fexofenadine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Camber Consumer Care","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69230-201-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598082314","name":"FEXOFENADINE-PSE ER 60-120 TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-823-14","proprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","nonproprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 120 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"4 BLISTER PACK in 1 CARTON (43598-823-14) / 5 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.48321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598082331","name":"FEXOFENADINE-PSE ER 60-120 TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-823-31","proprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","nonproprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 120 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"6 BLISTER PACK in 1 CARTON (43598-823-31) / 5 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.48321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598082335","name":"FEXOFENADINE-PSE ER 60-120 TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-823-35","proprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","nonproprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 120 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"2 BLISTER PACK in 1 CARTON (43598-823-35) / 5 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.48321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660003731","name":"FEXOFENADINE-PSE ER 60-120 TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-037-31","proprietary_name":"Fexofenadine Hydrochloride and Pseudoephedrine Hydrochloride","nonproprietary_name":"Fexofenadine Hydrochloride and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 120 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51660-037-31) / 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.48321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111044714","name":"FEXOFENADINE-PSE ER 60-120 TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-447-14","proprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","nonproprietary_name":"Fexofenadine HCl and Pseudoephedrine HCI","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 120 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"4 BLISTER PACK in 1 CARTON (55111-447-14) / 5 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (55111-447-07)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.48321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169320415","name":"FIASP 100 UNIT/ML FLEXTOUCH","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3204-15","proprietary_name":"Fiasp","nonproprietary_name":"insulin aspart injection","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-3204-15) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.9104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fiasp Flextouch|Insulin Aspart (Niacinamide)","basis":"brand"},"part_b":null}, {"ndc":"00169320111","name":"FIASP 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3201-11","proprietary_name":"Fiasp","nonproprietary_name":"insulin aspart injection","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"1 VIAL, GLASS in 1 CARTON (0169-3201-11) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.92167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fiasp|Insulin Aspart (Niacinamide)","basis":"brand"},"part_b":{"hcpcs":"J1811","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1811 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0169-3201-11) / 10 mL in 1 VIAL, GLASS) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00169320515","name":"FIASP PENFILL 100 UNIT/ML CART","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3205-15","proprietary_name":"Fiasp","nonproprietary_name":"insulin aspart injection","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"5 CARTRIDGE in 1 CARTON (0169-3205-15) / 3 mL in 1 CARTRIDGE (0169-3205-11)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.54568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169320615","name":"FIASP PUMPCART 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3206-15","proprietary_name":"Fiasp","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"5 CARTRIDGE in 1 CARTON (0169-3206-15) / 1.6 mL in 1 CARTRIDGE (0169-3206-11)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.56863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1811","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1811 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3.2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 CARTRIDGE in 1 CARTON (0169-3206-15) / 1.6 mL in 1 CARTRIDGE (0169-3206-11)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00904250091","name":"FIBER 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-2500-91","proprietary_name":"FIBER TABS","nonproprietary_name":"calcium polycarbophil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Major Pharmaceuticals","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0904-2500-91)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000006701","name":"FIBER LAXATIVE 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0067-1","proprietary_name":"Calcium Polycarbophil","nonproprietary_name":"Calcium Polycarbophil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"250 TABLET, FILM COATED in 1 BOTTLE (70000-0067-1)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385012576","name":"FIBER TABS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-125-76","proprietary_name":"Good Neighbor Pharmacy Fiber-Caps Fiber Laxative Stimulant Free","nonproprietary_name":"Calcium Polycarbophil","dosage_form":"CAPSULE","route":"ORAL","strength":"625 mg/1","labeler":"Amerisourcebergen Drug Corporation","package_description":"90 CAPSULE in 1 BOTTLE (24385-125-76)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904567516","name":"FIBER THERAPY POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5675-16","proprietary_name":"FIBER THERAPY","nonproprietary_name":"methylcellulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"2 g/19g","labeler":"Major Pharmaceuticals","package_description":"454 g in 1 BOTTLE (0904-5675-16)"},"nadac":{"value":0.01349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536430605","name":"FIBER-LAX 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-4306-05","proprietary_name":"Fiber Lax","nonproprietary_name":"Calcium Polycarbophil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Rugby Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0536-4306-05)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536430608","name":"FIBER-LAX 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-4306-08","proprietary_name":"Fiber Lax","nonproprietary_name":"Calcium Polycarbophil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Rugby Laboratories","package_description":"2 BLISTER PACK in 1 CARTON (0536-4306-08) / 30 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536430611","name":"FIBER-LAX 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-4306-11","proprietary_name":"Fiber Lax","nonproprietary_name":"Calcium Polycarbophil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"Rugby Laboratories","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0536-4306-11)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480259634","name":"FIDAXOMICIN 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2596-34","proprietary_name":"Fidaxomicin","nonproprietary_name":"fidaxomicin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (0480-2596-34)","pharm_classes":["Macrolide Antibacterial [EPC]","Macrolides [CS]"]},"nadac":{"value":90.5046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668074521","name":"FIDAXOMICIN 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-745-21","proprietary_name":"Fidaxomicin","nonproprietary_name":"Fidaxomicin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (13668-745-21)","pharm_classes":["Macrolide Antibacterial [EPC]","Macrolides [CS]"]},"nadac":{"value":90.5046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505483302","name":"FIDAXOMICIN 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4833-2","proprietary_name":"Fidaxomicin","nonproprietary_name":"Fidaxomicin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-4833-2) / 20 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Macrolide Antibacterial [EPC]","Macrolides [CS]"]},"nadac":{"value":90.5046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50222030350","name":"FINACEA 15% FOAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50222-303-50","proprietary_name":"FINACEA FOAM","nonproprietary_name":"azelaic acid","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".15 g/g","labeler":"LEO Pharma Inc.","package_description":"1 CAN in 1 CARTON (50222-303-50) / 50 g in 1 CAN","pharm_classes":["Decreased Protein Synthesis [PE]","Decreased Sebaceous Gland Activity [PE]"]},"nadac":{"value":8.33372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Finacea|Azelaic Acid","basis":"brand"},"part_b":null}, {"ndc":"31722052630","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-526-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-526-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"31722052690","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-526-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-526-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"35573040099","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-400-99","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (35573-400-99)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"57237006130","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-061-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-061-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"57237006190","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-061-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-061-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"65862092730","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-927-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-927-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"65862092790","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-927-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-927-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"67877045505","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-455-05","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (67877-455-05)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"67877045590","name":"FINASTERIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-455-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (67877-455-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"00904683006","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6830-06","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6830-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"00904683061","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6830-61","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6830-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"31722052510","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-525-10","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-525-10)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"31722052530","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-525-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-525-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"31722052590","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-525-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-525-90) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"50268031411","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"50268031415","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-314-15","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-314-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-314-11)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"55111017205","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-172-05","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-172-05)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"55111017290","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-172-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-172-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"57237006205","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-062-05","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-062-05)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"57237006230","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-062-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-062-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"57237006290","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-062-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-062-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"60687042801","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-428-01","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-428-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-428-11)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"60687042811","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"60687042865","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-428-65","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-428-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-428-11)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"65862014901","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-149-01","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-149-01)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"65862014905","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-149-05","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-149-05)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"65862014930","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-149-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-149-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"65862014990","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-149-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-149-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"67877028810","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-288-10","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-288-10)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"67877028890","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-288-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-288-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"68645054154","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-541-54","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68645-541-54)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"76282041205","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-412-05","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-412-05)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"76282041230","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-412-30","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-412-30)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"76282041290","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-412-90","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-412-90)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"82009006105","name":"FINASTERIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-061-05","proprietary_name":"Finasteride","nonproprietary_name":"Finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-061-05)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finasteride|Finasteride","basis":"generic"},"part_b":null}, {"ndc":"00480782056","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7820-56","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0480-7820-56)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"31722088930","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-889-30","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-889-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"43598028530","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-285-30","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 CAPSULE in 1 BOTTLE (43598-285-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"60505433203","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4332-3","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-4332-3)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"64980044903","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-449-03","proprietary_name":"fingolimod","nonproprietary_name":"Fingolimod hcl","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (64980-449-03)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"65862095230","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-952-30","proprietary_name":"FINGOLIMOD","nonproprietary_name":"FINGOLIMOD","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (65862-952-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"67877047630","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-476-30","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE (67877-476-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"68382091206","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-912-06","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68382-912-06)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"68462016630","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-166-30","proprietary_name":"fingolimod","nonproprietary_name":"fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE in 1 BOTTLE (68462-166-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"82009014330","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-143-30","proprietary_name":"FINGOLIMOD","nonproprietary_name":"FINGOLIMOD","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"30 CAPSULE in 1 BOTTLE (82009-143-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"82249038530","name":"FINGOLIMOD 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-385-30","proprietary_name":"Fingolimod","nonproprietary_name":"Fingolimod","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"CivicaScript LLC","package_description":"30 CAPSULE in 1 BOTTLE (82249-385-30)","pharm_classes":["Sphingosine 1-Phosphate Receptor Modulators [MoA]","Sphingosine 1-phosphate Receptor Modulator [EPC]"]},"nadac":{"value":1.57913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fingolimod|Fingolimod HCl","basis":"generic"},"part_b":null}, {"ndc":"00093821028","name":"FINZALA 1-0.02(24)-75 CHEW TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finzala|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"00093821062","name":"FINZALA 1-0.02(24)-75 CHEW TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8210-62","proprietary_name":"Finzala","nonproprietary_name":"norethindrone acetate and ethinyl estradiol and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0093-8210-62) / 1 BLISTER PACK in 1 POUCH (0093-8210-28) / 1 KIT in 1 BLISTER PACK * 24 TABLET, CHEWABLE in 1 BLISTER PACK (0093-3476-38) * 4 TABLET in 1 BLISTER PACK (0093-3525-44)"},"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Finzala|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"52544008001","name":"FIORICET 50-300-40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52544-080-01","proprietary_name":"Fioricet","nonproprietary_name":"Butalbital, Acetaminophen, and Caffeine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1; 300 mg/1; 40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (52544-080-01)","pharm_classes":["Barbiturate [EPC]","Barbiturates [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":8.82367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31632,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fioricet|Butalb/Acetaminophen/Caffeine","basis":"brand"},"part_b":null}, {"ndc":"00536127180","name":"FIRST AID ANTISEPTIC 10% OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0536-1271-80","proprietary_name":"First Aid Antiseptic","nonproprietary_name":"POVIDONE-IODINE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1271-80) / 28.4 g in 1 TUBE"},"nadac":{"value":0.05435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65628020605","name":"FIRVANQ 50 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65628-206-05","proprietary_name":"FIRVANQ","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"Azurity Pharmaceuticals, Inc","package_description":"1 KIT in 1 CARTON (65628-206-05) * 7.5 g in 1 BOTTLE * 145 mL in 1 BOTTLE"},"nadac":{"value":1.18602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.70181,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Firvanq|Vancomycin HCl","basis":"brand"},"part_b":null}, {"ndc":"71776010005","name":"FLAREX 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71776-100-05","proprietary_name":"Flarex","nonproprietary_name":"fluorometholone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Eyevance Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (71776-100-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":23.94627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flarex|Fluorometholone Acetate","basis":"brand"},"part_b":null}, {"ndc":"00574011501","name":"FLAVOXATE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0115-01","proprietary_name":"FLAVOXATE HYDROCHLORIDE","nonproprietary_name":"FLAVOXATE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0574-0115-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.3894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flavoxate HCl|Flavoxate HCl","basis":"generic"},"part_b":null}, {"ndc":"42806005801","name":"FLAVOXATE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-058-01","proprietary_name":"Flavoxate Hydrochloride","nonproprietary_name":"Flavoxate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-058-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.3894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flavoxate HCl|Flavoxate HCl","basis":"generic"},"part_b":null}, {"ndc":"00054001120","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0011-20","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-0011-20) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001121","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0011-21","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0011-21)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001125","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0011-25","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0011-25)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"42806081801","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-818-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-818-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268032111","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268032115","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-321-15","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-321-15) / 1 TABLET in 1 BLISTER PACK (50268-321-11)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"53746064201","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-642-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-642-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"57237006401","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-064-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-064-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"62135066160","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-661-60","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE, GLASS (62135-661-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"62559038101","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-381-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate Tablet","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-381-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"65862062201","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-622-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-622-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"76385014601","name":"FLECAINIDE ACETATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-146-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-146-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.17126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001221","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0012-21","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0012-21)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001225","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0012-25","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0012-25)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"42806081901","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-819-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-819-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"53746064301","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-643-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-643-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"57237006501","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-065-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-065-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"62135066260","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-662-60","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE, GLASS (62135-662-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"62559038201","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-382-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate Tablet","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-382-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"65862062301","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-623-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-623-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"76385014701","name":"FLECAINIDE ACETATE 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-147-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-147-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.26903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001020","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0010-20","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-0010-20) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001021","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0010-21","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (0054-0010-21)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00054001025","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0010-25","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0010-25)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"42806081701","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-817-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-817-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268032011","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268032015","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-320-15","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-320-15) / 1 TABLET in 1 BLISTER PACK (50268-320-11)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"53746064101","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-641-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-641-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"57237006301","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-063-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-063-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"62135066060","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-660-60","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE, GLASS (62135-660-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"62559038001","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-380-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate Tablet","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-380-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"65862062101","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-621-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"Flecainide Acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-621-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"76385014501","name":"FLECAINIDE ACETATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-145-01","proprietary_name":"Flecainide Acetate","nonproprietary_name":"flecainide acetate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-145-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flecainide Acetate|Flecainide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00132070336","name":"FLEET BISACODYL 10 MG ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0703-36","proprietary_name":"Fleet","nonproprietary_name":"Bisacodyl","dosage_form":"ENEMA","route":"RECTAL","strength":"10 mg/30mL","labeler":"C.B. Fleet Company, Inc.","package_description":"37 mL in 1 BOTTLE, WITH APPLICATOR (0132-0703-36)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.06458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132020140","name":"FLEET ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0201-40","proprietary_name":"Fleet","nonproprietary_name":"sodium phosphate, dibasic and sodium phosphate, monobasic","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"C.B. Fleet Company, Inc.","package_description":"133 mL in 1 BOTTLE, WITH APPLICATOR (0132-0201-40)"},"nadac":{"value":0.00954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.0067,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132020142","name":"FLEET ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0201-42","proprietary_name":"Fleet","nonproprietary_name":"sodium phosphate, dibasic and sodium phosphate, monobasic","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"C.B. Fleet Company, Inc.","package_description":"133 mL in 1 BOTTLE, WITH APPLICATOR (0132-0201-42)"},"nadac":{"value":0.00837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.00715,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132007900","name":"FLEET GLYCERIN 2 GM ADULT SUPP","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.06428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06779,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00132007912","name":"FLEET GLYCERIN 2 GM ADULT SUPP","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.1,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.21712,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00132007924","name":"FLEET GLYCERIN 2 GM ADULT SUPP","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.09598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10312,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00132007950","name":"FLEET GLYCERIN 2 GM ADULT SUPP","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.06428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06779,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00132018582","name":"FLEET GLYCERIN LIQUID SUPP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0185-82","proprietary_name":"Fleet","nonproprietary_name":"glycerin","dosage_form":"LIQUID","route":"RECTAL","strength":"5.4 g/1","labeler":"C.B. Fleet Company, Inc.","package_description":"4 LIQUID in 1 CARTON (0132-0185-82)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.13862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132030140","name":"FLEET MINERAL OIL ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0301-40","proprietary_name":"FLEET","nonproprietary_name":"Mineral Oil","dosage_form":"ENEMA","route":"RECTAL","strength":"100 g/100mL","labeler":"C.B. Fleet Company, Inc.","package_description":"133 mL in 1 BOTTLE, WITH APPLICATOR (0132-0301-40)"},"nadac":{"value":0.01707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-10","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132020220","name":"FLEET PEDIA-LAX ENEMA","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0132-0202-20","proprietary_name":"Pedia-Lax","nonproprietary_name":"sodium phosphate, dibasic and sodium phosphate, monobasic","dosage_form":"ENEMA","route":"RECTAL","strength":"3.5 g/66mL; 9.5 g/66mL","labeler":"C.B. Fleet Company, Inc.","package_description":"66 mL in 1 BOTTLE, WITH APPLICATOR (0132-0202-20)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.02044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132019012","name":"FLEET PEDIA-LAX SUPPOSITORIES","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0132-0190-12","proprietary_name":"Pedia-Lax","nonproprietary_name":"Glycerin","dosage_form":"LIQUID","route":"RECTAL","strength":"2.8 g/2.7mL","labeler":"C.B. Fleet Company, Inc.","package_description":"6 APPLICATOR in 1 CARTON (0132-0190-12) / 4 mL in 1 APPLICATOR","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.20902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00132065501","name":"FLEET PEDIA-LAX TABLET CHEW","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0655-01","proprietary_name":"Pedia-Lax","nonproprietary_name":"Magnesium hydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"400 mg/1","labeler":"C.B. Fleet Company, Inc.","package_description":"1 BOTTLE in 1 CARTON (0132-0655-01) / 30 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.1512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52652600101","name":"FLEQSUVY 25 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-6001-1","proprietary_name":"FLEQSUVY","nonproprietary_name":"baclofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"5 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52652-6001-1) / 120 mL in 1 BOTTLE","pharm_classes":["GABA A Agonists [MoA]","GABA B Agonists [MoA]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":5.98153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":3.76436,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fleqsuvy|Baclofen","basis":"brand"},"part_b":null}, {"ndc":"59088001754","name":"FLOTREX 0.25 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59088-017-54","proprietary_name":"Flotrex","nonproprietary_name":"Multivitamins, Sodium Fluoride 0.25 mg","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":".25 mg/1; 750 ug/1; 24 mg/1; 36 mg/1; 10 ug/1; 6.75 mg/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1","labeler":"PureTek Corporation","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (59088-017-54)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.10233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000005001","name":"FLU HBP 325-2-10 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0050-1","proprietary_name":"Flu HBP Maximum Strength","nonproprietary_name":"Acetaminophen, Chlorpheniramine maleate, Dextromethorphan HBr","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 2 mg/1; 10 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0050-1) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.09594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069501","name":"FLUCONAZOLE 10 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-695-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (16714-695-01) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.27773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237014935","name":"FLUCONAZOLE 10 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-149-35","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (57237-149-35) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.27773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762502901","name":"FLUCONAZOLE 10 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5029-1","proprietary_name":"Fluconazole","nonproprietary_name":"fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-5029-1) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.27773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904650006","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6500-06","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6500-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904650061","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6500-61","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6500-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069101","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-691-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-691-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069102","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-691-02","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-691-02)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268033711","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268033715","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-337-15","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-337-15) / 1 TABLET in 1 BLISTER PACK (50268-337-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014401","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-144-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-144-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014430","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-144-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET in 1 BOTTLE (55111-144-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237000430","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-004-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-004-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135013130","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-131-30","proprietary_name":"FLUCONAZOLE","nonproprietary_name":"FLUCONAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-131-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559099130","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-991-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-991-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001025204","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-252-04","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET in 1 BOTTLE (68001-252-04)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084072801","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-728-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-728-01) / 1 TABLET in 1 BLISTER PACK (68084-728-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084072811","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462010230","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-102-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-102-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710113801","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1138-1","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1138-1)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710113803","name":"FLUCONAZOLE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1138-3","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1138-3)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.22275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069210","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069211","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-692-11","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar Rx LLC","package_description":"12 BLISTER PACK in 1 CARTON (16714-692-11) / 1 TABLET in 1 BLISTER PACK (16714-692-10)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014512","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-145-12","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"12 DOSE PACK in 1 CARTON (55111-145-12) / 1 TABLET in 1 DOSE PACK (55111-145-71)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014571","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237000511","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-005-11","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (57237-005-11) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135013277","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-132-77","proprietary_name":"FLUCONAZOLE","nonproprietary_name":"FLUCONAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Chartwell RX, LLC","package_description":"1 TABLET in 1 BOTTLE (62135-132-77)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559099212","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-992-12","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (62559-992-12) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001025317","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-253-17","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"12 BLISTER PACK in 1 CARTON (68001-253-17) / 1 TABLET in 1 BLISTER PACK (68001-253-44)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001025344","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462011940","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-119-40","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-119-40) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462011944","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-119-44","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"12 BLISTER PACK in 1 CARTON (68462-119-44) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710113907","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1139-7","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1 BLISTER PACK in 1 CARTON (70710-1139-7) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710113908","name":"FLUCONAZOLE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1139-8","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"12 BLISTER PACK in 1 CARTON (70710-1139-8) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.46976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904650106","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6501-06","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6501-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904650161","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6501-61","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6501-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069301","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-693-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-693-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069302","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-693-02","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-693-02)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268033911","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268033915","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-339-15","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-339-15) / 1 TABLET in 1 BLISTER PACK (50268-339-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014601","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-146-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-146-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014630","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-146-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET in 1 BOTTLE (55111-146-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237000601","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-006-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-006-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237000630","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-006-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-006-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135013330","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-133-30","proprietary_name":"FLUCONAZOLE","nonproprietary_name":"FLUCONAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-133-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559099330","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-993-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-993-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001025404","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-254-04","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET in 1 BOTTLE (68001-254-04)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084073501","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-735-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-735-01) / 1 TABLET in 1 BLISTER PACK (68084-735-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084073511","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462010430","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-104-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-104-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710114001","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1140-1","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1140-1)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710114003","name":"FLUCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1140-3","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1140-3)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.37982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714069601","name":"FLUCONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-696-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (16714-696-01) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.54679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237015035","name":"FLUCONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-150-35","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (57237-150-35) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.54679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762503001","name":"FLUCONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5030-1","proprietary_name":"Fluconazole","nonproprietary_name":"fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-5030-1) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.54679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70436022748","name":"FLUCONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-227-48","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Slate Run Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (70436-227-48) / 35 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.54679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714069401","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-694-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-694-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014301","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-143-01","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-143-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111014330","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-143-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET in 1 BOTTLE (55111-143-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237000330","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-003-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-003-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135013030","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-130-30","proprietary_name":"FLUCONAZOLE","nonproprietary_name":"FLUCONAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-130-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559099030","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-990-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-990-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001025104","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-251-04","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET in 1 BOTTLE (68001-251-04)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462010130","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-101-30","proprietary_name":"Fluconazole","nonproprietary_name":"Fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-101-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710113703","name":"FLUCONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1137-3","proprietary_name":"fluconazole","nonproprietary_name":"fluconazole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1137-3)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.20764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115703301","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-7033-01","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"FLUDROCORTISONE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-7033-01)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00115703302","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-7033-02","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"FLUDROCORTISONE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (0115-7033-02)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00904731706","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7317-06","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7317-06) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00904731761","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7317-61","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7317-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268033011","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"50268033015","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-330-15","proprietary_name":"FLUDROCORTISONE ACETATE","nonproprietary_name":"FLUDROCORTISONE ACETATE","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-330-15) / 1 TABLET in 1 BLISTER PACK (50268-330-11)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68084028801","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-288-01","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-288-01) / 1 TABLET in 1 BLISTER PACK (68084-288-11)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68084028811","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"68084028865","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-288-65","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-288-65) / 1 TABLET in 1 BLISTER PACK (68084-288-11)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"70954025220","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-252-20","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-252-20)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"70954025230","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-252-30","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Novitium Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70954-252-30)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"71930008812","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-088-12","proprietary_name":"fludrocortisone acetate","nonproprietary_name":"fludrocortisone acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-088-12)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"71930008852","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-088-52","proprietary_name":"fludrocortisone acetate","nonproprietary_name":"fludrocortisone acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-088-52)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72578016401","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-164-01","proprietary_name":"Fludrocortisone acetate","nonproprietary_name":"Fludrocortisone acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-164-01)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72578016405","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-164-05","proprietary_name":"Fludrocortisone acetate","nonproprietary_name":"Fludrocortisone acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-164-05)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"72603017001","name":"FLUDROCORTISONE 0.1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-170-01","proprietary_name":"Fludrocortisone Acetate","nonproprietary_name":"Fludrocortisone Acetate","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-170-01)"},"nadac":{"value":0.3109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fludrocortisone Acetate|Fludrocortisone Acetate","basis":"generic"},"part_b":null}, {"ndc":"00143968410","name":"FLUMAZENIL 0.5 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9684-10","proprietary_name":"Flumazenil","nonproprietary_name":"Flumazenil","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":".1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (0143-9684-10) / 5 mL in 1 VIAL, MULTI-DOSE (0143-9684-01)","pharm_classes":["Benzodiazepine Antagonist [EPC]"]},"nadac":{"value":1.17913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flumazenil|Flumazenil","basis":"generic"},"part_b":null}, {"ndc":"00143978410","name":"FLUMAZENIL 0.5 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9784-10","proprietary_name":"Flumazenil","nonproprietary_name":"flumazenil","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":".1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (0143-9784-10) / 5 mL in 1 VIAL, MULTI-DOSE (0143-9784-01)","pharm_classes":["Benzodiazepine Antagonist [EPC]"]},"nadac":{"value":1.17913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flumazenil|Flumazenil","basis":"generic"},"part_b":null}, {"ndc":"36000014810","name":"FLUMAZENIL 0.5 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"36000-148-10","proprietary_name":"Flumazenil","nonproprietary_name":"Flumazenil","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":".1 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"10 VIAL, MULTI-DOSE in 1 PACKAGE (36000-148-10) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Benzodiazepine Antagonist [EPC]"]},"nadac":{"value":1.17913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flumazenil|Flumazenil","basis":"generic"},"part_b":null}, {"ndc":"63323042405","name":"FLUMAZENIL 0.5 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-424-05","proprietary_name":"Flumazenil","nonproprietary_name":"FLUMAZENIL","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":".1 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, MULTI-DOSE in 1 TRAY (63323-424-05) / 5 mL in 1 VIAL, MULTI-DOSE (63323-424-01)","pharm_classes":["Benzodiazepine Antagonist [EPC]"]},"nadac":{"value":1.17913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flumazenil|Flumazenil","basis":"generic"},"part_b":null}, {"ndc":"50742031725","name":"FLUNISOLIDE 0.025% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-317-25","proprietary_name":"Flunisolide","nonproprietary_name":"Flunisolide","dosage_form":"SOLUTION","route":"NASAL","strength":".25 mg/mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (50742-317-25) / 25 mL in 1 BOTTLE, PUMP","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.98777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flunisolide|Flunisolide","basis":"generic"},"part_b":null}, {"ndc":"45802088726","name":"FLUOCINOLONE 0.01% BODY OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-887-26","proprietary_name":"fluocinolone acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".01 mg/100mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"118.28 mL in 1 BOTTLE (45802-887-26)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135608","name":"FLUOCINOLONE 0.01% BODY OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1356-8","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/118.28mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1356-8) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980033104","name":"FLUOCINOLONE 0.01% BODY OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-331-04","proprietary_name":"Fluocinolone Acetonide Oil","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118.28 mL in 1 BOTTLE (64980-331-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752015606","name":"FLUOCINOLONE 0.01% BODY OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-156-06","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/mL","labeler":"Quagen Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (70752-156-06) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713022315","name":"FLUOCINOLONE 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0223-15","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0223-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.70556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022360","name":"FLUOCINOLONE 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0223-60","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0223-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.19699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559028815","name":"FLUOCINOLONE 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-288-15","proprietary_name":"fluocinolone acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".1 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-288-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.70556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559028860","name":"FLUOCINOLONE 0.01% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-288-60","proprietary_name":"fluocinolone acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".1 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-288-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.19699,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802048526","name":"FLUOCINOLONE 0.01% SCALP OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-485-26","proprietary_name":"Fluocinolone acetonide","nonproprietary_name":"Fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".01 mg/100mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-485-26) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135708","name":"FLUOCINOLONE 0.01% SCALP OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1357-8","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/118.28mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1357-8) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980033004","name":"FLUOCINOLONE 0.01% SCALP OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-330-04","proprietary_name":"FLUOCINOLONE ACETONIDE Oil","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/mL","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"118.28 mL in 1 BOTTLE (64980-330-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752015806","name":"FLUOCINOLONE 0.01% SCALP OIL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-158-06","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"TOPICAL","strength":".11 mg/mL","labeler":"Quagen Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (70752-158-06) / 118.28 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168005960","name":"FLUOCINOLONE 0.01% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0059-60","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".1 mg/mL","labeler":"Fougera Pharmaceuticals, LLC","package_description":"60 mL in 1 BOTTLE (0168-0059-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922000301","name":"FLUOCINOLONE 0.01% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-003-01","proprietary_name":"Fluocinolone Acetonide Topical Solution USP, 0.01%","nonproprietary_name":"Fluocinolone Acetonide Topical Solution USP, 0.01%","dosage_form":"SOLUTION","route":"TOPICAL","strength":".1 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-003-01) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluocinolone Acetonide|Fluocinolone Acetonide","basis":"generic"},"part_b":null}, {"ndc":"51672136504","name":"FLUOCINOLONE 0.01% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1365-4","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".1 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1365-4) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713070915","name":"FLUOCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0709-15","proprietary_name":"FLUOCINOLONE ACETONIDE","nonproprietary_name":"FLUOCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0709-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.39123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713070960","name":"FLUOCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0709-60","proprietary_name":"FLUOCINOLONE ACETONIDE","nonproprietary_name":"FLUOCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0709-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.01007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559028915","name":"FLUOCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-289-15","proprietary_name":"fluocinolone acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-289-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.39123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559028960","name":"FLUOCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-289-60","proprietary_name":"fluocinolone acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-289-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.01007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168006415","name":"FLUOCINOLONE 0.025% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0064-15","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"15 g in 1 TUBE (0168-0064-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.25943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168006460","name":"FLUOCINOLONE 0.025% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0064-60","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"60 g in 1 TUBE (0168-0064-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.57096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022415","name":"FLUOCINOLONE 0.025% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0224-15","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0224-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.25943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022460","name":"FLUOCINOLONE 0.025% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0224-60","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0224-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.57096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559029915","name":"FLUOCINOLONE 0.025% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-299-15","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-299-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.25943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559029960","name":"FLUOCINOLONE 0.025% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-299-60","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-299-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.57096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802000910","name":"FLUOCINOLONE OIL 0.01% EAR DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-009-10","proprietary_name":"Fluocinolone Acetonide","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OIL","route":"AURICULAR (OTIC)","strength":".11 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-009-10) / 20 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.92434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980032920","name":"FLUOCINOLONE OIL 0.01% EAR DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-329-20","proprietary_name":"Fluocinolone Acetonide Oil","nonproprietary_name":"Fluocinolone Acetonide","dosage_form":"OIL","route":"AURICULAR (OTIC)","strength":".11 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"20 mL in 1 BOTTLE (64980-329-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.92434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752015920","name":"FLUOCINOLONE OIL 0.01% EAR DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-159-20","proprietary_name":"FLUOCINOLONE ACETONIDE","nonproprietary_name":"fluocinolone acetonide","dosage_form":"OIL","route":"AURICULAR (OTIC)","strength":".11 mg/mL","labeler":"Quagen Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (70752-159-20) / 20 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.92434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093026215","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0262-15","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0262-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026230","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0262-30","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0262-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026292","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0262-92","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0262-92) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.21715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066315","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0663-15","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0663-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066331","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0663-31","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0663-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066360","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0663-60","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0663-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.21715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006403","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-064-03","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-064-03) / 120 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006404","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-064-04","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-064-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006405","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-064-05","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-064-05) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006407","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-064-07","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-064-07) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.21715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138601","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1386-1","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1386-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138602","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1386-2","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1386-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138603","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1386-3","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1386-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.21715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672138604","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1386-4","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1386-4) / 120 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153402","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1534-2","proprietary_name":"Fluocinonide Cream","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-1534-2) / 120 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153403","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1534-3","proprietary_name":"Fluocinonide Cream","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-1534-3) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153405","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1534-5","proprietary_name":"Fluocinonide Cream","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-1534-5) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238153406","name":"FLUOCINONIDE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1534-6","proprietary_name":"Fluocinonide Cream","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-1534-6) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.21715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802076115","name":"FLUOCINONIDE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-761-15","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"fluocinonide","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-761-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.08419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802076130","name":"FLUOCINONIDE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-761-30","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"fluocinonide","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-761-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.02121,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802076160","name":"FLUOCINONIDE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-761-60","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"fluocinonide","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-761-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127901","name":"FLUOCINONIDE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1279-1","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1279-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.08419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127902","name":"FLUOCINONIDE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1279-2","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1279-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.02121,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672127903","name":"FLUOCINONIDE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1279-3","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1279-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026415","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0264-15","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0264-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36848,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026430","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0264-30","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0264-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026492","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0264-92","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0264-92) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126401","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1264-1","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1264-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36848,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126402","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1264-2","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1264-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126403","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1264-3","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1264-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700014615","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-146-15","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Xiromed LLC","package_description":"1 TUBE in 1 CARTON (70700-146-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36848,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700014616","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-146-16","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Xiromed LLC","package_description":"1 TUBE in 1 CARTON (70700-146-16) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700014617","name":"FLUOCINONIDE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-146-17","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Xiromed LLC","package_description":"1 TUBE in 1 CARTON (70700-146-17) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168013460","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0134-60","proprietary_name":"fluocinonide","nonproprietary_name":"fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (0168-0134-60) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922000101","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-001-01","proprietary_name":"Fluocinonide","nonproprietary_name":"fluocinonide topical solution usp, 0.05%","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-001-01) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"33342032084","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-320-84","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BOTTLE in 1 CARTON (33342-320-84) / 20 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"33342032085","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-320-85","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BOTTLE in 1 CARTON (33342-320-85) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43386002602","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-026-02","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 BOTTLE in 1 CARTON (43386-026-02) / 20 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43386002606","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-026-06","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 BOTTLE in 1 CARTON (43386-026-06) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672127302","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1273-2","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-1273-2) / 20 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.31434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672127304","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1273-4","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (51672-1273-4) / 60 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710128403","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1284-3","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 mL in 1 BOTTLE (70710-1284-3)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752015405","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-154-05","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"FLUOCINONIDE","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 BOTTLE in 1 CARTON (70752-154-05) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603070301","name":"FLUOCINONIDE 0.05% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-703-01","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"SOLUTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-703-01) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672135302","name":"FLUOCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1353-2","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1353-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672135303","name":"FLUOCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1353-3","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1353-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672135304","name":"FLUOCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1353-4","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1353-4) / 120 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008702","name":"FLUOCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-087-02","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"FLUOCINONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"60 g in 1 TUBE (72578-087-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008706","name":"FLUOCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-087-06","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"FLUOCINONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"30 g in 1 TUBE (72578-087-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008707","name":"FLUOCINONIDE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72578-087-07","proprietary_name":"FLUOCINONIDE","nonproprietary_name":"FLUOCINONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"120 g in 1 TUBE (72578-087-07)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.25434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026315","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0263-15","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0263-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.90595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026330","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0263-30","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0263-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.76709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093026392","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0263-92","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-0263-92) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066415","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0664-15","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0664-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.90595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066431","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0664-31","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0664-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.76709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713066460","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0664-60","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0664-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125401","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1254-1","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1254-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.90595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125402","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1254-2","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1254-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.76709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672125403","name":"FLUOCINONIDE-E 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1254-3","proprietary_name":"Fluocinonide","nonproprietary_name":"Fluocinonide","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1254-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75826016320","name":"FLUORIDE 0.25 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-163-20","proprietary_name":"Fluoride","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":".25 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"120 TABLET, CHEWABLE in 1 BOTTLE (75826-163-20)"},"nadac":{"value":0.0774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoride|Fluoride (Sodium)","basis":"generic"},"part_b":null}, {"ndc":"75826016420","name":"FLUORIDE 0.5 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-164-20","proprietary_name":"Fluoride","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":".5 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"120 TABLET, CHEWABLE in 1 BOTTLE (75826-164-20)"},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoride|Fluoride (Sodium)","basis":"generic"},"part_b":null}, {"ndc":"75826016520","name":"FLUORIDE 1 MG TABLET CHEWABLE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-165-20","proprietary_name":"Fluoride","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"120 TABLET, CHEWABLE in 1 BOTTLE (75826-165-20)"},"nadac":{"value":0.07223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoride|Fluoride (Sodium)","basis":"generic"},"part_b":null}, {"ndc":"00781618770","name":"FLUOROMETHOLONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6187-70","proprietary_name":"fluorometholone","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0781-6187-70) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.43126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluorometholone|Fluorometholone","basis":"generic"},"part_b":null}, {"ndc":"00781618775","name":"FLUOROMETHOLONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6187-75","proprietary_name":"fluorometholone","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0781-6187-75) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.55194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluorometholone|Fluorometholone","basis":"generic"},"part_b":null}, {"ndc":"60219158503","name":"FLUOROMETHOLONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1585-3","proprietary_name":"fluorometholone ophthalmic suspension","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-1585-3) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.55194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluorometholone|Fluorometholone","basis":"generic"},"part_b":null}, {"ndc":"60219158606","name":"FLUOROMETHOLONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1586-6","proprietary_name":"fluorometholone ophthalmic suspension","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-1586-6) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.43126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluorometholone|Fluorometholone","basis":"generic"},"part_b":null}, {"ndc":"60758088005","name":"FLUOROMETHOLONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-880-05","proprietary_name":"FLUOROMETHOLONE","nonproprietary_name":"fluorometholone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-880-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.55194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluorometholone|Fluorometholone","basis":"generic"},"part_b":null}, {"ndc":"60758088010","name":"FLUOROMETHOLONE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-880-10","proprietary_name":"FLUOROMETHOLONE","nonproprietary_name":"fluorometholone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-880-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.43126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluorometholone|Fluorometholone","basis":"generic"},"part_b":null}, {"ndc":"75907016911","name":"FLUOROURACIL 0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-169-11","proprietary_name":"FLUOROURACIL","nonproprietary_name":"Fluorouracil Cream, 0.5%","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 TUBE in 1 CARTON (75907-169-11) / 30 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":42.87573,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672406201","name":"FLUOROURACIL 2% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4062-1","proprietary_name":"Fluorouracil","nonproprietary_name":"Fluorouracil","dosage_form":"SOLUTION","route":"TOPICAL","strength":"20 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4062-1) / 10 mL in 1 BOTTLE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":3.42131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378479106","name":"FLUOROURACIL 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4791-06","proprietary_name":"Fluorouracil","nonproprietary_name":"Fluorouracil","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-4791-06) / 40 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.61563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714017801","name":"FLUOROURACIL 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-178-01","proprietary_name":"Fluorouracil","nonproprietary_name":"Fluorouracil","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-178-01) / 40 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.61563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922004917","name":"FLUOROURACIL 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-049-17","proprietary_name":"FLUOROURACIL","nonproprietary_name":"Fluorouracil","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/40g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-049-17) / 40 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.61563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672411806","name":"FLUOROURACIL 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4118-6","proprietary_name":"Fluorouracil","nonproprietary_name":"Fluorouracil","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4118-6) / 40 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.61563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51862036240","name":"FLUOROURACIL 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51862-362-40","proprietary_name":"FLUOROURACIL","nonproprietary_name":"FLUOROURACIL","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 TUBE in 1 CARTON (51862-362-40) / 40 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.61563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75907009540","name":"FLUOROURACIL 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-095-40","proprietary_name":"FLUOROURACIL","nonproprietary_name":"FLUOROURACIL","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Dr. Reddy's Labratories Inc.","package_description":"1 TUBE in 1 CARTON (75907-095-40) / 40 g in 1 TUBE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":0.61563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922004112","name":"FLUOROURACIL 5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-041-12","proprietary_name":"Fluorouracil","nonproprietary_name":"Fluorouracil","dosage_form":"SOLUTION","route":"TOPICAL","strength":"50 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-041-12) / 10 mL in 1 BOTTLE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":4.17343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672406301","name":"FLUOROURACIL 5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4063-1","proprietary_name":"Fluorouracil","nonproprietary_name":"Fluorouracil","dosage_form":"SOLUTION","route":"TOPICAL","strength":"50 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4063-1) / 10 mL in 1 BOTTLE","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":4.17343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832603212","name":"FLUOXETINE 20 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6032-12","proprietary_name":"Fluoxetine hydrochloride","nonproprietary_name":"Fluoxetine hydrochloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-6032-12) / 120 mL in 1 BOTTLE","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.20327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838052340","name":"FLUOXETINE 20 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-523-40","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/5mL","labeler":"Lannett Company, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (54838-523-40)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.20327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135073041","name":"FLUOXETINE 20 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-730-41","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"120 mL in 1 BOTTLE (62135-730-41)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.20327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862030612","name":"FLUOXETINE 20 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-306-12","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"120 mL in 1 BOTTLE, GLASS (65862-306-12)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.20327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954060010","name":"FLUOXETINE 20 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-600-10","proprietary_name":"Fluoxetine Hydrochloride","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (70954-600-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.20327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656008904","name":"FLUOXETINE 20 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-089-04","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"120 mL in 1 BOTTLE (71656-089-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.20327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55111028448","name":"FLUOXETINE DR 90 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-284-48","proprietary_name":"Fluoxetine hydrochloride","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"90 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"1 BLISTER PACK in 1 CARTON (55111-284-48) / 4 CAPSULE, DELAYED RELEASE PELLETS in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":30.68175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine Dr|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904734561","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7345-61","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7345-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072002","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-720-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-720-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072003","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-720-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE in 1 BOTTLE (16714-720-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002801","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-028-01","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-028-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002810","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-028-10","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-028-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070101","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-701-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"100 CAPSULE in 1 BOTTLE (49483-701-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070110","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-701-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"1000 CAPSULE in 1 BOTTLE (49483-701-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064701","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-647-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50111-647-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064702","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-647-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (50111-647-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064703","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-647-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (50111-647-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011301","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-113-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50228-113-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011310","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-113-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (50228-113-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651089800","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-898-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-898-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651089899","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-898-99","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (59651-898-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002231","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-022-31","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-022-31)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002291","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-022-91","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (62332-022-91)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019201","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-192-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-192-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019299","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-192-99","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (65862-192-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001039900","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-399-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-399-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001039908","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-399-08","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 CAPSULE in 1 BOTTLE (68001-399-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067000","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-670-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-670-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067008","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-670-08","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 CAPSULE in 1 BOTTLE (68001-670-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68645013154","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-131-54","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 CAPSULE in 1 BOTTLE (68645-131-54)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367023501","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367023510","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000705","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-007-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72241-007-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000711","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-007-11","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72241-007-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603048801","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-488-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-488-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603048802","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-488-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72603-488-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009010010","name":"FLUOXETINE HCL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-100-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"1000 CAPSULE in 1 BOTTLE (82009-100-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13668044330","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-443-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-443-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13668044391","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-443-91","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"28 TABLET in 1 CARTON (13668-443-91)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714011201","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-112-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-112-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714011202","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-112-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-112-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884033501","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-335-01","proprietary_name":"fluoxetine hydrochloride","nonproprietary_name":"fluoxetine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (49884-335-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884033511","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-335-11","proprietary_name":"fluoxetine hydrochloride","nonproprietary_name":"fluoxetine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (49884-335-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228042001","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-420-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50228-420-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228042030","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-420-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-420-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111015001","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-150-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (55111-150-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111015010","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-150-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (55111-150-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111015030","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-150-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-150-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651030801","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-308-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-308-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651030830","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-308-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-308-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332024230","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-242-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-242-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332024231","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-242-31","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-242-31)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380090206","name":"FLUOXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-902-06","proprietary_name":"FLUOXETINE","nonproprietary_name":"fluoxetine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-902-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904734661","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7346-61","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7346-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072102","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-721-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-721-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072103","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-721-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE in 1 BOTTLE (16714-721-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002901","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-029-01","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-029-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002910","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-029-10","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-029-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070201","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-702-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"100 CAPSULE in 1 BOTTLE (49483-702-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070210","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-702-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"1000 CAPSULE in 1 BOTTLE (49483-702-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064801","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-648-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50111-648-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064802","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-648-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (50111-648-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064803","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-648-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (50111-648-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111064844","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-648-44","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2000 CAPSULE in 1 BOTTLE (50111-648-44)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011401","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-114-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50228-114-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011410","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-114-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (50228-114-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651089900","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-899-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-899-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651089999","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-899-99","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (59651-899-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002331","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-023-31","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-023-31)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002391","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-023-91","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (62332-023-91)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019301","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-193-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-193-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019399","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-193-99","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (65862-193-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001040000","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-400-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-400-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001040008","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-400-08","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 CAPSULE in 1 BOTTLE (68001-400-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067100","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-671-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-671-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067108","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-671-08","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 CAPSULE in 1 BOTTLE (68001-671-08)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68645013054","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-130-54","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 CAPSULE in 1 BOTTLE (68645-130-54)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367023601","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367023610","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000805","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-008-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72241-008-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000811","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-008-11","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72241-008-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603048902","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-489-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72603-489-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009010110","name":"FLUOXETINE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-101-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"1000 CAPSULE in 1 BOTTLE (82009-101-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13668047330","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-473-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-473-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13668047391","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-473-91","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"28 TABLET in 1 CARTON (13668-473-91)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714011301","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-113-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-113-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714011302","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-113-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-113-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598056601","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-566-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-566-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598056630","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-566-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-566-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884033601","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-336-01","proprietary_name":"fluoxetine hydrochloride","nonproprietary_name":"fluoxetine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (49884-336-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884033611","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-336-11","proprietary_name":"fluoxetine hydrochloride","nonproprietary_name":"fluoxetine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (49884-336-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228042101","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-421-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (50228-421-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228042130","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-421-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-421-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651030901","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-309-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-309-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651030930","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-309-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-309-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332024330","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-243-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-243-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332024331","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-243-31","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-243-31)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380090306","name":"FLUOXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-903-06","proprietary_name":"FLUOXETINE","nonproprietary_name":"fluoxetine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-903-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.08383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093719801","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7198-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-7198-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093719805","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7198-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-7198-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093719856","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7198-56","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-7198-56)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072202","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-722-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-722-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072203","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-722-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-722-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714072204","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-722-04","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE in 1 BOTTLE (16714-722-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155003001","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-030-01","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-030-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155003003","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-030-03","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (23155-030-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155003005","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-030-05","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-030-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155003010","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-030-10","proprietary_name":"FLUOXETINE","nonproprietary_name":"FLUOXETINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-030-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070301","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-703-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"100 CAPSULE in 1 BOTTLE (49483-703-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070303","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-703-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"30 CAPSULE in 1 BOTTLE (49483-703-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49483070350","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-703-50","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"500 CAPSULE in 1 BOTTLE (49483-703-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011501","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-115-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (50228-115-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011505","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-115-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (50228-115-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228011530","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-115-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (50228-115-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651090000","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-900-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-900-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651090005","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-900-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (59651-900-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651090030","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-900-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-900-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651090099","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-900-99","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (59651-900-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687065901","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-659-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-659-01) / 1 CAPSULE in 1 BLISTER PACK (60687-659-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687065911","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002430","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-024-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-024-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002431","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-024-31","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-024-31)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332002491","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-024-91","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (62332-024-91)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019401","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-194-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-194-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019405","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-194-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-194-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019430","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-194-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (65862-194-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862019499","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-194-99","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (65862-194-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001040100","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-401-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-401-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001040103","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-401-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE in 1 BOTTLE (68001-401-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001040104","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-401-04","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE in 1 BOTTLE (68001-401-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067200","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-672-00","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-672-00)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067203","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-672-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE in 1 BOTTLE (68001-672-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001067204","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-672-04","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE in 1 BOTTLE (68001-672-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68002010501","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68002-105-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68002-105-01) / 1 CAPSULE in 1 BLISTER PACK (68002-105-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68002010502","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367023701","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367023705","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000905","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-009-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72241-009-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000910","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-009-10","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"500 CAPSULE in 1 BOTTLE (72241-009-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603049001","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-490-01","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-490-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603049002","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-490-02","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (72603-490-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603049003","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-490-03","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72603-490-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009010205","name":"FLUOXETINE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-102-05","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 CAPSULE in 1 BOTTLE (82009-102-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714011401","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-114-01","proprietary_name":"Fluoxetine hydrochloride","nonproprietary_name":"Fluoxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL; ORAL","strength":"60 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-114-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598063230","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-632-30","proprietary_name":"Fluoxetine hydrochloride","nonproprietary_name":"Fluoxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-632-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884046811","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-468-11","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-468-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228042230","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-422-30","proprietary_name":"Fluoxetine","nonproprietary_name":"FLUOXETINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (50228-422-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228063830","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-638-30","proprietary_name":"Fluoxetine","nonproprietary_name":"FLUOXETINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (50228-638-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651032430","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-324-30","proprietary_name":"Fluoxetine","nonproprietary_name":"Fluoxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-324-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380090004","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-900-04","proprietary_name":"FLUOXETINE HCL","nonproprietary_name":"fluoxetine hcl","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET in 1 BOTTLE (64380-900-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834014830","name":"FLUOXETINE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18175,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluoxetine HCl|Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527178801","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1788-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1788-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832600311","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"0832-6003","inner_of":[]},"part_b":null}, {"ndc":"00904715761","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7157-61","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7157-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571088909","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-889-09","proprietary_name":"Fluphenazine Hydrochoride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 CONTAINER (16571-889-09)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979013601","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-136-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (24979-136-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241025501","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-255-01","proprietary_name":"Fluphenazine hydrochloride","nonproprietary_name":"Fluphenazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-255-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722038401","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-384-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-384-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598003401","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-034-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43598-034-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268036611","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-366","inner_of":["50268-366-15"]},"part_b":null}, {"ndc":"50268036615","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-366-15","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-366-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-366-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672423301","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4233-1","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4233-1) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651068601","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-686-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-686-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135041590","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-415-90","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-415-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332078831","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-788-31","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-788-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238167801","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1678-1","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69238-1678-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954027310","name":"FLUPHENAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-273-10","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-273-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.2128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527179101","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1791-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1791-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527179105","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1791-05","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1791-05)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832600611","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6006-11","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories,LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6006-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904716061","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7160-61","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7160-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571089209","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-892-09","proprietary_name":"Fluphenazine Hydrochoride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 CONTAINER (16571-892-09)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979013901","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-139-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (24979-139-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241025201","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-252-01","proprietary_name":"Fluphenazine hydrochloride","nonproprietary_name":"Fluphenazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-252-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722038701","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-387-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-387-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598003701","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-037-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43598-037-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268036911","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-369","inner_of":["50268-369-15"]},"part_b":null}, {"ndc":"50268036915","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-369-15","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-369-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-369-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672423601","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4236-1","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51672-4236-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651068901","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-689-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-689-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687076101","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-761-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-761-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-761-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687076111","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-761","inner_of":["60687-761-01"]},"part_b":null}, {"ndc":"62135041990","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-419-90","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-419-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332079131","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-791-31","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-791-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033801","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-338-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68462-338-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238168101","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1681-1","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69238-1681-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710149101","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1491-1","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1491-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710149105","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1491-5","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70710-1491-5)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954027610","name":"FLUPHENAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-276-10","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-276-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.43085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527178901","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1789-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1789-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832600411","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6004-11","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories,LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6004-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904715861","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7158-61","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7158-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571089009","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-890-09","proprietary_name":"Fluphenazine Hydrochoride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 CONTAINER (16571-890-09)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979013701","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-137-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (24979-137-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241025401","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-254-01","proprietary_name":"Fluphenazine hydrochloride","nonproprietary_name":"Fluphenazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-254-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722038501","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-385-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-385-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598003501","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-035-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43598-035-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268036711","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-367","inner_of":["50268-367-15"]},"part_b":null}, {"ndc":"50268036715","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-367-15","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-367-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-367-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672423401","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4234-1","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51672-4234-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651068701","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-687-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-687-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135041690","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-416-90","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-416-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332078931","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-789-31","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-789-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033601","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-336-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68462-336-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238167901","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1679-1","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69238-1679-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954027410","name":"FLUPHENAZINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-274-10","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-274-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527179001","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1790-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1790-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527179005","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1790-05","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-1790-05)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832600511","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6005-11","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories,LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-6005-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904715961","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7159-61","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7159-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571089109","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-891-09","proprietary_name":"Fluphenazine Hydrochoride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 CONTAINER (16571-891-09)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979013801","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-138-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (24979-138-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241025301","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-253-01","proprietary_name":"Fluphenazine hydrochloride","nonproprietary_name":"Fluphenazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-253-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722038601","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-386-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-386-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598003601","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-036-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43598-036-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268036811","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-368","inner_of":["50268-368-15"]},"part_b":null}, {"ndc":"50268036815","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-368-15","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-368-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-368-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672423501","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4235-1","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51672-4235-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651068801","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-688-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-688-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687074901","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-749-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-749-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-749-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687074911","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-749","inner_of":["60687-749-01"]},"part_b":null}, {"ndc":"62135041890","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-418-90","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-418-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332079031","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-790-31","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-790-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033701","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-337-01","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68462-337-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238168001","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1680-1","proprietary_name":"fluphenazine hydrochloride","nonproprietary_name":"fluphenazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69238-1680-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710149001","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1490-1","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1490-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710149005","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1490-5","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70710-1490-5)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954027510","name":"FLUPHENAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-275-10","proprietary_name":"Fluphenazine Hydrochloride","nonproprietary_name":"Fluphenazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-275-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.14825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluphenazine HCl*|Fluphenazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00143952901","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9529-01","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"Fluphenazine Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 BOX (0143-9529-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 BOX (0143-9529-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021083805","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-838-05","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"Fluphenazine Decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 VIAL in 1 CARTON (25021-838-05) / 5 mL in 1 VIAL","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (25021-838-05) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42023012901","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-129-01","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"Fluphenazine Decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Par Health USA, LLC","package_description":"1 VIAL in 1 CARTON (42023-129-01) / 5 mL in 1 VIAL","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (42023-129-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42023012989","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-129-89","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"Fluphenazine Decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Par Health USA, LLC","package_description":"1 VIAL in 1 CARTON (42023-129-89) / 5 mL in 1 VIAL","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (42023-129-89) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150026705","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-267-05","proprietary_name":"FLUPHENAZINE DECANOATE","nonproprietary_name":"FLUPHENAZINE DECANOATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"125 mg/5mL","labeler":"Eugia US LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (55150-267-05) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (55150-267-05) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323027205","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-272-05","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"FLUPHENAZINE DECANOATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (63323-272-05) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (63323-272-05) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457035959","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-359-59","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"FLUPHENAZINE DECANOATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Mylan Institutional LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (67457-359-59) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (67457-359-59) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72205010001","name":"FLUPHENAZINE DEC 125 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-100-01","proprietary_name":"Fluphenazine Decanoate","nonproprietary_name":"Fluphenazine Decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (72205-100-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":10.84399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fluphenazine Decanoate|Fluphenazine Decanoate","basis":"generic"},"part_b":{"hcpcs":"J2680","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2680 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (72205-100-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"45802092803","name":"FLURANDRENOLIDE 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"45802-928-03","proprietary_name":"Flurandrenolide","nonproprietary_name":"Flurandrenolide","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"120 mL in 1 BOTTLE, PLASTIC (45802-928-03)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.15517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Flurandrenolide|Flurandrenolide","basis":"generic"},"part_b":null}, {"ndc":"69292072225","name":"FLURBIPROFEN 0.03% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-722-25","proprietary_name":"Flurbiprofen Sodium","nonproprietary_name":"Flurbiprofen Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Amici Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69292-722-25) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.8292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950021810","name":"FLURBIPROFEN 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-218-10","proprietary_name":"Flurbiprofen","nonproprietary_name":"Flurbiprofen","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Genus Lifesciences","package_description":"100 TABLET in 1 BOTTLE (64950-218-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":3.17335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flurbiprofen|Flurbiprofen","basis":"generic"},"part_b":null}, {"ndc":"66993016797","name":"FLUTICASONE ELLIPTA 100 MCG INH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-167-97","proprietary_name":"Fluticasone Furoate Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-167-97) / 30 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.28421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993016897","name":"FLUTICASONE ELLIPTA 200 MCG INH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-168-97","proprietary_name":"Fluticasone Furoate Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-168-97) / 30 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.71401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993016697","name":"FLUTICASONE ELLIPTA 50 MCG INH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-166-97","proprietary_name":"Fluticasone Furoate Ellipta","nonproprietary_name":"fluticasone furoate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-166-97) / 30 POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.22058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713063215","name":"FLUTICASONE PROP 0.005% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0632-15","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0632-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063231","name":"FLUTICASONE PROP 0.005% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0632-31","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0632-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.43253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063260","name":"FLUTICASONE PROP 0.005% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0632-60","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0632-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802022111","name":"FLUTICASONE PROP 0.005% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-221-11","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-221-11) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.43253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802022135","name":"FLUTICASONE PROP 0.005% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-221-35","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-221-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802022137","name":"FLUTICASONE PROP 0.005% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-221-37","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".05 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-221-37) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.36476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063115","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0631-15","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0631-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.35643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063131","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0631-31","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0631-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063160","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0631-60","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0631-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.22386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007504","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-075-04","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-075-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.35643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007505","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-075-05","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-075-05) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007507","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-075-07","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-075-07) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.22386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802022211","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-222-11","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-222-11) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.24346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802022235","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-222-35","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-222-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.35643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802022237","name":"FLUTICASONE PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-222-37","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-222-37) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.22386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802044102","name":"FLUTICASONE PROP 0.05% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-441-02","proprietary_name":"fluticasone propionate","nonproprietary_name":"fluticasone propionate","dosage_form":"LOTION","route":"TOPICAL","strength":".5 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"60 mL in 1 BOTTLE (45802-441-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.96333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993079197","name":"FLUTICASONE PROP 100 MCG DISKUS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-791-97","proprietary_name":"FLUTICASONE PROPIONATE DISKUS","nonproprietary_name":"fluticasone propionate","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-791-97) / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.05252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993079297","name":"FLUTICASONE PROP 250 MCG DISK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-792-97","proprietary_name":"FLUTICASONE PROPIONATE DISKUS","nonproprietary_name":"fluticasone propionate","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"250 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-792-97) / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.69048,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993079097","name":"FLUTICASONE PROP 50 MCG DISKUS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-790-97","proprietary_name":"FLUTICASONE PROPIONATE DISKUS","nonproprietary_name":"fluticasone propionate","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-790-97) / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.91829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054327099","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3270-99","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (0054-3270-99) / 120 SPRAY, METERED in 1 BOTTLE, GLASS","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536118313","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1183-13","proprietary_name":"RUGBY FLUTICASONE PROPIONATE NASAL","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0536-1183-13) / 72 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.80745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536118321","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1183-21","proprietary_name":"RUGBY FLUTICASONE PROPIONATE NASAL","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0536-1183-21) / 144 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536118365","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1183-65","proprietary_name":"RUGBY FLUTICASONE PROPIONATE NASAL","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0536-1183-65) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.89591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536118399","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1183-99","proprietary_name":"RUGBY FLUTICASONE PROPIONATE NASAL","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0536-1183-99) / 60 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.8424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505082901","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0829-1","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-0829-1) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"60505620503","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6205-3","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-6205-3) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.89591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135081061","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-810-61","proprietary_name":"Fluticasone Propionate spray, metered","nonproprietary_name":"Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Chartwell RX, LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (62135-810-61) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000070301","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0703-1","proprietary_name":"leader fluticasone propionate","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70000-0703-1) / 72 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.80745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71085009016","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71085-090-16","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"IPG Pharmaceuticals, Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (71085-090-16) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72888014135","name":"FLUTICASONE PROP 50 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-141-35","proprietary_name":"FLUTICASONE PROPIONATE","nonproprietary_name":"FLUTICASONE PROPIONATE","dosage_form":"SPRAY","route":"NASAL","strength":"50 ug/1","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE, SPRAY in 1 CARTON (72888-141-35) / 120 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.44509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993007996","name":"FLUTICASONE PROPIONATE HFA 110 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-079-96","proprietary_name":"Fluticasone Propionate HFA","nonproprietary_name":"fluticasone propionate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"110 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-079-96) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":13.59154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Fluticasone Propionate HFA|Fluticasone Propionate","basis":"generic"},"part_b":null}, {"ndc":"66993008096","name":"FLUTICASONE PROPIONATE HFA 220 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-080-96","proprietary_name":"Fluticasone Propionate HFA","nonproprietary_name":"fluticasone propionate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"220 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-080-96) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":21.79067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Fluticasone Propionate HFA|Fluticasone Propionate","basis":"generic"},"part_b":null}, {"ndc":"66993007896","name":"FLUTICASONE PROPIONATE HFA 44 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-078-96","proprietary_name":"Fluticasone Propionate HFA","nonproprietary_name":"fluticasone propionate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"44 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-078-96) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.8186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Fluticasone Propionate HFA|Fluticasone Propionate","basis":"generic"},"part_b":null}, {"ndc":"68462093720","name":"FLUTICASONE PROPIONATE HFA 44 MCG INHALER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-937-20","proprietary_name":"FLUTICASONE PROPIONATE","nonproprietary_name":"fluticasone propionate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"44 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 INHALER in 1 CARTON (68462-937-20) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.8186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00054032656","name":"FLUTICASONE-SALMETEROL 100-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0326-56","proprietary_name":"fluticasone propionate and salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 100 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 POUCH in 1 CARTON (0054-0326-56) / 1 INHALER in 1 POUCH / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.07358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00093751731","name":"FLUTICASONE-SALMETEROL 100-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7517-31","proprietary_name":"fluticasone propionate and salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 50 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 POUCH in 1 CARTON (0093-7517-31) / 1 INHALER in 1 POUCH / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.07358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00527601006","name":"FLUTICASONE-SALMETEROL 100-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-6010-06","proprietary_name":"Fluticasone Propionate and Salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 100 ug/1","labeler":"Lannett Company, Inc.","package_description":"1 INHALER in 1 CARTON (0527-6010-06) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.07358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"66993058497","name":"FLUTICASONE-SALMETEROL 100-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-584-97","proprietary_name":"Fluticasone Propionate and Salmeterol DISKUS","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 50 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-584-97) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.07358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00093360882","name":"FLUTICASONE-SALMETEROL 113-14","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3608-82","proprietary_name":"Fluticasone Propionate and Salmeterol","nonproprietary_name":"Fluticasone Propionate and Salmeterol","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"113 ug/1; 14 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 POUCH in 1 CARTON (0093-3608-82) / 1 INHALER in 1 POUCH / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":108.27886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"66993008796","name":"FLUTICASONE-SALMETEROL 115-21","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-087-96","proprietary_name":"Fluticasone Propionate and Salmeterol HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"115 ug/1; 21 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-087-96) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":20.70767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993008896","name":"FLUTICASONE-SALMETEROL 230-21","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-088-96","proprietary_name":"Fluticasone Propionate and Salmeterol HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"230 ug/1; 21 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-088-96) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":26.74598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093360982","name":"FLUTICASONE-SALMETEROL 232-14","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3609-82","proprietary_name":"Fluticasone Propionate and Salmeterol","nonproprietary_name":"Fluticasone Propionate and Salmeterol","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"232 ug/1; 14 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 POUCH in 1 CARTON (0093-3609-82) / 1 INHALER in 1 POUCH / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":105.32145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00054032756","name":"FLUTICASONE-SALMETEROL 250-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0327-56","proprietary_name":"fluticasone propionate and salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 250 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 POUCH in 1 CARTON (0054-0327-56) / 1 INHALER in 1 POUCH / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.24514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00093751831","name":"FLUTICASONE-SALMETEROL 250-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7518-31","proprietary_name":"fluticasone propionate and salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"250 ug/1; 50 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 POUCH in 1 CARTON (0093-7518-31) / 1 INHALER in 1 POUCH / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.24514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00527601106","name":"FLUTICASONE-SALMETEROL 250-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-6011-06","proprietary_name":"Fluticasone Propionate and Salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 250 ug/1","labeler":"Lannett Company, Inc.","package_description":"1 INHALER in 1 CARTON (0527-6011-06) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.24514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"66993058597","name":"FLUTICASONE-SALMETEROL 250-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-585-97","proprietary_name":"Fluticasone Propionate and Salmeterol DISKUS","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"250 ug/1; 50 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-585-97) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.24514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"66993008696","name":"FLUTICASONE-SALMETEROL 45-21","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-086-96","proprietary_name":"Fluticasone Propionate and Salmeterol HFA","nonproprietary_name":"fluticasone propionate and salmeterol xinafoate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"45 ug/1; 21 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-086-96) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":16.6775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00054032856","name":"FLUTICASONE-SALMETEROL 500-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0328-56","proprietary_name":"fluticasone propionate and salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"50 ug/1; 500 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 POUCH in 1 CARTON (0054-0328-56) / 1 INHALER in 1 POUCH / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.63625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00093751631","name":"FLUTICASONE-SALMETEROL 500-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7516-31","proprietary_name":"fluticasone propionate and salmeterol","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"500 ug/1; 50 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 POUCH in 1 CARTON (0093-7516-31) / 1 INHALER in 1 POUCH / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.63625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"66993058697","name":"FLUTICASONE-SALMETEROL 500-50","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-586-97","proprietary_name":"Fluticasone Propionate and Salmeterol DISKUS","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"500 ug/1; 50 ug/1","labeler":"Prasco Laboratories","package_description":"1 INHALER in 1 CARTON (66993-586-97) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.63625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"00093360782","name":"FLUTICASONE-SALMETEROL 55-14","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3607-82","proprietary_name":"Fluticasone Propionate and Salmeterol","nonproprietary_name":"Fluticasone Propionate and Salmeterol","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"55 ug/1; 14 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 POUCH in 1 CARTON (0093-3607-82) / 1 INHALER in 1 POUCH / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":114.84895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluticasone-Salmeterol|Fluticasone Propion/Salmeterol","basis":"generic"},"part_b":null}, {"ndc":"66993013597","name":"FLUTICASONE-VILANTEROL 100-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-135-97","proprietary_name":"Fluticasone Furoate and Vilanterol","nonproprietary_name":"fluticasone furoate and vilanterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 25 ug/1","labeler":"Prasco Laboratories","package_description":"1 TRAY in 1 CARTON (66993-135-97) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":3.8971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993013697","name":"FLUTICASONE-VILANTEROL 200-25","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-136-97","proprietary_name":"Fluticasone Furoate and Vilanterol","nonproprietary_name":"fluticasone furoate and vilanterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 25 ug/1","labeler":"Prasco Laboratories","package_description":"1 TRAY in 1 CARTON (66993-136-97) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":3.91371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093744601","name":"FLUVASTATIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7446-01","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"Fluvastatin Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0093-7446-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin ER|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093744656","name":"FLUVASTATIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7446-56","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"Fluvastatin Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0093-7446-56)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin ER|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527258032","name":"FLUVASTATIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2580-32","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"Fluvastatin Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0527-2580-32)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin ER|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527258037","name":"FLUVASTATIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2580-37","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"Fluvastatin Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0527-2580-37)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin ER|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00781801701","name":"FLUVASTATIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8017-01","proprietary_name":"FLUVASTATIN SODIUM ER","nonproprietary_name":"fluvastatin sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0781-8017-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin ER|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00781801731","name":"FLUVASTATIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8017-31","proprietary_name":"FLUVASTATIN SODIUM ER","nonproprietary_name":"fluvastatin sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0781-8017-31)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin ER|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093744201","name":"FLUVASTATIN SODIUM 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7442-01","proprietary_name":"Fluvastatin","nonproprietary_name":"Fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-7442-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.67293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093744256","name":"FLUVASTATIN SODIUM 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7442-56","proprietary_name":"Fluvastatin","nonproprietary_name":"Fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-7442-56)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.67293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378802077","name":"FLUVASTATIN SODIUM 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8020-77","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-8020-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.67293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378802093","name":"FLUVASTATIN SODIUM 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8020-93","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0378-8020-93)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.67293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093744301","name":"FLUVASTATIN SODIUM 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7443-01","proprietary_name":"Fluvastatin","nonproprietary_name":"Fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-7443-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.86261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093744356","name":"FLUVASTATIN SODIUM 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7443-56","proprietary_name":"Fluvastatin","nonproprietary_name":"Fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-7443-56)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.86261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378802177","name":"FLUVASTATIN SODIUM 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8021-77","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-8021-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.86261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378802193","name":"FLUVASTATIN SODIUM 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8021-93","proprietary_name":"Fluvastatin Sodium","nonproprietary_name":"fluvastatin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0378-8021-93)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":2.86261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvastatin Sodium|Fluvastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00228284803","name":"FLUVOXAMINE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2848-03","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2848-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"10370017511","name":"FLUVOXAMINE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-175-11","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-175-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"27241027430","name":"FLUVOXAMINE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-274-30","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (27241-274-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"31722006430","name":"FLUVOXAMINE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-064-30","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-064-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452018213","name":"FLUVOXAMINE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-182-13","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69452-182-13)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"70710184703","name":"FLUVOXAMINE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1847-3","proprietary_name":"Fluvoxamine maleate extended-release","nonproprietary_name":"Fluvoxamine maleate extended-release","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1847-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"00228284903","name":"FLUVOXAMINE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2849-03","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2849-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"10370017611","name":"FLUVOXAMINE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-176-11","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-176-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"27241027530","name":"FLUVOXAMINE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-275-30","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (27241-275-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"31722006530","name":"FLUVOXAMINE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-065-30","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-065-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452018313","name":"FLUVOXAMINE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-183-13","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Bionpharma Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69452-183-13)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"70710184803","name":"FLUVOXAMINE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1848-3","proprietary_name":"Fluvoxamine maleate extended-release","nonproprietary_name":"Fluvoxamine maleate extended-release","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1848-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.97362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate ER|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"60505016601","name":"FLUVOXAMINE MALEATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0166-1","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-0166-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.24481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135093330","name":"FLUVOXAMINE MALEATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-933-30","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-933-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.24481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62559016001","name":"FLUVOXAMINE MALEATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-160-01","proprietary_name":"fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (62559-160-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.24481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452028920","name":"FLUVOXAMINE MALEATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-289-20","proprietary_name":"Fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-289-20)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.24481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452045520","name":"FLUVOXAMINE MALEATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-455-20","proprietary_name":"Fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-455-20)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.24481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"60505016401","name":"FLUVOXAMINE MALEATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0164-1","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-0164-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.15136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135093190","name":"FLUVOXAMINE MALEATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-931-90","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-931-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.15136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62559015801","name":"FLUVOXAMINE MALEATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-158-01","proprietary_name":"fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (62559-158-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.15136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452028720","name":"FLUVOXAMINE MALEATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-287-20","proprietary_name":"Fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-287-20)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.15136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452045420","name":"FLUVOXAMINE MALEATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-454-20","proprietary_name":"Fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-454-20)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.15136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"60505016501","name":"FLUVOXAMINE MALEATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0165-1","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-0165-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.19537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62135093260","name":"FLUVOXAMINE MALEATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-932-60","proprietary_name":"Fluvoxamine Maleate","nonproprietary_name":"Fluvoxamine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-932-60)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.19537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"62559015901","name":"FLUVOXAMINE MALEATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-159-01","proprietary_name":"fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (62559-159-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.19537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"68084083711","name":"FLUVOXAMINE MALEATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69452028820","name":"FLUVOXAMINE MALEATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-288-20","proprietary_name":"Fluvoxamine maleate","nonproprietary_name":"Fluvoxamine maleate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-288-20)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.19537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fluvoxamine Maleate|Fluvoxamine Maleate","basis":"generic"},"part_b":null}, {"ndc":"11980022805","name":"FML FORTE 0.25% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11980-228-05","proprietary_name":"FML FORTE","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11980-228-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":32.1483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fml Forte|Fluorometholone","basis":"brand"},"part_b":null}, {"ndc":"11980022810","name":"FML FORTE 0.25% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"11980-228-10","proprietary_name":"FML FORTE","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11980-228-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":32.1856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fml Forte|Fluorometholone","basis":"brand"},"part_b":null}, {"ndc":"11980021105","name":"FML LIQUIFILM 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11980-211-05","proprietary_name":"FML","nonproprietary_name":"fluorometholone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11980-211-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":32.16,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":11.55194,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fml|Fluorometholone","basis":"brand"},"part_b":null}, {"ndc":"66758025201","name":"FOCALIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-252-01","proprietary_name":"Focalin","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (66758-252-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.32932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.34138,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758025001","name":"FOCALIN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66758-250-01","proprietary_name":"Focalin","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (66758-250-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.64992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.19002,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758025101","name":"FOCALIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-251-01","proprietary_name":"Focalin","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (66758-251-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.92343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023601","name":"FOCALIN XR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-236-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-236-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.76073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023631","name":"FOCALIN XR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-236-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-236-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.76073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.45204,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023701","name":"FOCALIN XR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-237-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-237-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.90722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.79814,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"00078043205","name":"FOCALIN XR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0432-05","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0078-0432-05)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.90695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023801","name":"FOCALIN XR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66758-238-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-238-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.90695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023831","name":"FOCALIN XR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66758-238-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-238-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.90695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.6924,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023901","name":"FOCALIN XR 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-239-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-239-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.14314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023931","name":"FOCALIN XR 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-239-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-239-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.14314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75805,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"00078043305","name":"FOCALIN XR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0433-05","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0078-0433-05)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758024001","name":"FOCALIN XR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-240-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-240-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758024031","name":"FOCALIN XR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-240-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-240-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.55941,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758024131","name":"FOCALIN XR 35 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66758-241-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"35 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-241-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.42512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-14","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.07153,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758024201","name":"FOCALIN XR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-242-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-242-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.42108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758024231","name":"FOCALIN XR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-242-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-242-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.42108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.65667,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023501","name":"FOCALIN XR 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-235-01","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-235-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.70352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758023531","name":"FOCALIN XR 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-235-31","proprietary_name":"Focalin XR","nonproprietary_name":"dexmethylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66758-235-31)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.70352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.01375,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Focalin XR|Dexmethylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"00904722461","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7224-61","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7224-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"11534016501","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-165-01","proprietary_name":"FOLIC ACID","nonproprietary_name":"folic acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-165-01)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"11534016503","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-165-03","proprietary_name":"FOLIC ACID","nonproprietary_name":"folic acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"1000 TABLET in 1 BOTTLE (11534-165-03)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"16571088101","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-881-01","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-881-01)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"16571088110","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-881-10","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-881-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"53746036101","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-361-01","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-361-01)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"53746036110","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-361-10","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 TABLET in 1 BOTTLE (53746-361-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"58657015101","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-151-01","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-151-01)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"58657015110","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-151-10","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-151-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"60687068101","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-681-01","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-681-01) / 1 TABLET in 1 BLISTER PACK (60687-681-11)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"60687068111","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-681","inner_of":["60687-681-01"]},"part_b":null}, {"ndc":"62135021001","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-210-01","proprietary_name":"Folic acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE (62135-210-01)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"62135021005","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-210-05","proprietary_name":"Folic acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"500 TABLET in 1 BOTTLE (62135-210-05)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"62135021010","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-210-10","proprietary_name":"Folic acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"1000 TABLET in 1 BOTTLE (62135-210-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"62135021072","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-210-72","proprietary_name":"Folic acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"1800 TABLET in 1 BOTTLE (62135-210-72)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"62135021090","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-210-90","proprietary_name":"Folic acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET in 1 BOTTLE (62135-210-90)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"65162036110","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-361-10","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-361-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"65162036111","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-361-11","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-361-11)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"69315012701","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-127-01","proprietary_name":"FOLIC ACID","nonproprietary_name":"FOLIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-127-01)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"69315012710","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-127-10","proprietary_name":"FOLIC ACID","nonproprietary_name":"FOLIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-127-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"70752023110","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-231-10","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (70752-231-10)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"70752023111","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-231-11","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE (70752-231-11)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"72241005005","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-050-05","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (72241-050-05)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"72241005011","name":"FOLIC ACID 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-050-11","proprietary_name":"Folic Acid","nonproprietary_name":"Folic Acid","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-050-11)"},"nadac":{"value":0.02013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Folic Acid*|Folic Acid","basis":"generic"},"part_b":null}, {"ndc":"13811053890","name":"FOLIVANE-F CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781347695","name":"FONDAPARINUX 10 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3476-95","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"10 mg/.8mL","labeler":"Sandoz Inc.","package_description":"10 SYRINGE in 1 CARTON (0781-3476-95) / .8 mL in 1 SYRINGE (0781-3476-94)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":44.81613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3476-95) / .8 mL in 1 SYRINGE (0781-3476-94)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55111068110","name":"FONDAPARINUX 10 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-681-10","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"10 mg/.8mL","labeler":"Dr. Reddy's Laboratories Limited","package_description":"10 SYRINGE in 1 CARTON (55111-681-10) / .8 mL in 1 SYRINGE (55111-681-11)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":44.81613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (55111-681-10) / .8 mL in 1 SYRINGE (55111-681-11)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150023310","name":"FONDAPARINUX 10 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-233-10","proprietary_name":"FONDAPARINUX SODIUM","nonproprietary_name":"FONDAPARINUX SODIUM","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"10 mg/.8mL","labeler":"Eugia US LLC","package_description":"10 SYRINGE, GLASS in 1 CARTON (55150-233-10) / .8 mL in 1 SYRINGE, GLASS (55150-233-00)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":44.81613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE, GLASS in 1 CARTON (55150-233-10) / .8 mL in 1 SYRINGE, GLASS (55150-233-00)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457058508","name":"FONDAPARINUX 10 MG/0.8 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-585-08","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"fondaparinux sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"10 mg/.8mL","labeler":"Mylan Institutional LLC","package_description":"10 SYRINGE, GLASS in 1 CARTON (67457-585-08) / .8 mL in 1 SYRINGE, GLASS (67457-585-00)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":44.81613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE, GLASS in 1 CARTON (67457-585-08) / .8 mL in 1 SYRINGE, GLASS (67457-585-00)) gives 8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781344395","name":"FONDAPARINUX 2.5 MG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-3443-95","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Sandoz Inc.","package_description":"10 SYRINGE in 1 CARTON (0781-3443-95) / .5 mL in 1 SYRINGE (0781-3443-94)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":22.16233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3443-95) / .5 mL in 1 SYRINGE (0781-3443-94)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55111067802","name":"FONDAPARINUX 2.5 MG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-678-02","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Dr. Reddy's Laboratories Limited","package_description":"2 SYRINGE in 1 CARTON (55111-678-02) / .5 mL in 1 SYRINGE (55111-678-11)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":12.12467,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 SYRINGE in 1 CARTON (55111-678-02) / .5 mL in 1 SYRINGE (55111-678-11)) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":2,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55111067810","name":"FONDAPARINUX 2.5 MG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55111-678-10","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Dr. Reddy's Laboratories Limited","package_description":"10 SYRINGE in 1 CARTON (55111-678-10) / .5 mL in 1 SYRINGE (55111-678-11)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":22.16233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (55111-678-10) / .5 mL in 1 SYRINGE (55111-678-11)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150023010","name":"FONDAPARINUX 2.5 MG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-230-10","proprietary_name":"FONDAPARINUX SODIUM","nonproprietary_name":"FONDAPARINUX SODIUM","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Eugia US LLC","package_description":"10 SYRINGE, GLASS in 1 CARTON (55150-230-10) / .5 mL in 1 SYRINGE, GLASS (55150-230-00)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":22.16233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE, GLASS in 1 CARTON (55150-230-10) / .5 mL in 1 SYRINGE, GLASS (55150-230-00)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457058210","name":"FONDAPARINUX 2.5 MG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67457-582-10","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"fondaparinux sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Mylan Institutional LLC","package_description":"10 SYRINGE, GLASS in 1 CARTON (67457-582-10) / .5 mL in 1 SYRINGE, GLASS (67457-582-00)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":22.16233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE, GLASS in 1 CARTON (67457-582-10) / .5 mL in 1 SYRINGE, GLASS (67457-582-00)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781346595","name":"FONDAPARINUX 7.5 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3465-95","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.6mL","labeler":"Sandoz Inc.","package_description":"10 SYRINGE in 1 CARTON (0781-3465-95) / .6 mL in 1 SYRINGE (0781-3465-94)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":42.80893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0781-3465-95) / .6 mL in 1 SYRINGE (0781-3465-94)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55111068010","name":"FONDAPARINUX 7.5 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-680-10","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"Fondaparinux Sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.6mL","labeler":"Dr. Reddy's Laboratories Limited","package_description":"10 SYRINGE in 1 CARTON (55111-680-10) / .6 mL in 1 SYRINGE (55111-680-11)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":42.80893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (55111-680-10) / .6 mL in 1 SYRINGE (55111-680-11)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150023210","name":"FONDAPARINUX 7.5 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-232-10","proprietary_name":"FONDAPARINUX SODIUM","nonproprietary_name":"FONDAPARINUX SODIUM","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.6mL","labeler":"Eugia US LLC","package_description":"10 SYRINGE, GLASS in 1 CARTON (55150-232-10) / .6 mL in 1 SYRINGE, GLASS (55150-232-00)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":42.80893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE, GLASS in 1 CARTON (55150-232-10) / .6 mL in 1 SYRINGE, GLASS (55150-232-00)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457058406","name":"FONDAPARINUX 7.5 MG/0.6 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-584-06","proprietary_name":"Fondaparinux Sodium","nonproprietary_name":"fondaparinux sodium","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.6mL","labeler":"Mylan Institutional LLC","package_description":"10 SYRINGE, GLASS in 1 CARTON (67457-584-06) / .6 mL in 1 SYRINGE, GLASS (67457-584-00)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":42.80893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fondaparinux Sodium|Fondaparinux Sodium","basis":"generic"},"part_b":{"hcpcs":"J1652","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1652 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (15 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE, GLASS in 1 CARTON (67457-584-06) / .6 mL in 1 SYRINGE, GLASS (67457-584-00)) gives 6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093406106","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4061-06","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 POUCH in 1 CARTON (0093-4061-06) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (0093-4061-06) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093406130","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4061-30","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 POUCH in 1 CARTON (0093-4061-30) / 1 VIAL in 1 POUCH (0093-4061-19) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00378163191","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1631-91","proprietary_name":"FORMOTEROL FUMARATE","nonproprietary_name":"formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 POUCH in 1 CARTON (0378-1631-91) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (0378-1631-91) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378163193","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1631-93","proprietary_name":"FORMOTEROL FUMARATE","nonproprietary_name":"formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-1631-93) / 1 VIAL in 1 POUCH (0378-1631-32) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0378-1631-93) / 1 VIAL in 1 POUCH (0378-1631-32) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42571046362","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-463-62","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Micro Labs Limited","package_description":"60 POUCH in 1 CARTON (42571-463-62) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (42571-463-62) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42571046373","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-463-73","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Micro Labs Limited","package_description":"30 POUCH in 1 CARTON (42571-463-73) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (42571-463-73) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598077830","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-778-30","proprietary_name":"Formoterol Fumarate","nonproprietary_name":"formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 POUCH in 1 CARTON (43598-778-30) / 1 VIAL in 1 POUCH (43598-778-11) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (43598-778-30) / 1 VIAL in 1 POUCH (43598-778-11) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598077860","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-778-60","proprietary_name":"Formoterol Fumarate","nonproprietary_name":"formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 POUCH in 1 CARTON (43598-778-60) / 1 VIAL in 1 POUCH (43598-778-11) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (43598-778-60) / 1 VIAL in 1 POUCH (43598-778-11) / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50742039430","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-394-30","proprietary_name":"Formoterol Fumarate","nonproprietary_name":"Formoterol Fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".02 mg/2mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (50742-394-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH (50742-394-01) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (50742-394-30) / 1 VIAL, SINGLE-DOSE in 1 POUCH (50742-394-01) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50742039460","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-394-60","proprietary_name":"Formoterol Fumarate","nonproprietary_name":"Formoterol Fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".02 mg/2mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"60 POUCH in 1 CARTON (50742-394-60) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (50742-394-60) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62332065530","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-655-30","proprietary_name":"Formoterol Fumarate","nonproprietary_name":"Formoterol Fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (62332-655-30) / 1 VIAL in 1 POUCH (62332-655-01) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (62332-655-30) / 1 VIAL in 1 POUCH (62332-655-01) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62332065560","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-655-60","proprietary_name":"Formoterol Fumarate","nonproprietary_name":"Formoterol Fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 POUCH in 1 CARTON (62332-655-60) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (62332-655-60) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70748026130","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-261-30","proprietary_name":"formoterol fumarate","nonproprietary_name":"formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 POUCH in 1 CARTON (70748-261-30) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (70748-261-30) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70748026160","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-261-60","proprietary_name":"formoterol fumarate","nonproprietary_name":"formoterol fumarate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 POUCH in 1 CARTON (70748-261-60) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (70748-261-60) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756060860","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-608-60","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Lifestar Pharma LLC","package_description":"60 POUCH in 1 CARTON (70756-608-60) / 4 VIAL in 1 POUCH (70756-608-44) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"70756060870","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-608-70","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Lifestar Pharma LLC","package_description":"30 POUCH in 1 CARTON (70756-608-70) / 1 VIAL in 1 POUCH (70756-608-12) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (70756-608-70) / 1 VIAL in 1 POUCH (70756-608-12) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603062030","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-620-30","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"NorthStar RxLLC","package_description":"30 POUCH in 1 CARTON (72603-620-30) / 1 VIAL in 1 POUCH (72603-620-01) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (72603-620-30) / 1 VIAL in 1 POUCH (72603-620-01) / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603062060","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-620-60","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"NorthStar RxLLC","package_description":"60 POUCH in 1 CARTON (72603-620-60) / 4 VIAL in 1 POUCH (72603-620-04) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"73043005193","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-051-93","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Devatis, Inc.","package_description":"30 POUCH in 1 CARTON (73043-051-93) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"73043005196","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-051-96","proprietary_name":"Formoterol fumarate","nonproprietary_name":"Formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Devatis, Inc.","package_description":"60 POUCH in 1 CARTON (73043-051-96) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":null}, {"ndc":"76204003001","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-030-01","proprietary_name":"Formoterol Fumarate Inhalation Solution","nonproprietary_name":"formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-030-01) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-030-01) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204003002","name":"FORMOTEROL 20 MCG/2 ML NEB VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-030-02","proprietary_name":"Formoterol Fumarate Inhalation Solution","nonproprietary_name":"formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"60 POUCH in 1 CARTON (76204-030-02) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Formoterol Fumarate|Formoterol Fumarate","basis":"generic"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (76204-030-02) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002840001","name":"FORTEO 560 MCG/2.24 ML PEN INJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8400-01","proprietary_name":"Forteo","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-8400-01) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":1841.27488,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Forteo|Teriparatide","basis":"brand"},"part_b":null}, {"ndc":"00002967801","name":"FORTEO 560 MCG/2.24 ML PEN INJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-9678-01","proprietary_name":"Forteo","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-9678-01) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":1841.27488,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Forteo|Teriparatide","basis":"brand"},"part_b":null}, {"ndc":"78206013501","name":"FOSAMAX 70 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-135-01","proprietary_name":"FOSAMAX","nonproprietary_name":"alendronate sodium","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1","labeler":"Organon LLC","package_description":"4 TABLET in 1 BLISTER PACK (78206-135-01)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":38.70415,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.25627,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosamax|Alendronate Sodium","basis":"brand"},"part_b":null}, {"ndc":"78206013701","name":"FOSAMAX PLUS D 70 MG-2800 UNIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-137-01","proprietary_name":"FOSAMAX PLUS D","nonproprietary_name":"ALENDRONATE SODIUM and CHOLECALCIFEROL","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1; 2800 [iU]/1","labeler":"Organon LLC","package_description":"4 TABLET in 1 BLISTER PACK (78206-137-01)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":52.5645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosamax Plus D|Alendronate Sodium/Vitamin D3","basis":"brand"},"part_b":null}, {"ndc":"78206013601","name":"FOSAMAX PLUS D 70 MG-5600 UNIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-136-01","proprietary_name":"FOSAMAX PLUS D","nonproprietary_name":"ALENDRONATE SODIUM and CHOLECALCIFEROL","dosage_form":"TABLET","route":"ORAL","strength":"70 mg/1; 5600 [iU]/1","labeler":"Organon LLC","package_description":"4 TABLET in 1 BLISTER PACK (78206-136-01)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":52.51292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosamax Plus D|Alendronate Sodium/Vitamin D3","basis":"brand"},"part_b":null}, {"ndc":"59651065103","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-651-03","proprietary_name":"Fosfomycin tromethamine","nonproprietary_name":"Fosfomycin tromethamine","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"3 g/1","labeler":"Aurobindo Pharma Limited","package_description":"1 PACKET in 1 CARTON (59651-651-03) / 1 GRANULE, FOR SOLUTION in 1 PACKET"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"60219395501","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-3955-1","proprietary_name":"Fosfomycin Tromethamine","nonproprietary_name":"Fosfomycin Tromethamine","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"3 g/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 PACKET in 1 CARTON (60219-3955-1) / 1 GRANULE, FOR SOLUTION in 1 PACKET (60219-3955-3)"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"60219395503","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"67877074957","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-749-57","proprietary_name":"Fosfomycin Tromethamine","nonproprietary_name":"Fosfomycin Tromethamine","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"3 g/1","labeler":"Ascend Laboratories, LLC","package_description":"1 PACKET in 1 CARTON (67877-749-57) / 1 GRANULE, FOR SOLUTION in 1 PACKET"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"68094006401","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"68094006420","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-064-20","proprietary_name":"Fosfomycin Tromethamine","nonproprietary_name":"Fosfomycin Tromethamine","dosage_form":"GRANULE","route":"ORAL","strength":"3 g/1","labeler":"Precision Dose, Inc.","package_description":"1 PACKET in 1 CARTON (68094-064-20) / 1 GRANULE in 1 PACKET (68094-064-01)"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"69097057967","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-579-67","proprietary_name":"FOSFOMYCIN TROMETHAMINE","nonproprietary_name":"FOSFOMYCIN TROMETHAMINE","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"3 g/1","labeler":"Cipla USA Inc.","package_description":"1 DOSE PACK in 1 CARTON (69097-579-67) / 1 GRANULE, FOR SOLUTION in 1 DOSE PACK"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"70700026894","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-268-94","proprietary_name":"FOSFOMYCIN TROMETHAMINE","nonproprietary_name":"Granules for Oral Solution","dosage_form":"POWDER","route":"ORAL","strength":"3 g/1","labeler":"XIROMED LLC","package_description":"1 DOSE PACK in 1 CARTON (70700-268-94) / 1 POWDER in 1 DOSE PACK"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700026899","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-268-99","proprietary_name":"FOSFOMYCIN TROMETHAMINE","nonproprietary_name":"Granules for Oral Solution","dosage_form":"POWDER","route":"ORAL","strength":"3 g/1","labeler":"XIROMED LLC","package_description":"1 POWDER in 1 PACKET (70700-268-99)"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033002403","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"81033002411","name":"FOSFOMYCIN 3 GM SACHET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-024-11","proprietary_name":"Fosfomycin Tromethamine","nonproprietary_name":"Fosfomycin Tromethamine","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL","strength":"3 g/1","labeler":"Kesin Pharma Corporation","package_description":"1 PACKET in 1 CARTON (81033-024-11) / 1 GRANULE, FOR SOLUTION in 1 PACKET (81033-024-03)"},"nadac":{"value":26.22036,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosfomycin Tromethamine|Fosfomycin Tromethamine","basis":"generic"},"part_b":null}, {"ndc":"43547038609","name":"FOSINOPRIL SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-386-09","proprietary_name":"Fosinopril sodium","nonproprietary_name":"fosinopirl sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare LLC","package_description":"90 TABLET in 1 BOTTLE (43547-386-09)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547038611","name":"FOSINOPRIL SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-386-11","proprietary_name":"Fosinopril sodium","nonproprietary_name":"fosinopirl sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-386-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135004190","name":"FOSINOPRIL SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-041-90","proprietary_name":"Fosinopril Sodium","nonproprietary_name":"Fosinopril Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-041-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097085605","name":"FOSINOPRIL SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-856-05","proprietary_name":"Fosinopril Sodium","nonproprietary_name":"Fosinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-856-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282020010","name":"FOSINOPRIL SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-200-10","proprietary_name":"Fosinopril sodium","nonproprietary_name":"Fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-200-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282020090","name":"FOSINOPRIL SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-200-90","proprietary_name":"Fosinopril sodium","nonproprietary_name":"Fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-200-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"43547038709","name":"FOSINOPRIL SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-387-09","proprietary_name":"Fosinopril sodium","nonproprietary_name":"fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare LLC","package_description":"90 TABLET in 1 BOTTLE (43547-387-09)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"43547038711","name":"FOSINOPRIL SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-387-11","proprietary_name":"Fosinopril sodium","nonproprietary_name":"fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-387-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"62135004290","name":"FOSINOPRIL SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-042-90","proprietary_name":"Fosinopril Sodium","nonproprietary_name":"Fosinopril Sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-042-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097085705","name":"FOSINOPRIL SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-857-05","proprietary_name":"Fosinopril Sodium","nonproprietary_name":"Fosinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-857-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282020110","name":"FOSINOPRIL SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-201-10","proprietary_name":"Fosinopril sodium","nonproprietary_name":"Fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-201-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282020190","name":"FOSINOPRIL SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-201-90","proprietary_name":"Fosinopril sodium","nonproprietary_name":"Fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-201-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"43547038809","name":"FOSINOPRIL SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-388-09","proprietary_name":"Fosinopril sodium","nonproprietary_name":"fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare LLC","package_description":"90 TABLET in 1 BOTTLE (43547-388-09)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.2119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"43547038811","name":"FOSINOPRIL SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-388-11","proprietary_name":"Fosinopril sodium","nonproprietary_name":"fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-388-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.2119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"62135004390","name":"FOSINOPRIL SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-043-90","proprietary_name":"Fosinopril Sodium","nonproprietary_name":"Fosinopril Sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-043-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.2119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097085805","name":"FOSINOPRIL SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-858-05","proprietary_name":"Fosinopril Sodium","nonproprietary_name":"Fosinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-858-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.2119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282020210","name":"FOSINOPRIL SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-202-10","proprietary_name":"Fosinopril sodium","nonproprietary_name":"Fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-202-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.2119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282020290","name":"FOSINOPRIL SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-202-90","proprietary_name":"Fosinopril sodium","nonproprietary_name":"Fosinopril sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-202-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.2119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril Sodium|Fosinopril Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862030801","name":"FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-308-01","proprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","nonproprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-308-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.63418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril-Hydrochlorothiazide|Fosinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097097207","name":"FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-972-07","proprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","nonproprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"CIPLA USA INC.","package_description":"100 TABLET in 1 BOTTLE (69097-972-07)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.63418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril-Hydrochlorothiazide|Fosinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862030901","name":"FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-309-01","proprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","nonproprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-309-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.55955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril-Hydrochlorothiazide|Fosinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097097307","name":"FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-973-07","proprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","nonproprietary_name":"Fosinopril Sodium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"CIPLA USA INC.","package_description":"100 TABLET in 1 BOTTLE (69097-973-07)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.55955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fosinopril-Hydrochlorothiazide|Fosinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00002417801","name":"FOUNDAYO 0.8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":20.89256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002417831","name":"FOUNDAYO 0.8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4178-31","proprietary_name":"FOUNDAYO","nonproprietary_name":"orforglipron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".8 mg/1","labeler":"Eli Lilly and Company","package_description":"1 BOTTLE in 1 CARTON (0002-4178-31) / 30 TABLET, FILM COATED in 1 BOTTLE (0002-4178-01)","pharm_classes":["Decreased Gastric Motility [PE]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Increased Gastric Muscle Tone [PE]"]},"nadac":{"value":20.89256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002450301","name":"FOUNDAYO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":20.83709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002450331","name":"FOUNDAYO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4503-31","proprietary_name":"FOUNDAYO","nonproprietary_name":"orforglipron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Eli Lilly and Company","package_description":"1 BOTTLE in 1 CARTON (0002-4503-31) / 30 TABLET, FILM COATED in 1 BOTTLE (0002-4503-01)","pharm_classes":["Decreased Gastric Motility [PE]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Increased Gastric Muscle Tone [PE]"]},"nadac":{"value":20.83709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002479401","name":"FOUNDAYO 5.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":20.81886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002479431","name":"FOUNDAYO 5.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4794-31","proprietary_name":"FOUNDAYO","nonproprietary_name":"orforglipron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5.5 mg/1","labeler":"Eli Lilly and Company","package_description":"1 BOTTLE in 1 CARTON (0002-4794-31) / 30 TABLET, FILM COATED in 1 BOTTLE (0002-4794-01)","pharm_classes":["Decreased Gastric Motility [PE]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Increased Gastric Muscle Tone [PE]"]},"nadac":{"value":20.81886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002480301","name":"FOUNDAYO 9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":20.8537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002480331","name":"FOUNDAYO 9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4803-31","proprietary_name":"FOUNDAYO","nonproprietary_name":"orforglipron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"9 mg/1","labeler":"Eli Lilly and Company","package_description":"1 BOTTLE in 1 CARTON (0002-4803-31) / 30 TABLET, FILM COATED in 1 BOTTLE (0002-4803-01)","pharm_classes":["Decreased Gastric Motility [PE]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Increased Gastric Muscle Tone [PE]"]},"nadac":{"value":20.8537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71776000110","name":"FRESHKOTE EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71776-001-10","proprietary_name":"FreshKote Preservative Free Lubricant Eye Drops","nonproprietary_name":"Povidone, Polyvinyl Alcohol","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 g/1000mL; 27 g/1000mL","labeler":"Eyevance Pharmaceuticals","package_description":"1 BOTTLE, DROPPER in 1 BOX (71776-001-10) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":2.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50742029909","name":"FROVATRIPTAN SUCC 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-299-09","proprietary_name":"FROVATRIPTAN","nonproprietary_name":"frovatriptan succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1 BLISTER PACK in 1 CARTON (50742-299-09) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.71707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Frovatriptan Succinate|Frovatriptan Succinate","basis":"generic"},"part_b":null}, {"ndc":"68462069497","name":"FROVATRIPTAN SUCC 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-694-97","proprietary_name":"frovatriptan succinate","nonproprietary_name":"frovatriptan succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-694-97) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.71707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Frovatriptan Succinate|Frovatriptan Succinate","basis":"generic"},"part_b":null}, {"ndc":"69238153909","name":"FROVATRIPTAN SUCC 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1539-9","proprietary_name":"Frovatriptan","nonproprietary_name":"Frovatriptan succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BLISTER PACK in 1 CARTON (69238-1539-9) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.71707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Frovatriptan Succinate|Frovatriptan Succinate","basis":"generic"},"part_b":null}, {"ndc":"69315015713","name":"FROVATRIPTAN SUCC 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-157-13","proprietary_name":"FROVATRIPTAN SUCCINATE","nonproprietary_name":"FROVATRIPTAN SUCCINATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Leading Pharma, LLC","package_description":"9 TABLET, FILM COATED in 1 CARTON (69315-157-13)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.71707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Frovatriptan Succinate|Frovatriptan Succinate","basis":"generic"},"part_b":null}, {"ndc":"70677102501","name":"FT 12-HR COUGH RLF 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1025-1","proprietary_name":"foster and thrive 12 hour cough relief","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1025-1) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677102601","name":"FT 12-HR COUGH RLF 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1026-1","proprietary_name":"foster and thrive 12 hour cough relief","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1026-1) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677102301","name":"FT 24H NASAL ALLERGY 55 MCG SPR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1023-1","proprietary_name":"foster and thrive 24 hour nasal allergy","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70677-1023-1) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677112301","name":"FT 8 HOUR PAIN RLF ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1123-1","proprietary_name":"8 Hour Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1123-1) / 100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110201","name":"FT ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1102-1","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"30 BLISTER PACK in 1 CARTON (70677-1102-1) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110202","name":"FT ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1102-2","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1102-2) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110203","name":"FT ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1102-3","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1102-3) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110101","name":"FT ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1101-1","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"25 BLISTER PACK in 1 CARTON (70677-1101-1) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110102","name":"FT ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1101-2","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1101-2) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110301","name":"FT ACID REDUCER DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1103-1","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1103-1) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110302","name":"FT ACID REDUCER DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1103-2","proprietary_name":"foster and thrive acid reducer","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 BOTTLE in 1 CARTON (70677-1103-2) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109901","name":"FT ACID REDUCER DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1099-1","proprietary_name":"Foster and Thrive Acid Reducer","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1099-1) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109902","name":"FT ACID REDUCER DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1099-2","proprietary_name":"Foster and Thrive Acid Reducer","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BOTTLE in 1 CARTON (70677-1099-2) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109903","name":"FT ACID REDUCER DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1099-3","proprietary_name":"Foster and Thrive Acid Reducer","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 BOTTLE in 1 CARTON (70677-1099-3) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110001","name":"FT ACID REDUCER-ANTACID TB CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1100-1","proprietary_name":"foster and thrive acid reducer antacid","nonproprietary_name":"famotidine, calcium carbonate and magnesium hydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1; 800 mg/1; 165 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"25 TABLET, CHEWABLE in 1 BOTTLE (70677-1100-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.2578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100702","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1007-2","proprietary_name":"cetirizine hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1007-2) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100703","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1007-3","proprietary_name":"cetirizine hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1007-3) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100704","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1007-4","proprietary_name":"cetirizine hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1007-4) / 300 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677104701","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1047-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Cetirizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"14 BLISTER PACK in 1 CARTON (70677-1047-1) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127901","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1279-1","proprietary_name":"Cetirizine HCl","nonproprietary_name":"Cetirizine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1279-1) / 14 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127902","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1279-2","proprietary_name":"Cetirizine HCl","nonproprietary_name":"Cetirizine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1279-2) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127903","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1279-3","proprietary_name":"Cetirizine HCl","nonproprietary_name":"Cetirizine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1279-3) / 60 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127904","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1279-4","proprietary_name":"Cetirizine HCl","nonproprietary_name":"Cetirizine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1279-4) / 90 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127905","name":"FT AD ALLERGY (CETRZN) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1279-5","proprietary_name":"Cetirizine HCl","nonproprietary_name":"Cetirizine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1279-5) / 300 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105301","name":"FT AD ALLERGY (LORAT) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105302","name":"FT AD ALLERGY (LORAT) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105303","name":"FT AD ALLERGY (LORAT) 10 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677118601","name":"FT ADULT TUSSIN 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1186-1","proprietary_name":"Tussin","nonproprietary_name":"Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"200 mg/10mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1186-1) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677118602","name":"FT ADULT TUSSIN 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1186-2","proprietary_name":"Tussin","nonproprietary_name":"Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"200 mg/10mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1186-2) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677102001","name":"FT ALL DAY ALLERGY-D 5-120 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1020-1","proprietary_name":"Allergy relief-D","nonproprietary_name":"Cetirizine Hydrochloride and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"4 BLISTER PACK in 1 CARTON (70677-1020-1) / 6 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113701","name":"FT ALL DAY PAIN 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1137-1","proprietary_name":"foster and thrive all day pain relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1137-1) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113702","name":"FT ALL DAY PAIN 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1137-2","proprietary_name":"foster and thrive all day pain relief","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1137-2) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102002","name":"FT ALL DY ALLERGY-D 5-120 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1020-2","proprietary_name":"Allergy relief-D","nonproprietary_name":"Cetirizine Hydrochloride and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1020-2) / 6 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677131101","name":"FT ALL DY ALLERGY-D 5-120 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1311-1","proprietary_name":"FOSTER AND THRIVE ALL DAY ALLERGY D","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"12 BLISTER PACK in 1 CARTON (70677-1311-1) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677131102","name":"FT ALL DY ALLERGY-D 5-120 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1311-2","proprietary_name":"FOSTER AND THRIVE ALL DAY ALLERGY D","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"24 BLISTER PACK in 1 CARTON (70677-1311-2) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677124101","name":"FT ALLERGY (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1241-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (70677-1241-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101601","name":"FT ALLERGY (CHLORPHEN) 4 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1016-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Chlorpheniramine maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1016-1) / 100 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101501","name":"FT ALLERGY (DIPHEN) 25 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1015-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1015-1) / 12 CAPSULE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101502","name":"FT ALLERGY (DIPHEN) 25 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1015-2","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1015-2) / 100 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101401","name":"FT ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1014-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1014-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101402","name":"FT ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1014-2","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1014-2) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677123801","name":"FT ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1238-1","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (70677-1238-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100901","name":"FT ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1009-1","proprietary_name":"Fexofenadine Hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"3 BLISTER PACK in 1 CARTON (70677-1009-1) / 5 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100902","name":"FT ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1009-2","proprietary_name":"Fexofenadine Hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1009-2) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100903","name":"FT ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1009-3","proprietary_name":"Fexofenadine Hydrochloride","nonproprietary_name":"Fexofenadine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1009-3) / 70 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677123901","name":"FT ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1239-1","proprietary_name":"FEXOFENADINE HCl","nonproprietary_name":"FEXOFENADINE HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70677-1239-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125601","name":"FT ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1256-1","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1256-1) / 30 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125602","name":"FT ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1256-2","proprietary_name":"Fexofenadine HCL","nonproprietary_name":"Fexofenadine HCL","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1256-2) / 500 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100801","name":"FT ALLERGY (FEXO) 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102201","name":"FT ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1022-1","proprietary_name":"foster and thrive allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1022-1) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102202","name":"FT ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1022-2","proprietary_name":"foster and thrive allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1022-2) / 70 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102203","name":"FT ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1022-3","proprietary_name":"foster and thrive allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1022-3) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102204","name":"FT ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1022-4","proprietary_name":"foster and thrive allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1022-4) / 300 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102401","name":"FT ALLERGY D-12HR 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1024-1","proprietary_name":"foster and thrive allergy D 12 hour","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"20 BLISTER PACK in 1 CARTON (70677-1024-1) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102402","name":"FT ALLERGY D-12HR 5-120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1024-2","proprietary_name":"foster and thrive allergy D 12 hour","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"30 BLISTER PACK in 1 CARTON (70677-1024-2) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100401","name":"FT ALLERGY MULTI-SYMPTOM CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1004-1","proprietary_name":"Allergy Multi-Symptom","nonproprietary_name":"ACETAMINOPHEN, CHLORPHENIRAMINE MALEATE, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 2 mg/1; 5 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1004-1) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677102101","name":"FT ALLERGY RELIEF 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1021-1","proprietary_name":"Foster and Thrive Allergy Relief","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70677-1021-1) / 72 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.80745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677102102","name":"FT ALLERGY RELIEF 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1021-2","proprietary_name":"Foster and Thrive Allergy Relief","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70677-1021-2) / 144 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677101801","name":"FT ALLERGY RELIEF D-24HR TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1018-1","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1018-1) / 10 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101802","name":"FT ALLERGY RELIEF D-24HR TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1018-2","proprietary_name":"Loratadine and Pseudoephedrine","nonproprietary_name":"loratadine and pseudoephedrine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1018-2) / 15 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677107501","name":"FT ANTACID 500 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1075-1","proprietary_name":"Foster and Thrive Regular Strength Antacid","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE (70677-1075-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677108101","name":"FT ANTACID 500 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1081-1","proprietary_name":"Foster and Thrive Regular Strength Antacid Peppermint","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE (70677-1081-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677107601","name":"FT ANTACID EX-STR 750 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1076-1","proprietary_name":"Foster and Thrive Extra Strength Antacid 127AF Extra Strength Antacid Assorted Fruit","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (70677-1076-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677107901","name":"FT ANTACID EX-STR 750 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1079-1","proprietary_name":"Foster and Thrive Extra Strength Sugar Free Antacid Orange","nonproprietary_name":"calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"80 TABLET, CHEWABLE in 1 BOTTLE (70677-1079-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677106301","name":"FT ANTACID-ANTIGAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1063-1","proprietary_name":"REGULAR STRENGTH ANTACID AND ANTIGAS","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 200 mg/5mL; 20 mg/5mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"355 mL in 1 BOTTLE (70677-1063-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677106601","name":"FT ANTACID-ANTIGAS LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1066-1","proprietary_name":"REGULAR STRENGTH ANTACID AND ANTIGAS","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 200 mg/5mL; 20 mg/5mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"355 mL in 1 BOTTLE (70677-1066-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677106401","name":"FT ANTACID-ANTIGAS MAX STR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1064-1","proprietary_name":"MAXIMUM STRENGTH ANTACID ANTIGAS","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 400 mg/5mL; 40 mg/5mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"355 mL in 1 BOTTLE (70677-1064-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677106501","name":"FT ANTACID-ANTIGAS MAX STR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1065-1","proprietary_name":"MAXIMUM STRENGTH ANTACID AND ANTIGAS","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, simethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 400 mg/5mL; 40 mg/5mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"355 mL in 1 BOTTLE (70677-1065-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677110701","name":"FT ANTI-DIARRHEAL 1 MG/7.5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1107-1","proprietary_name":"foster and thrive anti-diarrheal","nonproprietary_name":"loperamide HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/7.5mL","labeler":"Strategic Sourcing Services LLC","package_description":"120 mL in 1 BOTTLE (70677-1107-1)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.02644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677110601","name":"FT ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1106-1","proprietary_name":"foster and thrive anti diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"12 BLISTER PACK in 1 CARTON (70677-1106-1) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110602","name":"FT ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1106-2","proprietary_name":"foster and thrive anti diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"24 BLISTER PACK in 1 CARTON (70677-1106-2) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677106201","name":"FT ANTI-DIARRHEAL 2 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1062-1","proprietary_name":"Anti-Diarrheal","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 mg/1","labeler":"STRATEGIC SOURCING SERVICES","package_description":"2 BLISTER PACK in 1 CARTON (70677-1062-1) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110501","name":"FT ANTI-DIARRHEAL-ANTIGAS CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1105-1","proprietary_name":"foster and thrive anti diarrheal anti gas","nonproprietary_name":"loperamide hydrochloride, simethicone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 125 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"12 BLISTER PACK in 1 CARTON (70677-1105-1) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]","Skin Barrier Activity [PE]"]},"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128901","name":"FT ANTI-ITCH 2%-0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1289-1","proprietary_name":"foster and thrive anti itch cream","nonproprietary_name":"Diphenhydramine Hydrochloride, Zinc Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g; .1 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (70677-1289-1) / 28 g in 1 TUBE","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121101","name":"FT ANTIBIOTIC 500 UNIT/GM OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1211-1","proprietary_name":"Bacitracin Zinc","nonproprietary_name":"Bacitracin Zinc","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1211-1) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121801","name":"FT ANTIBIOTIC-PAIN RELIEF CRM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70677-1218-1","proprietary_name":"Antibiotic and Pain Relief","nonproprietary_name":"Neomycin Sulfate, Polymyxin B Sulfate, and Pramoxine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"3.5 mg/g; 10000 [USP'U]/g; 10 mg/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1218-1) / 14.2 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.18873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677100101","name":"FT ANTIFUNGAL 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1001-1","proprietary_name":"Tolnaftate Antifungal","nonproprietary_name":"Tolnaftate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1001-1) / 15 g in 1 TUBE"},"nadac":{"value":0.15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677100001","name":"FT ANTIFUNGAL 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1000-1","proprietary_name":"Miconazole Nitrate","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1000-1) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.12071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677122101","name":"FT ANTISEPTIC SKIN CLEANSR 4%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1221-1","proprietary_name":"Foster and Thrive","nonproprietary_name":"Chlorhexidine Gluconate 4%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"4 g/100mL","labeler":"McKesson Corporation","package_description":"237 mL in 1 BOTTLE (70677-1221-1)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.03664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677112501","name":"FT ARTHRITIS PAIN 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1125-1","proprietary_name":"Arthritis Pain","nonproprietary_name":"diclofenac sodium topical gel, 1%","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Strategic Sourcing Services, LLC","package_description":"1 TUBE in 1 CARTON (70677-1125-1) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677129301","name":"FT ARTHRITIS PAIN 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1293-1","proprietary_name":"FOSTER AND THRIVE ARTHRITIS PAIN","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (70677-1293-1) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677118901","name":"FT ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1189-1","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1189-1) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113401","name":"FT ASPIRIN 81 MG CHEWABLE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1134-1","proprietary_name":"foster and thrive aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1134-1) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112201","name":"FT ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1122-1","proprietary_name":"Enteric Coated Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1122-1) / 125 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112101","name":"FT ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1121-1","proprietary_name":"Aspirin","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 PACKAGE (70677-1121-1) / 180 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115001","name":"FT ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1150-1","proprietary_name":"Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1150-1) / 120 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115002","name":"FT ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1150-2","proprietary_name":"Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1150-2) / 180 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115003","name":"FT ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1150-3","proprietary_name":"Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1150-3) / 300 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677126001","name":"FT ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1260-1","proprietary_name":"Aspirin Low Dose","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1260-1) / 120 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677131001","name":"FT ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1310-1","proprietary_name":"foster and thrive aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"McKesson Medical-Surgical, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (70677-1310-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100201","name":"FT ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1002-1","proprietary_name":"Clotrimazole 1% Athletes Foot","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1002-1) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.11771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677100301","name":"FT ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1003-1","proprietary_name":"Terbinafine Hydrochloride","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1003-1) / 30 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.30853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677126901","name":"FT ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1269-1","proprietary_name":"Athletes Foot","nonproprietary_name":"BUTENAFINE HYDROCHLORIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1269-1) / 30 g in 1 TUBE","pharm_classes":["Benzylamine Antifungal [EPC]","Benzylamines [CS]"]},"nadac":{"value":0.30701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677119601","name":"FT CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1196-1","proprietary_name":"Calamine","nonproprietary_name":"Calamine and Zinc Oxide","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 80 mg/mL","labeler":"Strategic Sourcing Services, LLC","package_description":"177 mL in 1 BOTTLE, PLASTIC (70677-1196-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677131601","name":"FT CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1316-1","proprietary_name":"calamine","nonproprietary_name":"Calamine and Zinc oxide","dosage_form":"LOTION","route":"TOPICAL","strength":"160 mg/mL","labeler":"STRATEGIC SOURCING SERVICES","package_description":"177 mL in 1 BOTTLE (70677-1316-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677119801","name":"FT CALDYPHEN 1%-8% LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1198-1","proprietary_name":"Foster and Thrive Caldyphen","nonproprietary_name":"Calamine and Pramoxine Hydrochloride","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 10 mg/mL","labeler":"Strategic Sourcing Services, LLC","package_description":"177 mL in 1 BOTTLE, PLASTIC (70677-1198-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677120101","name":"FT CAMPHOR SPIRIT","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1201-1","proprietary_name":"Camphor Spirit","nonproprietary_name":"Camphor 10%","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/mL","labeler":"Strategic Sourcing Services, LLC","package_description":"59 mL in 1 BOTTLE, PLASTIC (70677-1201-1)"},"nadac":{"value":0.04804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677108501","name":"FT CASTOR OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1085-1","proprietary_name":"Foster and Thrive Castor Oil","nonproprietary_name":"Castor Oil","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/mL","labeler":"Strategic Sourcing Services, LLC","package_description":"177 mL in 1 BOTTLE, PLASTIC (70677-1085-1)"},"nadac":{"value":0.01988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677131701","name":"FT CASTOR OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1317-1","proprietary_name":"Castor Oil","nonproprietary_name":"Castor Oil","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/mL","labeler":"STRATEGIC SOURCING SERVICES","package_description":"177 mL in 1 BOTTLE (70677-1317-1)"},"nadac":{"value":0.01988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677105501","name":"FT CHEST CONG RLF DM 400-20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1055-1","proprietary_name":"Foster and Thrive Chest Congestion Relief DM DM","nonproprietary_name":"Dextromethorphan Hydrobromide / Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1055-1) / 50 TABLET in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105601","name":"FT CHEST CONG RLF PE 400-10 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1056-1","proprietary_name":"Foster and Thrive Chest Congestion Relief PE PE","nonproprietary_name":"Guaifenesin/phenylephrine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1056-1) / 50 TABLET in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105401","name":"FT CHEST CONGEST 400 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1054-1","proprietary_name":"Foster and Thrive Chest Congestion Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1054-1) / 50 TABLET in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677106101","name":"FT CHEST RUB 4.8%-1.2%-2.6%","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70677-1061-1","proprietary_name":"Chest Rub","nonproprietary_name":"Camphor, Eucalyptus Oil, Menthol","dosage_form":"JELLY","route":"TOPICAL","strength":"48 mg/g; 12 mg/g; 26 mg/g","labeler":"Strategic Sourcing Services LLC","package_description":"1 JAR in 1 CARTON (70677-1061-1) / 100 g in 1 JAR"},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677112701","name":"FT CHILD ACETAMINOPHEN 160 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1127-1","proprietary_name":"Childrens Chewables","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"4 BLISTER PACK in 1 CARTON (70677-1127-1) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.11643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677123601","name":"FT CHILD ALL DAY ALLER 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1236-1","proprietary_name":"Cetirizine Hydrochloride","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1236-1) / 120 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677126801","name":"FT CHILD ALLERGY 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1268-1","proprietary_name":"foster and thrive childrens allergy relief","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1268-1) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677105701","name":"FT CHILD ALLERGY 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1057-1","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1057-1) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677105801","name":"FT CHILD ALLERGY 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1058-1","proprietary_name":"Childrens Loratadine Sugar Free","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1058-1) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677104201","name":"FT CHILD ALLERGY RLF 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1042-1","proprietary_name":"foster and thrive childrens allergy relief","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1042-1) / 120 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677104301","name":"FT CHILD ALLERGY RLF 5 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1043-1","proprietary_name":"foster and thrive childrens allergy relief","nonproprietary_name":"loratadine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"30 BLISTER PACK in 1 CARTON (70677-1043-1) / 1 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.52124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128701","name":"FT CHILD COLD-COUGH RLF DM LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1287-1","proprietary_name":"Foster and Thrive childrens cold cough relief dm","nonproprietary_name":"brompheniramine maleate, dextromethorphan hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1287-1) / 118 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111501","name":"FT CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1115-1","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1115-1) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111502","name":"FT CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1115-2","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1115-2) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111601","name":"FT CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1116-1","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1116-1) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111701","name":"FT CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1117-1","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1117-1) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111801","name":"FT CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1118-1","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-1118-1) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677127001","name":"FT CHILD PAIN REL 120 MG SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1270-1","proprietary_name":"Foster and Thrive Pain Reliever","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"120 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"12 BLISTER PACK in 1 CARTON (70677-1270-1) / 1 SUPPOSITORY in 1 BLISTER PACK"},"nadac":{"value":0.24417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677114201","name":"FT CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1142-1","proprietary_name":"foster and thrive childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1142-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677114301","name":"FT CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1143-1","proprietary_name":"foster and thrive childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1143-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677110901","name":"FT CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1109-1","proprietary_name":"foster and thrive clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Strategic Sourcing Services LLC","package_description":"119 g in 1 BOTTLE (70677-1109-1)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677110902","name":"FT CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1109-2","proprietary_name":"foster and thrive clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Strategic Sourcing Services LLC","package_description":"238 g in 1 BOTTLE (70677-1109-2)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677110903","name":"FT CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1109-3","proprietary_name":"foster and thrive clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Strategic Sourcing Services LLC","package_description":"510 g in 1 BOTTLE (70677-1109-3)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677110904","name":"FT CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1109-4","proprietary_name":"foster and thrive clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Strategic Sourcing Services LLC","package_description":"765 g in 1 BOTTLE (70677-1109-4)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677126201","name":"FT CLOTRIMAZOLE 1% VAG CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1262-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"1 g/100g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1262-1) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677123101","name":"FT CLOTRIMAZOLE-3 2% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1231-1","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"Foster and Thrive (Mckesson /STRATEGIC SOURCING SERVICES LLC)","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (70677-1231-1) / 21 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.3124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677123701","name":"FT CORN REMOVER 40% DISC","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1237-1","proprietary_name":"Foster and Thrive Medicated Corn Removers","nonproprietary_name":"40% w/w Salicylic Acid Corn Remover","dosage_form":"PLASTER","route":"TOPICAL","strength":"40 mg/100mg","labeler":"Strategic Sourcing Services LLC","package_description":"100 mg in 1 BOX (70677-1237-1)"},"nadac":{"value":0.10249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677129801","name":"FT COUGH DROPS 5.8 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1298-1","proprietary_name":"Foster and Thrive Cherry Cough Drops","nonproprietary_name":"Menthol","dosage_form":"LOZENGE","route":"ORAL","strength":"5.8 mg/1","labeler":"McKesson","package_description":"80 LOZENGE in 1 BAG (70677-1298-1)"},"nadac":{"value":0.04242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677129701","name":"FT COUGH DROPS 7.5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1297-1","proprietary_name":"Foster and Thrive Honey Lemon Cough Drops","nonproprietary_name":"Menthol","dosage_form":"LOZENGE","route":"ORAL","strength":"7.5 mg/1","labeler":"McKesson","package_description":"80 LOZENGE in 1 BAG (70677-1297-1)"},"nadac":{"value":0.03382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677129601","name":"FT COUGH DROPS 7.6 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1296-1","proprietary_name":"Foster and Thrive SF Honey Lemon Cough Drops","nonproprietary_name":"Menthol","dosage_form":"LOZENGE","route":"ORAL","strength":"7.6 mg/1","labeler":"McKesson","package_description":"80 LOZENGE in 1 BAG (70677-1296-1)"},"nadac":{"value":0.04354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677103101","name":"FT DAYTIME COLD-FLU RELIEF LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1031-1","proprietary_name":"foster and thrive daytime cold and flu relief","nonproprietary_name":"acetaminophen, dextromethorphan Hbr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"325 mg/15mL; 10 mg/15mL; 5 mg/15mL","labeler":"Strategic Sourcing Services LLC","package_description":"237 mL in 1 BOTTLE (70677-1031-1)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.01374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677102701","name":"FT DAYTIME SEVERE CLD-FLU CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1027-1","proprietary_name":"foster and thrive daytime severe cold and flu relief","nonproprietary_name":"acetaminophen, dextromethorphan hydrobromide, guaifenesin, phenylephrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"6 BLISTER PACK in 1 CARTON (70677-1027-1) / 2 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125501","name":"FT DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1255-1","proprietary_name":"Cold Sore Fever Blister Treatment","nonproprietary_name":"Docosanol","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 PACKAGE (70677-1255-1) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121201","name":"FT DOUBLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1212-1","proprietary_name":"Double Antibiotic","nonproprietary_name":"Bacitracin Zinc and Polymyxin B Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g; 10000 [USP'U]/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1212-1) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.1148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677127401","name":"FT DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1274-1","proprietary_name":"foster and thrive dual action","nonproprietary_name":"Acetaminophen, Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1274-1) / 36 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115401","name":"FT EAR WAX REMOVAL 6.5% DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1154-1","proprietary_name":"Foster and Thrive Earwax Removal Drops","nonproprietary_name":"CARBAMIDE PEROXIDE","dosage_form":"SOLUTION/ DROPS","route":"TOPICAL","strength":"65 mg/mL","labeler":"Mckesson Corp. Via Strategic Sourcing Services","package_description":"1 BOTTLE in 1 BOX (70677-1154-1) / 15 mL in 1 BOTTLE"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677115301","name":"FT EAR WAX REMOVAL 6.5% KIT","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1153-1","proprietary_name":"Foster and Thrive Earwax Removal Kit Ear wax drops","nonproprietary_name":"CARBAMIDE PEROXIDE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mckesson Corp. Via Strategic Sourcing Services","package_description":"1 KIT in 1 KIT (70677-1153-1) * 1 BOTTLE in 1 BOX (70677-1154-1) / 15 mL in 1 BOTTLE"},"nadac":{"value":0.16216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677108901","name":"FT ENEMA READY TO USE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1089-1","proprietary_name":"Foster and Thrive Ready to Use Saline Laxative","nonproprietary_name":"SODIUM PHOSPHATE, DIBASIC, UNSPECIFIED FORM and SODIUM PHOSPHATE, MONOBASIC, UNSPECIFIED FORM","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"McKesson","package_description":"1 BOTTLE in 1 CARTON (70677-1089-1) / 133 mL in 1 BOTTLE"},"nadac":{"value":0.0067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677108902","name":"FT ENEMA READY TO USE TWIN PAK","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1089-2","proprietary_name":"Foster and Thrive Ready to Use Saline Laxative","nonproprietary_name":"SODIUM PHOSPHATE, DIBASIC, UNSPECIFIED FORM and SODIUM PHOSPHATE, MONOBASIC, UNSPECIFIED FORM","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"McKesson","package_description":"2 BOTTLE in 1 CARTON (70677-1089-2) / 133 mL in 1 BOTTLE"},"nadac":{"value":0.00715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677121001","name":"FT EPSOM SALT GRANULES","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1210-1","proprietary_name":"Epsom Salt","nonproprietary_name":"Epsom Salt","dosage_form":"GRANULE","route":"ORAL; TOPICAL","strength":"1 g/g","labeler":"Strategic Sourcing Services LLC","package_description":"454 g in 1 POUCH (70677-1210-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677115501","name":"FT EYE ALLERGY ITCH RLF 0.2%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1155-1","proprietary_name":"Eye Allergy Itch Relief Once Daily Relief","nonproprietary_name":"Olopatadine Hydrochloride Ophthalmic","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1155-1) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677128001","name":"FT EYE ALLERGY ITCH-RED 0.1%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1280-1","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"Olopatadine Hydrochloride ophthalmic","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1280-1) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677108301","name":"FT FIBER LAXATIVE 625 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1083-1","proprietary_name":"Foster and Thrive Fiber Laxative 147","nonproprietary_name":"Calcium polycarbophil","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"90 TABLET in 1 BOTTLE (70677-1083-1)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677107701","name":"FT GAS RELIEF 125 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1077-1","proprietary_name":"Foster and Thrive Extra Strength Gas Relief Cherry","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"125 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1077-1) / 9 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109201","name":"FT GAS RELIEF 125 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1092-1","proprietary_name":"Gas Relief","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"125 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"30 BLISTER PACK in 1 CARTON (70677-1092-1) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.07065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109301","name":"FT GAS RELIEF 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1093-1","proprietary_name":"Gas Relief","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1093-1) / 60 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125401","name":"FT GAS RELIEF 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1254-1","proprietary_name":"Gas Relief","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"180 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1254-1) / 60 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677106701","name":"FT GAS RELIEF(SIMETH) 80 MG CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1067-1","proprietary_name":"GAS RELIEF","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"80 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1067-1) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.0322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677106702","name":"FT GAS RELIEF(SIMETH) 80 MG CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1067-2","proprietary_name":"GAS RELIEF","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"80 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1067-2) / 100 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.0322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109101","name":"FT GENTLE LAXATIVE 10 MG SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1091-1","proprietary_name":"Foster and Thrive Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/2000mg","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1091-1) / 40 mg in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110801","name":"FT HEMORRHOIDAL OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1108-1","proprietary_name":"foster and thrive hemorrhoidal","nonproprietary_name":"mineral oil, petrolatum, phenylephrine HCl","dosage_form":"OINTMENT","route":"RECTAL","strength":"14 g/100g; 74.9 g/100g; .25 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (70677-1108-1) / 57 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677129201","name":"FT HEMORRHOIDAL SUPPOSITORIES","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1292-1","proprietary_name":"foster and thrive hemorrhoidal","nonproprietary_name":"cocoa butter, phenylephrine HCl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2211 mg/1; 6.5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"12 BLISTER PACK in 1 CARTON (70677-1292-1) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677124801","name":"FT HYDROGEN PEROXIDE 3% SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70677-1248-1","proprietary_name":"Hydrogen Peroxide","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"2.65 mL/100mL","labeler":"Strategic Sourcing Services LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70677-1248-1)"},"nadac":{"value":0.01814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677113601","name":"FT IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1136-1","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1136-1) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113602","name":"FT IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1136-2","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1136-2) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113603","name":"FT IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1136-3","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70677-1136-3)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128201","name":"FT IBUPROFEN 200 MG LIQUID GEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1282-1","proprietary_name":"Foster and Thrive Ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1282-1) / 160 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677111301","name":"FT IBUPROFEN 200 MG MINI SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1113-1","proprietary_name":"Ibuprofen minis","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1113-1) / 20 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677111401","name":"FT IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1114-1","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1114-1) / 40 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113201","name":"FT IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1132-1","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1132-1) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113202","name":"FT IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1132-2","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1132-2) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113203","name":"FT IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1132-3","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1132-3) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113204","name":"FT IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1132-4","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70677-1132-4)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113205","name":"FT IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1132-5","proprietary_name":"foster and thrive ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70677-1132-5)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677114501","name":"FT IBUPROFEN IB 100 MG CHEW TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1145-1","proprietary_name":"foster and thrive childrens ibuprofen ib","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1145-1) / 24 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.1544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113101","name":"FT IBUPROFEN PM 200-38 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1131-1","proprietary_name":"foster and thrive ibuprofen pm","nonproprietary_name":"diphenhydramine citrate, ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"38 mg/1; 200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1131-1) / 40 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677114401","name":"FT INF IBUPROFEN 50 MG/1.25 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1144-1","proprietary_name":"Foster and Thrive Infants Ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"50 mg/1.25mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1144-1) / 15 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.32528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677114601","name":"FT INF IBUPROFEN 50 MG/1.25 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1146-1","proprietary_name":"Foster and Thrive Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"50 mg/1.25mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1146-1) / 30 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677125301","name":"FT INFANT PAIN-FEVER 160 MG/5","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1253-1","proprietary_name":"foster and thrive infants pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1253-1) / 60 mL in 1 BOTTLE"},"nadac":{"value":0.04059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677107801","name":"FT INFT GAS RLF 20 MG/0.3 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1078-1","proprietary_name":"Foster and Thrive infants Gas relief","nonproprietary_name":"simethicone","dosage_form":"SOLUTION/ DROPS","route":"ORAL","strength":"20 mg/.3mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70677-1078-1) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677120401","name":"FT IODINE 2% TINCTURE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1204-1","proprietary_name":"Foster and Thrive 2% Mild Iodine Tincture","nonproprietary_name":"Iodine and Sodium Iodide and Alcohol Liquid","dosage_form":"LIQUID","route":"TOPICAL","strength":"24 mg/mL; 20 mg/mL","labeler":"Strategic Sourcing Services, LLC","package_description":"30 mL in 1 BOTTLE, PLASTIC (70677-1204-1)"},"nadac":{"value":0.07191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677125001","name":"FT ISOPROPYL ALCOHOL 91%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1250-1","proprietary_name":"Isopropyl alcohol","nonproprietary_name":"Isopropyl alcohol","dosage_form":"LIQUID","route":"TOPICAL","strength":"91 mL/100mL","labeler":"Strategic Sourcing Services LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70677-1250-1)"},"nadac":{"value":0.05372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677121401","name":"FT ITCH RELIEF 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1214-1","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1214-1) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121501","name":"FT ITCH RLF WITH ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1215-1","proprietary_name":"Itch Relief","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1215-1) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121601","name":"FT ITCH RLF WITH ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1216-1","proprietary_name":"Hydrocortisone with Aloe","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1216-1) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677108601","name":"FT LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1086-1","proprietary_name":"Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1086-1) / 10 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677108602","name":"FT LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1086-2","proprietary_name":"Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1086-2) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677108603","name":"FT LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1086-3","proprietary_name":"Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (70677-1086-3)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677118401","name":"FT LICE KILLING SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1184-1","proprietary_name":"Foster and Thrive Lice Killing","nonproprietary_name":"Piperonyl Butoxide, Pyrethrum Extract","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".33 g/100mL; 4 g/100mL","labeler":"Strategic Sourcing Services, LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1184-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.04662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677119001","name":"FT LUBRICANT 0.5% EYE DROP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1190-1","proprietary_name":"Foster and Thrive Lubricant Eye Drops","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Strategic Sourcing Services LLC","package_description":"30 VIAL, SINGLE-USE in 1 BOX (70677-1190-1) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.22679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677111101","name":"FT MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1111-1","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Magnesium Citrate","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"STRATEGIC SOURCING SERVICES","package_description":"296 mL in 1 BOTTLE, PLASTIC (70677-1111-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111201","name":"FT MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1112-1","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Magnesium Citrate","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"STRATEGIC SOURCING SERVICES","package_description":"296 mL in 1 BOTTLE, PLASTIC (70677-1112-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677129401","name":"FT MICONAZOLE 1 COMBO PACK","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1294-1","proprietary_name":"FOSTER AND THRIVE MICONAZOLE 1","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Strategic Sourcing Services LLC","package_description":"1 KIT in 1 CARTON (70677-1294-1) * 1 SUPPOSITORY in 1 POUCH (0113-3023-00) * 1 TUBE in 1 CARTON (0113-8123-00) / 9 g in 1 TUBE"},"nadac":{"value":11.54805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677122301","name":"FT MICONAZOLE 3 COMBO PACK","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1223-1","proprietary_name":"foster and thrive miconazole 3","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Strategic Sourcing Services LLC","package_description":"1 KIT in 1 CARTON (70677-1223-1) * 1 APPLICATOR in 1 POUCH (0113-7198-00) / 5 g in 1 APPLICATOR * 1 TUBE in 1 CARTON (0113-8123-00) / 9 g in 1 TUBE"},"nadac":{"value":0.41315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677122601","name":"FT MICONAZOLE 3 COMBO PACK","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1226-1","proprietary_name":"Foster and Thrive Miconazole 3","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Strategic Sourcing Services LLC","package_description":"1 KIT in 1 CARTON (70677-1226-1) * 3 BLISTER PACK in 1 KIT (0113-6650-00) / 1 SUPPOSITORY in 1 BLISTER PACK * 1 TUBE in 1 KIT (0113-8123-00) / 9 g in 1 TUBE"},"nadac":{"value":7.427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677122201","name":"FT MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1222-1","proprietary_name":"foster and thrive miconazole","nonproprietary_name":"Miconazole nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (70677-1222-1) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677122501","name":"FT MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1225-1","proprietary_name":"foster and thrive miconazole 7","nonproprietary_name":"Miconazole nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (70677-1225-1) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677113301","name":"FT MIGRAINE 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1133-1","proprietary_name":"foster and thrive migraine relief","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1133-1) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677107201","name":"FT MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1072-1","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"1200 mg/15mL","labeler":"Strategic Sourcing Services LLC","package_description":"355 mL in 1 BOTTLE (70677-1072-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677107301","name":"FT MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1073-1","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"1200 mg/15mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"355 mL in 1 BOTTLE (70677-1073-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677107401","name":"FT MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1074-1","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"1200 mg/15mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"355 mL in 1 BOTTLE (70677-1074-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677107402","name":"FT MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1074-2","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"1200 mg/15mL","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"473 mL in 1 BOTTLE (70677-1074-2)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677111001","name":"FT MINERAL OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1110-1","proprietary_name":"Mineral Oil","nonproprietary_name":"Mineral Oil","dosage_form":"LIQUID","route":"ORAL","strength":"999 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70677-1110-1)"},"nadac":{"value":0.00991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677129001","name":"FT MOTION SICKNESS 25 MG CHWTB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1290-1","proprietary_name":"Motion Sickness","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (70677-1290-1)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677108801","name":"FT MOTION SICKNESS 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1088-1","proprietary_name":"Motion Sickness","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1088-1) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677108701","name":"FT MOTION SICKNESS 50 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1087-1","proprietary_name":"Motion Sickness","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1087-1) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105001","name":"FT MUCUS DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1050-1","proprietary_name":"Mucus Relief DM","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 30 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"20 BLISTER PACK in 1 CARTON (70677-1050-1) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677104901","name":"FT MUCUS DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1049-1","proprietary_name":"Mucus Relief DM","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 1200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"14 BLISTER PACK in 1 CARTON (70677-1049-1) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127301","name":"FT MUCUS RELIEF D ER 1,200-120","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1273-1","proprietary_name":"foster and thrive mucus relief d","nonproprietary_name":"guaifenesin, pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 120 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"4 BLISTER PACK in 1 CARTON (70677-1273-1) / 6 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.42347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677126301","name":"FT MUCUS RELIEF D ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1263-1","proprietary_name":"Guaifenesin and Pseudoephedrine HCl","nonproprietary_name":"Guaifenesin and Pseudoephedrine HCl","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1263-1) / 18 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127201","name":"FT MUCUS RELIEF D ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1272-1","proprietary_name":"foster and thrive mucus relief d","nonproprietary_name":"guaifenesin and pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1272-1) / 18 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677105101","name":"FT MUCUS RELIEF ER 1,200 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1051-1","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"14 BLISTER PACK in 1 CARTON (70677-1051-1) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125801","name":"FT MUCUS RELIEF ER 1,200 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1258-1","proprietary_name":"Guaifenesin 1200 mg","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1258-1) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101301","name":"FT MUCUS RELIEF ER 600 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1013-1","proprietary_name":"Foster and Thrive Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"4 BLISTER PACK in 1 CARTON (70677-1013-1) / 10 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101302","name":"FT MUCUS RELIEF ER 600 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1013-2","proprietary_name":"Foster and Thrive Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70677-1013-2)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125701","name":"FT MUCUS RELIEF ER 600 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1257-1","proprietary_name":"Guaifenesin 600 mg","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1257-1) / 20 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125702","name":"FT MUCUS RELIEF ER 600 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1257-2","proprietary_name":"Guaifenesin 600 mg","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1257-2) / 20 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677129101","name":"FT MUCUS RELIEF ER 600 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1291-1","proprietary_name":"foster and thrive mucus relief","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"5 BLISTER PACK in 1 CARTON (70677-1291-1) / 20 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128301","name":"FT NALOXONE HCL 4 MG NASAL SPR","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1283-1","proprietary_name":"NALOXONE HYDROCHLORIDE","nonproprietary_name":"naloxone hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"Strategic Sourcing Services LLC","package_description":"2 VIAL, SINGLE-DOSE in 1 CARTON (70677-1283-1) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677114801","name":"FT NAPROXEN SODIUM 220 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1148-1","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"220 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1148-1) / 40 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.14941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115201","name":"FT NASAL DECONG PE 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1152-1","proprietary_name":"Nasal Decongestant PE Maximum Strength","nonproprietary_name":"Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1152-1) / 18 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115202","name":"FT NASAL DECONG PE 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1152-2","proprietary_name":"Nasal Decongestant PE Maximum Strength","nonproprietary_name":"Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1152-2) / 18 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101701","name":"FT NASAL DECONGEST 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1017-1","proprietary_name":"Nasal Decongestant Maximum Strength","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1017-1) / 24 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101702","name":"FT NASAL DECONGEST 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1017-2","proprietary_name":"Nasal Decongestant Maximum Strength","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1017-2) / 24 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101703","name":"FT NASAL DECONGEST 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1017-3","proprietary_name":"Nasal Decongestant Maximum Strength","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"4 BLISTER PACK in 1 CARTON (70677-1017-3) / 24 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101901","name":"FT NASAL DECONGEST ER 120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1019-1","proprietary_name":"Pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1019-1) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677101902","name":"FT NASAL DECONGEST ER 120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1019-2","proprietary_name":"Pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1019-2) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677103701","name":"FT NASAL SPRAY 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1037-1","proprietary_name":"foster and thrive nasal","nonproprietary_name":"oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70677-1037-1) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677103901","name":"FT NASAL SPRAY 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1039-1","proprietary_name":"foster and thrive nasal","nonproprietary_name":"Oxymetazoline Hydrochloride","dosage_form":"SPRAY, METERED","route":"NASAL","strength":".05 g/100mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70677-1039-1) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.09967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677118101","name":"FT NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1181-1","proprietary_name":"foster and thrive STEP 2","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"14 POUCH in 1 CARTON (70677-1181-1) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677116401","name":"FT NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1164-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 BLISTER PACK in 1 CARTON (70677-1164-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677116601","name":"FT NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1166-1","proprietary_name":"Foster and Thrive Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"50 BLISTER PACK in 1 CARTON (70677-1166-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677116602","name":"FT NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1166-2","proprietary_name":"Foster and Thrive Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"110 BLISTER PACK in 1 CARTON (70677-1166-2) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117001","name":"FT NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1170-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 BLISTER PACK in 1 CARTON (70677-1170-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677119201","name":"FT NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1192-1","proprietary_name":"Foster and Thrive Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"110 BLISTER PACK in 1 CARTON (70677-1192-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117401","name":"FT NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1174-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1174-1) / 24 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117601","name":"FT NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1176-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1176-1) / 24 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117201","name":"FT NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1172-1","proprietary_name":"Foster and Thrive Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1172-1) / 27 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117801","name":"FT NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1178-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1178-1) / 27 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677118201","name":"FT NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1182-1","proprietary_name":"foster and thrive STEP 1","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"14 POUCH in 1 CARTON (70677-1182-1) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677116501","name":"FT NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1165-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 BLISTER PACK in 1 CARTON (70677-1165-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677116701","name":"FT NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1167-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"50 BLISTER PACK in 1 CARTON (70677-1167-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677116702","name":"FT NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1167-2","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"110 BLISTER PACK in 1 CARTON (70677-1167-2) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117101","name":"FT NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1171-1","proprietary_name":"Foster and Thrive Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 BLISTER PACK in 1 CARTON (70677-1171-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677119301","name":"FT NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1193-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"110 BLISTER PACK in 1 CARTON (70677-1193-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117501","name":"FT NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1175-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1175-1) / 24 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117701","name":"FT NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1177-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1177-1) / 24 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117301","name":"FT NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1173-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1173-1) / 27 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677117901","name":"FT NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1179-1","proprietary_name":"foster and thrive nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CONTAINER in 1 CARTON (70677-1179-1) / 27 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677118001","name":"FT NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1180-1","proprietary_name":"foster and thrive STEP 3","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"14 PATCH in 1 CARTON (70677-1180-1) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677103201","name":"FT NIGHTTIME COLD-FLU RLF LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1032-1","proprietary_name":"foster and thrive nighttime cold and flu relief","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Strategic Sourcing Services LLC","package_description":"355 mL in 1 BOTTLE (70677-1032-1)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677103301","name":"FT NIGHTTIME COLD-FLU RLF LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1033-1","proprietary_name":"foster and thrive nighttime cold and flu relief","nonproprietary_name":"Acetaminophen, Dextromethorphan Hydrobromide, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Strategic Sourcing Services LLC","package_description":"237 mL in 1 BOTTLE (70677-1033-1)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677103302","name":"FT NIGHTTIME COLD-FLU RLF LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1033-2","proprietary_name":"foster and thrive nighttime cold and flu relief","nonproprietary_name":"Acetaminophen, Dextromethorphan Hydrobromide, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Strategic Sourcing Services LLC","package_description":"355 mL in 1 BOTTLE (70677-1033-2)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677112801","name":"FT NIGHTTIME SLEEP 25 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1128-1","proprietary_name":"Nighttime Sleep Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1128-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109801","name":"FT OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1098-1","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1098-1) / 14 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110401","name":"FT OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1104-1","proprietary_name":"foster and thrive omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 CARTON in 1 CARTON (70677-1104-1) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677110402","name":"FT OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1104-2","proprietary_name":"foster and thrive omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 CARTON in 1 CARTON (70677-1104-2) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127501","name":"FT OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1275-1","proprietary_name":"foster and thrive omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"3 BOTTLE in 1 CARTON (70677-1275-1) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE (70677-1275-2)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127502","name":"FT OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677111901","name":"FT PAIN RELIEF 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1119-1","proprietary_name":"Pain Relief Regular Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1119-1) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677124201","name":"FT PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1242-1","proprietary_name":"EXTRA STRENGTH PAIN RELEIF","nonproprietary_name":"ACETAMINOPHEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (70677-1242-1)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127601","name":"FT PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1276-1","proprietary_name":"foster and thrive rapid release pain relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"225 TABLET, FILM COATED in 1 BOTTLE (70677-1276-1)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112001","name":"FT PAIN RELIEF 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1120-1","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1120-1) / 24 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112002","name":"FT PAIN RELIEF 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1120-2","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1120-2) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112401","name":"FT PAIN RELIEF 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1124-1","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1124-1) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677118801","name":"FT PAIN RELIEF(LIDO) 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1188-1","proprietary_name":"Foster and Thrive","nonproprietary_name":"Lidocaine","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/g","labeler":"STRATEGIC SOURCING SERVICES, LLC","package_description":"6 POUCH in 1 CARTON (70677-1188-1) / 1 g in 1 POUCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128401","name":"FT PAIN RELIEF(LIDO) 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1284-1","proprietary_name":"Foster and Thrive Lidocaine Pain Relief Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"5 PATCH in 1 BOX (70677-1284-1) / 1 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128402","name":"FT PAIN RELIEF(LIDO) 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1284-2","proprietary_name":"Foster and Thrive Lidocaine Pain Relief Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"30 PATCH in 1 BOX (70677-1284-2) / 1 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677128501","name":"FT PAIN RELIEF(LIDO) 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1285-1","proprietary_name":"Foster and Thrive Lidocaine Pain Relief Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"6 PATCH in 1 BOX (70677-1285-1) / 1 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113801","name":"FT PAIN RELIEVER 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1138-1","proprietary_name":"foster and thrive pain reliever","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1138-1) / 50 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113802","name":"FT PAIN RELIEVER 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1138-2","proprietary_name":"foster and thrive pain reliever","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1138-2) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113803","name":"FT PAIN RELIEVER 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1138-3","proprietary_name":"foster and thrive pain reliever","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"500 TABLET in 1 BOTTLE (70677-1138-3)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113805","name":"FT PAIN RELIEVER 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1138-5","proprietary_name":"foster and thrive pain reliever","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1000 TABLET in 1 BOTTLE (70677-1138-5)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677113901","name":"FT PAIN RELIEVER 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1139-1","proprietary_name":"foster and thrive pain reliever","nonproprietary_name":"acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1139-1) / 100 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677127101","name":"FT PAIN RELIEVER 650 MG SUPPOS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1271-1","proprietary_name":"foster and thrive pain reliever","nonproprietary_name":"Acetaminophen","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"650 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"12 BLISTER PACK in 1 CARTON (70677-1271-1) / 1 SUPPOSITORY in 1 BLISTER PACK"},"nadac":{"value":0.34938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677114901","name":"FT PAIN RELIEVER PM 500-25 MG GELTAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1149-1","proprietary_name":"Pain Reliever PM","nonproprietary_name":"Acetaminophen, Diphenhydramine HCl","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1149-1) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677123501","name":"FT PETROLEUM JELLY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1235-1","proprietary_name":"Petroleum","nonproprietary_name":"White Petrolatum","dosage_form":"JELLY","route":"TOPICAL","strength":"1 g/g","labeler":"Strategic Sourcing Services LLC","package_description":"106 g in 1 JAR (70677-1235-1)"},"nadac":{"value":0.01315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677123502","name":"FT PETROLEUM JELLY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1235-2","proprietary_name":"Petroleum","nonproprietary_name":"White Petrolatum","dosage_form":"JELLY","route":"TOPICAL","strength":"1 g/g","labeler":"Strategic Sourcing Services LLC","package_description":"368 g in 1 JAR (70677-1235-2)"},"nadac":{"value":0.00816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677120801","name":"FT POVIDONE-IODINE 10% SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1208-1","proprietary_name":"Foster and Thrive Povidone-Iodine","nonproprietary_name":"Povidone Iodine","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/mL","labeler":"Strategic Sourcing Services, LLC","package_description":"237 mL in 1 BOTTLE, PLASTIC (70677-1208-1)"},"nadac":{"value":0.02034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677109701","name":"FT SENNA LAXATIVE 8.6 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1097-1","proprietary_name":"Senna Laxative","nonproprietary_name":"Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1097-1) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677106901","name":"FT SENNA-S 8.6-50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1069-1","proprietary_name":"SENNA-S","nonproprietary_name":"Sennosides and Docusate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1069-1) / 60 TABLET in 1 BOTTLE"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677100501","name":"FT SINUS SEVERE 325-200-5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1005-1","proprietary_name":"Sinus Severe","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1005-1) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125901","name":"FT SINUS SEVERE 325-200-5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1259-1","proprietary_name":"Sinus Severe","nonproprietary_name":"Acetaminophen, Guaifenesin, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1259-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112901","name":"FT SLEEP AID 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1129-1","proprietary_name":"Sleep Aid","nonproprietary_name":"Doxylamine succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1129-1) / 16 TABLET in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677115101","name":"FT SLEEP AID 50 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1151-1","proprietary_name":"Sleep Aid","nonproprietary_name":"Diphenhydramine HCL","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70677-1151-1) / 32 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677112601","name":"FT STAY AWAKE 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1126-1","proprietary_name":"Stay Awake","nonproprietary_name":"caffeine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"2 BLISTER PACK in 1 CARTON (70677-1126-1) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.08299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677119101","name":"FT STOMACH RELIEF 525 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1191-1","proprietary_name":"Foster and Thrive Regular Strength Stomach Relief 527","nonproprietary_name":"Bismuth subsalicylate 525 mg","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/30mL","labeler":"Strategic Sourcing Services LLC","package_description":"236 mL in 1 BOTTLE (70677-1191-1)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677108201","name":"FT STOMACH RLF 262 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1082-1","proprietary_name":"Foster and Thrive Stomach Relief","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"TABLET","route":"ORAL","strength":"262 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1082-1) / 40 TABLET in 1 BOTTLE"},"nadac":{"value":0.09302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677108001","name":"FT STOMACH RLF 262 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1080-1","proprietary_name":"Foster and Thrive Stomach Relief","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"262 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"5 BLISTER PACK in 1 BOX (70677-1080-1) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.08166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109501","name":"FT STOOL SOFTENER 100 MG SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1095-1","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70677-1095-1)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109502","name":"FT STOOL SOFTENER 100 MG SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1095-2","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"250 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70677-1095-2)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677107101","name":"FT STOOL SOFTENER 100 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1071-1","proprietary_name":"Stool Softener","nonproprietary_name":"docusate sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1071-1) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109601","name":"FT STOOL SOFTENER 250 MG SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1096-1","proprietary_name":"Stool Softener","nonproprietary_name":"Docusate Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70677-1096-1)"},"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677109401","name":"FT STOOL SOFTENER-STIM LAX TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1094-1","proprietary_name":"Stool Softener","nonproprietary_name":"docusate sodium and sennosides","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70677-1094-1)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677122401","name":"FT TIOCONAZOLE-1 6.5% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1224-1","proprietary_name":"foster and thrive tioconazole","nonproprietary_name":"Tioconazole","dosage_form":"OINTMENT","route":"VAGINAL","strength":"6.5 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 APPLICATOR in 1 CARTON (70677-1224-1) / 4.6 g in 1 APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.40894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121701","name":"FT TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1217-1","proprietary_name":"Triple Antibiotic","nonproprietary_name":"bacitracin zinc, neomycin sulfate, and polymyxin b sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [iU]/g; 3.5 mg/g; 5000 [iU]/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1217-1) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.11088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677121901","name":"FT TRIPLE ANTIBIOTIC-PAIN OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1219-1","proprietary_name":"Triple Antibiotic plus Pain Relief","nonproprietary_name":"Bacitracin Zinc, Neomycin Sulfate, Polymyxin B Sulfate, and Pramoxine Hydrochloride","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g; 3.5 mg/g; 10000 [USP'U]/g; 10 mg/g","labeler":"STRATEGIC SOURCING SERVICES LLC","package_description":"1 TUBE in 1 CARTON (70677-1219-1) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677103501","name":"FT TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1035-1","proprietary_name":"foster and thrive adult tussin dm","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1035-1) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677126101","name":"FT TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1261-1","proprietary_name":"Tussin DM","nonproprietary_name":"Dextromethorphan HBr Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1261-1) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677126102","name":"FT TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1261-2","proprietary_name":"Tussin DM","nonproprietary_name":"Dextromethorphan HBr Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70677-1261-2) / 237 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677103601","name":"FT TUSSIN DM 400-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1036-1","proprietary_name":"Foster and Thrive Adult Tussin DM MAX","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (70677-1036-1) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677122901","name":"FT URINARY PAIN RLF 95 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1229-1","proprietary_name":"Foster and Thrive Neighbor Pharmacy Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"95 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1229-1) / 30 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.13162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677123001","name":"FT URINARY PAIN RLF 99.5 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1230-1","proprietary_name":"Foster and Thrive Maximum Strength Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"99.5 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BLISTER PACK in 1 CARTON (70677-1230-1) / 12 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.18404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677125201","name":"FT WITCH HAZEL 86% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1252-1","proprietary_name":"Witch Hazel","nonproprietary_name":"Witch hazel","dosage_form":"LIQUID","route":"TOPICAL","strength":"842 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70677-1252-1)"},"nadac":{"value":0.00761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83257000541","name":"FULPHILA 6 MG/0.6 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-005-41","proprietary_name":"Fulphila","nonproprietary_name":"pegfilgrastim-jmdb","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.6mL","labeler":"Biocon Biologics Inc.","package_description":"1 SYRINGE in 1 CARTON (83257-005-41) / .6 mL in 1 SYRINGE","pharm_classes":["Granulocyte Colony-Stimulating Factor [CS]","Increased Myeloid Cell Production [PE]","Leukocyte Growth Factor [EPC]"]},"nadac":{"value":3369.51,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Fulphila|PEGfilgrastim-Jmdb","basis":"brand"},"part_b":{"hcpcs":"Q5108","bill_units_per_package":{"value":12,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5108 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.6,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (83257-005-41) / .6 mL in 1 SYRINGE) gives 0.6 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143915901","name":"FUROSEMIDE 1,000 MG/100 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9159-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9159-01) / 100 mL in 1 VIAL","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9159-01) / 100 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054329446","name":"FUROSEMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3294-46","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 mL in 1 BOTTLE (0054-3294-46)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.09203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054329450","name":"FUROSEMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3294-50","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 mL in 1 BOTTLE (0054-3294-50)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.09203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143915710","name":"FUROSEMIDE 100 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9157-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0143-9157-10) / 10 mL in 1 VIAL, SINGLE-DOSE (0143-9157-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0143-9157-10) / 10 mL in 1 VIAL, SINGLE-DOSE (0143-9157-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054429725","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4297-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4297-25)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054429731","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4297-31","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0054-4297-31)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054829725","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8297-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0054-8297-25) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904717761","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7177-61","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7177-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547040110","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-401-10","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-401-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547040111","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-401-11","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-401-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079601","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-796-01","proprietary_name":"FUROSEMIDE","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-796-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079699","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-796-99","proprietary_name":"FUROSEMIDE","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-796-99)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135075390","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-753-90","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 PACKAGE (62135-753-90)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63561016402","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0164-2","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Granulation Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (63561-0164-2)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056201","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-562-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-562-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056210","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-562-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-562-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315011601","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-116-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-116-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315011610","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-116-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-116-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980000201","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-002-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-002-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980000210","name":"FUROSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-002-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-002-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143915525","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9155-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (0143-9155-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0143-9155-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (0143-9155-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0143-9155-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409610202","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6102-02","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6102-02) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-6102-19)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6102-02) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-6102-19)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409610225","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6102-25","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6102-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-6102-35)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155047341","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-473-41","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (23155-473-41) / 2 mL in 1 VIAL (23155-473-31)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (23155-473-41) / 2 mL in 1 VIAL (23155-473-31)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021031102","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-311-02","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-311-02) / 2 mL in 1 VIAL","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-311-02) / 2 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021032002","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-320-02","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-320-02) / 2 mL in 1 VIAL","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-320-02) / 2 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"31722030932","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-309-32","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, GLASS in 1 BOX (31722-309-32) / 2 mL in 1 VIAL, GLASS (31722-309-31)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"36000028225","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-282-25","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"25 VIAL, SINGLE-DOSE in 1 BOX (36000-282-25) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 BOX (36000-282-25) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150032225","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-322-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"20 mg/2mL","labeler":"Eugia US LLC","package_description":"25 VIAL in 1 CARTON (55150-322-25) / 2 mL in 1 VIAL (55150-322-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (55150-322-25) / 2 mL in 1 VIAL (55150-322-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323028002","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-280-02","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-280-02) / 2 mL in 1 VIAL (63323-280-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-280-02) / 2 mL in 1 VIAL (63323-280-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323028016","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-280-16","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-280-16) / 2 mL in 1 VIAL (63323-280-41)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-280-16) / 2 mL in 1 VIAL (63323-280-41)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288020303","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-203-03","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71288-203-03) / 2 mL in 1 VIAL, SINGLE-DOSE (71288-203-02)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71288-203-03) / 2 mL in 1 VIAL, SINGLE-DOSE (71288-203-02)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603013325","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-133-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"NorthStar Rx LLC","package_description":"25 VIAL in 1 CARTON (72603-133-25) / 2 mL in 1 VIAL (72603-133-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72603-133-25) / 2 mL in 1 VIAL (72603-133-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"73043002201","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-022-01","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Devatis Inc.","package_description":"25 VIAL, GLASS in 1 BOX (73043-022-01) / 2 mL in 1 VIAL, GLASS","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81565020102","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81565-201-02","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Phlow Corporation","package_description":"25 VIAL in 1 TRAY (81565-201-02) / 2 mL in 1 VIAL (81565-201-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (81565-201-02) / 2 mL in 1 VIAL (81565-201-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"83634030202","name":"FUROSEMIDE 20 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-302-02","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Avenacy Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (83634-302-02) / 2 mL in 1 VIAL, SINGLE-DOSE (83634-302-42)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (83634-302-02) / 2 mL in 1 VIAL, SINGLE-DOSE (83634-302-42)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054429925","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4299-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-4299-25)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054429931","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4299-31","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (0054-4299-31)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054829925","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8299-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0054-8299-25) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904717861","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7178-61","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7178-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547040210","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-402-10","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-402-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547040211","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-402-11","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-402-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079701","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-797-01","proprietary_name":"FUROSEMIDE","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-797-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079799","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-797-99","proprietary_name":"FUROSEMIDE","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-797-99)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135075490","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-754-90","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 PACKAGE (62135-754-90)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63561016502","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0165-2","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Granulation Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (63561-0165-2)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056301","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-563-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-563-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056310","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-563-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-563-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315011701","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-117-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-117-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315011710","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-117-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-117-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980000301","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-003-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-003-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980000310","name":"FUROSEMIDE 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-003-10","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-003-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094075659","name":"FUROSEMIDE 40 MG/4 ML ORAL SOLUTION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68094075662","name":"FUROSEMIDE 40 MG/4 ML ORAL SOLUTION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-756-62","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"SOLUTION","route":"ORAL","strength":"40 mg/4mL","labeler":"Precision Dose Inc.","package_description":"3 TRAY in 1 CASE (68094-756-62) / 10 CUP, UNIT-DOSE in 1 TRAY / 4 mL in 1 CUP, UNIT-DOSE (68094-756-59)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.09203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409610204","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6102-04","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6102-04) / 4 mL in 1 VIAL, SINGLE-DOSE (0409-6102-18)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6102-04) / 4 mL in 1 VIAL, SINGLE-DOSE (0409-6102-18)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409610226","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6102-26","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6102-26) / 4 mL in 1 VIAL, SINGLE-DOSE (0409-6102-36)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155047342","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-473-42","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (23155-473-42) / 4 mL in 1 VIAL (23155-473-32)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (23155-473-42) / 4 mL in 1 VIAL (23155-473-32)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021031104","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-311-04","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-311-04) / 4 mL in 1 VIAL","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-311-04) / 4 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021032004","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-320-04","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-320-04) / 4 mL in 1 VIAL","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-320-04) / 4 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"31722031032","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-310-32","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, GLASS in 1 BOX (31722-310-32) / 4 mL in 1 VIAL, GLASS (31722-310-31)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"36000028325","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-283-25","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"25 VIAL, SINGLE-DOSE in 1 BOX (36000-283-25) / 4 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 BOX (36000-283-25) / 4 mL in 1 VIAL, SINGLE-DOSE) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150032325","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-323-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/4mL","labeler":"Eugia US LLC","package_description":"25 VIAL in 1 CARTON (55150-323-25) / 4 mL in 1 VIAL (55150-323-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (55150-323-25) / 4 mL in 1 VIAL (55150-323-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323028004","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-280-04","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-280-04) / 4 mL in 1 VIAL (63323-280-03)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-280-04) / 4 mL in 1 VIAL (63323-280-03)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323028026","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-280-26","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-280-26) / 4 mL in 1 VIAL (63323-280-43)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-280-26) / 4 mL in 1 VIAL (63323-280-43)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288020305","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-203-05","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71288-203-05) / 4 mL in 1 VIAL, SINGLE-DOSE (71288-203-04)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71288-203-05) / 4 mL in 1 VIAL, SINGLE-DOSE (71288-203-04)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572019025","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-190-25","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 BOX (72572-190-25) / 4 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 BOX (72572-190-25) / 4 mL in 1 VIAL, SINGLE-DOSE) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603025125","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-251-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"NorthStar Rx LLC","package_description":"25 VIAL in 1 CARTON (72603-251-25) / 4 mL in 1 VIAL (72603-251-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72603-251-25) / 4 mL in 1 VIAL (72603-251-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"73043002301","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-023-01","proprietary_name":"FUROSEMIDE","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Devatis Inc.","package_description":"25 VIAL, GLASS in 1 BOX (73043-023-01) / 4 mL in 1 VIAL, GLASS","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634030204","name":"FUROSEMIDE 40 MG/4 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-302-04","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Avenacy Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (83634-302-04) / 4 mL in 1 VIAL, SINGLE-DOSE (83634-302-43)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.25253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (83634-302-04) / 4 mL in 1 VIAL, SINGLE-DOSE (83634-302-43)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143915801","name":"FUROSEMIDE 500 MG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9158-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9158-01) / 50 mL in 1 VIAL","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.49014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1938","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1938 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9158-01) / 50 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054430125","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4301-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4301-25)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054430129","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4301-29","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0054-4301-29)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054830125","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8301-25","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0054-8301-25) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547040310","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-403-10","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-403-10)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547040350","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-403-50","proprietary_name":"Furosemide","nonproprietary_name":"furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-403-50)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079801","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-798-01","proprietary_name":"FUROSEMIDE","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-798-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079805","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-798-05","proprietary_name":"FUROSEMIDE","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-798-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63561016605","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0166-5","proprietary_name":"Furosemide","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Granulation Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (63561-0166-5)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056401","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-564-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-564-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056450","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-564-50","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-564-50)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315011801","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-118-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-118-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315011805","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-118-05","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-118-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980000401","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-004-01","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-004-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980000405","name":"FUROSEMIDE 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-004-05","proprietary_name":"Furosemide","nonproprietary_name":"Furosemide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Ipca Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (83980-004-05)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52747050230","name":"FUSION PLUS CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.02444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180082709","name":"FYAVOLV 0.5 MG-2.5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-827-09","proprietary_name":"Fyavolv","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".0025 mg/1; .5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-827-09)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.9127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fyavolv|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180082771","name":"FYAVOLV 0.5 MG-2.5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.9127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fyavolv|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180082773","name":"FYAVOLV 0.5 MG-2.5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-827-73","proprietary_name":"Fyavolv","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".0025 mg/1; .5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-827-73) / 1 BLISTER PACK in 1 POUCH / 28 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.9127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fyavolv|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180082809","name":"FYAVOLV 1 MG-5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-828-09","proprietary_name":"Fyavolv","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".005 mg/1; 1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-828-09)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fyavolv|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180082871","name":"FYAVOLV 1 MG-5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fyavolv|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180082873","name":"FYAVOLV 1 MG-5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-828-73","proprietary_name":"Fyavolv","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".005 mg/1; 1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-828-73) / 1 BLISTER PACK in 1 POUCH / 28 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fyavolv|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"69616029038","name":"FYCOMPA 0.5 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-290-38","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"SUSPENSION","route":"ORAL","strength":".5 mg/mL","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"340 mL in 1 BOTTLE (69616-290-38)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":4.45662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":3.94521,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62856028030","name":"FYCOMPA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-280-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET in 1 BOTTLE (62856-280-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.11546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":15.64335,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"69616028030","name":"FYCOMPA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-280-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (69616-280-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.11546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":15.64335,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"62856028230","name":"FYCOMPA 12 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-282-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"12 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET in 1 BOTTLE (62856-282-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.10963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":14.39738,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"69616028230","name":"FYCOMPA 12 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-282-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"12 mg/1","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (69616-282-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.10963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":14.39738,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"62856027230","name":"FYCOMPA 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-272-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET in 1 BOTTLE (62856-272-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":19.75426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.43174,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"69616027230","name":"FYCOMPA 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-272-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (69616-272-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":19.75426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.43174,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"62856027430","name":"FYCOMPA 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-274-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET in 1 BOTTLE (62856-274-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.14028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":14.43393,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"69616027430","name":"FYCOMPA 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-274-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (69616-274-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.14028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":14.43393,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"62856027630","name":"FYCOMPA 6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-276-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET in 1 BOTTLE (62856-276-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.13335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":18.30465,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"69616027630","name":"FYCOMPA 6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-276-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (69616-276-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.13335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":18.30465,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"62856027830","name":"FYCOMPA 8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62856-278-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Eisai Inc.","package_description":"30 TABLET in 1 BOTTLE (62856-278-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.08722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":18.37646,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"69616027830","name":"FYCOMPA 8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69616-278-30","proprietary_name":"Fycompa","nonproprietary_name":"perampanel","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Catalyst Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (69616-278-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":39.08722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":18.37646,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Fycompa|Perampanel","basis":"brand"},"part_b":null}, {"ndc":"55566101001","name":"FYREMADEL 250 MCG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55566-1010-1","proprietary_name":"Fyremadel","nonproprietary_name":"ganirelix acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Ferring Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (55566-1010-1) / 1 SYRINGE in 1 BLISTER PACK / .5 mL in 1 SYRINGE","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00480349405","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3494-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0480-3494-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00904666561","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6665-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6665-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086701","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-867-01","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-867-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086710","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-867-10","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (16571-867-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086750","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-867-50","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (16571-867-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714066101","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-661-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-661-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714066102","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-661-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-661-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086601","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-866-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-866-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086605","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-866-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-866-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086610","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722014801","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-148-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-148-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722014805","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-148-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-148-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722014810","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-148-10","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (31722-148-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42385097201","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-972-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Laurus Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42385-972-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42385097205","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-972-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Laurus Labs Limited","package_description":"500 CAPSULE in 1 BOTTLE (42385-972-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42385097211","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-972-11","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 CAPSULE in 1 BOTTLE (42385-972-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547026510","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547026550","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"45963055511","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-555-11","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (45963-555-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"45963055550","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-555-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (45963-555-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060501","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-605-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 CAPSULE in 1 BOTTLE (49483-605-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060510","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-605-10","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 CAPSULE in 1 BOTTLE (49483-605-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060550","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-605-50","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 CAPSULE in 1 BOTTLE (49483-605-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017901","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-179-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (50228-179-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017905","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-179-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (50228-179-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017910","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-179-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (50228-179-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687058001","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-580-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-580-01) / 1 CAPSULE in 1 BLISTER PACK (60687-580-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687058011","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380075301","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-753-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (64380-753-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380075302","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-753-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (64380-753-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380075303","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-753-03","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (64380-753-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010110","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-101-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (65162-101-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010111","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-101-11","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 CAPSULE in 1 BOTTLE (65162-101-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010150","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-101-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 CAPSULE in 1 BOTTLE (65162-101-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862019801","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-198-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-198-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862019805","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-198-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-198-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862019899","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-198-99","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (65862-198-99)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022201","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-222-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-222-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022205","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-222-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-222-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022210","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-222-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE in 1 BOTTLE (67877-222-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69097081307","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-813-07","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-813-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69097081312","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-813-12","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69097-813-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69292064001","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-640-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amici Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69292-640-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69292064050","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-640-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amici Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69292-640-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367013106","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-131-06","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-131-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367034305","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-343-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69367-343-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092601","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-926-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (70010-926-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092605","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-926-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (70010-926-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092610","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-926-10","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"1000 CAPSULE in 1 BOTTLE (70010-926-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093012004","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093012005","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093016104","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000301","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0003-1","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (83301-0003-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000302","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0003-2","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (83301-0003-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000303","name":"GABAPENTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0003-3","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (83301-0003-3)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00121106716","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1067-16","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"470 mL in 1 BOTTLE, PLASTIC (0121-1067-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722006947","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-069-47","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-069-47) / 470 mL in 1 BOTTLE","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192060816","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-608-16","proprietary_name":"Gabapentin","nonproprietary_name":"gabapentin","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"470 mL in 1 BOTTLE (42192-608-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"44523012016","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44523-120-16","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"BioComp Pharma, Inc.","package_description":"470 mL in 1 BOTTLE (44523-120-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762505007","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5050-7","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"SUSPENSION","route":"ORAL","strength":"250 mg/5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (59762-5050-7) / 470 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162069890","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65162-698-90","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE (65162-698-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.1712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888010425","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-104-25","proprietary_name":"Gabapentin","nonproprietary_name":"gabapentin","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Advagen Pharma Ltd","package_description":"470 mL in 1 BOTTLE (72888-104-25)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82983042347","name":"GABAPENTIN 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82983-423-47","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Ajenat Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE (82983-423-47)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00480349501","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3495-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3495-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00480349505","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3495-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0480-3495-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00904666661","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6666-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6666-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086801","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-868-01","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-868-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086810","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-868-10","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (16571-868-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086850","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-868-50","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (16571-868-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714066201","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-662-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-662-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714066202","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-662-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-662-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086701","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-867-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-867-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086705","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-867-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-867-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086710","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722014901","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-149-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-149-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722014905","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-149-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-149-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42385097301","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-973-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Laurus Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42385-973-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42385097305","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-973-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Laurus Labs Limited","package_description":"500 CAPSULE in 1 BOTTLE (42385-973-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547026610","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"45963055611","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-556-11","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (45963-556-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"45963055650","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-556-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (45963-556-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060601","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-606-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 CAPSULE in 1 BOTTLE (49483-606-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060610","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-606-10","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 CAPSULE in 1 BOTTLE (49483-606-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060650","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-606-50","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 CAPSULE in 1 BOTTLE (49483-606-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228018001","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-180-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (50228-180-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228018005","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-180-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (50228-180-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228018010","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-180-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (50228-180-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687059101","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-591-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-591-01) / 1 CAPSULE in 1 BLISTER PACK (60687-591-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687059111","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380075401","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-754-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (64380-754-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380075402","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-754-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (64380-754-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380075403","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-754-03","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (64380-754-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010210","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-102-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (65162-102-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010211","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-102-11","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 CAPSULE in 1 BOTTLE (65162-102-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010250","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-102-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 CAPSULE in 1 BOTTLE (65162-102-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862019901","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-199-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-199-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862019905","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-199-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-199-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862019999","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-199-99","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (65862-199-99)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022301","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-223-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-223-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022305","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-223-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-223-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022310","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-223-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE in 1 BOTTLE (67877-223-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69097094312","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-943-12","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69097-943-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69292064101","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-641-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Amici Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69292-641-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69292064150","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-641-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Amici Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69292-641-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367013206","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-132-06","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-132-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367034405","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-344-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69367-344-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092701","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-927-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (70010-927-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092705","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-927-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (70010-927-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092710","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-927-10","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"1000 CAPSULE in 1 BOTTLE (70010-927-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093012104","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093012105","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093016204","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093016205","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282062705","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-627-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (76282-627-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000401","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0004-1","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (83301-0004-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000402","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0004-2","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (83301-0004-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000403","name":"GABAPENTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0004-3","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (83301-0004-3)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00480349605","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3496-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0480-3496-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00904666761","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6667-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6667-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00904761561","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7615-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7615-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086901","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-869-01","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-869-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086910","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-869-10","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (16571-869-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571086950","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-869-50","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (16571-869-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714066301","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-663-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-663-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714066302","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-663-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (16714-663-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086801","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-868-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-868-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086805","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-868-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (23155-868-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"23155086810","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722015001","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-150-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-150-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722015005","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-150-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-150-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547026710","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547026750","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"45963055711","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-557-11","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (45963-557-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"45963055750","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-557-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (45963-557-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060701","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-607-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 CAPSULE in 1 BOTTLE (49483-607-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060710","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-607-10","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 CAPSULE in 1 BOTTLE (49483-607-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"49483060750","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-607-50","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 CAPSULE in 1 BOTTLE (49483-607-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228018101","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-181-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (50228-181-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228018105","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-181-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (50228-181-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687060201","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-602-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-602-01) / 1 CAPSULE in 1 BLISTER PACK (60687-602-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687060211","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380073101","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-731-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (64380-731-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380073102","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-731-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (64380-731-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380086908","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-869-08","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 CAPSULE in 1 BOTTLE (64380-869-08)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010310","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-103-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (65162-103-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65162010350","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-103-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 CAPSULE in 1 BOTTLE (65162-103-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862020001","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-200-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-200-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862020005","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-200-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-200-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022401","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-224-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-224-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022405","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-224-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-224-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877022410","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-224-10","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE in 1 BOTTLE (67877-224-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69097081507","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-815-07","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-815-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69292064201","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-642-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Amici Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69292-642-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69292064250","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-642-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Amici Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (69292-642-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367013306","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-133-06","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-133-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367034505","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-345-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69367-345-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092801","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-928-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (70010-928-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010092805","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-928-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (70010-928-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093012204","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093012205","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093016304","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282032305","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-323-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (76282-323-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000501","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0005-1","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (83301-0005-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000502","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0005-2","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (83301-0005-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000503","name":"GABAPENTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0005-3","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (83301-0005-3)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00904682361","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6823-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6823-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571011601","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571011650","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571022601","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-226-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-226-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571022650","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-226-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-226-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714033001","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-330-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-330-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714033002","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-330-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-330-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722016601","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-166-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-166-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722016605","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-166-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-166-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547033210","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547033250","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547038910","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547038950","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017701","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-177-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-177-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017705","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-177-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-177-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50268032511","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50268032515","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-325-15","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-325-15) / 1 TABLET, COATED in 1 BLISTER PACK (50268-325-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687050701","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-507-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-507-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-507-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687050711","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380072701","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-727-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 CONTAINER (64380-727-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380072702","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-727-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 CONTAINER (64380-727-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862052301","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-523-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-523-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862052305","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-523-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-523-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877042801","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-428-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-428-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877042805","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-428-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-428-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68001041100","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-411-00","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-411-00)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68001041103","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-411-03","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-411-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68094006959","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68094006961","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-069-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"Precision Dose, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68094-069-61) / 10 TABLET, COATED in 1 BLISTER PACK (68094-069-59)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68094058950","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-589-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (68094-589-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68094058960","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-589-60","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (68094-589-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68382020401","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-204-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-204-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68382020405","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-204-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-204-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68462012601","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-126-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-126-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68462012605","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-126-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-126-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367013406","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367034605","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-346-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-346-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010022701","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-227-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70010-227-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010022705","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-227-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-227-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093011104","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093011105","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"72888013101","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-131-01","proprietary_name":"Gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-131-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"72888013105","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-131-05","proprietary_name":"Gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-131-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282040501","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-405-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-405-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282040505","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-405-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-405-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282040590","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-405-90","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-405-90)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282070605","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-706-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-706-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282070690","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-706-90","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-706-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"82009007105","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-071-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-071-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000101","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0001-1","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (83301-0001-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000102","name":"GABAPENTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0001-2","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"600 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE, PLASTIC (83301-0001-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"00904710861","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7108-61","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7108-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571011701","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-117-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-117-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16571011750","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-117-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-117-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714033201","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-332-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-332-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"16714033202","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-332-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-332-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722016701","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-167-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-167-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722016705","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-167-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-167-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547033310","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547033350","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547039010","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"43547039050","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017801","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-178-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-178-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228017805","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-178-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-178-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687051801","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-518-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-518-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-518-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"60687051811","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380072801","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-728-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 CONTAINER (64380-728-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"64380072802","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-728-02","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 CONTAINER (64380-728-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862052401","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-524-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-524-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"65862052405","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-524-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-524-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877042901","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-429-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-429-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"67877042905","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-429-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-429-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68001041200","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-412-00","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-412-00)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68001041203","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-412-03","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-412-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68094048950","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-489-50","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"800 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (68094-489-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68094048960","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-489-60","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"800 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (68094-489-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68382020501","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-205-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-205-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68382020505","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-205-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-205-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68462012701","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-127-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-127-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68462012705","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-127-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-127-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367013506","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"69367034705","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-347-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE, PLASTIC (69367-347-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010022801","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-228-01","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70010-228-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"70010022805","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-228-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-228-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"71093011205","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"72888013201","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-132-01","proprietary_name":"Gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-132-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"72888013205","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-132-05","proprietary_name":"Gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-132-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282040601","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-406-01","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-406-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282040605","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-406-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-406-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282040690","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-406-90","proprietary_name":"GABAPENTIN","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-406-90)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282070705","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-707-05","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-707-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"76282070790","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-707-90","proprietary_name":"GABAPENTIN","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-707-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"82009007205","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-072-05","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-072-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000201","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0002-1","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"800 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (83301-0002-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"83301000202","name":"GABAPENTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0002-2","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"800 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE, PLASTIC (83301-0002-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722009190","name":"GABAPENTIN ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-091-90","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-091-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.63846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42806065609","name":"GABAPENTIN ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-656-09","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 TABLET in 1 BOTTLE (42806-656-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.63846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228052390","name":"GABAPENTIN ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-523-90","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (50228-523-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.63846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68382060816","name":"GABAPENTIN ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-608-16","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-608-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.63846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"31722009290","name":"GABAPENTIN ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-092-90","proprietary_name":"GABAPENTIN","nonproprietary_name":"GABAPENTIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-092-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.02497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"42806065709","name":"GABAPENTIN ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-657-09","proprietary_name":"Gabapentin","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 TABLET in 1 BOTTLE (42806-657-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.02497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"50228052490","name":"GABAPENTIN ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-524-90","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (50228-524-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.02497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"68382060716","name":"GABAPENTIN ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-607-16","proprietary_name":"gabapentin","nonproprietary_name":"gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-607-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.02497,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin ER|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"74157001390","name":"GABARONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"74157-013-90","proprietary_name":"GABARONE","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"INA Pharmaceutics Inc.","package_description":"90 TABLET in 1 BOTTLE (74157-013-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":8.78889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"74157011190","name":"GABARONE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"74157-111-90","proprietary_name":"GABARONE","nonproprietary_name":"Gabapentin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"INA Pharmaceutics Inc.","package_description":"90 TABLET in 1 BOTTLE (74157-111-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":8.57111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335083683","name":"GALANTAMINE ER 16 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-836-83","proprietary_name":"Galantamine Hydrobromide","nonproprietary_name":"Galantamine Hydrobromide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"16 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (47335-836-83)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Galantamine ER|Galantamine HBr","basis":"generic"},"part_b":null}, {"ndc":"65862074530","name":"GALANTAMINE ER 16 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-745-30","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"16 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-745-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Galantamine ER|Galantamine HBr","basis":"generic"},"part_b":null}, {"ndc":"47335083783","name":"GALANTAMINE ER 24 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-837-83","proprietary_name":"Galantamine Hydrobromide","nonproprietary_name":"Galantamine Hydrobromide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"24 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (47335-837-83)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.90496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Galantamine ER|Galantamine HBr","basis":"generic"},"part_b":null}, {"ndc":"65862074630","name":"GALANTAMINE ER 24 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-746-30","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"24 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-746-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.90496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Galantamine ER|Galantamine HBr","basis":"generic"},"part_b":null}, {"ndc":"47335083583","name":"GALANTAMINE ER 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-835-83","proprietary_name":"Galantamine Hydrobromide","nonproprietary_name":"Galantamine Hydrobromide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (47335-835-83)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.80235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Galantamine ER|Galantamine HBr","basis":"generic"},"part_b":null}, {"ndc":"65862074430","name":"GALANTAMINE ER 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-744-30","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-744-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.80235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Galantamine ER|Galantamine HBr","basis":"generic"},"part_b":null}, {"ndc":"24979072404","name":"GALANTAMINE HBR 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-724-04","proprietary_name":"Galantamine","nonproprietary_name":"galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (24979-724-04)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.51261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237005160","name":"GALANTAMINE HBR 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-051-60","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-051-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.51261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862046060","name":"GALANTAMINE HBR 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-460-60","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-460-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.51261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979072204","name":"GALANTAMINE HBR 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-722-04","proprietary_name":"Galantamine","nonproprietary_name":"galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (24979-722-04)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.29398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004960","name":"GALANTAMINE HBR 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-049-60","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-049-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.29398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862045860","name":"GALANTAMINE HBR 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-458-60","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-458-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.29398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084072911","name":"GALANTAMINE HBR 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084072921","name":"GALANTAMINE HBR 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-729-21","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-729-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-729-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.29398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979072304","name":"GALANTAMINE HBR 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-723-04","proprietary_name":"Galantamine","nonproprietary_name":"galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (24979-723-04)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.40165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237005060","name":"GALANTAMINE HBR 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-050-60","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-050-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.40165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862045960","name":"GALANTAMINE HBR 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-459-60","proprietary_name":"Galantamine","nonproprietary_name":"Galantamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-459-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.40165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030685","name":"GALBRIELA 0.8-0.025 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-306-85","proprietary_name":"GALBRIELA","nonproprietary_name":"norethindrone and ethinyl estradiol and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC","package_description":"3 POUCH in 1 CARTON (70700-306-85) / 1 BLISTER PACK in 1 POUCH (70700-306-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":1.40353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700032650","name":"GALLIFREY 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-326-50","proprietary_name":"Gallifrey","nonproprietary_name":"Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Xiromed LLC","package_description":"50 TABLET in 1 BOTTLE (70700-326-50)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gallifrey|Norethindrone Acetate","basis":"brand"},"part_b":null}, {"ndc":"00548500100","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0548-5001-00","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 CARTON (0548-5001-00) / .5 mL in 1 SYRINGE","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65219002805","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65219-028-05","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (65219-028-05) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700032798","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70700-327-98","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Xiromed LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (70700-327-98) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748027401","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70748-274-01","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TRAY in 1 CARTON (70748-274-01) / 1 SYRINGE, GLASS in 1 TRAY / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71288055480","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-554-80","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (71288-554-80) / 1 SYRINGE, GLASS in 1 BLISTER PACK / .5 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"78206013802","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-138-02","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Organon LLC","package_description":"1 BLISTER PACK in 1 CARTON (78206-138-02) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83301008201","name":"GANIRELIX ACET 250 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83301-0082-1","proprietary_name":"Ganirelix Acetate","nonproprietary_name":"Ganirelix Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"Mullan Pharmaceutical Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (83301-0082-1) / .5 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]"]},"nadac":{"value":62.34667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-25","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000043401","name":"GAS RELIEF (SIMETH) 80 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0434-1","proprietary_name":"Leader Gas relief","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"80 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70000-0434-1)","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.0322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536122308","name":"GAS RELIEF 125 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1223-08","proprietary_name":"Rugby Gas relief","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"125 mg/1","labeler":"Rugby Laboratories","package_description":"60 TABLET, CHEWABLE in 1 BOTTLE (0536-1223-08)","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385030789","name":"GAS RELIEF 125 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113042865","name":"GAS RELIEF 125 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0428-65","proprietary_name":"Good Sense Gas Relief Extra Strength","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"125 mg/1","labeler":"L. Perrigo Company","package_description":"30 BLISTER PACK in 1 CARTON (0113-0428-65) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.07065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904699446","name":"GAS RELIEF 125 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6994-46","proprietary_name":"Gas Relief Extra Strength","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"125 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6994-46) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.07065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000056601","name":"GAS RELIEF 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00037067896","name":"GASTROCROM 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-0678-96","proprietary_name":"Gastrocrom","nonproprietary_name":"cromolyn sodium","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/mL","labeler":"Viatris Specialty LLC","package_description":"12 POUCH in 1 CARTON (0037-0678-96) / 8 AMPULE in 1 POUCH (0037-0678-08) / 5 mL in 1 AMPULE","pharm_classes":["Decreased Histamine Release [PE]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.43248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.34899,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gastrocrom|Cromolyn Sodium","basis":"brand"},"part_b":null}, {"ndc":"61314067225","name":"GATIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-672-25","proprietary_name":"Gatifloxacin","nonproprietary_name":"gatifloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (61314-672-25) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":8.8549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gatifloxacin|Gatifloxacin","basis":"generic"},"part_b":null}, {"ndc":"69315033102","name":"GATIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-331-02","proprietary_name":"GATIFLOXACIN","nonproprietary_name":"GATIFLOXACIN","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"2.5 mL in 1 BOTTLE (69315-331-02)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":8.8549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gatifloxacin|Gatifloxacin","basis":"generic"},"part_b":null}, {"ndc":"43386031208","name":"GAVILAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-312-08","proprietary_name":"GAVILAX","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"238 g in 1 BOTTLE (43386-312-08)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43386031214","name":"GAVILAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-312-14","proprietary_name":"GAVILAX","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"510 g in 1 BOTTLE (43386-312-14)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43386006019","name":"GAVILYTE-C SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-060-19","proprietary_name":"GaviLyte - C TM","nonproprietary_name":"polyethylene glycol-3350 and electrolytes with Flavor Pack","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"240 g/278.26g; 5.84 g/278.26g; 2.98 g/278.26g; 6.72 g/278.26g; 22.72 g/278.26g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"278.26 g in 1 BOTTLE (43386-060-19)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43386009019","name":"GAVILYTE-G SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-090-19","proprietary_name":"GAVILYTE G TM","nonproprietary_name":"polyethylene glycol-3350 and Electrolytes","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"236 g/274.31g; 22.74 g/274.31g; 6.74 g/274.31g; 5.86 g/274.31g; 2.97 g/274.31g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"274.31 g in 1 BOTTLE (43386-090-19)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43386005019","name":"GAVILYTE-N SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-050-19","proprietary_name":"GAVILYTE-N","nonproprietary_name":"polyethylene glycol-3350, sodium chloride, potassium chloride and sodium bicarbonate","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"420 g/438.4g; 11.2 g/438.4g; 5.72 g/438.4g; 1.48 g/438.4g","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"438.4 g in 1 BOTTLE (43386-050-19)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gavilyte-N|Sodium Chloride/NaHCO3/KCl/PEG","basis":"brand"},"part_b":null}, {"ndc":"16571078406","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-784-06","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (16571-784-06)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"16571078450","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-784-50","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-784-50)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"16714010102","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-101-02","proprietary_name":"Gemfibrozil","nonproprietary_name":"gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Northstar RxLLC","package_description":"60 TABLET in 1 BOTTLE (16714-101-02)","pharm_classes":["Fibric Acids [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"16714010105","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-101-05","proprietary_name":"Gemfibrozil","nonproprietary_name":"gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Northstar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-101-05)","pharm_classes":["Fibric Acids [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"24658026005","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"24658026018","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"24658026060","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"31722012805","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-128-05","proprietary_name":"GEMFIBROZIL","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-128-05)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"31722012860","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-128-60","proprietary_name":"GEMFIBROZIL","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-128-60)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"50268035011","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"50268035015","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-350-15","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-350-15) / 1 TABLET in 1 BLISTER PACK (50268-350-11)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"60687022401","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-224-01","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-224-01) / 1 TABLET in 1 BLISTER PACK (60687-224-11)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"60687022411","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"62135016060","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-160-60","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-160-60)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"65862062405","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-624-05","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-624-05)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"65862062460","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-624-60","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-624-60)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"69097082103","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-821-03","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET in 1 BOTTLE (69097-821-03)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"69097082112","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-821-12","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-821-12)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"72603020601","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-206-01","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72603-206-01)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"72603020602","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-206-02","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-206-02)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"76282022505","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-225-05","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-225-05)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"76282022518","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-225-18","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (76282-225-18)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"76282022560","name":"GEMFIBROZIL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-225-60","proprietary_name":"Gemfibrozil","nonproprietary_name":"Gemfibrozil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-225-60)","pharm_classes":["PPAR alpha [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]"]},"nadac":{"value":0.10376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemfibrozil|Gemfibrozil","basis":"generic"},"part_b":null}, {"ndc":"70700015284","name":"GEMMILY 1 MG-20 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemmily|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"70700015285","name":"GEMMILY 1 MG-20 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-152-85","proprietary_name":"Gemmily","nonproprietary_name":"norethindrone acetate and ethinyl estradiol, and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC","package_description":"3 CARTON in 1 CARTON (70700-152-85) / 1 BLISTER PACK in 1 CARTON (70700-152-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemmily|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"73336007530","name":"GEMTESA 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73336-075-30","proprietary_name":"GEMTESA","nonproprietary_name":"vibegron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (73336-075-30)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":16.45975,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemtesa|Vibegron","basis":"brand"},"part_b":null}, {"ndc":"73336007590","name":"GEMTESA 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73336-075-90","proprietary_name":"GEMTESA","nonproprietary_name":"vibegron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (73336-075-90)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":16.45975,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gemtesa|Vibegron","basis":"brand"},"part_b":null}, {"ndc":"62135089247","name":"GENERLAC 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-892-47","proprietary_name":"Generlac","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-892-47)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Generlac|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"00074310832","name":"GENGRAF 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0074-3108-32","proprietary_name":"Gengraf","nonproprietary_name":"Cyclosporine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AbbVie Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0074-3108-32) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.86549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gengraf|Cyclosporine, Modified","basis":"brand"},"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 BLISTER PACK in 1 CARTON (0074-3108-32) / 10 CAPSULE in 1 BLISTER PACK) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00013264681","name":"GENOTROPIN 12 MG CARTRIDGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0013-2646-81","proprietary_name":"GENOTROPIN","nonproprietary_name":"somatropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 CARTRIDGE in 1 CARTON (0013-2646-81) / 1 KIT in 1 CARTRIDGE"},"nadac":{"value":1810.40353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Genotropin|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"00013262681","name":"GENOTROPIN 5 MG CARTRIDGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0013-2626-81","proprietary_name":"GENOTROPIN","nonproprietary_name":"somatropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 CARTRIDGE in 1 CARTON (0013-2626-81) / 1 KIT in 1 CARTRIDGE"},"nadac":{"value":752.224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Genotropin|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"00013264902","name":"GENOTROPIN MINIQUICK 0.2 MG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0013-2649-02","proprietary_name":"GENOTROPIN","nonproprietary_name":"somatropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"7 CARTRIDGE in 1 CARTON (0013-2649-02) / 1 KIT in 1 CARTRIDGE"},"nadac":{"value":30.89868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Genotropin|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"00013265002","name":"GENOTROPIN MINIQUICK 0.4 MG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0013-2650-02","proprietary_name":"GENOTROPIN","nonproprietary_name":"somatropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"7 CARTRIDGE in 1 CARTON (0013-2650-02) / 1 KIT in 1 CARTRIDGE"},"nadac":{"value":61.6398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Genotropin|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"00713068315","name":"GENTAMICIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0683-15","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0683-15) / 15 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.88433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713068331","name":"GENTAMICIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0683-31","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0683-31) / 30 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.88707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005611","name":"GENTAMICIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-056-11","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-056-11) / 30 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.88707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005635","name":"GENTAMICIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-056-35","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-056-35) / 15 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.88433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713068215","name":"GENTAMICIN 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0682-15","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0682-15) / 15 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.94071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713068231","name":"GENTAMICIN 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0682-31","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0682-31) / 30 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.77054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004611","name":"GENTAMICIN 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-046-11","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-046-11) / 30 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.77054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004635","name":"GENTAMICIN 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-046-35","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-046-35) / 15 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.94071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208058060","name":"GENTAMICIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-580-60","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-580-60) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.79003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314063305","name":"GENTAMICIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-633-05","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"Gentamicin Sulfate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, DROPPER in 1 CARTON (61314-633-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.79003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143912825","name":"GENTAMICIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9128-25","proprietary_name":"Gentamicin","nonproprietary_name":"Gentamicin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0143-9128-25) / 2 mL in 1 VIAL (0143-9128-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.3026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gentamicin Sulfate*|Gentamicin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J1580","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1580 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0143-9128-25) / 2 mL in 1 VIAL (0143-9128-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409120703","name":"GENTAMICIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-1207-03","proprietary_name":"Gentamicin Sulfate","nonproprietary_name":"GENTAMICIN SULFATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-1207-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-1207-13)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.3026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1580","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1580 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-1207-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-1207-13)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150040225","name":"GENTAMICIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-402-25","proprietary_name":"Gentamicin","nonproprietary_name":"Gentamicin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-402-25) / 2 mL in 1 VIAL, MULTI-DOSE (55150-402-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.3026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gentamicin Sulfate*|Gentamicin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J1580","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1580 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (55150-402-25) / 2 mL in 1 VIAL, MULTI-DOSE (55150-402-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323001002","name":"GENTAMICIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-010-02","proprietary_name":"Gentamicin","nonproprietary_name":"GENTAMICIN SULFATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-010-02) / 2 mL in 1 VIAL (63323-010-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.3026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gentamicin Sulfate*|Gentamicin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J1580","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1580 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-010-02) / 2 mL in 1 VIAL (63323-010-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323001094","name":"GENTAMICIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-010-94","proprietary_name":"Gentamicin","nonproprietary_name":"GENTAMICIN SULFATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-010-94) / 2 mL in 1 VIAL, MULTI-DOSE (63323-010-41)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.3026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gentamicin Sulfate*|Gentamicin Sulfate","basis":"generic"},"part_b":{"hcpcs":"J1580","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1580 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-010-94) / 2 mL in 1 VIAL, MULTI-DOSE (63323-010-41)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00065042636","name":"GENTEAL TEARS 0.1%-0.2%-0.3%","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0426-36","proprietary_name":"GenTeal Tears (Moderate)","nonproprietary_name":"Dextran 70, Glycerin, Hypromellose","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL; 2 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0426-36) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Increased Intravascular Volume [PE]","Non-Standardized Chemical Allergen [EPC]","Osmotic Activity [MoA]","Plasma Volume Expander [EPC]"]},"nadac":{"value":0.48066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.40378,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065042637","name":"GENTEAL TEARS 0.1%-0.2%-0.3%","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0426-37","proprietary_name":"GenTeal Tears (Moderate)","nonproprietary_name":"Dextran 70, Glycerin, Hypromellose","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL; 2 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0065-0426-37) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Increased Intravascular Volume [PE]","Non-Standardized Chemical Allergen [EPC]","Osmotic Activity [MoA]","Plasma Volume Expander [EPC]"]},"nadac":{"value":0.42498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065806301","name":"GENTEAL TEARS 0.1%-0.3% DROP","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-8063-01","proprietary_name":"GenTeal Tears Moderate Preservative Free","nonproprietary_name":"dextran 70, hypromellose 2910","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"36 VIAL, SINGLE-DOSE in 1 CARTON (0065-8063-01) / .9 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Increased Intravascular Volume [PE]","Osmotic Activity [MoA]","Plasma Volume Expander [EPC]"]},"nadac":{"value":0.29966,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00065806401","name":"GENTEAL TEARS SEVERE 0.3% GEL","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0065-8064-01","proprietary_name":"GenTeal Tears Severe","nonproprietary_name":"Hypromellose","dosage_form":"GEL","route":"OPHTHALMIC","strength":".003 g/g","labeler":"Alcon Laboratories, Inc.","package_description":"1 TUBE in 1 CARTON (0065-8064-01) / 10 g in 1 TUBE"},"nadac":{"value":0.90372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00065051801","name":"GENTEAL TEARS SEVERE 3-94% OIN","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0518-01","proprietary_name":"GenTeal Tears NIGHT-TIME","nonproprietary_name":"mineral oil, white petrolatum","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":".03 g/g; .94 g/g","labeler":"Alcon Laboratories, Inc.","package_description":"1 TUBE in 1 CARTON (0065-0518-01) / 3.5 g in 1 TUBE"},"nadac":{"value":2.47963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00065806701","name":"GENTEAL TEARS SEVERE GEL DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-8067-01","proprietary_name":"GenTeal Tears Gel Drops","nonproprietary_name":"polyethylene glycol 400 and propylene glycol","dosage_form":"GEL","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"8 mL in 1 BOTTLE, DROPPER (0065-8067-01)"},"nadac":{"value":1.08984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385000346","name":"GENTIAN VIOLET 1% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-003-46","proprietary_name":"GNP Gentian Violet 1%","nonproprietary_name":"Gentian Violet 1%","dosage_form":"LIQUID","route":"TOPICAL","strength":"10 mg/mL","labeler":"Amerrisource Bergen","package_description":"59 mL in 1 BOTTLE, PLASTIC (24385-003-46)"},"nadac":{"value":0.04949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000057301","name":"GENTLE LAXATIVE 10 MG SUPPOSIT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0573-1","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Cardinal Health","package_description":"1 BLISTER PACK in 1 CARTON (70000-0573-1) / 4 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000057302","name":"GENTLE LAXATIVE 10 MG SUPPOSIT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0573-2","proprietary_name":"Bisacodyl","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Cardinal Health","package_description":"4 BLISTER PACK in 1 CARTON (70000-0573-2) / 4 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122052978","name":"GENTLE LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-529-78","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Amerisource Bergen","package_description":"4 BLISTER PACK in 1 CARTON (46122-529-78) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000022101","name":"GENTLE LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0221-1","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BLISTER PACK in 1 CARTON (70000-0221-1) / 10 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000022102","name":"GENTLE LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0221-2","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BLISTER PACK in 1 CARTON (70000-0221-2) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000022103","name":"GENTLE LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0221-3","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"7 BLISTER PACK in 1 CARTON (70000-0221-3) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000053801","name":"GENTLE LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0538-1","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"CARDINAL HEALTH","package_description":"100 TABLET in 1 BOTTLE (70000-0538-1)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61958190101","name":"GENVOYA TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-1901-1","proprietary_name":"Genvoya","nonproprietary_name":"elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1; 150 mg/1; 200 mg/1; 10 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-1901-1)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","HIV Integrase Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":143.3532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00049035860","name":"GEODON 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0049-0358-60","proprietary_name":"Geodon","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"ROERIG","package_description":"60 CAPSULE in 1 BOTTLE (0049-0358-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":31.10811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151013491","name":"GEODON 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58151-134-91","proprietary_name":"Geodon","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Viatris Specialty LLC","package_description":"60 CAPSULE in 1 BOTTLE (58151-134-91)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":31.10811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-03","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378696093","name":"GLATIRAMER 20 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6960-93","proprietary_name":"Glatiramer Acetate","nonproprietary_name":"glatiramer acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0378-6960-93) / 1 SYRINGE in 1 BLISTER PACK (0378-6960-32) / 1 mL in 1 SYRINGE"},"nadac":{"value":41.75705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"00832608430","name":"GLATIRAMER 20 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6084-30","proprietary_name":"Glatiramer Acetate","nonproprietary_name":"Glatiramer Acetate Injection","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/mL","labeler":"UPSHER-SMITH LABORATORIES, LLC","package_description":"30 SYRINGE, GLASS in 1 CARTON (0832-6084-30) / 1 mL in 1 SYRINGE, GLASS (0832-6084-89)"},"nadac":{"value":41.75705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"47335099002","name":"GLATIRAMER 20 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-990-02","proprietary_name":"Glatiramer Acetate","nonproprietary_name":"Glatiramer Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (47335-990-02) / 1 SYRINGE in 1 BLISTER PACK / 1 mL in 1 SYRINGE"},"nadac":{"value":41.75705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"70710154809","name":"GLATIRAMER 20 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1548-9","proprietary_name":"GLATIRAMER ACETATE","nonproprietary_name":"glatiramer acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 BLISTER PACK in 1 CARTON (70710-1548-9) / 1 SYRINGE in 1 BLISTER PACK / 1 mL in 1 SYRINGE (70710-1548-2)"},"nadac":{"value":41.75705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"00378696112","name":"GLATIRAMER 40 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6961-12","proprietary_name":"Glatiramer Acetate","nonproprietary_name":"Glatiramer","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"12 BLISTER PACK in 1 CARTON (0378-6961-12) / 1 SYRINGE in 1 BLISTER PACK (0378-6961-32) / 1 mL in 1 SYRINGE"},"nadac":{"value":86.09516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832608512","name":"GLATIRAMER 40 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6085-12","proprietary_name":"Glatiramer Acetate","nonproprietary_name":"Glatiramer Acetate Injection","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/mL","labeler":"UPSHER-SMITH LABORATORIES, LLC","package_description":"12 SYRINGE, GLASS in 1 CARTON (0832-6085-12) / 1 mL in 1 SYRINGE, GLASS (0832-6085-89)"},"nadac":{"value":86.09516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"47335099102","name":"GLATIRAMER 40 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-991-02","proprietary_name":"Glatiramer Acetate","nonproprietary_name":"Glatiramer Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (47335-991-02) / 1 SYRINGE in 1 BLISTER PACK / 1 mL in 1 SYRINGE"},"nadac":{"value":86.09516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"70710154906","name":"GLATIRAMER 40 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1549-6","proprietary_name":"GLATIRAMER ACETATE","nonproprietary_name":"glatiramer acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"12 BLISTER PACK in 1 CARTON (70710-1549-6) / 1 SYRINGE in 1 BLISTER PACK / 1 mL in 1 SYRINGE (70710-1549-2)"},"nadac":{"value":86.09516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatiramer Acetate|Glatiramer Acetate","basis":"generic"},"part_b":null}, {"ndc":"00781323434","name":"GLATOPA 20 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3234-34","proprietary_name":"Glatopa","nonproprietary_name":"Glatiramer Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/mL","labeler":"Sandoz Inc","package_description":"30 BLISTER PACK in 1 CARTON (0781-3234-34) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS (0781-3234-71)"},"nadac":{"value":41.75705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatopa|Glatiramer Acetate","basis":"brand"},"part_b":null}, {"ndc":"00781325089","name":"GLATOPA 40 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3250-89","proprietary_name":"Glatopa","nonproprietary_name":"Glatiramer Acetate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/mL","labeler":"Sandoz Inc","package_description":"12 BLISTER PACK in 1 CARTON (0781-3250-89) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS (0781-3250-71)"},"nadac":{"value":86.09516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glatopa|Glatiramer Acetate","basis":"brand"},"part_b":null}, {"ndc":"16571077301","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-773-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-773-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"16571077350","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-773-50","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-773-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"42571010001","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-100-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-100-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"43547039410","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-394-10","proprietary_name":"Glimepiride","nonproprietary_name":"glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-394-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"43547039450","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-394-50","proprietary_name":"Glimepiride","nonproprietary_name":"glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-394-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"50268035811","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"50268035815","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-358-15","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-358-15) / 1 TABLET in 1 BLISTER PACK (50268-358-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"55111032001","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-320-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-320-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"55111032005","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-320-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-320-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"61442011501","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-115-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (61442-115-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"61442011505","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-115-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (61442-115-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68001058400","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-584-00","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-584-00)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68001058403","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-584-03","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-584-03)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68084078825","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-788-25","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-788-25) / 1 TABLET in 1 BLISTER PACK (68084-788-95)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68084078895","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"71921021401","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-214-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"100 TABLET in 1 BOTTLE (71921-214-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"71921021450","name":"GLIMEPIRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-214-50","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"500 TABLET in 1 BOTTLE (71921-214-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"16571077401","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-774-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-774-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"16571077450","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-774-50","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-774-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"42571010101","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-101-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-101-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"43547039510","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-395-10","proprietary_name":"Glimepiride","nonproprietary_name":"glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-395-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"43547039550","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-395-50","proprietary_name":"Glimepiride","nonproprietary_name":"glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-395-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"50268035911","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"50268035915","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-359-15","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-359-15) / 1 TABLET in 1 BLISTER PACK (50268-359-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"55111032101","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-321-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-321-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"55111032105","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-321-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-321-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"61442011601","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-116-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (61442-116-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"61442011605","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-116-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (61442-116-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68001058500","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-585-00","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-585-00)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68001058503","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-585-03","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-585-03)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68084032601","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-326-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-326-01) / 1 TABLET in 1 BLISTER PACK (68084-326-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68084032611","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68645057290","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"71921021501","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-215-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"100 TABLET in 1 BOTTLE (71921-215-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"71921021550","name":"GLIMEPIRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-215-50","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"500 TABLET in 1 BOTTLE (71921-215-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"16571077501","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-775-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-775-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"16571077550","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-775-50","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-775-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"42571010301","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-103-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-103-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"42571010305","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-103-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Micro Labs Limited","package_description":"500 TABLET in 1 BOTTLE (42571-103-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"43547039610","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-396-10","proprietary_name":"Glimepiride","nonproprietary_name":"glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-396-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"43547039650","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-396-50","proprietary_name":"Glimepiride","nonproprietary_name":"glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (43547-396-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"50268036011","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"50268036015","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-360-15","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-360-15) / 1 TABLET in 1 BLISTER PACK (50268-360-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"55111032201","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-322-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-322-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"55111032205","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-322-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-322-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"61442011701","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-117-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (61442-117-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"61442011705","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-117-05","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (61442-117-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68001058600","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-586-00","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-586-00)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68001058603","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-586-03","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-586-03)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68084032701","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-327-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-327-01) / 1 TABLET in 1 BLISTER PACK (68084-327-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68084032711","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"68645057390","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"71921021601","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-216-01","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"100 TABLET in 1 BOTTLE (71921-216-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"71921021650","name":"GLIMEPIRIDE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-216-50","proprietary_name":"Glimepiride","nonproprietary_name":"Glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"500 TABLET in 1 BOTTLE (71921-216-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.05069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glimepiride|Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"00591046101","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0461-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0461-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00591046105","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0461-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0461-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00591046110","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0461-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0461-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"50268036211","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"50268036215","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-362-15","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-362-15) / 1 TABLET in 1 BLISTER PACK (50268-362-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014200","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0142-0","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0142-0)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014201","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0142-1","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0142-1)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014202","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0142-2","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET in 1 BOTTLE (60505-0142-2)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014204","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0142-4","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"10000 TABLET in 1 BOTTLE (60505-0142-4)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687070101","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-701-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-701-01) / 1 TABLET in 1 BLISTER PACK (60687-701-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687070111","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"62559031610","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-316-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (62559-316-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"68645057559","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-575-59","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET in 1 BOTTLE (68645-575-59)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"69584031010","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-310-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-310-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"69584031050","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-310-50","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-310-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"69584031090","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-310-90","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-310-90)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"72888011700","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-117-00","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (72888-117-00)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"72888011701","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-117-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-117-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"72888011705","name":"GLIPIZIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-117-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-117-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.04476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"52817038510","name":"GLIPIZIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-385-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET in 1 BOTTLE (52817-385-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":1.26741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00591046001","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0460-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0460-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00591046005","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0460-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0460-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00591046010","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0460-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0460-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00904663761","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6637-61","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6637-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"50268036111","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"50268036115","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-361-15","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-361-15) / 1 TABLET in 1 BLISTER PACK (50268-361-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014100","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0141-0","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0141-0)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014101","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0141-1","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0141-1)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014102","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0141-2","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET in 1 BOTTLE (60505-0141-2)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60505014108","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0141-8","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"18000 TABLET in 1 BOTTLE (60505-0141-8)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687069001","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-690-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-690-01) / 1 TABLET in 1 BLISTER PACK (60687-690-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687069011","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"62559031510","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-315-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (62559-315-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"68645057454","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-574-54","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-574-54)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"69584030910","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-309-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-309-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"69584030950","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-309-50","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-309-50)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"69584030990","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-309-90","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-309-90)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"72888011600","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-116-00","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (72888-116-00)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"72888011601","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-116-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-116-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"72888011605","name":"GLIPIZIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-116-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-116-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.03388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"16714089601","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-896-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-896-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"16714089602","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-896-02","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-896-02)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651027001","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651027005","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651078201","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-782-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-782-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651078205","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-782-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-782-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980028101","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-281-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-281-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980028105","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-281-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-281-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980028110","name":"GLIPIZIDE ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-281-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-281-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"16714089401","name":"GLIPIZIDE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-894-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Northstar Rx LLC.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-894-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.09927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651026830","name":"GLIPIZIDE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651078030","name":"GLIPIZIDE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-780-30","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-780-30)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.09927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687076811","name":"GLIPIZIDE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687076821","name":"GLIPIZIDE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-768-21","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-768-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-768-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.09927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980027903","name":"GLIPIZIDE ER 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-279-03","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-279-03)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.09927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"16714089501","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-895-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-895-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"16714089502","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-895-02","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Northstar Rx LLC.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-895-02)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651026901","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651026905","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651078101","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-781-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-781-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"59651078105","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-781-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-781-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687088101","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-881-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-881-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-881-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"60687088111","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980028001","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-280-01","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-280-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980028005","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-280-05","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-280-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"64980028010","name":"GLIPIZIDE ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-280-10","proprietary_name":"Glipizide","nonproprietary_name":"Glipizide","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (64980-280-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.07375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide ER|Glipizide","basis":"generic"},"part_b":null}, {"ndc":"00093745501","name":"GLIPIZIDE-METFORMIN 2.5-250 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7455-01","proprietary_name":"Glipizide and Metformin Hydrochloride","nonproprietary_name":"Glipizide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-7455-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.2418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155011501","name":"GLIPIZIDE-METFORMIN 2.5-250 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-115-01","proprietary_name":"Glipizide and Metformin HCl","nonproprietary_name":"Glipizide and Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (23155-115-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.2418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135073160","name":"GLIPIZIDE-METFORMIN 2.5-250 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-731-60","proprietary_name":"Glipizide and metformin hcl","nonproprietary_name":"Glipizide and metformin hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 250 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-731-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.2418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018401","name":"GLIPIZIDE-METFORMIN 2.5-250 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-184-01","proprietary_name":"Glipizide and Metformin Hydrochloride","nonproprietary_name":"Glipizide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 250 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-184-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.2418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093745601","name":"GLIPIZIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7456-01","proprietary_name":"Glipizide and Metformin Hydrochloride","nonproprietary_name":"Glipizide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-7456-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.22051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155011601","name":"GLIPIZIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-116-01","proprietary_name":"Glipizide and Metformin HCl","nonproprietary_name":"Glipizide and Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (23155-116-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.22051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135073260","name":"GLIPIZIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-732-60","proprietary_name":"Glipizide and metformin hcl","nonproprietary_name":"Glipizide and metformin hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-732-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.22051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018501","name":"GLIPIZIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-185-01","proprietary_name":"Glipizide and Metformin Hydrochloride","nonproprietary_name":"Glipizide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-185-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.22051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093745701","name":"GLIPIZIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7457-01","proprietary_name":"Glipizide and Metformin Hydrochloride","nonproprietary_name":"Glipizide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-7457-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.20234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155011701","name":"GLIPIZIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-117-01","proprietary_name":"Glipizide and Metformin HCl","nonproprietary_name":"Glipizide and Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (23155-117-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.20234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135073360","name":"GLIPIZIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-733-60","proprietary_name":"Glipizide and metformin hcl","nonproprietary_name":"Glipizide and metformin hcl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-733-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.20234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382018601","name":"GLIPIZIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-186-01","proprietary_name":"Glipizide and Metformin Hydrochloride","nonproprietary_name":"Glipizide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-186-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.20234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glipizide-Metformin|Glipizide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378806790","name":"GLUCAGON 1 MG EMERGENCY KIT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8067-90","proprietary_name":"Glucagon","nonproprietary_name":"glucagon","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 KIT in 1 KIT (0378-8067-90) * 1 mL in 1 VIAL (0378-8065-32) * 1 mL in 1 SYRINGE (0378-8066-32)"},"nadac":{"value":154.20337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1610","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1610 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 KIT (0378-8067-90) * 1 mL in 1 VIAL (0378-8065-32) * 1 mL in 1 SYRINGE (0378-8066-32)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00548585000","name":"GLUCAGON 1 MG EMERGENCY KIT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5850-00","proprietary_name":"Glucagon","nonproprietary_name":"Glucagon","dosage_form":"KIT","route":null,"strength":null,"labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 KIT in 1 KIT (0548-5850-00) * 1 mL in 1 VIAL (0548-5905-00) * 1 mL in 1 SYRINGE (0548-5831-00)"},"nadac":{"value":154.20337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1610","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1610 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 KIT (0548-5850-00) * 1 mL in 1 VIAL (0548-5905-00) * 1 mL in 1 SYRINGE (0548-5831-00)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323058282","name":"GLUCAGON 1 MG EMERGENCY KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-582-82","proprietary_name":"Glucagon","nonproprietary_name":"Glucagon","dosage_form":"KIT","route":null,"strength":null,"labeler":"Fresenius Kabi USA, LLC","package_description":"1 KIT in 1 KIT (63323-582-82) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-583-13) * 1 mL in 1 SYRINGE, GLASS (63323-185-82)"},"nadac":{"value":240.40425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1611","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1611 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 KIT (63323-582-82) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-583-13) * 1 mL in 1 SYRINGE, GLASS (63323-185-82)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69097002750","name":"GLUCAGON 1 MG EMERGENCY KIT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-027-50","proprietary_name":"Glucagon","nonproprietary_name":"Glucagon","dosage_form":"KIT","route":null,"strength":null,"labeler":"Cipla USA Inc.","package_description":"1 KIT in 1 CARTON (69097-027-50) * 1 mL in 1 VIAL, GLASS (69097-028-32) * 1 mL in 1 SYRINGE, GLASS (69097-029-31)"},"nadac":{"value":154.20337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1610","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1610 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (69097-027-50) * 1 mL in 1 VIAL, GLASS (69097-028-32) * 1 mL in 1 SYRINGE, GLASS (69097-029-31)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70748031101","name":"GLUCAGON 1 MG EMERGENCY KIT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-311-01","proprietary_name":"GLUCAGON","nonproprietary_name":"GLUCAGON","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (70748-311-01) * 1 mL in 1 VIAL (70748-309-01) * 1 mL in 1 SYRINGE (70748-310-01)"},"nadac":{"value":154.20337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00548590500","name":"GLUCAGON 1 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":154.20337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63323058313","name":"GLUCAGON 1 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":240.40425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748030901","name":"GLUCAGON 1 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":154.20337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093834201","name":"GLYBURIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8342-01","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-8342-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093947753","name":"GLYBURIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9477-53","proprietary_name":"Glyburide","nonproprietary_name":"glyburide","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1","labeler":"TEVA Pharmaceuticals USA Inc","package_description":"50 TABLET in 1 BOTTLE (0093-9477-53)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"23155005601","name":"GLYBURIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-056-01","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-056-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"62135058330","name":"GLYBURIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-583-30","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-583-30)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241003805","name":"GLYBURIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-038-05","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (72241-038-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834301","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8343-01","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-8343-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834305","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8343-05","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-8343-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834310","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8343-10","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-8343-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834398","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8343-98","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-8343-98)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093943301","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9433-01","proprietary_name":"Glyburide","nonproprietary_name":"glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"TEVA Pharmaceuticals USA Inc","package_description":"100 TABLET in 1 BOTTLE (0093-9433-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"23155005701","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-057-01","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-057-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"62135058430","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-584-30","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-584-30)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241003905","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-039-05","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (72241-039-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241003910","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-039-10","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (72241-039-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241003911","name":"GLYBURIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-039-11","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-039-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834401","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8344-01","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-8344-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834405","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8344-05","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-8344-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834410","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8344-10","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-8344-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093834498","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8344-98","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-8344-98)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093936401","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9364-01","proprietary_name":"Glyburide","nonproprietary_name":"glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TEVA Pharmaceuticals USA Inc","package_description":"100 TABLET in 1 BOTTLE (0093-9364-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093936410","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9364-10","proprietary_name":"Glyburide","nonproprietary_name":"glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TEVA Pharmaceuticals USA Inc","package_description":"1000 TABLET in 1 BOTTLE (0093-9364-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"23155005801","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-058-01","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-058-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"23155005810","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-058-10","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-058-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"62135058590","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-585-90","proprietary_name":"GLYBURIDE","nonproprietary_name":"GLYBURIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-585-90)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241004005","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-040-05","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (72241-040-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241004010","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-040-10","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (72241-040-10)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"72241004011","name":"GLYBURIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-040-11","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-040-11)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.06427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide|Glyburide","basis":"generic"},"part_b":null}, {"ndc":"00093803501","name":"GLYBURIDE MICRO 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-8035-01","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-8035-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide Micronized|Glyburide,Micronized","basis":"generic"},"part_b":null}, {"ndc":"00093803505","name":"GLYBURIDE MICRO 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-8035-05","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-8035-05)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide Micronized|Glyburide,Micronized","basis":"generic"},"part_b":null}, {"ndc":"00093803601","name":"GLYBURIDE MICRO 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-8036-01","proprietary_name":"Glyburide","nonproprietary_name":"Glyburide","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-8036-01)","pharm_classes":["Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.23939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide Micronized|Glyburide,Micronized","basis":"generic"},"part_b":null}, {"ndc":"23155023401","name":"GLYBURIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-234-01","proprietary_name":"glyburide-metformin hydrochloride","nonproprietary_name":"glyburide-metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-234-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.17146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237002401","name":"GLYBURIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-024-01","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-024-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.17146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237002405","name":"GLYBURIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-024-05","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-024-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.17146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862008101","name":"GLYBURIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-081-01","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-081-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.17146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862008105","name":"GLYBURIDE-METFORMIN 2.5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-081-05","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-081-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.17146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155023501","name":"GLYBURIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-235-01","proprietary_name":"glyburide-metformin hydrochloride","nonproprietary_name":"glyburide-metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-235-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.18963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237002501","name":"GLYBURIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-025-01","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-025-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.18963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237002505","name":"GLYBURIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-025-05","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-025-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.18963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862008201","name":"GLYBURIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-082-01","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-082-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.18963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862008205","name":"GLYBURIDE-METFORMIN 5-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-082-05","proprietary_name":"Glyburide and Metformin Hydrochloride","nonproprietary_name":"Glyburide and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-082-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]"]},"nadac":{"value":0.18963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyburide-Metformin HCl|Glyburide/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237032521","name":"GLYCERIN 2 GM SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57237-325-21","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (57237-325-21) / 6 SUPPOSITORY in 1 BLISTER PACK (57237-325-16)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.21712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032552","name":"GLYCERIN 2 GM SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-325-52","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-325-52) / 5 SUPPOSITORY in 1 BLISTER PACK (57237-325-51)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.10312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000057201","name":"GLYCERIN ADULT SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0572-1","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2 g/1","labeler":"Cardinal Health","package_description":"25 SUPPOSITORY in 1 JAR (70000-0572-1)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.10312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122022163","name":"GLYCERIN SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-221-63","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2.1 g/1","labeler":"Amerisource Bergen/Good Neighbor Pharmacy","package_description":"25 SUPPOSITORY in 1 JAR (46122-221-63)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.10312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122022171","name":"GLYCERIN SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-221-71","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2.1 g/1","labeler":"Amerisource Bergen/Good Neighbor Pharmacy","package_description":"50 SUPPOSITORY in 1 JAR (46122-221-71)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.06779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122022263","name":"GLYCERIN SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-222-63","proprietary_name":"Glycerin","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1.2 g/1","labeler":"Amerisource Bergen/Good Neighbor Pharmacy","package_description":"25 SUPPOSITORY in 1 JAR (46122-222-63)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.12192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143968225","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9682-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0143-9682-25) / 1 mL in 1 VIAL (0143-9682-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0143-9682-25) / 1 mL in 1 VIAL (0143-9682-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00517460125","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-4601-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"American Regent, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0517-4601-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0517-4601-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0517-4601-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0517-4601-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781382596","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3825-96","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Sandoz Inc","package_description":"25 VIAL in 1 CARTON (0781-3825-96) / 1 mL in 1 VIAL (0781-3825-71)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0781-3825-96) / 1 mL in 1 VIAL (0781-3825-71)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021079601","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-796-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-796-01) / 1 mL in 1 VIAL","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"43547054325","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-543-25","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Solco Healthcare US, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (43547-543-25) / 1 mL in 1 VIAL, SINGLE-DOSE (43547-543-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43547063925","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-639-25","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Solco Healthcare US, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (43547-639-25) / 1 mL in 1 VIAL, SINGLE-DOSE (43547-639-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332060725","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-607-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (62332-607-25) / 1 mL in 1 VIAL (62332-607-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (62332-607-25) / 1 mL in 1 VIAL (62332-607-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323057801","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-578-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (63323-578-01) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-578-03)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (63323-578-01) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-578-03)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323057811","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-578-11","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (63323-578-11) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-578-41)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (63323-578-11) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-578-41)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145010225","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-102-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Caplin Steriles Limited","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (65145-102-25) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-102-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65219080101","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-801-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (65219-801-01) / 1 mL in 1 VIAL, SINGLE-DOSE (65219-801-00)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (65219-801-01) / 1 mL in 1 VIAL, SINGLE-DOSE (65219-801-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"66794020242","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66794-202-42","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Piramal Critical Care Inc","package_description":"25 VIAL, GLASS in 1 CARTON (66794-202-42) / 1 mL in 1 VIAL, GLASS (66794-202-02)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, GLASS in 1 CARTON (66794-202-42) / 1 mL in 1 VIAL, GLASS (66794-202-02)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069001125","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-011-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"25 VIAL in 1 CARTON (70069-011-25) / 1 mL in 1 VIAL (70069-011-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069061725","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-617-25","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"25 VIAL in 1 CARTON (70069-617-25) / 1 mL in 1 VIAL (70069-617-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70069-617-25) / 1 mL in 1 VIAL (70069-617-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700016525","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-165-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Xiromed LLC","package_description":"25 VIAL in 1 CARTON (70700-165-25) / 1 mL in 1 VIAL (70700-165-22)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70700-165-25) / 1 mL in 1 VIAL (70700-165-22)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288041403","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-414-03","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71288-414-03) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-414-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71288-414-03) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-414-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288041492","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-414-92","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71288-414-92) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-414-91)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71288-414-92) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-414-91)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71839012325","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71839-123-25","proprietary_name":"glycopyrrolate","nonproprietary_name":"glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"BE Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71839-123-25) / 1 mL in 1 VIAL, SINGLE-DOSE (71839-123-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71839-123-25) / 1 mL in 1 VIAL, SINGLE-DOSE (71839-123-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572022525","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-225-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (72572-225-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72572-225-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (2 per item) x PKG QTY (50); the crosswalk contradicts itself, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (72572-225-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72572-225-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML. But the crosswalk's two billable-unit columns disagree, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"72572022625","name":"GLYCOPYRROLATE 0.2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-226-25","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":".2 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (72572-226-25) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.51425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1596","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1596 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (72572-226-25) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00904670961","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6709-61","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6709-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107001401","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-014-01","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-014-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571074309","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-743-09","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 CONTAINER (16571-743-09)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155060601","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-606-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-606-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884006501","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-065-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-065-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268036311","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268036315","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-363-15","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-363-15) / 1 TABLET in 1 BLISTER PACK (50268-363-11)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687045801","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-458-01","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-458-01) / 1 TABLET in 1 BLISTER PACK (60687-458-11)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687045811","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135073460","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-734-60","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-734-60)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69076047501","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69076-475-01","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Quinn Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (69076-475-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315013901","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-139-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-139-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752010810","name":"GLYCOPYRROLATE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-108-10","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-108-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722001647","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-016-47","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-016-47) / 473 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49884004233","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-042-33","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/5mL","labeler":"Par Health USA, LLC","package_description":"16 mL in 1 BOTTLE (49884-042-33)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672531609","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-5316-9","proprietary_name":"Glycopyrrolate Oral Solution","nonproprietary_name":"Glycopyrrolate Oral Solution","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-5316-9) / 500 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651043547","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-435-47","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-435-47) / 473 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656006116","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-061-16","proprietary_name":"glycopyrrolate","nonproprietary_name":"glycopyrrolate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/5mL","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"1 BOTTLE in 1 BOTTLE (71656-061-16) / 473 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205007072","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-070-72","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/5mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-070-72) / 473 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603024001","name":"GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-240-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/5mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-240-01) / 473 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"13107001501","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-015-01","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-015-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571074409","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-744-09","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 CONTAINER (16571-744-09)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155060701","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-607-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-607-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884006601","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-066-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-066-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135073560","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-735-60","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-735-60)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69076047601","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69076-476-01","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Quinn Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (69076-476-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315014001","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-140-01","proprietary_name":"Glycopyrrolate","nonproprietary_name":"Glycopyrrolate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-140-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70752010910","name":"GLYCOPYRROLATE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-109-10","proprietary_name":"GLYCOPYRROLATE","nonproprietary_name":"GLYCOPYRROLATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70752-109-10)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"25021067376","name":"GLYDO 2% JELLY SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-673-76","proprietary_name":"glydo","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"JELLY","route":"TOPICAL","strength":"20 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-673-76) / 6 mL in 1 SYRINGE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.89771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glydo|Lidocaine HCl","basis":"brand"},"part_b":null}, {"ndc":"25021067377","name":"GLYDO 2% JELLY SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-673-77","proprietary_name":"glydo","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"JELLY","route":"TOPICAL","strength":"20 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 SYRINGE in 1 CARTON (25021-673-77) / 11 mL in 1 SYRINGE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.51624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Glydo|Lidocaine HCl","basis":"brand"},"part_b":null}, {"ndc":"00597018230","name":"GLYXAMBI 10 MG-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0182-30","proprietary_name":"Glyxambi","nonproprietary_name":"empagliflozin and linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0597-0182-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.24368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyxambi|Empagliflozin/Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597018239","name":"GLYXAMBI 10 MG-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0182-39","proprietary_name":"Glyxambi","nonproprietary_name":"empagliflozin and linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0597-0182-39) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.24368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyxambi|Empagliflozin/Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597018290","name":"GLYXAMBI 10 MG-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0182-90","proprietary_name":"Glyxambi","nonproprietary_name":"empagliflozin and linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0597-0182-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.24368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyxambi|Empagliflozin/Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597016430","name":"GLYXAMBI 25 MG-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0164-30","proprietary_name":"Glyxambi","nonproprietary_name":"empagliflozin and linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0597-0164-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.19937,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyxambi|Empagliflozin/Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597016439","name":"GLYXAMBI 25 MG-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0164-39","proprietary_name":"Glyxambi","nonproprietary_name":"empagliflozin and linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0597-0164-39) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.19937,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyxambi|Empagliflozin/Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597016490","name":"GLYXAMBI 25 MG-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0164-90","proprietary_name":"Glyxambi","nonproprietary_name":"empagliflozin and linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0597-0164-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.19937,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Glyxambi|Empagliflozin/Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"46122063078","name":"GNP 8 HOUR PAIN RELIEF 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-630-78","proprietary_name":"8 Hour Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-630-78) / 100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122063071","name":"GNP 8 HOUR PAIN RLF ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-630-71","proprietary_name":"8 Hour Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 PACKAGE (46122-630-71) / 50 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062962","name":"GNP 8HR ARTHRIT PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-629-62","proprietary_name":"8 Hour Arthritis Pain","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-629-62) / 24 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062971","name":"GNP 8HR ARTHRIT PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-629-71","proprietary_name":"8 Hour Arthritis Pain","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-629-71) / 50 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062981","name":"GNP 8HR ARTHRIT PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-629-81","proprietary_name":"8 Hour Arthritis Pain","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"200 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (46122-629-81)"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122074268","name":"GNP ACETAMINOPHEN-IBUPROFEN 250-125 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-742-68","proprietary_name":"Acetaminophen and Ibuprofen","nonproprietary_name":"Acetaminophen and Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1; 250 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"36 TABLET, FILM COATED in 1 CARTON (46122-742-68)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073565","name":"GNP ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-735-65","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-735-65) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073575","name":"GNP ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-735-75","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-735-75) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073763","name":"GNP ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-737-63","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-737-63) / 25 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073771","name":"GNP ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-737-71","proprietary_name":"Famotidine","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-737-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076836","name":"GNP ADAPALENE 0.1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-768-36","proprietary_name":"Adapalene","nonproprietary_name":"Adapalene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"AMERISOURCE BERGEN","package_description":"1 TUBE in 1 CARTON (46122-768-36) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.4655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122061363","name":"GNP ALL DAY ALLERGY 10 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-613-63","proprietary_name":"Cetirizine HCl","nonproprietary_name":"Cetirizine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-613-63) / 25 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.19613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122066062","name":"GNP ALLERGY MULTI-SYMPTOM CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-660-62","proprietary_name":"Allergy Multi Symptom","nonproprietary_name":"ACETAMINOPHEN, CHLORPHENIRAMINE MALEATE, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 2 mg/1; 5 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"2 BLISTER PACK in 1 CARTON (46122-660-62) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122046222","name":"GNP ALLERGY RELIEF 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122046261","name":"GNP ALLERGY RELIEF 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122046265","name":"GNP ALLERGY RELIEF 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122046275","name":"GNP ALLERGY RELIEF 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069962","name":"GNP ALLERGY RELIEF 25 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-699-62","proprietary_name":"Good Neighbor Allergy Relief","nonproprietary_name":"diphenhydramine hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"2 BLISTER PACK in 1 CARTON (46122-699-62) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122082851","name":"GNP ALLERGY RELIEF 25 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-828-51","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"2 BLISTER PACK in 1 CARTON (46122-828-51) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044162","name":"GNP ALLERGY RELIEF 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-441-62","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-441-62) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122061862","name":"GNP ALLERGY RELIEF 4 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-618-62","proprietary_name":"Allergy Relief","nonproprietary_name":"Chlorpheniramine maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-618-62) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122053105","name":"GNP ALLERGY RELIEF 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-531-05","proprietary_name":"Allergy Relief","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"1 BOTTLE in 1 CARTON (46122-531-05) / 35 TABLET, COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122053152","name":"GNP ALLERGY RELIEF 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122053161","name":"GNP ALLERGY RELIEF 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-531-61","proprietary_name":"Allergy Relief","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"1 BOTTLE in 1 CARTON (46122-531-61) / 80 TABLET, COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122068526","name":"GNP ALLERGY RELIEF 50 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-685-26","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/20mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-685-26) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122022575","name":"GNP ANTACID EX-STR 750 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-225-75","proprietary_name":"Good Neighbor Extra Strength Assorted Fruits","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (46122-225-75)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073853","name":"GNP ANTI-DIARRHEAL 2 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-738-53","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-738-53) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073862","name":"GNP ANTI-DIARRHEAL 2 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-738-62","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amerisource Bergen","package_description":"4 BLISTER PACK in 1 CARTON (46122-738-62) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062062","name":"GNP ANTI-DIARRHEAL-GAS CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-620-62","proprietary_name":"good neighbor pharmacy anti diarrheal anti gas","nonproprietary_name":"loperamide hydrochloride, simethicone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 125 mg/1","labeler":"Amerisource Bergen","package_description":"24 BLISTER PACK in 1 CARTON (46122-620-62) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]","Skin Barrier Activity [PE]"]},"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122066272","name":"GNP ANTI-GAS 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122080436","name":"GNP ANTI-ITCH 2%-0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-804-36","proprietary_name":"GNP Extra Strength Anti-Itch Cream","nonproprietary_name":"Diphenhydramine hydrochloride, Zinc acetate","dosage_form":"CREAM","route":"TOPICAL","strength":".1 g/100g; 2 g/100g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (46122-804-36) / 1 g in 1 TUBE","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122072926","name":"GNP ANTI-NAUSEA LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-729-26","proprietary_name":"Good Neighbor Anti Nausea Cherry Flavor","nonproprietary_name":"dextrose(glucose),Levulose(fructose),Phosphoric acid","dosage_form":"LIQUID","route":"ORAL","strength":"1.87 g/5mL; 1.87 g/5mL; 21.5 mg/5mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-729-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122062262","name":"GNP ANTIBACTRL-URINARY PAIN TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-622-62","proprietary_name":"Good Neighbor Antibacterial Plus Urinary Pain Relief","nonproprietary_name":"METHENAMINE, SODIUM SALICYLATE","dosage_form":"TABLET","route":"ORAL","strength":"162 mg/1; 162.5 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BLISTER PACK in 1 CARTON (46122-622-62) / 24 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.17591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122024403","name":"GNP ANTIBIOTIC-PAIN RELIEF CRM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-244-03","proprietary_name":"Good Neighbor Pharmacy Antibiotic and Pain Relief","nonproprietary_name":"Neomycin, Polymyxin B, Pramoxine HCl","dosage_form":"CREAM","route":"TOPICAL","strength":"3.5 mg/g; 10 mg/g; 10000 [USP'U]/g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (46122-244-03) / 28 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.09714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122013743","name":"GNP ANTISEPTIC SKIN CLEANSR 4%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-137-43","proprietary_name":"Antiseptic Skin Cleanser","nonproprietary_name":"Chlorhexidine Gluconate 4%","dosage_form":"LIQUID","route":"TOPICAL","strength":"4 mg/100mL","labeler":"AmerisourceBergen Drug Corporation","package_description":"473 mL in 1 BOTTLE (46122-137-43)","pharm_classes":["Decreased Cell Wall Integrity [PE]"]},"nadac":{"value":0.01776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122071321","name":"GNP ARTHRITIS 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.0344,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122069178","name":"GNP ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-691-78","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Amerisource Bergen","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (46122-691-78)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122059848","name":"GNP ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-598-48","proprietary_name":"Aspirin 81","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-598-48) / 180 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122059887","name":"GNP ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-598-87","proprietary_name":"Aspirin 81","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Amerisource Bergen","package_description":"300 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (46122-598-87)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076158","name":"GNP ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-761-58","proprietary_name":"Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-761-58) / 120 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076161","name":"GNP ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-761-61","proprietary_name":"Low Dose Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-761-61) / 300 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079166","name":"GNP ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-791-66","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-791-66) / 120 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079167","name":"GNP ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-791-67","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-791-67) / 300 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385020501","name":"GNP ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-205-01","proprietary_name":"Good Neighbor Pharmacy Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-205-01) / 14.2 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385020503","name":"GNP ATHLETE'S FOOT 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-205-03","proprietary_name":"Good Neighbor Pharmacy Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-205-03) / 28.4 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122080929","name":"GNP CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-809-29","proprietary_name":"Calamine","nonproprietary_name":"Calamine","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/100mL; 80 mg/100mL","labeler":"AMERISOURCE BERGEN","package_description":"177 mL in 1 BOTTLE, PLASTIC (46122-809-29)"},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122074531","name":"GNP CALAMINE PLUS 8%-1% SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-745-31","proprietary_name":"Calamine Plus","nonproprietary_name":"Calamine Plus Pramoxine HCl","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":".345 mg/116g; 24.16 mg/116g; 2.72 mg/116g","labeler":"AmerisourceBergen Drug Corporation","package_description":"116 g in 1 CANISTER (46122-745-31)"},"nadac":{"value":0.04339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122075355","name":"GNP CAPSAICIN 0.025% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-753-55","proprietary_name":"Good Neighbor Capsaicin Heat Patch for Back","nonproprietary_name":"Capsaicin","dosage_form":"PATCH","route":"TOPICAL","strength":".025 g/100g","labeler":"Amerisource Bergen","package_description":"3 PATCH in 1 POUCH (46122-753-55) / 1 g in 1 PATCH"},"nadac":{"value":1.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069726","name":"GNP CHEST RUB","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-697-26","proprietary_name":"Good Neighbor Pharmacy Medicated Chest Rub","nonproprietary_name":"camphor, menthol, eucalyptus oil","dosage_form":"OINTMENT","route":"TOPICAL","strength":".012 g/g; .048 g/g; .026 g/g","labeler":"AMERISOURCE BERGEN","package_description":"113 g in 1 JAR (46122-697-26)"},"nadac":{"value":0.02637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122079851","name":"GNP CHILD ALLERGY 12.5 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"46122-798-51","proprietary_name":"GOOD NEIGHBOR PHARMACY Childrens Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"12.5 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"2 BLISTER PACK in 1 CARTON (46122-798-51) / 10 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-24","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079329","name":"GNP CHILD ALLERGY 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-793-29","proprietary_name":"Good NeighborChildrens Allergy Relief Bubblegum flavor","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-793-29) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078629","name":"GNP CHILD CGH RLF 5-100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-786-29","proprietary_name":"Good Neighbor Childrens Cough Relief Cherry Flavor","nonproprietary_name":"DEXTROMETHORPHAN HYDROBROMIDE AND GUAIFENESIN","dosage_form":"LIQUID","route":"ORAL","strength":"5 mg/5mL; 100 mg/5mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-786-29) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122081329","name":"GNP CHILD COLD AND COUGH LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-813-29","proprietary_name":"good neighbor pharmacy childrens cold and cough","nonproprietary_name":"brompheniramine maleate, dextromethorphan hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-813-29) / 118 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078734","name":"GNP CHILD LORATADINE 5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-787-34","proprietary_name":"good neighbor pharmacy childrens loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-787-34) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122042462","name":"GNP CHILD PAIN RELIEF 160 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-424-62","proprietary_name":"Pain Relief Childrens","nonproprietary_name":"acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1","labeler":"Amerisource Bergen","package_description":"4 BLISTER PACK in 1 CARTON (46122-424-62) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.11643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122080529","name":"GNP CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-805-29","proprietary_name":"good neighbor pharmacy clearlax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Amerisource Bergen","package_description":"238 g in 1 BOTTLE (46122-805-29)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122041562","name":"GNP COLD HEAD CONGST SEVR CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-415-62","proprietary_name":"Cold Head Congestion Severe","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"AmeriSource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-415-62) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122041162","name":"GNP COLD MAX DAY-NIGHT CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-411-62","proprietary_name":"Cold Max Day and Night","nonproprietary_name":"Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, and Phenylephrine Hydrochloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"AmeriSource Bergen","package_description":"1 KIT in 1 CARTON (46122-411-62) * 12 TABLET, COATED in 1 BLISTER PACK * 8 TABLET, COATED in 1 BLISTER PACK"},"nadac":{"value":0.1202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122041062","name":"GNP COLD MAX DAYTIME CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-410-62","proprietary_name":"Cold Max","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1; 325 mg/1; 10 mg/1","labeler":"AmeriSource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-410-62) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122041862","name":"GNP COLD-FLU SEVERE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-418-62","proprietary_name":"Cold Flu Severe","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"AmeriSource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-418-62) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122074327","name":"GNP COOL-HEAT APPLICATOR LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.04193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122052623","name":"GNP CORN REMOVER 40% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-526-23","proprietary_name":"Salicylic Acid","nonproprietary_name":"Medicated Corn Removers","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/91","labeler":"AmerisourceBergen Drug Corporation","package_description":"9 PATCH in 1 PACKAGE (46122-526-23)"},"nadac":{"value":0.10249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122070573","name":"GNP COUGH-COLD HBP TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-705-73","proprietary_name":"Cough and Cold HBP","nonproprietary_name":"Chlorpheniramine maleate, Dextromethorphan HBr","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1; 30 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-705-73) / 8 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385000534","name":"GNP DAY TIME COLD-FLU LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-005-34","proprietary_name":"Good Neighbor Pharmacy Day Time","nonproprietary_name":"acetaminophen, dextromethorphan Hbr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"325 mg/15mL; 10 mg/15mL; 5 mg/15mL","labeler":"Amerisource Bergen","package_description":"237 mL in 1 BOTTLE (24385-005-34)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.01374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122075237","name":"GNP DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-752-37","proprietary_name":"Arthritis Pain Reliever","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 TUBE in 1 CARTON (46122-752-37) / 50 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.11749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122075252","name":"GNP DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-752-52","proprietary_name":"Arthritis Pain Reliever","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 TUBE in 1 CARTON (46122-752-52) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122075253","name":"GNP DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-752-53","proprietary_name":"Arthritis Pain Reliever","nonproprietary_name":"Diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 TUBE in 1 CARTON (46122-752-53) / 150 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122080036","name":"GNP DOCOSANOL 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-800-36","proprietary_name":"DOCOSANOL","nonproprietary_name":"DOCOSANOL","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 PACKAGE (46122-800-36) / 2 g in 1 TUBE"},"nadac":{"value":5.79261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122060505","name":"GNP DRY EYE RELIEF EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.16867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122081861","name":"GNP DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-818-61","proprietary_name":"Acetaminophen and Ibuprofen","nonproprietary_name":"Acetaminophen and Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1; 250 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-818-61) / 80 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122034563","name":"GNP DUAL ACTN COMPLETE TB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-345-63","proprietary_name":"Good Neighbor Pharmacy Dual Action Complete","nonproprietary_name":"famotidine, calcium carbonate and magnesium hydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1; 800 mg/1; 165 mg/1","labeler":"Amerisource Bergen","package_description":"25 TABLET, CHEWABLE in 1 BOTTLE (46122-345-63)","pharm_classes":["Calculi Dissolution Agent [EPC]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.2578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122064104","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-641-04","proprietary_name":"Good Neighbor Pharmacy Esomeprazole Magnesium","nonproprietary_name":"esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"3 BOTTLE in 1 CARTON (46122-641-04) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE (46122-641-63)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122064803","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122064804","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122064874","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073603","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-736-03","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"2 BOTTLE in 1 CARTON (46122-736-03) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073604","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-736-04","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"3 BOTTLE in 1 CARTON (46122-736-04) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073674","name":"GNP ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-736-74","proprietary_name":"Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-736-74) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122077958","name":"GNP FEXOFENADINE HCL 180 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-779-58","proprietary_name":"FEXOFENADINE HYDROCHLORIDE","nonproprietary_name":"FEXOFENADINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"3 BLISTER PACK in 1 CARTON (46122-779-58) / 5 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122077961","name":"GNP FEXOFENADINE HCL 180 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-779-61","proprietary_name":"FEXOFENADINE HYDROCHLORIDE","nonproprietary_name":"FEXOFENADINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-779-61) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122077966","name":"GNP FEXOFENADINE HCL 180 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-779-66","proprietary_name":"FEXOFENADINE HYDROCHLORIDE","nonproprietary_name":"FEXOFENADINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-779-66) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069465","name":"GNP FEXOFENADINE-PSE ER 60-120","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-694-65","proprietary_name":"Fexofenadine Hydrochloride and Pseudoephedrine Hydrochloride","nonproprietary_name":"Fexofenadine Hydrochloride and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 120 mg/1","labeler":"AmeriSource Bergen","package_description":"3 BLISTER PACK in 1 CARTON (46122-694-65) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.48321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122068429","name":"GNP FLUTICASONE PROP 50 MCG SP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-684-29","proprietary_name":"good neighbor pharmacy fluticasone propionate","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, SPRAY in 1 CARTON (46122-684-29) / 144 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122068435","name":"GNP FLUTICASONE PROP 50 MCG SP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-684-35","proprietary_name":"good neighbor pharmacy fluticasone propionate","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, SPRAY in 1 CARTON (46122-684-35) / 72 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.80745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122081108","name":"GNP GAS RELIEF 125 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-811-08","proprietary_name":"extra strength Gas Relief cherry creme","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"125 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-811-08) / 9 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385011878","name":"GNP GAS RLF(SIMETH) 80 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-118-78","proprietary_name":"GNP Regular Strength Gas Relief","nonproprietary_name":"DIMETHICONE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"80 mg/1","labeler":"Amerisource Bergen","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (24385-118-78)","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.0322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122060851","name":"GNP GENTLE LAXATIVE 10 MG SUPP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-608-51","proprietary_name":"Good Neighbor Pharmacy Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/2000mg","labeler":"AmerisourceBergen Drug Corp","package_description":"2 BLISTER PACK in 1 CARTON (46122-608-51) / 40 mg in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122052963","name":"GNP GENTLE LAXATIVE EC 5 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-529-63","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Amerisource Bergen","package_description":"1 BLISTER PACK in 1 CARTON (46122-529-63) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076711","name":"GNP GENTLE LAXATIVE EC 5 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-767-11","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Amerisource Bergen","package_description":"1 BLISTER PACK in 1 CARTON (46122-767-11) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069078","name":"GNP HEADACHE RELIEF CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-690-78","proprietary_name":"Headache Relief","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-690-78) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122067746","name":"GNP HEMORRHOIDAL OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-677-46","proprietary_name":"GNP Hemorrhoidal","nonproprietary_name":"Mineral oil, Petrolatum, Phenylephrine, HCL","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g; 749 mg/g; 140 mg/g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (46122-677-46) / 57 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122077637","name":"GNP HEMORRHOIDAL PAIN RLF CRM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-776-37","proprietary_name":"GNP Hemorrhoidal Maximum Strength","nonproprietary_name":"Hemorrhoidal","dosage_form":"CREAM","route":"TOPICAL","strength":"150 mg/g; 144 mg/g; 10 mg/g; 25 mg/g","labeler":"Amerisourcebergen Drug Corporation","package_description":"1 TUBE in 1 CARTON (46122-776-37) / 25.5 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122077765","name":"GNP HEMORRHOIDAL SUPPOSITORIES","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-777-65","proprietary_name":"Hemorrhoidal","nonproprietary_name":"Cocoa Butter, Phenylephrine HCl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2.39 g/1; 6.75 mg/1","labeler":"Amerisourcebergen Drug Corporation","package_description":"2 BLISTER PACK in 1 CARTON (46122-777-65) / 6 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122077334","name":"GNP HYDROGEN PEROXIDE 3% SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"46122-773-34","proprietary_name":"Hydrogen Peroxide","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"2.65 mL/100mL","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"473 mL in 1 BOTTLE, PLASTIC (46122-773-34)"},"nadac":{"value":0.01814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122061762","name":"GNP IBUPROFEN 100 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-617-62","proprietary_name":"Good Neighbor Pharmacy Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-617-62) / 24 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.1544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122063262","name":"GNP IBUPROFEN 100 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-632-62","proprietary_name":"good neighbor pharmacy childrens ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-632-62) / 24 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.1544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122059341","name":"GNP IBUPROFEN 200 MG MINI SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-593-41","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-593-41) / 80 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122059360","name":"GNP IBUPROFEN 200 MG MINI SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-593-60","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-593-60) / 20 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122058055","name":"GNP IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-580-55","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (46122-580-55)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122058058","name":"GNP IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-580-58","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"40 BOTTLE in 1 CARTON (46122-580-58) / 40 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122054890","name":"GNP IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-548-90","proprietary_name":"Good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (46122-548-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122070860","name":"GNP IBUPROFEN PM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-708-60","proprietary_name":"good neighbor pharmacy ibuprofen pm","nonproprietary_name":"diphenhydramine citrate, ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"38 mg/1; 200 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-708-60) / 20 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076434","name":"GNP INFANT PAIN-FEVER 160 MG/5","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-764-34","proprietary_name":"good neighbor pharmacy infants pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-764-34) / 60 mL in 1 BOTTLE"},"nadac":{"value":0.04059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122076534","name":"GNP INFANT PAIN-FEVER 160 MG/5","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-765-34","proprietary_name":"Good Neighbor Pharmacy Infants Pain and Fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-765-34) / 60 mL in 1 BOTTLE"},"nadac":{"value":0.04059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122033243","name":"GNP ISOPROPYL ALCOHOL 91%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.05372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122077234","name":"GNP ISOPROPYL ALCOHOL 91%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-772-34","proprietary_name":"Isopropyl alcohol","nonproprietary_name":"Isopropyl alcohol","dosage_form":"LIQUID","route":"TOPICAL","strength":"91 mL/100mL","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"473 mL in 1 BOTTLE, PLASTIC (46122-772-34)"},"nadac":{"value":0.05372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122057246","name":"GNP ITCH RELIEF 2%-0.1% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-572-46","proprietary_name":"Good neighbor Pharmacy Itch Relief","nonproprietary_name":"Diphenhydramine HCl, Zinc Acetate","dosage_form":"SPRAY","route":"TOPICAL","strength":".1 g/100mL; 2 g/100mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"59 mL in 1 BOTTLE, SPRAY (46122-572-46)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122069804","name":"GNP LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-698-04","proprietary_name":"good neighbor pharmacy lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Amerisource Bergen","package_description":"3 BOTTLE in 1 CARTON (46122-698-04) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069874","name":"GNP LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-698-74","proprietary_name":"good neighbor pharmacy lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-698-74) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122074404","name":"GNP LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-744-04","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"3 BOTTLE in 1 CARTON (46122-744-04) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122074474","name":"GNP LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122075929","name":"GNP LICE KILLING SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-759-29","proprietary_name":"GNP Lice Killing","nonproprietary_name":"Piperonyl Butoxide, Pyrethrum Extract","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".33 g/100mL; 4 g/100mL","labeler":"AmerisourceBergen Drug Corporation","package_description":"1 BOTTLE in 1 CARTON (46122-759-29) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.04662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122061410","name":"GNP LIDOCAINE HCL 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-614-10","proprietary_name":"GNP Lidocaine Maximum Strength","nonproprietary_name":"Lidocaine HCl","dosage_form":"CREAM","route":"TOPICAL","strength":"4 g/100g","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-614-10) / 76.5 g in 1 BOTTLE, PLASTIC","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122082045","name":"GNP LIDOCAINE PAIN RLF 4% PTCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-820-45","proprietary_name":"Good Neighbor Pain Relief Patch With Lidocaine 4%","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Amerisource Bergen","package_description":"5 PATCH in 1 CARTON (46122-820-45) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122057421","name":"GNP LIDOCAINE-MENTHOL PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-574-21","proprietary_name":"Lidocaine Menthol Pain Relief","nonproprietary_name":"Lidocaine, Menthol","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g; 1 g/100g","labeler":"Amerisource Bergen","package_description":"5 PATCH in 1 POUCH (46122-574-21) / 8 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.95193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122053965","name":"GNP LORATADINE 10 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-539-65","proprietary_name":"Loratadine ODT","nonproprietary_name":"Loratadine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"3 BLISTER PACK in 1 CARTON (46122-539-65) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.52737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385047152","name":"GNP LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-471-52","proprietary_name":"good neighbor pharmacy loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"10 BLISTER PACK in 1 CARTON (24385-471-52) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385047161","name":"GNP LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-471-61","proprietary_name":"good neighbor pharmacy loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-471-61) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385047199","name":"GNP LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-471-99","proprietary_name":"good neighbor pharmacy loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-471-99) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122045514","name":"GNP LORATADINE-D 12 HR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-455-14","proprietary_name":"good neighbor pharmacy loratadine d","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Amerisource Bergen","package_description":"30 BLISTER PACK in 1 CARTON (46122-455-14) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122060705","name":"GNP LUBRICANT 0.4-0.3% EYE DRP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.36253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122075656","name":"GNP LUBRICANT 0.5% EYE DROP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-756-56","proprietary_name":"Good Neighbor Pharmacy Lubricant Eye Drops","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Amerisource Bergen Drug Corp.","package_description":"30 VIAL, SINGLE-USE in 1 BOX (46122-756-56) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.22679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122074038","name":"GNP MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-740-38","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Magnesium Citrate","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"AMERISOURCE BERGEN","package_description":"296 mL in 1 BOTTLE, PLASTIC (46122-740-38)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122074138","name":"GNP MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-741-38","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Magnesium Citrate","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"AMERISOURCE BERGEN","package_description":"296 mL in 1 BOTTLE, PLASTIC (46122-741-38)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122064513","name":"GNP MED RELIEF 3.1-6-10% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-645-13","proprietary_name":"Large Medicate Relief Patches","nonproprietary_name":"CAMPHOR, MENTHOL, METHYL SALICYLATE","dosage_form":"PATCH","route":"TOPICAL","strength":"3.1 g/100g; 6 g/100g; 10 g/100g","labeler":"Amerisource Bergen","package_description":"6 PATCH in 1 BOX (46122-645-13) / 9 g in 1 PATCH"},"nadac":{"value":0.66456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122080329","name":"GNP MENTHOL 4% GEL ROLL-ON","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-803-29","proprietary_name":"Good Neighbor Roll-on Menthol Pain Relief Gel","nonproprietary_name":"Menthol","dosage_form":"GEL","route":"TOPICAL","strength":"4 g/mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (46122-803-29) / 74 mL in 1 BOTTLE, WITH APPLICATOR"},"nadac":{"value":0.0593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122057702","name":"GNP MICONAZOLE 1 COMBO PACK","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-577-02","proprietary_name":"Good Neighbor Pharmacy Miconazole 1","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Amerisource Bergen","package_description":"1 KIT in 1 CARTON (46122-577-02) * 1 SUPPOSITORY in 1 POUCH * 9 g in 1 TUBE"},"nadac":{"value":11.54805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044427","name":"GNP MICONAZORB AF 2% POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.05789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122078929","name":"GNP MICONAZORB AF 2% POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-789-29","proprietary_name":"Miconazorb AF","nonproprietary_name":"Miconazole Nitrate","dosage_form":"POWDER","route":"TOPICAL","strength":"20 mg/g","labeler":"AmerisourceBergen Drug Corporation","package_description":"71 g in 1 BOTTLE, PLASTIC (46122-789-29)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.05789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122077451","name":"GNP MOTION SICKNESS 25 MG CHWTB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-774-51","proprietary_name":"Motion Sickness Relief","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-774-51) / 8 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122081761","name":"GNP MUCUS DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-817-61","proprietary_name":"GOOD NEIGHBOR PHARMACY MUCUS DM","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1; 600 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-817-61) / 20 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122063703","name":"GNP MUCUS DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-637-03","proprietary_name":"good neighbor pharmacy mucus dm","nonproprietary_name":"dextromethorphan HBr, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 60 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-637-03) / 28 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122063774","name":"GNP MUCUS DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-637-74","proprietary_name":"good neighbor pharmacy mucus dm","nonproprietary_name":"dextromethorphan HBr, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 60 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-637-74) / 14 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122081404","name":"GNP MUCUS ER 1,200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-814-04","proprietary_name":"Good Neighbor Pharmacy Mucus ER","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-814-04) / 7 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122075051","name":"GNP MUCUS ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-750-51","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"2 BLISTER PACK in 1 CARTON (46122-750-51) / 10 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385060265","name":"GNP MUCUS RELIEF 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-602-65","proprietary_name":"Good Neighbor Pharmacy Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (24385-602-65)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079461","name":"GNP MUCUS RELIEF 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-794-61","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-794-61) / 50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122070071","name":"GNP MUCUS RELIEF PE 400-10 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-700-71","proprietary_name":"GNP Mucus Relief PE","nonproprietary_name":"Guaifenesin/phenylephrine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 10 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BOTTLE in 1 CARTON (46122-700-71) / 50 TABLET in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079061","name":"GNP MUCUS RLF DM 20-400 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-790-61","proprietary_name":"Mucus Relief DM Cough","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-790-61) / 50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071260","name":"GNP MUCUS RLF SINUS CONG PAIN","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-712-60","proprietary_name":"Mucus Relief Sinus Severe Congestion and Pain","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"2 BLISTER PACK in 1 CARTON (46122-712-60) / 10 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122068374","name":"GNP MUCUS-ER MAX 1,200 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122081636","name":"GNP MUSCLE RUB 4-10-30% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-816-36","proprietary_name":"Good Neighbor Muscle Rub Cream","nonproprietary_name":"Camphor 4.0%, Menthol 10.0%, Methyl Salicylate 30.0%,","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g; 40 mg/g; 300 mg/g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (46122-816-36) / 113 g in 1 TUBE"},"nadac":{"value":0.03595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122081271","name":"GNP NALOXONE HCL 4 MG NASAL SP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-812-71","proprietary_name":"NALOXONE HYDROCHLORIDE","nonproprietary_name":"naloxone hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"AMERISOURCE BERGEN","package_description":"2 VIAL, SINGLE-DOSE in 1 CARTON (46122-812-71) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056471","name":"GNP NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-564-71","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-564-71) / 50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056478","name":"GNP NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-564-78","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-564-78) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056481","name":"GNP NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-564-81","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Amerisource Bergen","package_description":"200 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (46122-564-81)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056258","name":"GNP NAPROXEN SOD 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-562-58","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-562-58) / 24 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056271","name":"GNP NAPROXEN SOD 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-562-71","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-562-71) / 50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122078064","name":"GNP NAPROXEN SODIUM 220 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-780-64","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"220 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-780-64) / 20 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.14941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122065068","name":"GNP NASAL DECONG PE 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122042861","name":"GNP NASAL DECONGEST 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-428-61","proprietary_name":"Nasal Decongestant Maximum Strength, Non-Drowsy","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Amerisource Bergen","package_description":"4 BLISTER PACK in 1 CARTON (46122-428-61) / 24 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385005461","name":"GNP NASAL DECONGEST ER 120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-054-61","proprietary_name":"good neighbor pharmacy nasal decongestant","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Amerisource Bergen","package_description":"20 BLISTER PACK in 1 CARTON (24385-054-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122028460","name":"GNP NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044858","name":"GNP NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-448-58","proprietary_name":"Nicotine Polacrilex coated ice mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"40 BLISTER PACK in 1 CARTON (46122-448-58) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071760","name":"GNP NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-717-60","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"20 BLISTER PACK in 1 CARTON (46122-717-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071960","name":"GNP NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-719-60","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"20 BLISTER PACK in 1 CARTON (46122-719-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122072425","name":"GNP NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-724-25","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"110 BLISTER PACK in 1 CARTON (46122-724-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073408","name":"GNP NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-734-08","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"3 BOTTLE, PLASTIC in 1 BOX (46122-734-08) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073462","name":"GNP NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-734-62","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"24 LOZENGE in 1 BOTTLE, PLASTIC (46122-734-62)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122066315","name":"GNP NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071560","name":"GNP NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-715-60","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-715-60) / 20 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073115","name":"GNP NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-731-15","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"3 BOTTLE, PLASTIC in 1 BOX (46122-731-15) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073116","name":"GNP NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-731-16","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-731-16) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056803","name":"GNP NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-568-03","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"AmerisourceBergen Drug Corporation","package_description":"28 POUCH in 1 CARTON (46122-568-03) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056807","name":"GNP NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-568-07","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"AmerisourceBergen Drug Corporation","package_description":"7 POUCH in 1 CARTON (46122-568-07) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044958","name":"GNP NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-449-58","proprietary_name":"Nicotine Polacrilex coated ice mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"40 BLISTER PACK in 1 CARTON (46122-449-58) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122066678","name":"GNP NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071860","name":"GNP NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-718-60","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"20 BLISTER PACK in 1 CARTON (46122-718-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122072025","name":"GNP NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-720-25","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"110 BLISTER PACK in 1 CARTON (46122-720-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122072571","name":"GNP NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-725-71","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"50 BLISTER PACK in 1 CARTON (46122-725-71) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073360","name":"GNP NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-733-60","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"20 BLISTER PACK in 1 CARTON (46122-733-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073208","name":"GNP NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-732-08","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"3 BOTTLE, PLASTIC in 1 BOX (46122-732-08) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073262","name":"GNP NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-732-62","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-732-62) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122066515","name":"GNP NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071615","name":"GNP NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-716-15","proprietary_name":"Mini Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"3 BOTTLE, PLASTIC in 1 BOX (46122-716-15) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071660","name":"GNP NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-716-60","proprietary_name":"Mini Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-716-60) / 20 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122078815","name":"GNP NIGHTTIME SLEEP 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-788-15","proprietary_name":"Nighttime Sleep Aid","nonproprietary_name":"Doxylamine Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-788-15) / 16 TABLET in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069572","name":"GNP NIGHTTIME SLEEP AID 50 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122077564","name":"GNP NIGHTTIME SLEEP AID 50 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-775-64","proprietary_name":"Nighttime Sleep-Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"50 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-775-64) / 60 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079235","name":"GNP NO DRIP NASAL MIST 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-792-35","proprietary_name":"Good Neighbor No Drip Nasal Mist Extra Moisturizing","nonproprietary_name":"Oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, SPRAY in 1 CARTON (46122-792-35) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.09967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122079635","name":"GNP NO DRIP NASAL MIST 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-796-35","proprietary_name":"GOOD NEIGHBOR PHARMACY No Drip Nasal Mist","nonproprietary_name":"Oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, SPRAY in 1 CARTON (46122-796-35) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.09967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122067264","name":"GNP OLOPATADINE 0.1% EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-672-64","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-672-64) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122067127","name":"GNP OLOPATADINE 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-671-27","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-671-27) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122073903","name":"GNP OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073904","name":"GNP OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-739-04","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"3 BOTTLE in 1 CARTON (46122-739-04) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122073974","name":"GNP OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-739-74","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"1 BOTTLE in 1 CARTON (46122-739-74) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122075145","name":"GNP PAIN RELIEF 5% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-751-45","proprietary_name":"Good Neighbor Pharmacy Cold Therapy Pain Relief Patch","nonproprietary_name":"Menthol","dosage_form":"PATCH","route":"TOPICAL","strength":"5 g/100g","labeler":"Amerisource Bergen","package_description":"5 PATCH in 1 CARTON (46122-751-45) / 1 g in 1 PATCH"},"nadac":{"value":1.02295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385048447","name":"GNP PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-484-47","proprietary_name":"Good Neighbor Pharmacy Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-484-47) / 150 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385048471","name":"GNP PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-484-71","proprietary_name":"Good Neighbor Pharmacy Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-484-71) / 50 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385048478","name":"GNP PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-484-78","proprietary_name":"Good Neighbor Pharmacy Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-484-78) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385048490","name":"GNP PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-484-90","proprietary_name":"Good Neighbor Pharmacy Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"500 TABLET in 1 BOTTLE (24385-484-90)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122031270","name":"GNP PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-312-70","proprietary_name":"Good Neighbor Pharmacy Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"225 TABLET, FILM COATED in 1 BOTTLE (46122-312-70)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122031278","name":"GNP PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-312-78","proprietary_name":"Good Neighbor Pharmacy Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-312-78) / 100 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069662","name":"GNP PAIN RELIEF 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-696-62","proprietary_name":"Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-696-62) / 24 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122071426","name":"GNP PETROLEUM JELLY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-714-26","proprietary_name":"Good Neighbor Petroleum Jelly","nonproprietary_name":"White Petrolatum","dosage_form":"JELLY","route":"TOPICAL","strength":"100 g/100g","labeler":"AmerisourceBergen","package_description":"113 g in 1 JAR (46122-714-26)"},"nadac":{"value":0.01009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122071427","name":"GNP PETROLEUM JELLY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-714-27","proprietary_name":"Good Neighbor Petroleum Jelly","nonproprietary_name":"White Petrolatum","dosage_form":"JELLY","route":"TOPICAL","strength":"100 g/100g","labeler":"AmerisourceBergen","package_description":"368 g in 1 JAR (46122-714-27)"},"nadac":{"value":0.00816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122070165","name":"GNP PINK BISMUTH 262 MG TB CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-701-65","proprietary_name":"GNP Pink Bismuth","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"262 mg/1","labeler":"Amerisource Bergen","package_description":"5 BLISTER PACK in 1 BOX (46122-701-65) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.08166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122074706","name":"GNP PINK BISMUTH 525 MG/15 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-747-06","proprietary_name":"Good Neighbor Ultra Strength Stomach Relief","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"SUSPENSION","route":"ORAL","strength":"525 mg/15mL","labeler":"AMERISOURCE BERGEN","package_description":"236 mL in 1 BOTTLE (46122-747-06)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122079969","name":"GNP PM PAIN RLF 25-500 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-799-69","proprietary_name":"Extra Strength PM Pain Medicine","nonproprietary_name":"Acetaminophen, Diphenhydramine HCl","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-799-69) / 50 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122079970","name":"GNP PM PAIN RLF 25-500 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-799-70","proprietary_name":"Extra Strength PM Pain Medicine","nonproprietary_name":"Acetaminophen, Diphenhydramine HCl","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"Amerisource Bergen","package_description":"100 TABLET in 1 BOTTLE (46122-799-70)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385005355","name":"GNP POVIDONE-IODINE 10% SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-053-55","proprietary_name":"Povidone Iodine","nonproprietary_name":"povidone-iodine","dosage_form":"SOLUTION","route":"TOPICAL","strength":".1 g/mL","labeler":"Amerisource Bergen","package_description":"236 mL in 1 BOTTLE (24385-053-55)"},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122080829","name":"GNP POVIDONE-IODINE 10% SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-808-29","proprietary_name":"First Aid Antiseptic","nonproprietary_name":"First Aid Antiseptic","dosage_form":"SOLUTION","route":"TOPICAL","strength":"10 mg/100mL","labeler":"Amerisource Bergen","package_description":"236 mL in 1 BOTTLE, PLASTIC (46122-808-29)"},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122060605","name":"GNP REDNESS RELIEF EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.10358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122070278","name":"GNP SENNA LAX 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-702-78","proprietary_name":"Senna","nonproprietary_name":"Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-702-78) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062572","name":"GNP SENNA PLUS 8.6-50 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-625-72","proprietary_name":"Senna Plus","nonproprietary_name":"Docusate Sodium, Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-625-72) / 60 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122044362","name":"GNP SINUS PRESSURE-PAIN CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-443-62","proprietary_name":"Sinus Pressure Pain Maximum Strength, Non-Drowsy","nonproprietary_name":"Acetaminophen, Phenylephrine HCl","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1; 5 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-443-62) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122041262","name":"GNP SINUS SEVERE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-412-62","proprietary_name":"Sinus Severe","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"AmeriSource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-412-62) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122065862","name":"GNP SINUS-HEADACHE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122065162","name":"GNP SLEEP AID 25 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-651-62","proprietary_name":"Sleep Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-651-62) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122065178","name":"GNP SLEEP AID 25 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122075429","name":"GNP SLEEP AID 50 MG/30 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-754-29","proprietary_name":"Sleep Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/30mL","labeler":"Amerisource Bergen","package_description":"355 mL in 1 BOTTLE, PLASTIC (46122-754-29)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.00864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122074876","name":"GNP SORE THROAT 1.4% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-748-76","proprietary_name":"Good Neighbor Sore Throat Cherry Flavor","nonproprietary_name":"Phenol","dosage_form":"SPRAY","route":"ORAL","strength":"1.4 g/100mL","labeler":"AMERISOURCE BERGEN","package_description":"177 mL in 1 BOTTLE, SPRAY (46122-748-76)"},"nadac":{"value":0.01244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122074976","name":"GNP SORE THROAT 1.4% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-749-76","proprietary_name":"ABC Sore Throat Menthol Flavor","nonproprietary_name":"Phenol","dosage_form":"SPRAY","route":"ORAL","strength":"1.4 g/100mL","labeler":"AMERISOURCE BERGEN","package_description":"177 mL in 1 BOTTLE, SPRAY (46122-749-76)"},"nadac":{"value":0.01244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122070326","name":"GNP STOMACH RLF 525 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-703-26","proprietary_name":"GNP Stomach Relief","nonproprietary_name":"Bismuth subsalicylate 525 mg","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/30mL","labeler":"Amerisource Bergen","package_description":"118 mL in 1 BOTTLE (46122-703-26)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122069272","name":"GNP STOOL SOFTENER 100 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-692-72","proprietary_name":"Good Neighbor Stool Softener","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BOTTLE in 1 CARTON (46122-692-72) / 60 CAPSULE, LIQUID FILLED in 1 BOTTLE"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069278","name":"GNP STOOL SOFTENER 100 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-692-78","proprietary_name":"Good Neighbor Stool Softener","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (46122-692-78)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069285","name":"GNP STOOL SOFTENER 100 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-692-85","proprietary_name":"Good Neighbor Stool Softener","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"250 CAPSULE, LIQUID FILLED in 1 BOTTLE (46122-692-85)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122069378","name":"GNP STOOL SOFTENER 250 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-693-78","proprietary_name":"Good Neighbor Stool Softener laxative","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (46122-693-78)"},"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122082674","name":"GNP STOOL SOFTENER 250 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-826-74","proprietary_name":"Stool Softener","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Amerisource Bergen","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (46122-826-74)"},"nadac":{"value":0.0523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122066978","name":"GNP STOOL SOFTENER-STIM LAX TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-669-78","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"docusate sodium and sennosides","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (46122-669-78)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122070426","name":"GNP TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-704-26","proprietary_name":"good neighbor pharmacy adult tussin DM","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-704-26) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122070434","name":"GNP TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-704-34","proprietary_name":"good neighbor pharmacy adult tussin DM","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-704-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078229","name":"GNP TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-782-29","proprietary_name":"Good Neighbor Sugar Free Adult Tussin DM Cough and Chest Congestion","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-782-29) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078234","name":"GNP TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-782-34","proprietary_name":"Good Neighbor Sugar Free Adult Tussin DM Cough and Chest Congestion","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-782-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078334","name":"GNP TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-783-34","proprietary_name":"Good Neighbor Dye Free Adult Tussin DM Cough and Chest Congestion","nonproprietary_name":"dextromethorphan hydrobromide and guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-783-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122054134","name":"GNP TUSSIN DM MAX LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-541-34","proprietary_name":"good neighbor pharmacy tussin dm max","nonproprietary_name":"Dextromethorphan Hydrobromide, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-541-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078429","name":"GNP TUSSIN LONG-ACTING LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-784-29","proprietary_name":"Good Neighbor Long Acting Cough Adult Tussin","nonproprietary_name":"Dextromethorphan HBr","dosage_form":"LIQUID","route":"ORAL","strength":"30 mg/10mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE, PLASTIC in 1 BOX (46122-784-29) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078529","name":"GNP TUSSIN MUCUS-CON 200 MG/10","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-785-29","proprietary_name":"Good Neighbor Adult Tussin Mucus and chest congestion","nonproprietary_name":"Guaifenesin","dosage_form":"SYRUP","route":"ORAL","strength":"200 mg/10mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-785-29) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122078534","name":"GNP TUSSIN MUCUS-CON 200 MG/10","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-785-34","proprietary_name":"Good Neighbor Adult Tussin Mucus and chest congestion","nonproprietary_name":"Guaifenesin","dosage_form":"SYRUP","route":"ORAL","strength":"200 mg/10mL","labeler":"AMERISOURCE BERGEN","package_description":"1 BOTTLE in 1 CARTON (46122-785-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122062853","name":"GNP URINARY PAIN RLF 99.5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-628-53","proprietary_name":"Good Neighbor Maximum Strength Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"99.5 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BLISTER PACK in 1 CARTON (46122-628-53) / 12 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.18404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122062862","name":"GNP URINARY PAIN RLF 99.5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-628-62","proprietary_name":"Good Neighbor Maximum Strength Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"99.5 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BLISTER PACK in 1 CARTON (46122-628-62) / 24 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.18404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122076229","name":"GNP VAPOR STEAM 6.2% LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-762-29","proprietary_name":"GNP Vapor Steam camphor (synthetic)","nonproprietary_name":"camphor (synthetic)","dosage_form":"LIQUID","route":"RESPIRATORY (INHALATION)","strength":".062 g/mL","labeler":"AmerisourceBergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-762-29) / 237 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.01884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122033543","name":"GNP WITCH HAZEL 86% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-335-43","proprietary_name":"GNP Witch Hazel","nonproprietary_name":"Witch Hazel","dosage_form":"LIQUID","route":"TOPICAL","strength":"855 mg/mL","labeler":"Amerisource Bergen","package_description":"473 mL in 1 BOTTLE (46122-335-43)"},"nadac":{"value":0.00761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122067646","name":"GNP ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-676-46","proprietary_name":"Good Neighbor Pharmacy Skin Protectant","nonproprietary_name":"Zinc Oxide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".2 g/g","labeler":"AMERISOURCE BERGEN","package_description":"1 TUBE in 1 CARTON (46122-676-46) / 57 g in 1 TUBE"},"nadac":{"value":0.03636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24338023601","name":"GOLYTELY SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24338-236-01","proprietary_name":"GoLYTELY","nonproprietary_name":"Polyethylene Glycol 3350, Sodium Sulfate Anhydrous, Sodium Bicarbonate, Sodium Chloride, Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"236 g/4L; 22.74 g/4L; 6.74 g/4L; 5.86 g/4L; 2.97 g/4L","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"4 L in 1 BOTTLE, PLASTIC (24338-236-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00597,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.00465,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Golytely|PEG3350/Sod Sulf,Bicarb,Cl/KCl","basis":"brand"},"part_b":null}, {"ndc":"52268010001","name":"GOLYTELY SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52268-100-01","proprietary_name":"GoLYTELY","nonproprietary_name":"Polyethylene Glycol 3350, Sodium Sulfate Anhydrous, Sodium Bicarbonate, Sodium Chloride, Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"236 g/4L; 22.74 g/4L; 6.74 g/4L; 5.86 g/4L; 2.97 g/4L","labeler":"Braintree Laboratories, Inc.","package_description":"4 L in 1 BOTTLE, PLASTIC (52268-100-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00597,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.00465,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Golytely|PEG3350/Sod Sulf,Bicarb,Cl/KCl","basis":"brand"},"part_b":null}, {"ndc":"52427080390","name":"GRALISE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-803-90","proprietary_name":"Gralise","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Almatica Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (52427-803-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.18511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.63846,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52427080460","name":"GRALISE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52427-804-60","proprietary_name":"Gralise","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Almatica Pharma LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (52427-804-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.14274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52427080690","name":"GRALISE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-806-90","proprietary_name":"Gralise","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Almatica Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (52427-806-90)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.15306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.02497,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52427089060","name":"GRALISE ER 900 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-890-60","proprietary_name":"Gralise","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"900 mg/1","labeler":"Almatica Pharma LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (52427-890-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":15.20748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991073520","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-735-20","proprietary_name":"Granisetron Hydrochloride","nonproprietary_name":"Granisetron Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (51991-735-20) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0166","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0166 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 BLISTER PACK in 1 CARTON (51991-735-20) / 10 TABLET in 1 BLISTER PACK) gives 20 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51991073532","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-735-32","proprietary_name":"Granisetron Hydrochloride","nonproprietary_name":"Granisetron Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51991-735-32) / 2 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0166","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0166 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (51991-735-32) / 2 TABLET in 1 BLISTER PACK) gives 2 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51991073599","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452035001","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-350-01","proprietary_name":"Granisetron Hydrochloride","nonproprietary_name":"Granisetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Bionpharma Inc.","package_description":"2 BLISTER PACK in 1 CARTON (69452-350-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452035011","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-350-11","proprietary_name":"Granisetron Hydrochloride","nonproprietary_name":"Granisetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Bionpharma Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-350-11)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452035060","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452035092","name":"GRANISETRON HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-350-92","proprietary_name":"Granisetron Hydrochloride","nonproprietary_name":"Granisetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Bionpharma Inc.","package_description":"2 BLISTER PACK in 1 CARTON (69452-350-92) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":1.30504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52709150101","name":"GRASTEK 2,800 BAU SL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Grastek|Grass Pollen-Timothy, Standard","basis":"brand"},"part_b":null}, {"ndc":"52709150103","name":"GRASTEK 2,800 BAU SL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Grastek|Grass Pollen-Timothy, Standard","basis":"brand"},"part_b":null}, {"ndc":"00472001304","name":"GRISEOFULVIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0013-04","proprietary_name":"Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Actavis Pharma, Inc.","package_description":"120 mL in 1 BOTTLE (0472-0013-04)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":0.25215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713085004","name":"GRISEOFULVIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0850-04","proprietary_name":"Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"118 mL in 1 BOTTLE, PLASTIC (0713-0850-04)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":0.39132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135096841","name":"GRISEOFULVIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-968-41","proprietary_name":"Griseofulvin","nonproprietary_name":"Griseofulvin (microsize)","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Chartwell RX, LLC.","package_description":"120 mL in 1 BOTTLE (62135-968-41)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":0.25215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69097036108","name":"GRISEOFULVIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-361-08","proprietary_name":"grisofulvin","nonproprietary_name":"grisofulvin","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Cipla USA Inc.","package_description":"120 mL in 1 BOTTLE (69097-361-08)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":0.25215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781551501","name":"GRISEOFULVIN MICRO 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5515-01","proprietary_name":"Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0781-5515-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":5.84687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155086501","name":"GRISEOFULVIN MICRO 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-865-01","proprietary_name":"GRISEOFULVIN MICROSIZE","nonproprietary_name":"griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc d/b/a Avet Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23155-865-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":5.84687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42794001208","name":"GRISEOFULVIN MICRO 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-012-08","proprietary_name":"Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (42794-012-08)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":5.84687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135049601","name":"GRISEOFULVIN MICRO 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-496-01","proprietary_name":"Griseofulvin MICROSIZE","nonproprietary_name":"griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE (62135-496-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":5.84687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135049630","name":"GRISEOFULVIN MICRO 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-496-30","proprietary_name":"Griseofulvin MICROSIZE","nonproprietary_name":"griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET in 1 BOTTLE (62135-496-30)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":5.84687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115172401","name":"GRISEOFULVIN ULTRA 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1724-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Ultramicrosize Griseofulvin Tablets","dosage_form":"TABLET, COATED","route":"ORAL","strength":"125 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (0115-1724-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":2.65182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781582701","name":"GRISEOFULVIN ULTRA 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5827-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Ultramicrosize Griseofulvin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"125 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, COATED in 1 BOTTLE (0781-5827-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":2.65182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155086301","name":"GRISEOFULVIN ULTRA 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-863-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Heritage Pharmaceuticals Inc d/b/a Avet Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23155-863-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":2.65182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42794001308","name":"GRISEOFULVIN ULTRA 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-013-08","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Ultramicrosize Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (42794-013-08)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":2.65182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135049401","name":"GRISEOFULVIN ULTRA 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-494-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (62135-494-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":2.65182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135049430","name":"GRISEOFULVIN ULTRA 125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-494-30","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (62135-494-30)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":2.65182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115172501","name":"GRISEOFULVIN ULTRA 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1725-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Ultramicrosize Griseofulvin Tablets","dosage_form":"TABLET, COATED","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (0115-1725-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":3.74144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781582801","name":"GRISEOFULVIN ULTRA 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5828-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Ultramicrosize Griseofulvin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, COATED in 1 BOTTLE (0781-5828-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":3.74144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155086401","name":"GRISEOFULVIN ULTRA 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-864-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc d/b/a Avet Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23155-864-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":3.74144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42794001408","name":"GRISEOFULVIN ULTRA 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-014-08","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Ultramicrosize Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (42794-014-08)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":3.74144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135049501","name":"GRISEOFULVIN ULTRA 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-495-01","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (62135-495-01)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":3.74144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135049530","name":"GRISEOFULVIN ULTRA 250 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-495-30","proprietary_name":"Ultramicrosize Griseofulvin","nonproprietary_name":"Griseofulvin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (62135-495-30)","pharm_classes":["Decreased Mitosis [PE]","Microtubule Inhibition [PE]","Tubulin Inhibiting Agent [EPC]"]},"nadac":{"value":3.74144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113002808","name":"GS 24 HOUR ALLERGY 50 MCG SPRY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0028-08","proprietary_name":"Good Sense 24 hour allergy nasal","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0113-0028-08) / 72 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.80745,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113002809","name":"GS 24 HOUR ALLERGY 50 MCG SPRY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0028-09","proprietary_name":"Good Sense 24 hour allergy nasal","nonproprietary_name":"Fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0113-0028-09) / 144 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113014165","name":"GS ACID REDUCER 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0141-65","proprietary_name":"good sense acid reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"30 BLISTER PACK in 1 CARTON (0113-0141-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113019402","name":"GS ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0194-02","proprietary_name":"Good Sense Acid Reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"25 BLISTER PACK in 1 CARTON (0113-0194-02) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113019471","name":"GS ACID REDUCER 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0194-71","proprietary_name":"Good Sense Acid Reducer","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0194-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113945839","name":"GS ALL DAY ALLERGY 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-9458-39","proprietary_name":"Good Sense all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-9458-39) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113945866","name":"GS ALL DAY ALLERGY 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-9458-66","proprietary_name":"Good Sense all day allergy","nonproprietary_name":"Cetirizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"14 BLISTER PACK in 1 CARTON (0113-9458-66) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113014762","name":"GS ALL DAY ALLERGY-D TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0147-62","proprietary_name":"good sense all day allergy d","nonproprietary_name":"Cetirizine hydrochloride, Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"L. Perrigo Company","package_description":"24 BLISTER PACK in 1 CARTON (0113-0147-62) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.56251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113084795","name":"GS ALLER-EASE 180 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0847-95","proprietary_name":"good sense aller ease","nonproprietary_name":"fexofenadine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0847-95) / 45 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113047962","name":"GS ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0479-62","proprietary_name":"good sense allergy relief","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"24 BLISTER PACK in 1 CARTON (0113-0479-62) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113047978","name":"GS ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0479-78","proprietary_name":"good sense allergy relief","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0479-78) / 100 TABLET in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113047979","name":"GS ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0479-79","proprietary_name":"good sense allergy relief","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"400 TABLET in 1 BOTTLE (0113-0479-79)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113061288","name":"GS ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0612-88","proprietary_name":"good sense allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0612-88) / 365 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113061239","name":"GS ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113061246","name":"GS ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0612-46","proprietary_name":"good sense allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"10 BLISTER PACK in 1 CARTON (0113-0612-46) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113061260","name":"GS ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113061265","name":"GS ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0612-65","proprietary_name":"good sense allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0612-65) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113061275","name":"GS ALLERGY RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0612-75","proprietary_name":"good sense allergy relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0612-75) / 90 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113164526","name":"GS ANTI-DIARRHEAL 1 MG/7.5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1645-26","proprietary_name":"Good Sense antidiarrheal","nonproprietary_name":"loperamide HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/7.5mL","labeler":"L. Perrigo Company","package_description":"120 mL in 1 BOTTLE (0113-1645-26)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.02644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113022453","name":"GS ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0224-53","proprietary_name":"Good Sense anti diarrheal","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"12 BLISTER PACK in 1 CARTON (0113-0224-53) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113022462","name":"GS ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0224-62","proprietary_name":"Good Sense anti diarrheal","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"24 BLISTER PACK in 1 CARTON (0113-0224-62) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113022491","name":"GS ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0224-91","proprietary_name":"Good Sense anti diarrheal","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"6 BLISTER PACK in 1 CARTON (0113-0224-91) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113008753","name":"GS ANTI-DIARRHEAL-ANTIGAS CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0087-53","proprietary_name":"good sense anti diarrheal anti gas","nonproprietary_name":"loperamide hydrochloride, simethicone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 125 mg/1","labeler":"L. Perrigo Company","package_description":"12 BLISTER PACK in 1 CARTON (0113-0087-53) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]","Skin Barrier Activity [PE]"]},"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113008762","name":"GS ANTI-DIARRHEAL-ANTIGAS CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0087-62","proprietary_name":"good sense anti diarrheal anti gas","nonproprietary_name":"loperamide hydrochloride, simethicone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 125 mg/1","labeler":"L. Perrigo Company","package_description":"24 BLISTER PACK in 1 CARTON (0113-0087-62) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]","Skin Barrier Activity [PE]"]},"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113054164","name":"GS ANTI-ITCH 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0541-64","proprietary_name":"good sense anti itch","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-0541-64) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113118901","name":"GS ARTHRITIS PAIN 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1189-01","proprietary_name":"good sense arthritis pain","nonproprietary_name":"diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-1189-01) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113118903","name":"GS ARTHRITIS PAIN 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1189-03","proprietary_name":"good sense arthritis pain","nonproprietary_name":"diclofenac sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"L. Perrigo Company","package_description":"150 g in 1 TUBE (0113-1189-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113817501","name":"GS ARTHRITIS PAIN 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8175-01","proprietary_name":"GOOD SENSE ARTHRITIS PAIN","nonproprietary_name":"DICLOFENAC SODIUM","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-8175-01) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113054478","name":"GS ARTHRITIS PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0544-78","proprietary_name":"good sense pain relief arthritis pain","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0544-78) / 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113027468","name":"GS ASPIRIN 81 MG CHEWABLE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0274-68","proprietary_name":"Good Sense aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0274-68) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113046708","name":"GS ASPIRIN 81 MG CHEWABLE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0467-08","proprietary_name":"good sense aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"L. Perrigo Company","package_description":"3 BOTTLE in 1 CARTON (0113-0467-08) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113046768","name":"GS ASPIRIN 81 MG CHEWABLE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0467-68","proprietary_name":"good sense aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0467-68) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113018926","name":"GS CHILD ALL DAY ALLER 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0189-26","proprietary_name":"Good Sense Childrens All Day Allergy","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0189-26) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113050326","name":"GS CHILD ALL DAY ALLER 1 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0503-26","proprietary_name":"Good Sense Childrens All Day Allergy","nonproprietary_name":"Cetirizine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0503-26) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113037926","name":"GS CHILD ALLERGY 12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0379-26","proprietary_name":"good sense allergy","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0379-26) / 118 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113067126","name":"GS CHILD ALLERGY RLF 5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0671-26","proprietary_name":"Good Sense childrens allergy relief","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0671-26) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113601926","name":"GS CHILD COLD AND COUGH LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-6019-26","proprietary_name":"good sense childrens cold cough","nonproprietary_name":"brompheniramine maleate, dextromethorphan hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-6019-26) / 118 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113060826","name":"GS CHILD FEVER-PAIN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0608-26","proprietary_name":"good sense childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0608-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113016626","name":"GS CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0166-26","proprietary_name":"good sense ibuprofen childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0166-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113016634","name":"GS CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0166-34","proprietary_name":"good sense ibuprofen childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0166-34) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113066026","name":"GS CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0660-26","proprietary_name":"Good Sense Ibuprofen Childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0660-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113068526","name":"GS CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0685-26","proprietary_name":"Good Sense Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0685-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113089726","name":"GS CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0897-26","proprietary_name":"good sense ibuprofen childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0897-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113089734","name":"GS CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0897-34","proprietary_name":"good sense ibuprofen childrens","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0897-34) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113002026","name":"GS CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0020-26","proprietary_name":"good sense childrens pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0020-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113021226","name":"GS CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0212-26","proprietary_name":"Good Sense Childrens Pain and Fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0212-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113895926","name":"GS CHILD PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8959-26","proprietary_name":"Good Sense Pain and Fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-8959-26) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113098726","name":"GS CHILDREN'S COLD-COUGH SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0987-26","proprietary_name":"Good Sense Childrens Cold and Cough","nonproprietary_name":"Brompheniramine maleate, Dextromethorphan HBr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/10mL; 10 mg/10mL; 5 mg/10mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0987-26) / 118 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113095821","name":"GS CHLD COUGH DM ER 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0958-21","proprietary_name":"Good Sense Cough DM","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0958-21) / 89 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.06641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113095828","name":"GS CHLD COUGH DM ER 30 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0958-28","proprietary_name":"Good Sense Cough DM","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0958-28) / 148 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.05255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113030601","name":"GS CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0306-01","proprietary_name":"Good Sense Clear Lax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"L. Perrigo Company","package_description":"119 g in 1 BOTTLE (0113-0306-01)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113030602","name":"GS CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0306-02","proprietary_name":"Good Sense Clear Lax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"L. Perrigo Company","package_description":"238 g in 1 BOTTLE (0113-0306-02)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113030603","name":"GS CLEARLAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0306-03","proprietary_name":"Good Sense Clear Lax","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"L. Perrigo Company","package_description":"510 g in 1 BOTTLE (0113-0306-03)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113038428","name":"GS COUGH DM ER 30 MG/5 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0384-28","proprietary_name":"good sense cough dm","nonproprietary_name":"dextromethorphan polistirex","dosage_form":"SUSPENSION","route":"ORAL","strength":"30 mg/5mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0384-28) / 148 mL in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.05255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113065634","name":"GS DAY TIME COLD-FLU LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0656-34","proprietary_name":"Good Sense Daytime non drowsy cold and flu","nonproprietary_name":"acetaminophen, dextromethorphan Hbr, Phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"325 mg/15mL; 10 mg/15mL; 5 mg/15mL","labeler":"L. Perrigo Company","package_description":"237 mL in 1 BOTTLE (0113-0656-34)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.01374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113003263","name":"GS DUAL ACTION COMPLETE TB CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0032-63","proprietary_name":"Good Sense Dual Action Complete","nonproprietary_name":"famotidine, calcium carbonate and magnesium hydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1; 800 mg/1; 165 mg/1","labeler":"L. Perrigo Company","package_description":"25 TABLET, CHEWABLE in 1 BOTTLE (0113-0032-63)","pharm_classes":["Calculi Dissolution Agent [EPC]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.2578,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113530016","name":"GS DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-5300-16","proprietary_name":"good sense dual action","nonproprietary_name":"Acetaminophen, Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"L Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-5300-16) / 144 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113530068","name":"GS DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-5300-68","proprietary_name":"good sense dual action","nonproprietary_name":"Acetaminophen, Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 125 mg/1","labeler":"L Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-5300-68) / 36 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113089801","name":"GS ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0898-01","proprietary_name":"Good Sense Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0898-01) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113089802","name":"GS ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0898-02","proprietary_name":"Good Sense Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"2 BOTTLE in 1 CARTON (0113-0898-02) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113089803","name":"GS ESOMEPRAZOLE MAG DR 20 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0898-03","proprietary_name":"Good Sense Esomeprazole Magnesium","nonproprietary_name":"Esomeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"3 BOTTLE in 1 CARTON (0113-0898-03) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.34596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113008464","name":"GS FIRST AID ANTIBIOTIC OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0084-64","proprietary_name":"Good Sense First Aid Antibiotic","nonproprietary_name":"bacitracin zinc, neomycin, polymyxin B","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-0084-64) / 28 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113065772","name":"GS GAS RELIEF 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0657-72","proprietary_name":"good sense gas relief","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"180 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0657-72) / 60 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113094424","name":"GS HEMORRHOIDAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0944-24","proprietary_name":"Good Sense Hemorrhoidal Maximum Strength Pain Relief","nonproprietary_name":"glycerin, phenylephrine HCl, pramoxine HCl, white petrolatum","dosage_form":"CREAM","route":"TOPICAL","strength":"14.4 g/100g; .25 g/100g; 1 g/100g; 15 g/100g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-0944-24) / 51 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04574,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113018816","name":"GS HEMORRHOIDAL OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0188-16","proprietary_name":"Good Sense Hemorrhoidal","nonproprietary_name":"mineral oil, petrolatum, phenylephrine HCl","dosage_form":"OINTMENT","route":"RECTAL","strength":"14 g/100g; 74.9 g/100g; .25 g/100g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-0188-16) / 57 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113027953","name":"GS HEMORRHOIDAL SUPPOSITORIES","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0279-53","proprietary_name":"Good Sense Hemorrhoidal","nonproprietary_name":"cocoa butter, phenylephrine HCl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2211 mg/1; 6.5 mg/1","labeler":"L. Perrigo Company","package_description":"12 BLISTER PACK in 1 CARTON (0113-0279-53) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113246162","name":"GS IBUPROFEN 100 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2461-62","proprietary_name":"Good Sense Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-2461-62) / 24 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.1544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113051771","name":"GS IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0517-71","proprietary_name":"Good Sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0517-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113064762","name":"GS IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0647-62","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0647-62) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113064771","name":"GS IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0647-71","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0647-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113064778","name":"GS IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0647-78","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0647-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113029827","name":"GS IBUPROFEN 200 MG LIQUID GEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0298-27","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0298-27) / 80 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113029858","name":"GS IBUPROFEN 200 MG LIQUID GEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0298-58","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0298-58) / 40 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113060462","name":"GS IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0604-62","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0604-62) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113060471","name":"GS IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0604-71","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0604-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113060478","name":"GS IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0604-78","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0604-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113060490","name":"GS IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0604-90","proprietary_name":"good sense ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0113-0604-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113121285","name":"GS IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1212-85","proprietary_name":"Good Sense Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"L. Perrigo Company","package_description":"250 TABLET, FILM COATED in 1 BOTTLE (0113-1212-85)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113005058","name":"GS IBUPROFEN PM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0050-58","proprietary_name":"good sense ibuprofen pm","nonproprietary_name":"diphenhydramine citrate, ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"38 mg/1; 200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0050-58) / 40 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113005060","name":"GS IBUPROFEN PM CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0050-60","proprietary_name":"good sense ibuprofen pm","nonproprietary_name":"diphenhydramine citrate, ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"38 mg/1; 200 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0050-60) / 20 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113005705","name":"GS INF IBUPROFEN 50 MG/1.25 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0057-05","proprietary_name":"Good Sense ibuprofen infants","nonproprietary_name":"ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"50 mg/1.25mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0057-05) / 15 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.32528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113062264","name":"GS ITCH RELIEF 2%-0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0622-64","proprietary_name":"good sense itch relief","nonproprietary_name":"Diphenhydramine Hydrochloride, Zinc Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g; .1 g/100g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-0622-64) / 28 g in 1 TUBE","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113111401","name":"GS LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1114-01","proprietary_name":"Good Sense Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-1114-01) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113111402","name":"GS LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1114-02","proprietary_name":"Good Sense Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"L. Perrigo Company","package_description":"2 BOTTLE in 1 CARTON (0113-1114-02) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113111403","name":"GS LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1114-03","proprietary_name":"Good Sense Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"L. Perrigo Company","package_description":"3 BOTTLE in 1 CARTON (0113-1114-03) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113008100","name":"GS MICONAZOLE 3 COMBO PACK","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0081-00","proprietary_name":"Good Sense Miconazole 3","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"L. Perrigo Company","package_description":"1 KIT in 1 CARTON (0113-0081-00) * 1 BLISTER PACK in 1 KIT / 3 SUPPOSITORY in 1 BLISTER PACK * 1 TUBE in 1 KIT / 9 g in 1 TUBE"},"nadac":{"value":7.427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113021429","name":"GS MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0214-29","proprietary_name":"Good Sense Miconazole 7","nonproprietary_name":"Miconazole nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"L Perrigo Company","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0113-0214-29) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113082529","name":"GS MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0825-29","proprietary_name":"good sense miconazole 7","nonproprietary_name":"Miconazole nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"L. Perrigo Company","package_description":"1 TUBE in 1 CARTON (0113-0825-29) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00113037462","name":"GS MIGRAINE 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0374-62","proprietary_name":"good sense migraine formula","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0374-62) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113037478","name":"GS MIGRAINE 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0374-78","proprietary_name":"good sense migraine formula","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0374-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113081266","name":"GS MUCUS DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0812-66","proprietary_name":"good sense mucus dm","nonproprietary_name":"dextromethorphan HBr, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 60 mg/1","labeler":"L Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0812-66) / 14 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113407774","name":"GS MUCUS ER 1,200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-4077-74","proprietary_name":"Good Sense Mucus ER","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"L. Perrigo Company","package_description":"2 BLISTER PACK in 1 CARTON (0113-4077-74) / 7 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113202360","name":"GS MUCUS ER 600 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2023-60","proprietary_name":"good sense mucus er","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-2023-60) / 20 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113202358","name":"GS MUCUS ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2023-58","proprietary_name":"good sense mucus er","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-2023-58) / 40 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113436862","name":"GS NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-4368-62","proprietary_name":"Good Sense Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-4368-62) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113436875","name":"GS NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-4368-75","proprietary_name":"Good Sense Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-4368-75) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113436879","name":"GS NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-4368-79","proprietary_name":"Good Sense Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"L. Perrigo Company","package_description":"400 TABLET, FILM COATED in 1 BOTTLE (0113-4368-79)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113090162","name":"GS NAPROXEN SOD 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0901-62","proprietary_name":"Good Sense Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0901-62) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113090175","name":"GS NAPROXEN SOD 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0901-75","proprietary_name":"Good Sense Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0901-75) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113044301","name":"GS NASAL ALLERGY 24HR SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0443-01","proprietary_name":"Good Sense Nasal Allergy","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0113-0443-01) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113043262","name":"GS NASAL DECONGEST 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0432-62","proprietary_name":"Good Sense Nasal Decongestant","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"L. Perrigo Company","package_description":"2 BLISTER PACK in 1 CARTON (0113-0432-62) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113064810","name":"GS NASAL FOUR 1% NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0648-10","proprietary_name":"Good Sense Nasal Four","nonproprietary_name":"Phenylephrine hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"1 g/100mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0113-0648-10) / 29.6 mL in 1 BOTTLE, SPRAY","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113030410","name":"GS NASAL SPRAY 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0304-10","proprietary_name":"Good Sense Nasal","nonproprietary_name":"oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".5 mg/mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0113-0304-10) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113002925","name":"GS NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0029-25","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"110 BLISTER PACK in 1 CARTON (0113-0029-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113002960","name":"GS NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0029-60","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"20 BLISTER PACK in 1 CARTON (0113-0029-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113002971","name":"GS NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0029-71","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"50 BLISTER PACK in 1 CARTON (0113-0029-71) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113020625","name":"GS NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113045660","name":"GS NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0456-60","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"20 BLISTER PACK in 1 CARTON (0113-0456-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113810025","name":"GS NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8100-25","proprietary_name":"good sense nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"110 BLISTER PACK in 1 CARTON (0113-8100-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113034405","name":"GS NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0344-05","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"3 CONTAINER in 1 CARTON (0113-0344-05) / 24 LOZENGE in 1 CONTAINER (0113-0344-03)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113073402","name":"GS NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0734-02","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"L. Perrigo Company","package_description":"3 CONTAINER in 1 CARTON (0113-0734-02) / 27 LOZENGE in 1 CONTAINER (0113-0734-01)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113005306","name":"GS NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0053-06","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"160 BLISTER PACK in 1 CARTON (0113-0053-06) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113017071","name":"GS NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0170-71","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"50 BLISTER PACK in 1 CARTON (0113-0170-71) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113042225","name":"GS NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113053260","name":"GS NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0532-60","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"20 BLISTER PACK in 1 CARTON (0113-0532-60) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113860025","name":"GS NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8600-25","proprietary_name":"good sense nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"110 BLISTER PACK in 1 CARTON (0113-8600-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113087305","name":"GS NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0873-05","proprietary_name":"good sense nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"3 CONTAINER in 1 CARTON (0113-0873-05) / 24 LOZENGE in 1 CONTAINER (0113-0873-03)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113095702","name":"GS NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0957-02","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"3 CONTAINER in 1 CARTON (0113-0957-02) / 27 LOZENGE in 1 CONTAINER (0113-0957-01)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113095760","name":"GS NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0957-60","proprietary_name":"Good Sense Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"L. Perrigo Company","package_description":"1 CONTAINER in 1 CARTON (0113-0957-60) / 20 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113033534","name":"GS NIGHTTIME COLD-FLU LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0335-34","proprietary_name":"good sense night time","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"L. Perrigo Company","package_description":"237 mL in 1 BOTTLE (0113-0335-34)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113005662","name":"GS NIGHTTIME COLD-FLU SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0056-62","proprietary_name":"good sense night time","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 15 mg/1; 6.25 mg/1","labeler":"L. Perrigo Company","package_description":"12 BLISTER PACK in 1 CARTON (0113-0056-62) / 2 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113005673","name":"GS NIGHTTIME COLD-FLU SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0056-73","proprietary_name":"good sense night time","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 15 mg/1; 6.25 mg/1","labeler":"L. Perrigo Company","package_description":"8 BLISTER PACK in 1 CARTON (0113-0056-73) / 2 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113043162","name":"GS NIGHTTIME SLEEP AID 25 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0431-62","proprietary_name":"good sense nighttime sleep aid","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"12 BLISTER PACK in 1 CARTON (0113-0431-62) / 2 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113038810","name":"GS NO DRIP 0.05% NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0388-10","proprietary_name":"good sense nasal","nonproprietary_name":"Oxymetazoline HCl","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0113-0388-10) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113052074","name":"GS OMEPRAZOLE DR 20 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0520-74","proprietary_name":"good sense omeprazole","nonproprietary_name":"omeprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"14 BLISTER PACK in 1 CARTON (0113-0520-74) / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.4682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113091530","name":"GS OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0915-30","proprietary_name":"Good Sense Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"2 CARTON in 1 CARTON (0113-0915-30) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113091555","name":"GS OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0915-55","proprietary_name":"Good Sense Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"3 CARTON in 1 CARTON (0113-0915-55) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113091574","name":"GS OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0915-74","proprietary_name":"Good Sense Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"14 BLISTER PACK in 1 CARTON (0113-0915-74) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113040378","name":"GS PAIN RELIEF 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0403-78","proprietary_name":"good sense pain relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0403-78) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113002562","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0025-62","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0025-62) / 24 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113002571","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0025-71","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0025-71) / 50 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113002578","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0025-78","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0025-78) / 100 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113048462","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0484-62","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0484-62) / 24 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113048471","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0484-71","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0484-71) / 50 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113048478","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0484-78","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0484-78) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113048490","name":"GS PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0484-90","proprietary_name":"Good Sense Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"L. Perrigo Company","package_description":"500 TABLET in 1 BOTTLE (0113-0484-90)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113043771","name":"GS PAIN RLF PM 25-500 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0437-71","proprietary_name":"good sense pain relief pm extra strength","nonproprietary_name":"Acetaminophen, Diphenhydramine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0437-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113001940","name":"GS SEVERE COLD-FLU NIGHTTME LQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0019-40","proprietary_name":"Good Sense Severe NightTime","nonproprietary_name":"Acetaminophen, dextromethorphan HBr, doxylamine succinate, phenylephrine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 20 mg/30mL; 12.5 mg/30mL; 10 mg/30mL","labeler":"L. Perrigo Company","package_description":"354 mL in 1 BOTTLE (0113-0019-40)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113044164","name":"GS SLEEP AID 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0441-64","proprietary_name":"Good sense sleep aid","nonproprietary_name":"Doxylamine succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"32 BLISTER PACK in 1 CARTON (0113-0441-64) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113044173","name":"GS SLEEP AID 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0441-73","proprietary_name":"Good sense sleep aid","nonproprietary_name":"Doxylamine succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"16 BLISTER PACK in 1 CARTON (0113-0441-73) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113403262","name":"GS SLEEP AID ULTRA 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-4032-62","proprietary_name":"good sense sleep aid ultra","nonproprietary_name":"doxylamine succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-4032-62) / 24 TABLET, COATED in 1 BOTTLE","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113403267","name":"GS SLEEP AID ULTRA 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-4032-67","proprietary_name":"good sense sleep aid ultra","nonproprietary_name":"doxylamine succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-4032-67) / 48 TABLET, COATED in 1 BOTTLE","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113018640","name":"GS SLEEP TIME 50 MG/30 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0186-40","proprietary_name":"Good Sense Sleep Time","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/30mL","labeler":"L. Perrigo Company","package_description":"355 mL in 1 BOTTLE (0113-0186-40)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.00864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113005452","name":"GS SUPHEDRINE 12HR 120 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0054-52","proprietary_name":"Good Sense Suphedrine 12 Hour","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"L. Perrigo Company","package_description":"10 BLISTER PACK in 1 CARTON (0113-0054-52) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113172526","name":"GS TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1725-26","proprietary_name":"good sense tussin dm","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-1725-26) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113172534","name":"GS TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1725-34","proprietary_name":"good sense tussin dm","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-1725-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113092726","name":"GS TUSSIN DM MAX LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0927-26","proprietary_name":"Good Sense Tussin DM Max","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0927-26) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113092734","name":"GS TUSSIN DM MAX LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0927-34","proprietary_name":"Good Sense Tussin DM Max","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"L. Perrigo Company","package_description":"1 BOTTLE in 1 CARTON (0113-0927-34) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121077504","name":"GUAIFEN-CODEINE 100-10 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0775-04","proprietary_name":"Guaifenesin and Codeine Phosphate","nonproprietary_name":"Guaifenesin and Codeine Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL; 10 mg/5mL","labeler":"PAI Holdings, LLC","package_description":"118 mL in 1 BOTTLE (0121-0775-04)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Full Opioid Agonists [MoA]","Increased Respiratory Secretions [PE]","Opioid Agonist [EPC]"]},"nadac":{"value":0.06445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121077516","name":"GUAIFEN-CODEINE 100-10 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0775-16","proprietary_name":"Guaifenesin and Codeine Phosphate","nonproprietary_name":"Guaifenesin and Codeine Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL; 10 mg/5mL","labeler":"PAI Holdings, LLC","package_description":"473 mL in 1 BOTTLE (0121-0775-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Full Opioid Agonists [MoA]","Increased Respiratory Secretions [PE]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657050816","name":"GUAIFENESIN 100 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-508-16","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (58657-508-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81033010216","name":"GUAIFENESIN 100 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-102-16","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"KESIN PHARMA CORPORATION","package_description":"473 mL in 1 BOTTLE (81033-102-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83720050316","name":"GUAIFENESIN 100 MG/5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83720-503-16","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"Oncor Pharmaceuticals","package_description":"473 mL in 1 BOTTLE (83720-503-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904515460","name":"GUAIFENESIN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5154-60","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0904-5154-60)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.03234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24689014401","name":"GUAIFENESIN 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-144-01","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-144-01)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660056786","name":"GUAIFENESIN ER 1,200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-567-86","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Ohm Laboratories, Inc.","package_description":"28 TABLET, EXTENDED RELEASE in 1 CARTON (51660-567-86)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536116361","name":"GUAIFENESIN ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1163-61","proprietary_name":"Mucus Relief Extended Release","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0536-1163-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660056621","name":"GUAIFENESIN ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-566-21","proprietary_name":"Guaifenesin","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Ohm Laboratories, Inc.","package_description":"20 TABLET, EXTENDED RELEASE in 1 CARTON (51660-566-21)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094004859","name":"GUAIFENESIN ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094004861","name":"GUAIFENESIN ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-048-61","proprietary_name":"Guaifenesin Extended-Release","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Precision Dose Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68094-048-61) / 10 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK (68094-048-59)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010019905","name":"GUAIFENESIN ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-199-05","proprietary_name":"GUAIFENESIN","nonproprietary_name":"GUAIFENESIN","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"GRANULES PHARMACEUTICALS INC.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-199-05)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657050408","name":"GUAIFENESIN-DM 100-10 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-504-08","proprietary_name":"Guaifenesin and Dextromethorphan Hydrobromide","nonproprietary_name":"Guaifenesin and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"Method Pharmaceuticals","package_description":"237 mL in 1 BOTTLE, PLASTIC (58657-504-08)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657050508","name":"GUAIFENESIN-DM 100-10 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-505-08","proprietary_name":"Guaifenesin and Dextromethorphan Hydrobromide","nonproprietary_name":"Guaifenesin and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"Method Pharmaceuticals","package_description":"237 mL in 1 BOTTLE, PLASTIC (58657-505-08)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51660011054","name":"GUAIFENESIN-DM ER 1,200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-110-54","proprietary_name":"Guaifenesin and Dextromethorphan HBr","nonproprietary_name":"Guaifenesin and Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 60 mg/1","labeler":"OHM LABORATORIES INC","package_description":"1 BLISTER PACK in 1 CARTON (51660-110-54) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660030141","name":"GUAIFENESIN-DM ER 600-30 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-301-41","proprietary_name":"Guaifenesin and Dextromethorphan HBr","nonproprietary_name":"Guaifenesin and Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 30 mg/1","labeler":"OHM LABORATORIES INC","package_description":"2 BLISTER PACK in 1 CARTON (51660-301-41) / 20 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-14","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111079924","name":"GUAIFENESIN-PSE ER 1200-120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-799-24","proprietary_name":"Guaifenesin and Pseudoephedrine HCL","nonproprietary_name":"Guaifenesin and Pseudoephedrine HCL","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 120 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"2 BLISTER PACK in 1 CARTON (55111-799-24) / 12 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.42347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133321","name":"GUAIFENESIN-PSE ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1333-21","proprietary_name":"Guaifenesin D","nonproprietary_name":"Guaifenesin and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"RUGBY LABORATORIES, INC.","package_description":"1 BLISTER PACK in 1 CARTON (0536-1333-21) / 18 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133336","name":"GUAIFENESIN-PSE ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1333-36","proprietary_name":"Guaifenesin D","nonproprietary_name":"Guaifenesin and Pseudoephedrine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"RUGBY LABORATORIES, INC.","package_description":"2 BLISTER PACK in 1 CARTON (0536-1333-36) / 18 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111079818","name":"GUAIFENESIN-PSE ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-798-18","proprietary_name":"Guaifenesin and Pseudoephedrine HCL","nonproprietary_name":"Guaifenesin and Pseudoephedrine HCL","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"2 BLISTER PACK in 1 CARTON (55111-798-18) / 9 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111079835","name":"GUAIFENESIN-PSE ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-798-35","proprietary_name":"Guaifenesin and Pseudoephedrine HCL","nonproprietary_name":"Guaifenesin and Pseudoephedrine HCL","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"1 BLISTER PACK in 1 CARTON (55111-798-35) / 18 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111079836","name":"GUAIFENESIN-PSE ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-798-36","proprietary_name":"Guaifenesin and Pseudoephedrine HCL","nonproprietary_name":"Guaifenesin and Pseudoephedrine HCL","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"4 BLISTER PACK in 1 CARTON (55111-798-36) / 9 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111079841","name":"GUAIFENESIN-PSE ER 600-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-798-41","proprietary_name":"Guaifenesin and Pseudoephedrine HCL","nonproprietary_name":"Guaifenesin and Pseudoephedrine HCL","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"2 BLISTER PACK in 1 CARTON (55111-798-41) / 18 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591044401","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0444-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0444-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904714004","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7140-04","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7140-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979019801","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-198-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"TWi Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (24979-198-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241024201","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-242-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-242-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300045801","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-458-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-458-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806004801","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-048-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-048-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746071101","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-711-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-711-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084001","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-840-01","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-840-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687071011","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687071021","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-710-21","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-710-21) / 1 TABLET in 1 BLISTER PACK (60687-710-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072790","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-727-90","proprietary_name":"GUANFACINE HYDROCHLORIDE","nonproprietary_name":"guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-727-90)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162071110","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-711-10","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-711-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094006559","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094006562","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-065-62","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Precision Dose, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68094-065-62) / 10 TABLET in 1 BLISTER PACK (68094-065-59)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700030101","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-301-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"XIROMED, LLC","package_description":"100 TABLET in 1 BOTTLE (70700-301-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72319001804","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-018-04","proprietary_name":"Guanfacine","nonproprietary_name":"Gaunfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (72319-018-04)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888012301","name":"GUANFACINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-123-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-123-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591045301","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0453-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-0453-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979019901","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-199-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"TWi Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (24979-199-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241024301","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-243-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-243-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300045901","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-459-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-459-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806029601","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-296-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-296-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268037411","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268037415","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-374-15","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-374-15) / 1 TABLET in 1 BLISTER PACK (50268-374-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746071301","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-713-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-713-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651084101","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-841-01","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-841-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135072890","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-728-90","proprietary_name":"GUANFACINE HYDROCHLORIDE","nonproprietary_name":"guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-728-90)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162071310","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-713-10","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-713-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700030201","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-302-01","proprietary_name":"Guanfacine Hydrochloride","nonproprietary_name":"Guanfacine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"XIROMED, LLC","package_description":"100 TABLET in 1 BOTTLE (70700-302-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72319001904","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-019-04","proprietary_name":"Guanfacine","nonproprietary_name":"Gaunfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (72319-019-04)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888012401","name":"GUANFACINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-124-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-124-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228285011","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2850-11","proprietary_name":"guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0228-2850-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979053301","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-533-01","proprietary_name":"Guanfacine Extended-Release","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-533-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046001","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-460-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (29300-460-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505392701","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3927-1","proprietary_name":"Guanfacine extended-release","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-3927-1)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332074531","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-745-31","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-745-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436003901","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-039-01","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-039-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72266025555","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-255-55","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Fosun Pharma USA, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72266-255-55)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888022401","name":"GUANFACINE HCL ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-224-01","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-224-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228285111","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2851-11","proprietary_name":"guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0228-2851-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979053401","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-534-01","proprietary_name":"Guanfacine Extended-Release","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-534-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046101","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-461-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (29300-461-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505392801","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3928-1","proprietary_name":"Guanfacine extended-release","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-3928-1)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332074631","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-746-31","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-746-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436004001","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-040-01","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-040-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72266025655","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-256-55","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Fosun Pharma USA, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72266-256-55)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888022501","name":"GUANFACINE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-225-01","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-225-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228285311","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2853-11","proprietary_name":"guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0228-2853-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979053601","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-536-01","proprietary_name":"Guanfacine Extended-Release","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-536-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046201","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-462-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (29300-462-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505392901","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3929-1","proprietary_name":"Guanfacine extended-release","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-3929-1)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332074731","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-747-31","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-747-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436004101","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-041-01","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-041-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72266025755","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-257-55","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Fosun Pharma USA, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72266-257-55)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888022601","name":"GUANFACINE HCL ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-226-01","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-226-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"00228285511","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2855-11","proprietary_name":"guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0228-2855-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"24979053801","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-538-01","proprietary_name":"Guanfacine Extended-Release","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-538-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300046301","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-463-01","proprietary_name":"Guanfacine","nonproprietary_name":"Guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (29300-463-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505393001","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3930-1","proprietary_name":"Guanfacine extended-release","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-3930-1)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332074831","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-748-31","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-748-31)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436004201","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-042-01","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70436-042-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72266025855","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-258-55","proprietary_name":"Guanfacine","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Fosun Pharma USA, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72266-258-55)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888022701","name":"GUANFACINE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-227-01","proprietary_name":"GUANFACINE","nonproprietary_name":"GUANFACINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-227-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Guanfacine HCl ER|Guanfacine HCl","basis":"generic"},"part_b":null}, {"ndc":"72065014011","name":"GVOKE 1 MG/0.2 ML KIT","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72065-140-11","proprietary_name":"Gvoke Kit","nonproprietary_name":"glucagon injection, solution","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1 mg/.2mL","labeler":"Xeris Pharmaceuticals, Inc.","package_description":".2 mL in 1 CARTON (72065-140-11)","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":1600.98636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gvoke|Glucagon","basis":"brand"},"part_b":null}, {"ndc":"72065014111","name":"GVOKE 1 MG/0.2 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1600.98636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Gvoke|Glucagon","basis":"brand"},"part_b":null}, {"ndc":"72065012111","name":"GVOKE HYPOPEN 1-PK 1 MG/0.2 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72065-121-11","proprietary_name":"Gvoke HypoPen 1 mg Auto-Injector","nonproprietary_name":"glucagon injection, solution","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1 mg/.2mL","labeler":"Xeris Pharmaceuticals, Inc.","package_description":"1 POUCH in 1 CARTON (72065-121-11) / 1 SYRINGE, PLASTIC in 1 POUCH / .2 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":1603.18226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72065012112","name":"GVOKE HYPOPEN 2-PK 1 MG/0.2 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72065-121-12","proprietary_name":"Gvoke HypoPen 1 mg Auto-Injector","nonproprietary_name":"glucagon injection, solution","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1 mg/.2mL","labeler":"Xeris Pharmaceuticals, Inc.","package_description":"2 POUCH in 1 CARTON (72065-121-12) / 1 SYRINGE, PLASTIC in 1 POUCH / .2 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":1596.19346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72065012012","name":"GVOKE HYPOPEN 2PK 0.5 MG/0.1 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72065-120-12","proprietary_name":"Gvoke HypoPen 0.5 mg Auto-Injector","nonproprietary_name":"glucagon injection, solution","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".5 mg/.1mL","labeler":"Xeris Pharmaceuticals, Inc.","package_description":"2 POUCH in 1 CARTON (72065-120-12) / 1 SYRINGE, PLASTIC in 1 POUCH / .1 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":3202.32985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72065013111","name":"GVOKE PFS 1-PK 1 MG/0.2 ML SYR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72065-131-11","proprietary_name":"Gvoke PFS 1 mg Pre-filled Syringe","nonproprietary_name":"glucagon injection, solution","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1 mg/.2mL","labeler":"Xeris Pharmaceuticals, Inc.","package_description":"1 POUCH in 1 CARTON (72065-131-11) / 1 SYRINGE, PLASTIC in 1 POUCH / .2 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":1600.95652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72065013112","name":"GVOKE PFS 2-PK 1 MG/0.2 ML SYR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72065-131-12","proprietary_name":"Gvoke PFS 1 mg Pre-filled Syringe","nonproprietary_name":"glucagon injection, solution","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1 mg/.2mL","labeler":"Xeris Pharmaceuticals, Inc.","package_description":"2 POUCH in 1 CARTON (72065-131-12) / 1 SYRINGE, PLASTIC in 1 POUCH / .2 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Antihypoglycemic Agent [EPC]","Decreased GI Motility [PE]","Decreased GI Smooth Muscle Tone [PE]","Decreased Glycolysis [PE]","Gastrointestinal Motility Inhibitor [EPC]","Increased Gluconeogenesis [PE]","Increased Glycogenolysis [PE]"]},"nadac":{"value":1604.33929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802039601","name":"GYNAZOLE 1 2% CREAM","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-396-01","proprietary_name":"gynazole 1","nonproprietary_name":"butoconazole nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"100 mg/5g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (45802-396-01) / 5.8 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":23.30382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Gynazole 1|Butoconazole Nitrate","basis":"brand"},"part_b":null}, {"ndc":"78206018301","name":"HADLIMA 40 MG/0.8 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-183-01","proprietary_name":"Hadlima","nonproprietary_name":"adalimumab-bwwd","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/.8mL","labeler":"Organon LLC","package_description":"2 CARTON in 1 CARTON (78206-183-01) / 1 SYRINGE in 1 CARTON (78206-183-99) / .8 mL in 1 SYRINGE","pharm_classes":["Antibodies, Monoclonal [CS]","Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":617.14196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Hadlima|Adalimumab-Bwwd","basis":"brand"},"part_b":null}, {"ndc":"78206018401","name":"HADLIMA PUSHTOUCH 40 MG/0.8 ML","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-184-01","proprietary_name":"Hadlima","nonproprietary_name":"adalimumab-bwwd","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/.8mL","labeler":"Organon LLC","package_description":"2 CARTON in 1 CARTON (78206-184-01) / 1 SYRINGE in 1 CARTON (78206-184-99) / .8 mL in 1 SYRINGE","pharm_classes":["Antibodies, Monoclonal [CS]","Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":623.49306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"78206018601","name":"HADLIMA(CF) 40 MG/0.4 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-186-01","proprietary_name":"Hadlima","nonproprietary_name":"adalimumab-bwwd","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Organon LLC","package_description":"2 SYRINGE in 1 CARTON (78206-186-01) / .4 mL in 1 SYRINGE (78206-186-99)","pharm_classes":["Antibodies, Monoclonal [CS]","Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":1258.37813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"78206018701","name":"HADLIMA(CF) PUSHTOUCH 40 MG/0.4 ML","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-187-01","proprietary_name":"Hadlima","nonproprietary_name":"adalimumab-bwwd","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Organon LLC","package_description":"2 SYRINGE in 1 CARTON (78206-187-01) / .4 mL in 1 SYRINGE (78206-187-99)","pharm_classes":["Antibodies, Monoclonal [CS]","Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":1259.15439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68462050479","name":"HAILEY 21 1.5 MG-30 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462050481","name":"HAILEY 21 1.5 MG-30 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-504-81","proprietary_name":"Hailey 1.5/30","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1; .03 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-504-81) / 1 BLISTER PACK in 1 POUCH (68462-504-79) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462073129","name":"HAILEY 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-731-29","proprietary_name":"Hailey 24 Fe","nonproprietary_name":"norethindrone acetate and ethinyl estradiol, and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-731-29) / 1 KIT in 1 BLISTER PACK (68462-731-84)"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462073184","name":"HAILEY 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462041929","name":"HAILEY FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-419-29","proprietary_name":"HAILEY Fe 1/20","nonproprietary_name":"norethindrone acetate and ethinyl estradiol and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-419-29) / 1 KIT in 1 BLISTER PACK (68462-419-84)"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hailey Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68462041984","name":"HAILEY FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hailey Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68462050329","name":"HAILEY FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-503-29","proprietary_name":"Hailey Fe 1.5/30","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-503-29) / 1 BLISTER PACK in 1 POUCH (68462-503-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hailey Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68462050384","name":"HAILEY FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hailey Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"21922006952","name":"HALCINONIDE 0.1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":6.08334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Halcinonide|Halcinonide","basis":"generic"},"part_b":null}, {"ndc":"74157001212","name":"HALCINONIDE 0.1% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"74157-012-12","proprietary_name":"Halcinonide Topical Solution","nonproprietary_name":"Halcinonide Topical","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"INA Pharmaceutics Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (74157-012-12) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.08334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Halcinonide|Halcinonide","basis":"generic"},"part_b":null}, {"ndc":"00713064015","name":"HALOBETASOL PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0640-15","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"15 g in 1 TUBE (0713-0640-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"00713064086","name":"HALOBETASOL PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0640-86","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"50 g in 1 TUBE (0713-0640-86)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.40852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"45802012932","name":"HALOBETASOL PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-129-32","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-129-32) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.40852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"45802012935","name":"HALOBETASOL PROP 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-129-35","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-129-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"00713033915","name":"HALOBETASOL PROP 0.05% OINTMNT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0339-15","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0339-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.84285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"00713033986","name":"HALOBETASOL PROP 0.05% OINTMNT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0339-86","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0339-86) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"45802013132","name":"HALOBETASOL PROP 0.05% OINTMNT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-131-32","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-131-32) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"45802013135","name":"HALOBETASOL PROP 0.05% OINTMNT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-131-35","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-131-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.84285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"70752011902","name":"HALOBETASOL PROP 0.05% OINTMNT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-119-02","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 TUBE in 1 CARTON (70752-119-02) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.84285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"70752011904","name":"HALOBETASOL PROP 0.05% OINTMNT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-119-04","proprietary_name":"Halobetasol Propionate","nonproprietary_name":"Halobetasol Propionate","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 TUBE in 1 CARTON (70752-119-04) / 50 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.39724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Halobetasol Propionate|Halobetasol Propionate","basis":"generic"},"part_b":null}, {"ndc":"00378035101","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0351-01","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0351-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00378035110","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0351-10","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0351-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832151011","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1510-11","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1510-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007101","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-071-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-071-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007110","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-071-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-071-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"51079073301","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"51079073320","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-733-20","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-733-20) / 1 TABLET in 1 BLISTER PACK (51079-733-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070001","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-700-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-700-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090001","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-900-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 CARTON (58657-900-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090010","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651078901","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-789-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-789-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382040701","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-407-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-407-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292058001","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-580-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69292-580-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70756000111","name":"HALOPERIDOL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-001-11","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-001-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.08568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00378025710","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0257-10","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0257-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832152011","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1520-11","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1520-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007201","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-072-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-072-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007210","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-072-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-072-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"51079073401","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"51079073420","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-734-20","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-734-20) / 1 TABLET in 1 BLISTER PACK (51079-734-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070101","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-701-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-701-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090101","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-901-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 CARTON (58657-901-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090110","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651079001","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-790-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-790-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382040801","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-408-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-408-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292058201","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-582-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69292-582-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70756000211","name":"HALOPERIDOL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-002-11","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-002-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.11953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832155001","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1550-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-1550-01) / 1 TABLET in 1 BLISTER PACK (0832-1550-89)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832155011","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1550-11","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1550-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832155089","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00904673361","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6733-61","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6733-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007501","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-075-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-075-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007510","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-075-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-075-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070401","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-704-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-704-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090401","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-904-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 CARTON (58657-904-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090410","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651079301","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-793-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-793-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68084024901","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-249-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-249-01) / 1 TABLET in 1 BLISTER PACK (68084-249-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68084024911","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382008001","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-080-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-080-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292058801","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-588-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69292-588-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70756024211","name":"HALOPERIDOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-242-11","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-242-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00378021410","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0214-10","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0214-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832153011","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1530-11","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1530-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00904750461","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7504-61","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7504-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007301","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-073-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-073-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007310","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-073-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-073-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070201","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-702-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-702-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090201","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-902-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 CARTON (58657-902-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090210","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651079101","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-791-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-791-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382040901","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-409-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-409-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292058401","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-584-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69292-584-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70756000311","name":"HALOPERIDOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-003-11","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-003-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.16576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832156011","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1560-11","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1560-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00904666104","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6661-04","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6661-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007601","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-076-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-076-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007610","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-076-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-076-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070501","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-705-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-705-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090501","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-905-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 CARTON (58657-905-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090503","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-905-03","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"30 TABLET in 1 CARTON (58657-905-03)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090510","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651079401","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-794-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-794-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68084025011","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68084025021","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-250-21","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-250-21) / 1 TABLET in 1 BLISTER PACK (68084-250-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382008101","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-081-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-081-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292059001","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-590-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69292-590-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70756023611","name":"HALOPERIDOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-236-11","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-236-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.37115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00378032710","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0327-10","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0327-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00832154011","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1540-11","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1540-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"00904678261","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6782-61","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6782-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007401","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-074-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-074-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"11788007410","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-074-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-074-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"51079073601","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"51079073620","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-736-20","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-736-20) / 1 TABLET in 1 BLISTER PACK (51079-736-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070301","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-703-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-703-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657070310","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-703-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-703-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090301","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-903-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 CARTON (58657-903-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"58657090310","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651079201","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-792-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-792-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"59651079299","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-792-99","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-792-99)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"60687016101","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-161-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-161-01) / 1 TABLET in 1 BLISTER PACK (60687-161-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"60687016111","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382007901","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-079-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-079-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"68382007910","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-079-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-079-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292058601","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-586-01","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69292-586-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"69292058610","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-586-10","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amici Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69292-586-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70756000411","name":"HALOPERIDOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-004-11","proprietary_name":"Haloperidol","nonproprietary_name":"haloperidol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-004-11)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.18065,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Haloperidol|Haloperidol","basis":"generic"},"part_b":null}, {"ndc":"70069003105","name":"HALOPERIDOL DEC 100 MG/ML AMP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-031-05","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"5 AMPULE in 1 CARTON (70069-031-05) / 1 mL in 1 AMPULE (70069-031-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":33.92227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 AMPULE in 1 CARTON (70069-031-05) / 1 mL in 1 AMPULE (70069-031-01)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143929501","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9295-01","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 BOX (0143-9295-01) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX (0143-9295-01) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021083301","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-833-01","proprietary_name":"haloperidol decanoate","nonproprietary_name":"haloperidol decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-833-01) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-833-01) / 1 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323047101","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-471-01","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL in 1 CARTON (63323-471-01) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (63323-471-01) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323047141","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-471-41","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL in 1 CARTON (63323-471-41) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (63323-471-41) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145016701","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145016710","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-167-10","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Caplin Steriles Limited","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (65145-167-10) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-167-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (65145-167-10) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-167-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457040900","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67457040913","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-409-13","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Mylan Institutional LLC","package_description":"5 VIAL in 1 CARTON (67457-409-13) / 1 mL in 1 VIAL (67457-409-00)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL in 1 CARTON (67457-409-13) / 1 mL in 1 VIAL (67457-409-00)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001065841","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-658-41","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (68001-658-41) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (68001-658-41) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001065852","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-658-52","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"BluePoint Laboratories","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (68001-658-52) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, SINGLE-DOSE in 1 CARTON (68001-658-52) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069038301","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-383-01","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (70069-383-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (70069-383-01) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069038305","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-383-05","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (70069-383-05) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, SINGLE-DOSE in 1 CARTON (70069-383-05) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069038310","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-383-10","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (70069-383-10) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069086701","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069086705","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-867-05","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"5 CARTON in 1 CARTON (70069-867-05) / 10 VIAL in 1 CARTON (70069-867-10) / 1 mL in 1 VIAL (70069-867-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069086710","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710146301","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1463-1","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (70710-1463-1) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (70710-1463-1) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710146305","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1463-5","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (70710-1463-5) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, SINGLE-DOSE in 1 CARTON (70710-1463-5) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756061610","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-616-10","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"10 VIAL in 1 CARTON (70756-616-10) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70756-616-10) / 1 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756061681","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-616-81","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 VIAL in 1 CARTON (70756-616-81) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70756-616-81) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288050301","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71288050302","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-503-02","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (71288-503-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-503-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (71288-503-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-503-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485052101","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485052110","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-521-10","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72485-521-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-521-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":7.5241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603023001","name":"HALOPERIDOL DEC 100 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-230-01","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 VIAL in 1 CARTON (72603-230-01) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":16.1395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":2,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (72603-230-01) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069003003","name":"HALOPERIDOL DEC 50 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-030-03","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"3 AMPULE in 1 CARTON (70069-030-03) / 1 mL in 1 AMPULE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":20.75247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 AMPULE in 1 CARTON (70069-030-03) / 1 mL in 1 AMPULE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021083101","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-831-01","proprietary_name":"haloperidol decanoate","nonproprietary_name":"haloperidol decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-831-01) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-831-01) / 1 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145016801","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145016810","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-168-10","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Caplin Steriles Limited","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (65145-168-10) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-168-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (65145-168-10) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-168-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457041000","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67457041013","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-410-13","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Mylan Institutional LLC","package_description":"10 VIAL in 1 CARTON (67457-410-13) / 1 mL in 1 VIAL (67457-410-00)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (67457-410-13) / 1 mL in 1 VIAL (67457-410-00)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001065741","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68001065751","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-657-51","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"BluePoint Laboratories","package_description":"3 VIAL, SINGLE-DOSE in 1 CARTON (68001-657-51) / 1 mL in 1 VIAL, SINGLE-DOSE (68001-657-41)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":12.05213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL, SINGLE-DOSE in 1 CARTON (68001-657-51) / 1 mL in 1 VIAL, SINGLE-DOSE (68001-657-41)) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069038101","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-381-01","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (70069-381-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (70069-381-01) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069038110","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-381-10","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (70069-381-10) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (70069-381-10) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069086601","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069086610","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-866-10","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL in 1 CARTON (70069-866-10) / 1 mL in 1 VIAL (70069-866-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710146101","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710146106","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1461-6","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (70710-1461-6) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (70710-1461-6) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70710146109","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1461-9","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 VIAL, SINGLE-DOSE in 1 CARTON (70710-1461-9) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":12.05213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 VIAL, SINGLE-DOSE in 1 CARTON (70710-1461-9) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":3,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756061510","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-615-10","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"10 VIAL in 1 CARTON (70756-615-10) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70756-615-10) / 1 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756061581","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-615-81","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 VIAL in 1 CARTON (70756-615-81) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70756-615-81) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288050201","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71288050202","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-502-02","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (71288-502-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-502-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (71288-502-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-502-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485052001","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":12.67801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485052010","name":"HALOPERIDOL DEC 50 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-520-10","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72485-520-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-520-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":6.57233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72485-520-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72485-520-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143929601","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9296-01","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 BOX (0143-9296-01) / 5 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX (0143-9296-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021083405","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-834-05","proprietary_name":"haloperidol decanoate","nonproprietary_name":"haloperidol decanoate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"500 mg/5mL","labeler":"Sagent Pharmaceuticals","package_description":"1 VIAL in 1 CARTON (25021-834-05) / 5 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (25021-834-05) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323047105","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-471-05","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (63323-471-05) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (63323-471-05) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145016901","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-169-01","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (65145-169-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (65145-169-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68001065941","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-659-41","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"500 mg/5mL","labeler":"BluePoint Laboratories","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (68001-659-41) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (68001-659-41) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069038401","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-384-01","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70069-384-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70069-384-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069086801","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-868-01","proprietary_name":"HALOPERIDOL DECANOATE","nonproprietary_name":"HALOPERIDOL DECANOATE","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 VIAL in 1 CARTON (70069-868-01) / 5 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710146401","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1464-1","proprietary_name":"Haloperidol decanoate","nonproprietary_name":"Haloperidol decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70710-1464-1) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70710-1464-1) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756062585","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-625-85","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"500 mg/5mL","labeler":"Lifestar Pharma LLC","package_description":"1 VIAL in 1 CARTON (70756-625-85) / 5 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70756-625-85) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288050405","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-504-05","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (71288-504-05) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1631","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1631 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (71288-504-05) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485052201","name":"HALOPERIDOL DEC 500 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-522-01","proprietary_name":"Haloperidol Decanoate","nonproprietary_name":"Haloperidol Decanoate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"500 mg/5mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (72485-522-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":15.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121058104","name":"HALOPERIDOL LAC 2 MG/ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0581-04","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"120 mL in 1 BOTTLE (0121-0581-04)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.17752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121058115","name":"HALOPERIDOL LAC 2 MG/ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0581-15","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"15 mL in 1 BOTTLE (0121-0581-15)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838050115","name":"HALOPERIDOL LAC 2 MG/ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-501-15","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"Lannett Company, Inc.","package_description":"15 mL in 1 BOTTLE, DROPPER (54838-501-15)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838050140","name":"HALOPERIDOL LAC 2 MG/ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-501-40","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"Lannett Company, Inc.","package_description":"120 mL in 1 BOTTLE, DROPPER (54838-501-40)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.17752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888017347","name":"HALOPERIDOL LAC 2 MG/ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-173-47","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"2 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"15 mL in 1 BOTTLE (72888-173-47)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888017348","name":"HALOPERIDOL LAC 2 MG/ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-173-48","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"2 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"120 mL in 1 BOTTLE (72888-173-48)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.17752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143950125","name":"HALOPERIDOL LAC 5 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9501-25","proprietary_name":"Haloperidol","nonproprietary_name":"Haloperidol lactate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 BOX (0143-9501-25) / 1 mL in 1 VIAL","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1630","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1630 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 BOX (0143-9501-25) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323047401","name":"HALOPERIDOL LAC 5 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-474-01","proprietary_name":"Haloperidol","nonproprietary_name":"HALOPERIDOL LACTATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"5 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-474-01) / 1 mL in 1 VIAL (63323-474-00)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1630","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1630 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-474-01) / 1 mL in 1 VIAL (63323-474-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457042612","name":"HALOPERIDOL LAC 5 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-426-12","proprietary_name":"HALOPERIDOL LACTATE","nonproprietary_name":"HALOPERIDOL LACTATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"5 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL in 1 CARTON (67457-426-12) / 1 mL in 1 VIAL (67457-426-00)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Haloperidol Lactate*|Haloperidol Lactate","basis":"generic"},"part_b":{"hcpcs":"J1630","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1630 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (67457-426-12) / 1 mL in 1 VIAL (67457-426-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70000008301","name":"HEAD CONGESTION-MUCUS CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0083-1","proprietary_name":"Head Congestion and Mucus","nonproprietary_name":"Acetaminophen, Guaifenesin, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0083-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000014601","name":"HEADACHE RELIEF CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0146-1","proprietary_name":"Headache Relief Extra Strength","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0146-1) / 24 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000006601","name":"HEADACHE RLF 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0066-1","proprietary_name":"Acetaminophen, Aspirin, Caffeine","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0066-1) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043127","name":"HEALTHYLAX POWDER PACKET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-431-27","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-431-27) / 17 g in 1 POUCH (60687-431-99)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043192","name":"HEALTHYLAX POWDER PACKET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-431-92","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"American Health Packaging","package_description":"100 POUCH in 1 CARTON (60687-431-92) / 17 g in 1 POUCH (60687-431-99)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043198","name":"HEALTHYLAX POWDER PACKET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-431-98","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"American Health Packaging","package_description":"14 POUCH in 1 CARTON (60687-431-98) / 17 g in 1 POUCH (60687-431-99)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043199","name":"HEALTHYLAX POWDER PACKET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904552952","name":"HEARTBURN RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5529-52","proprietary_name":"heartburn relief original strength","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-5529-52) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904552987","name":"HEARTBURN RELIEF 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5529-87","proprietary_name":"heartburn relief original strength","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-5529-87) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904578017","name":"HEARTBURN RELIEF 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5780-17","proprietary_name":"Major Heartburn Relief Maximum Strength","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"25 BLISTER PACK in 1 CARTON (0904-5780-17) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904578051","name":"HEARTBURN RELIEF 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5780-51","proprietary_name":"Major Heartburn Relief Maximum Strength","nonproprietary_name":"Famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-5780-51) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000036301","name":"HEARTBURN RELIEF LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0363-1","proprietary_name":"EXTRA STRENGTH HEARTBURN RELIEF","nonproprietary_name":"aluminum hydroxide and magnesium carbonate","dosage_form":"SUSPENSION","route":"ORAL","strength":"254 mg/5mL; 237.5 mg/5mL","labeler":"CARDINAL HEALTH","package_description":"355 mL in 1 BOTTLE (70000-0363-1)"},"nadac":{"value":0.01519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68462030329","name":"HEATHER 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-303-29","proprietary_name":"HEATHER","nonproprietary_name":"Norethindrone","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-303-29) / 28 TABLET in 1 BLISTER PACK (68462-303-84)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Heather|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"68462030384","name":"HEATHER 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Heather|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"50742028530","name":"HEMICLOR 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-285-30","proprietary_name":"HEMICLOR","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (50742-285-30)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.95713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742028590","name":"HEMICLOR 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-285-90","proprietary_name":"HEMICLOR","nonproprietary_name":"chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (50742-285-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.95713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52747080030","name":"HEMOCYTE PLUS CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.61679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52747080060","name":"HEMOCYTE PLUS CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.61679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000042501","name":"HEMORRHOIDAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0425-1","proprietary_name":"Hemorrhoidal Cream","nonproprietary_name":"Glycerin, Phenylephrine Hydrochloride, Pramoxine Hydrochloride, White Petrolatum","dosage_form":"CREAM","route":"TOPICAL","strength":".28 g/28g; 4.032 g/28g; .07 g/28g; 4.2 g/28g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 TUBE in 1 BOX (70000-0425-1) / 28 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000036401","name":"HEMORRHOIDAL MEDICATED 50% PAD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0364-1","proprietary_name":"Medicated Hemorrhoidal Pads","nonproprietary_name":"WITCH HAZEL","dosage_form":"CLOTH","route":"TOPICAL","strength":"500 mg/mL","labeler":"Cardinal Health","package_description":"1 JAR in 1 CARTON (70000-0364-1) / 100 JAR in 1 JAR / 200 mL in 1 JAR"},"nadac":{"value":0.04352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536128806","name":"HEMORRHOIDAL OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1288-06","proprietary_name":"Hemorrhoidal","nonproprietary_name":"Mineral Oil, Petrolatum, Phenylephrine HCI","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 g/100g; 14 g/100g; 74.9 g/100g","labeler":"Rugby","package_description":"1 TUBE in 1 BOX (0536-1288-06) / 57 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802018816","name":"HEMORRHOIDAL OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-188-16","proprietary_name":"Hemorrhoidal","nonproprietary_name":"mineral oil, petrolatum, phenylephrine HCl","dosage_form":"OINTMENT","route":"RECTAL","strength":"14 g/100g; 74.9 g/100g; .25 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-188-16) / 57 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000004601","name":"HEMORRHOIDAL OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0046-1","proprietary_name":"Hemorrhoidal","nonproprietary_name":"Mineral Oil, Petrolatum, Phenylephrine HCI","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 g/100g; 14 g/100g; 74.9 g/100g","labeler":"Cardinal Health 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0046-1) / 57 g in 1 TUBE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000065001","name":"HEMORRHOIDAL RELIEF 5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0650-1","proprietary_name":"Leader Maximum Strength Hemorrhoidal Relief","nonproprietary_name":"LIDOCAINE","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Cardinal Health,Inc.","package_description":"1 TUBE in 1 CARTON (70000-0650-1) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.39868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536118612","name":"HEMORRHOIDAL SUPPOSITORIES","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1186-12","proprietary_name":"rugby hemorrhoidal","nonproprietary_name":"cocoa butter, phenylephrine HCl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2211 mg/1; 6.5 mg/1","labeler":"Rugby Laboratories","package_description":"12 BLISTER PACK in 1 CARTON (0536-1186-12) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000022301","name":"HEMORRHOIDAL SUPPOSITORIES","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0223-1","proprietary_name":"Leader Hemorrhoidal","nonproprietary_name":"cocoa butter, phenylephrine HCl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2211 mg/1; 6.5 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"12 BLISTER PACK in 1 CARTON (70000-0223-1) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71288045102","name":"HEPARIN SOD 10,000 UNIT/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-451-02","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (71288-451-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-451-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (71288-451-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-451-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288040682","name":"HEPARIN SOD 5,000 UNIT/ML SYRG","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-406-82","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"24 BLISTER PACK in 1 CARTON (71288-406-82) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS (71288-406-81)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":3.19142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (24 BLISTER PACK in 1 CARTON (71288-406-82) / 1 SYRINGE, GLASS in 1 BLISTER PACK / 1 mL in 1 SYRINGE, GLASS (71288-406-81)) gives 24 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":24,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288045002","name":"HEPARIN SOD 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-450-02","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (71288-450-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-450-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (71288-450-02) / 1 mL in 1 VIAL, MULTI-DOSE (71288-450-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409272101","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2721-01","proprietary_name":"Heparin Sodium","nonproprietary_name":"HEPARIN SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-2721-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2721-30)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-2721-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2721-30)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641041012","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0410-12","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 PACKAGE (0641-0410-12) / 1 mL in 1 VIAL (0641-0410-37)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 PACKAGE (0641-0410-12) / 1 mL in 1 VIAL (0641-0410-37)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021040301","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-403-01","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-403-01) / 1 mL in 1 VIAL","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-403-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021040366","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-403-66","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Sagent Pharmaceticals","package_description":"25 VIAL in 1 CARTON (25021-403-66) / 1 mL in 1 VIAL","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-403-66) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323054213","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-542-13","proprietary_name":"Heparin Sodium","nonproprietary_name":"HEPARIN SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-542-13) / 1 mL in 1 VIAL (63323-542-09)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-542-13) / 1 mL in 1 VIAL (63323-542-09)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288040402","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-404-02","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71288-404-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-404-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71288-404-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-404-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288042496","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"72603050125","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-501-25","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (72603-501-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72603-501-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (72603-501-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72603-501-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603057925","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-579-25","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Northstar Rx LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72603-579-25) / 1 mL in 1 VIAL, MULTI-DOSE (72603-579-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (72603-579-25) / 1 mL in 1 VIAL, MULTI-DOSE (72603-579-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952011306","name":"HEPARIN SODIUM 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-113-06","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [USP'U]/mL","labeler":"Hepalink USA Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (81952-113-06) / 1 mL in 1 VIAL, MULTI-DOSE (81952-113-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":2.09398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (81952-113-06) / 1 mL in 1 VIAL, MULTI-DOSE (81952-113-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323011805","name":"HEPARIN SODIUM 5,000 UNIT/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-118-05","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/.5mL","labeler":"Fresenius Kabi USA, LLC","package_description":"24 BLISTER PACK in 1 CARTON (63323-118-05) / 1 SYRINGE in 1 BLISTER PACK (63323-118-01) / .5 mL in 1 SYRINGE","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":5.8995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (24 BLISTER PACK in 1 CARTON (63323-118-05) / 1 SYRINGE in 1 BLISTER PACK (63323-118-01) / .5 mL in 1 SYRINGE) gives 12 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":24,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288040581","name":"HEPARIN SODIUM 5,000 UNIT/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-405-81","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/.5mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"24 BLISTER PACK in 1 CARTON (71288-405-81) / 1 SYRINGE, GLASS in 1 BLISTER PACK (71288-405-80) / .5 mL in 1 SYRINGE, GLASS","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":5.8995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (24 BLISTER PACK in 1 CARTON (71288-405-81) / 1 SYRINGE, GLASS in 1 BLISTER PACK (71288-405-80) / .5 mL in 1 SYRINGE, GLASS) gives 12 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":24,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409272301","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2723-01","proprietary_name":"Heparin Sodium","nonproprietary_name":"HEPARIN SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-2723-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2723-30)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-2723-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2723-30)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641040012","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0400-12","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 PACKAGE (0641-0400-12) / 1 mL in 1 VIAL (0641-0400-37)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 PACKAGE (0641-0400-12) / 1 mL in 1 VIAL (0641-0400-37)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781354525","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3545-25","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Sandoz Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (0781-3545-25) / 1 mL in 1 VIAL, MULTI-DOSE (0781-3545-10)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (0781-3545-25) / 1 mL in 1 VIAL, MULTI-DOSE (0781-3545-10)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021040201","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-402-01","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-402-01) / 1 mL in 1 VIAL","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-402-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021040266","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-402-66","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Sagent Pharmaceticals","package_description":"25 VIAL in 1 CARTON (25021-402-66) / 1 mL in 1 VIAL","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-402-66) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323026206","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-262-06","proprietary_name":"Heparin Sodium","nonproprietary_name":"HEPARIN SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-262-06) / 1 mL in 1 VIAL (63323-262-03)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-262-06) / 1 mL in 1 VIAL (63323-262-03)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323026226","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-262-26","proprietary_name":"Heparin Sodium","nonproprietary_name":"HEPARIN SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-262-26) / 1 mL in 1 VIAL (63323-262-09)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-262-26) / 1 mL in 1 VIAL (63323-262-09)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323026236","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-262-36","proprietary_name":"Heparin Sodium","nonproprietary_name":"HEPARIN SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-262-36) / 1 mL in 1 VIAL (63323-262-11)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-262-36) / 1 mL in 1 VIAL (63323-262-11)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288040302","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-403-02","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (71288-403-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-403-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (71288-403-02) / 1 mL in 1 VIAL, SINGLE-DOSE (71288-403-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288042296","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"72572025525","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-255-25","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 PACKAGE (72572-255-25) / 1 mL in 1 VIAL (72572-255-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 PACKAGE (72572-255-25) / 1 mL in 1 VIAL (72572-255-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603041225","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-412-25","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (72603-412-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72603-412-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (72603-412-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72603-412-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603045625","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-456-25","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Northstar Rx LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72603-456-25) / 1 mL in 1 VIAL, MULTI-DOSE (72603-456-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (72603-456-25) / 1 mL in 1 VIAL, MULTI-DOSE (72603-456-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81952011106","name":"HEPARIN SODIUM 5,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81952-111-06","proprietary_name":"Heparin Sodium","nonproprietary_name":"Heparin Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"5000 [USP'U]/mL","labeler":"Hepalink USA Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (81952-111-06) / 1 mL in 1 VIAL, MULTI-DOSE (81952-111-01)","pharm_classes":["Anti-coagulant [EPC]","Heparin [CS]","Unfractionated Heparin [EPC]"]},"nadac":{"value":1.1796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1644","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1644 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (81952-111-06) / 1 mL in 1 VIAL, MULTI-DOSE (81952-111-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"28595080208","name":"HISTEX 2.5 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"28595-802-08","proprietary_name":"HISTEX","nonproprietary_name":"TRIPROLIDINE HYDROCHLORIDE","dosage_form":"SYRUP","route":"ORAL","strength":"2.5 mg/5mL","labeler":"Allegis Pharmaceuticals, LLC","package_description":"237 mL in 1 BOTTLE (28595-802-08)"},"nadac":{"value":0.10114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"28595080130","name":"HISTEX PD 0.938 MG/ML DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.40117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"28595080416","name":"HISTEX-DM SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"28595-804-16","proprietary_name":"HISTEX-DM","nonproprietary_name":"DEXTROMETHORPHAN HYDROBROMIDE, PHENYLEPHRINE HYDROCHLORIDE, and TRIPROLIDINE HYDROCHLORIDE","dosage_form":"SYRUP","route":"ORAL","strength":"20 mg/5mL; 10 mg/5mL; 2.5 mg/5mL","labeler":"Allegis Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (28595-804-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62011011401","name":"HM CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62011-0114-1","proprietary_name":"Health Mart Calamine","nonproprietary_name":"Calamine 8% and Zinc Oxide 8%","dosage_form":"LOTION","route":"TOPICAL","strength":"160 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"177 mL in 1 BOTTLE, PLASTIC (62011-0114-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62011027201","name":"HM ISOPROPYL ALCOHOL 91%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62011-0272-1","proprietary_name":"Health Mart Isopropyl Alcohol 91 Percent","nonproprietary_name":"Isopropyl Alcohol","dosage_form":"LIQUID","route":"TOPICAL","strength":"910 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"473 mL in 1 BOTTLE (62011-0272-1)"},"nadac":{"value":0.05372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"53451010301","name":"HORIZANT ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53451-0103-1","proprietary_name":"Horizant","nonproprietary_name":"gabapentin enacarbil","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Azurity Pharmaceuticals, Inc. (formerly Arbor Pharmaceuticals)","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (53451-0103-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":17.92822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53451010101","name":"HORIZANT ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53451-0101-1","proprietary_name":"Horizant","nonproprietary_name":"gabapentin enacarbil","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Azurity Pharmaceuticals, Inc. (formerly Arbor Pharmaceuticals)","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (53451-0101-1)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":17.90997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002751659","name":"HUMALOG 100 UNIT/ML CARTRIDGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7516-59","proprietary_name":"Humalog","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 CARTRIDGE in 1 CARTON (0002-7516-59) / 3 mL in 1 CARTRIDGE (0002-7516-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":9.78555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humalog|Insulin Lispro","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 CARTRIDGE in 1 CARTON (0002-7516-59) / 3 mL in 1 CARTRIDGE (0002-7516-01)) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002879959","name":"HUMALOG 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8799-59","proprietary_name":"Humalog KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8799-59) / 3 mL in 1 SYRINGE (0002-8799-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.16762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humalog Kwikpen U-100|Insulin Lispro","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 SYRINGE in 1 CARTON (0002-8799-59) / 3 mL in 1 SYRINGE (0002-8799-01)) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002751001","name":"HUMALOG 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7510-01","proprietary_name":"Humalog","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL in 1 CARTON (0002-7510-01) / 10 mL in 1 VIAL","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":6.35737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humalog|Insulin Lispro","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0002-7510-01) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002771227","name":"HUMALOG 200 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7712-27","proprietary_name":"Humalog KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"2 SYRINGE in 1 CARTON (0002-7712-27) / 3 mL in 1 SYRINGE (0002-7712-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":20.31012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humalog Kwikpen U-200|Insulin Lispro","basis":"brand"},"part_b":null}, {"ndc":"00002771459","name":"HUMALOG JR 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7714-59","proprietary_name":"Humalog Junior KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-7714-59) / 3 mL in 1 SYRINGE (0002-7714-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.15829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humalog Junior Kwikpen|Insulin Lispro","basis":"brand"},"part_b":null}, {"ndc":"00002879859","name":"HUMALOG MIX 50-50 KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8798-59","proprietary_name":"Humalog Mix50/50 KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8798-59) / 3 mL in 1 SYRINGE (0002-8798-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.14137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002879759","name":"HUMALOG MIX 75-25 KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8797-59","proprietary_name":"Humalog Mix75/25 KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8797-59) / 3 mL in 1 SYRINGE (0002-8797-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.1667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002751101","name":"HUMALOG MIX 75-25 VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7511-01","proprietary_name":"Humalog Mix75/25","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0002-7511-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":8.15257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002821305","name":"HUMALOG TEMPO PEN 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-8213-05","proprietary_name":"Humalog Tempo Pen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8213-05) / 3 mL in 1 SYRINGE (0002-8213-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.12721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 SYRINGE in 1 CARTON (0002-8213-05) / 3 mL in 1 SYRINGE (0002-8213-01)) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00074379902","name":"HUMIRA 40 MG/0.8 ML SYRINGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-3799-02","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"2 KIT in 1 CARTON (0074-3799-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .8 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":3369.09256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074433902","name":"HUMIRA PEN 40 MG/0.8 ML","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-4339-02","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"2 KIT in 1 CARTON (0074-4339-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .8 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":3366.89653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074061602","name":"HUMIRA(CF) 20 MG/0.2 ML SYRINGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0074-0616-02","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"2 KIT in 1 CARTON (0074-0616-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .2 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":3366.123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074024302","name":"HUMIRA(CF) 40 MG/0.4 ML SYRINGE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-0243-02","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"2 KIT in 1 CARTON (0074-0243-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":3367.18294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074055402","name":"HUMIRA(CF) PEN 40 MG/0.4 ML","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-0554-02","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"2 KIT in 1 CARTON (0074-0554-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":3367.41479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074012402","name":"HUMIRA(CF) PEN 80 MG/0.8 ML","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-0124-02","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"2 KIT in 1 CARTON (0074-0124-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .8 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":6736.7225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074012403","name":"HUMIRA(CF) PEN CROHN'S-UC-HS STARTER 80 MG/0.8 ML","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0074-0124-03","proprietary_name":"Humira","nonproprietary_name":"Adalimumab","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"3 KIT in 1 CARTON (0074-0124-03) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .8 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":6745.428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002871501","name":"HUMULIN 70-30 VIAL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8715-01","proprietary_name":"Humulin 70/30","nonproprietary_name":"Insulin human","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0002-8715-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":4.25636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002880359","name":"HUMULIN 70/30 KWIKPEN","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8803-59","proprietary_name":"Humulin 70/30 KwikPen","nonproprietary_name":"Insulin human","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8803-59) / 3 mL in 1 SYRINGE (0002-8803-01)","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":9.0349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002880559","name":"HUMULIN N 100 UNIT/ML KWIKPEN","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8805-59","proprietary_name":"Humulin N","nonproprietary_name":"Insulin human","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8805-59) / 3 mL in 1 SYRINGE (0002-8805-01)","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":9.03325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humulin N Kwikpen|Insulin NPh Human Isophane","basis":"brand"},"part_b":null}, {"ndc":"00002831501","name":"HUMULIN N 100 UNIT/ML VIAL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8315-01","proprietary_name":"Humulin N","nonproprietary_name":"Insulin human","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0002-8315-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":4.26742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humulin N|Insulin NPh Human Isophane","basis":"brand"},"part_b":null}, {"ndc":"00002821501","name":"HUMULIN R 100 UNIT/ML VIAL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8215-01","proprietary_name":"Humulin R","nonproprietary_name":"Insulin human","dosage_form":"INJECTION, SOLUTION","route":"PARENTERAL","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0002-8215-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":4.2629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Humulin R|Insulin Regular, Human","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0002-8215-01) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002882427","name":"HUMULIN R 500 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8824-27","proprietary_name":"Humulin R U-500 KwikPen","nonproprietary_name":"Insulin human","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"500 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"2 SYRINGE in 1 CARTON (0002-8824-27) / 3 mL in 1 SYRINGE","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":91.60736,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904744761","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7447-61","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7447-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155000101","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155000110","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083201","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-832-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-832-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155083210","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-832-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-832-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722051901","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-519-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-519-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111039801","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-398-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-398-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111039803","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-398-03","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-398-03)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018201","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-182-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-182-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018210","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-182-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-182-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079007401","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-074","inner_of":["51079-074-20"]},"part_b":null}, {"ndc":"51079007420","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-074-20","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-074-20) / 1 TABLET in 1 BLISTER PACK (51079-074-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687081101","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-811-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-811-01) / 1 TABLET in 1 BLISTER PACK (60687-811-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687081111","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-811","inner_of":["60687-811-01"]},"part_b":null}, {"ndc":"62135057912","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-579-12","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62135-579-12)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030901","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-309-01","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-309-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282030910","name":"HYDRALAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-309-10","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-309-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904745061","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7450-61","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7450-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155000401","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083501","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-835-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-835-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722052201","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-522-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-522-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722052205","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-522-05","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-522-05)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111039701","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-397-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-397-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018501","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-185-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-185-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135058212","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-582-12","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62135-582-12)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380073606","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-736-06","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-736-06)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000605","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-006-05","proprietary_name":"HYDRALAZINE HYDROCHLORIDE","nonproprietary_name":"hydralazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (72241-006-05)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282031201","name":"HYDRALAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-312-01","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-312-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.0717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904744861","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7448-61","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7448-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155000201","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155000210","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083301","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-833-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-833-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155083310","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-833-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-833-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722052001","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-520-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-520-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722052010","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-520-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-520-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111032701","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-327-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-327-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111032703","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-327-03","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-327-03)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018301","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-183-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-183-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018310","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-183-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-183-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079007501","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-075","inner_of":["51079-075-20"]},"part_b":null}, {"ndc":"51079007520","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-075-20","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-075-20) / 1 TABLET in 1 BLISTER PACK (51079-075-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687082201","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-822-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-822-01) / 1 TABLET in 1 BLISTER PACK (60687-822-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687082211","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-822","inner_of":["60687-822-01"]},"part_b":null}, {"ndc":"62135058012","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-580-12","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62135-580-12)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380073406","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-734-06","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-734-06)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380073408","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-734-08","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-734-08)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000411","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-004-11","proprietary_name":"HYDRALAZINE HYDROCHLORIDE","nonproprietary_name":"hydralazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-004-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282031001","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-310-01","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-310-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282031010","name":"HYDRALAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-310-10","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-310-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.03572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904744961","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7449-61","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7449-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155000301","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155000310","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083401","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-834-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-834-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155083410","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-834-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-834-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722052101","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-521-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-521-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722052110","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-521-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-521-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111032801","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-328-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-328-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50111032803","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-328-03","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-328-03)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018401","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-184-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-184-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"50228018410","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-184-10","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-184-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079007601","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-076","inner_of":["51079-076-20"]},"part_b":null}, {"ndc":"51079007620","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-076-20","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-076-20) / 1 TABLET in 1 BLISTER PACK (51079-076-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687083301","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-833-01","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-833-01) / 1 TABLET in 1 BLISTER PACK (60687-833-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687083311","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-833","inner_of":["60687-833-01"]},"part_b":null}, {"ndc":"62135058112","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-581-12","proprietary_name":"Hydralazine Hydrochloride","nonproprietary_name":"Hydralazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62135-581-12)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380073506","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-735-06","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-735-06)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380073508","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-735-08","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-735-08)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241000511","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-005-11","proprietary_name":"HYDRALAZINE HYDROCHLORIDE","nonproprietary_name":"hydralazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-005-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282031101","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-311-01","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-311-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"76282031110","name":"HYDRALAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-311-10","proprietary_name":"HydrALAZINE Hydrochloride","nonproprietary_name":"HydrALAZINE Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-311-10)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.04454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydralazine HCl*|Hydralazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591034701","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0347-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0591-0347-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00591034705","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0347-05","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, GELATIN COATED in 1 BOTTLE (0591-0347-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300013001","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-130-01","proprietary_name":"hydrochlorothiazide","nonproprietary_name":"hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (29300-130-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300013005","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-130-05","proprietary_name":"hydrochlorothiazide","nonproprietary_name":"hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (29300-130-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300013010","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-130-10","proprietary_name":"hydrochlorothiazide","nonproprietary_name":"hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (29300-130-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"50228014601","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-146-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (50228-146-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"50228014605","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-146-05","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-146-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"50228014610","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-146-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 CAPSULE in 1 BOTTLE (50228-146-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"50268040411","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"50268040415","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-404-15","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-404-15) / 1 CAPSULE in 1 BLISTER PACK (50268-404-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"57237000201","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-002-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-002-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"57237000205","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-002-05","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-002-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"57237000299","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-002-99","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (57237-002-99)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"60687068301","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-683-01","proprietary_name":"hydrochlorothiazide","nonproprietary_name":"hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-683-01) / 1 CAPSULE in 1 BLISTER PACK (60687-683-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"60687068311","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69367021901","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-219-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (69367-219-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69367021905","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-219-05","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69367-219-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69367021910","name":"HYDROCHLOROTHIAZIDE 12.5 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-219-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"12.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (69367-219-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00172344460","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3444-60","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-3444-60)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00172344480","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-3444-80","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-3444-80)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00228282011","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2820-11","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2820-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00228282096","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2820-96","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0228-2820-96)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16729018201","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-182-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-182-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16729018217","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-182-17","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-182-17)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"23155076401","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-764-01","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-764-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"23155076410","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-764-10","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-764-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300048501","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-485-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-485-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300048510","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-485-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-485-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62135073890","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-738-90","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-738-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69315015501","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-155-01","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"HYDROCHLOROTHIAZIDE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69315-155-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69315015510","name":"HYDROCHLOROTHIAZIDE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-155-10","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"HYDROCHLOROTHIAZIDE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69315-155-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00172208360","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-2083-60","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-2083-60)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00172208380","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-2083-80","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-2083-80)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16729018301","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-183-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-183-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16729018317","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-183-17","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-183-17)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"23155000801","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-008-01","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-008-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"23155000810","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-008-10","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-008-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300012801","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-128-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-128-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300012810","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-128-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-128-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039710","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-397-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-397-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039711","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-397-11","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-397-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"60687059301","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-593-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-593-01) / 1 TABLET in 1 BLISTER PACK (60687-593-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"60687059311","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"60687089401","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-894-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-894-01) / 1 TABLET in 1 BLISTER PACK (60687-894-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"60687089411","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62135044805","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-448-05","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-448-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62135044890","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-448-90","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-448-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862013399","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-133-99","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-133-99)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68645051054","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-510-54","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-510-54)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69315013101","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-131-01","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"HYDROCHLOROTHIAZIDE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69315-131-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69315013110","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-131-10","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"HYDROCHLOROTHIAZIDE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69315-131-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69584036110","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-361-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-361-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69584036190","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-361-90","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-361-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69584036195","name":"HYDROCHLOROTHIAZIDE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-361-95","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"5000 TABLET in 1 BOTTLE (69584-361-95)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.01153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00172208960","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-2089-60","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0172-2089-60)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00172208980","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0172-2089-80","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0172-2089-80)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16729018401","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-184-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-184-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16729018417","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-184-17","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-184-17)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"23155000901","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-009-01","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-009-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"23155000910","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-009-10","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-009-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300012901","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-129-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-129-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300012910","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-129-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-129-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039810","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-398-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-398-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039811","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-398-11","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-398-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62135044905","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-449-05","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-449-05)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62135044990","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-449-90","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-449-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862013401","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-134-01","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-134-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862013499","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-134-99","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-134-99)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69315013001","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-130-01","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"HYDROCHLOROTHIAZIDE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69315-130-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69315013010","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-130-10","proprietary_name":"HYDROCHLOROTHIAZIDE","nonproprietary_name":"HYDROCHLOROTHIAZIDE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69315-130-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69584036210","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-362-10","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-362-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69584036290","name":"HYDROCHLOROTHIAZIDE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-362-90","proprietary_name":"Hydrochlorothiazide","nonproprietary_name":"Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-362-90)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrochlorothiazide|Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"47781041060","name":"HYDROCODONE ER 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-410-60","proprietary_name":"Hydrocodone Bitartrate","nonproprietary_name":"Hydrocodone Bitartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Alvogen Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (47781-410-60)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":7.94694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone Bitartrate ER|Hydrocodone Bitartrate","basis":"generic"},"part_b":null}, {"ndc":"00406037801","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0378-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0378-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406037805","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0378-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0378-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019401","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-194-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-194-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107021301","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-213-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-213-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107021305","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-213-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-213-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808011601","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-116-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (27808-116-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004412","name":"HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-044-12","proprietary_name":"hydrocodone bitartrate and acetaminophen","nonproprietary_name":"hydrocodone bitartrate and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 300 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-044-12)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.2468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012501","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0125-01","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0125-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012505","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0125-05","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0125-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012510","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0125-10","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1000 TABLET in 1 BOTTLE (0406-0125-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012523","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0125-23","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0125-23)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012562","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0125-62","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0125-62)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019101","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-191-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-191-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019110","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-191-10","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 TABLET in 1 BOTTLE (10702-191-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019150","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-191-50","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-191-50)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107002101","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-021-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-021-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107002105","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-021-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-021-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107002199","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-021-99","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (13107-021-99)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003701","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-037-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (27808-037-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003702","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-037-02","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (27808-037-02)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003703","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-037-03","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (27808-037-03)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094301","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094305","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722099701","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-997-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-997-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722099705","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-997-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-997-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858020301","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-203-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-203-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858020350","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-203-50","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (42858-203-50)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268040211","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268040215","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-402-15","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-402-15) / 1 TABLET in 1 BLISTER PACK (50268-402-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746011001","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-110-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-110-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746011005","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-110-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-110-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687041801","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-418-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-418-01) / 1 TABLET in 1 BLISTER PACK (60687-418-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687041811","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64380044201","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-442-01","proprietary_name":"hydrocodone bitartrate and acetaminophen","nonproprietary_name":"hydrocodone bitartrate and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-442-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850063301","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-633-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64850-633-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930002112","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-021-12","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-021-12)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930002113","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-021-13","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"1000 TABLET in 1 BOTTLE (71930-021-13)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930002152","name":"HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-021-52","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-021-52)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406037601","name":"HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0376-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 300 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0376-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.17541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406037605","name":"HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0376-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 300 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0376-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.17541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019201","name":"HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-192-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 300 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-192-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.17541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107021101","name":"HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-211-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 300 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-211-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.17541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107021105","name":"HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-211-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 300 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-211-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.17541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808011401","name":"HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-114-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 300 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (27808-114-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.17541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012301","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0123-01","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0123-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012305","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0123-05","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0123-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012310","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0123-10","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1000 TABLET in 1 BOTTLE (0406-0123-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012323","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0123-23","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0123-23)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012362","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0123-62","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0123-62)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018901","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-189-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-189-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018910","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-189-10","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 TABLET in 1 BOTTLE (10702-189-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018950","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-189-50","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-189-50)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107001901","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-019-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-019-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107001905","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-019-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-019-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003501","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-035-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (27808-035-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003502","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-035-02","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (27808-035-02)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003503","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-035-03","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (27808-035-03)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094101","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094105","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722099601","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-996-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-996-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722099605","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-996-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-996-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858020101","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-201-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-201-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858020150","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-201-50","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (42858-201-50)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268040111","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268040115","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-401-15","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-401-15) / 1 TABLET in 1 BLISTER PACK (50268-401-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746010901","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-109-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-109-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746010905","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-109-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-109-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687039601","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-396-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-396-01) / 1 TABLET in 1 BLISTER PACK (60687-396-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687039611","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64380044001","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-440-01","proprietary_name":"hydrocodone bitartrate and acetaminophen","nonproprietary_name":"hydrocodone bitartrate and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-440-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850063101","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-631-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64850-631-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850063105","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70010067201","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-672-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-672-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930001912","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-019-12","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-019-12)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930001913","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-019-13","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"1000 TABLET in 1 BOTTLE (71930-019-13)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930001952","name":"HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-019-52","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-019-52)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406037701","name":"HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0377-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 300 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0377-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.21369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406037705","name":"HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0377-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 300 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0377-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.21369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019301","name":"HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-193-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 300 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-193-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.21369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107021201","name":"HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-212-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 300 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-212-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.21369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107021205","name":"HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-212-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 300 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-212-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.21369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808011501","name":"HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-115-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 300 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (27808-115-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.21369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012401","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0124-01","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0124-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012405","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0124-05","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0124-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012410","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0124-10","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1000 TABLET in 1 BOTTLE (0406-0124-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012423","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0124-23","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0124-23)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406012462","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0124-62","proprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","nonproprietary_name":"HYDROCODONE BITARTRATE AND ACETAMINOPHEN","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0124-62)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019001","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-190-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-190-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019010","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-190-10","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 TABLET in 1 BOTTLE (10702-190-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702019050","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-190-50","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-190-50)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107002001","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-020-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-020-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107002005","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-020-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-020-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003601","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-036-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (27808-036-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003602","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-036-02","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (27808-036-02)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"27808003603","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-036-03","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (27808-036-03)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094201","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-942-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-942-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094205","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-942-05","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-942-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858020201","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-202-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (42858-202-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"43547037310","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268040011","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268040015","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-400-15","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-400-15) / 1 TABLET in 1 BLISTER PACK (50268-400-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687040701","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-407-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-407-01) / 1 TABLET in 1 BLISTER PACK (60687-407-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687040711","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64380044101","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-441-01","proprietary_name":"hydrocodone bitartrate and acetaminophen","nonproprietary_name":"hydrocodone bitartrate and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-441-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850063201","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-632-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64850-632-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850063205","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65162011510","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-115-10","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-115-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65162011511","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-115-11","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-115-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65162011550","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-115-50","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-115-50)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70010067301","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-673-01","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-673-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930002012","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-020-12","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-020-12)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930002013","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-020-13","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"1000 TABLET in 1 BOTTLE (71930-020-13)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930002052","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-020-52","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-020-52)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Acetaminophen|Hydrocodone/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64950034316","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-343-16","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"hydrocodone bitartrate and acetaminophen","dosage_form":"SOLUTION","route":"ORAL","strength":"7.5 mg/15mL; 325 mg/15mL","labeler":"Genus Lifesciences Inc.","package_description":"473 mL in 1 BOTTLE (64950-343-16)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950037316","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-373-16","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"hydrocodone bitartrate and acetaminophen","dosage_form":"SOLUTION","route":"ORAL","strength":"7.5 mg/15mL; 325 mg/15mL","labeler":"Genus Lifesciences Inc.","package_description":"473 mL in 1 BOTTLE (64950-373-16)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71930002743","name":"HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-027-43","proprietary_name":"Hydrocodone Bitartrate and Acetaminophen","nonproprietary_name":"Hydrocodone Bitartrate and Acetaminophen","dosage_form":"SOLUTION","route":"ORAL","strength":"7.5 mg/15mL; 325 mg/15mL","labeler":"Eywa Pharma Inc","package_description":"473 mL in 1 BOTTLE (71930-027-43)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.24549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27808008601","name":"HYDROCODONE-CHLORPHEN ER SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-086-01","proprietary_name":"Hydrocodone Polistirex and Chlorpheniramine Polistirex extended-release","nonproprietary_name":"Hydrocodone Polistirex and Chlorpheniramine Polistirex","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/5mL; 8 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1 BOTTLE, UNIT-DOSE in 1 CARTON (27808-086-01) / 115 mL in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.47755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27808008602","name":"HYDROCODONE-CHLORPHEN ER SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-086-02","proprietary_name":"Hydrocodone Polistirex and Chlorpheniramine Polistirex extended-release","nonproprietary_name":"Hydrocodone Polistirex and Chlorpheniramine Polistirex","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/5mL; 8 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (27808-086-02)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.63422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"10702005501","name":"HYDROCODONE-HOMATROPINE 5-1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-055-01","proprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","nonproprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 1.5 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-055-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.92178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702005503","name":"HYDROCODONE-HOMATROPINE 5-1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-055-03","proprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","nonproprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 1.5 mg/1","labeler":"KVK-Tech, Inc.","package_description":"30 TABLET in 1 BOTTLE (10702-055-03)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.92178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64950020603","name":"HYDROCODONE-HOMATROPINE 5-1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-206-03","proprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","nonproprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 1.5 mg/1","labeler":"Genus Lifesciences Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (64950-206-03)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.92178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64950020610","name":"HYDROCODONE-HOMATROPINE 5-1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-206-10","proprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","nonproprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 1.5 mg/1","labeler":"Genus Lifesciences Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64950-206-10)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.92178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702015016","name":"HYDROCODONE-HOMATROPINE SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-150-16","proprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","nonproprietary_name":"hydrocodone bitartrate and homatropine methylbromide oral solution","dosage_form":"LIQUID","route":"ORAL","strength":"5 mg/5mL; 1.5 mg/5mL","labeler":"KVK-Tech, Inc.","package_description":"473 mL in 1 BOTTLE (10702-150-16)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.10305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950037147","name":"HYDROCODONE-HOMATROPINE SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-371-47","proprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","nonproprietary_name":"Hydrocodone Bitartrate and Homatropine Methylbromide","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL; 1.5 mg/5mL","labeler":"Genus Lifesciences Inc.","package_description":"473 mL in 1 BOTTLE (64950-371-47)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.10305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"53746011701","name":"HYDROCODONE-IBUPROFEN 10-200","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-117-01","proprietary_name":"Hydrocodone Bitartrate and Ibuprofen","nonproprietary_name":"Hydrocodone Bitartrate and Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 200 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-117-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":3.36042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Ibuprofen|Hydrocodone/Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"53746014601","name":"HYDROCODONE-IBUPROFEN 5-200 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"53746-146-01","proprietary_name":"Hydrocodone Bitartrate and Ibuprofen","nonproprietary_name":"Hydrocodone Bitartrate and Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 200 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-146-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":2.57162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Ibuprofen|Hydrocodone/Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"13107000401","name":"HYDROCODONE-IBUPROFEN 7.5-200","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-004-01","proprietary_name":"Hydrocodone Bitartrate and Ibuprofen","nonproprietary_name":"Hydrocodone Bitartrate and Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1; 200 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13107-004-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.48702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Ibuprofen|Hydrocodone/Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"53746014501","name":"HYDROCODONE-IBUPROFEN 7.5-200","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-145-01","proprietary_name":"Hydrocodone Bitartrate and Ibuprofen","nonproprietary_name":"Hydrocodone Bitartrate and Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 200 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-145-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.48702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocodone-Ibuprofen|Hydrocodone/Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"45802014464","name":"HYDROCORT-PRAMOXINE 1%-1% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-144-64","proprietary_name":"hydrocortisone acetate pramoxine hcl","nonproprietary_name":"hydrocortisone acetate pramoxine hcl","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g; 1 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-144-64) / 28.35 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.88922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817081701","name":"HYDROCORT-PRAMOXINE 2.5-1% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-817-01","proprietary_name":"hydrocortisone acetate pramoxine HCl","nonproprietary_name":"Hydrocortisone Acetate, Pramoxine HCl","dosage_form":"CREAM","route":"TOPICAL","strength":"2.5 g/100g; 1 g/100g","labeler":"TRUPHARMA, LLC","package_description":"1 TUBE in 1 CARTON (52817-817-01) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.58829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385019003","name":"HYDROCORTISONE 0.5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-190-03","proprietary_name":"Good Neighbor Pharmacy Hydrocortisone With Aloe for Sensitive Skin","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":".5 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-190-03) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672201002","name":"HYDROCORTISONE 0.5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2010-2","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":".5 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2010-2) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168001516","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0015-16","proprietary_name":"hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"453.6 g in 1 JAR (0168-0015-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168001531","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0015-31","proprietary_name":"hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0015-31) / 28.35 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11455,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472032126","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0472-0321-26","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0321-26) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385002103","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-021-03","proprietary_name":"Good Neighbor Pharmacy Hydrocortisone Plus 12 Moisturizers","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-021-03) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385027403","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-274-03","proprietary_name":"Good Neighbor Pharmacy Hydrocortisone with Aloe","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-274-03) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802043803","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-438-03","proprietary_name":"hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-438-03) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672206302","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2063-2","proprietary_name":"Hydrocortisone Plus 12 Moisturizers","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2063-2) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672206902","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2069-2","proprietary_name":"Hydrocortisone Acetate Antipruritic (Anti-Itch)","nonproprietary_name":"Hydrocortisone Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2069-2) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559043001","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-430-01","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-430-01) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001047646","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-476-46","proprietary_name":"Hydrocortisone","nonproprietary_name":"Antipruritic (Anti-Itch)","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-476-46) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001047650","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-476-50","proprietary_name":"Hydrocortisone","nonproprietary_name":"Antipruritic (Anti-Itch)","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"BluePoint Laboratories","package_description":"454 g in 1 JAR (68001-476-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000048501","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0485-1","proprietary_name":"Hydrocortisone","nonproprietary_name":"Anti-pruritic","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Cardinal Health","package_description":"72 BOX in 1 CASE (70000-0485-1) / 1 TUBE in 1 BOX / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70512010130","name":"HYDROCORTISONE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.0588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168002016","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0020-16","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"453.6 g in 1 JAR (0168-0020-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168002031","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0020-31","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0020-31) / 28.35 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.15449,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385027603","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-276-03","proprietary_name":"Good Neighbor Pharmacy Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-276-03) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802027603","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-276-03","proprietary_name":"hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-276-03) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672201802","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2018-2","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2018-2) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001052645","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-526-45","proprietary_name":"Hydrocortisone","nonproprietary_name":"Antipruritic (Anti-Itch)","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-526-45) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000048901","name":"HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0489-1","proprietary_name":"Hydrocortisone","nonproprietary_name":"Anti-Itch","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"Cardinal Health","package_description":"72 BOX in 1 CASE (70000-0489-1) / 1 TUBE in 1 BOX / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713084909","name":"HYDROCORTISONE 1%-ACETIC ACID 2% EAR DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0849-09","proprietary_name":"hydrocortisone and acetic acid","nonproprietary_name":"hydrocortisone and acetic acid","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"20 mg/mL; 10 mg/mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (0713-0849-09) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.4354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672300701","name":"HYDROCORTISONE 1%-ACETIC ACID 2% EAR DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-3007-1","proprietary_name":"Hydrocortisone and Acetic Acid","nonproprietary_name":"Hydrocortisone and Acetic Acid","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"10.4 mg/mL; 20.8 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-3007-1) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.4354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656006410","name":"HYDROCORTISONE 1%-ACETIC ACID 2% EAR DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-064-10","proprietary_name":"hydrocortisone and acetic acid","nonproprietary_name":"hydrocortisone and acetic acid otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"20.75 mg/mL; 10.375 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (71656-064-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.4354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115169701","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1697-01","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0115-1697-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904718861","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7188-61","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7188-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268040611","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268040615","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-406-15","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-406-15) / 1 TABLET in 1 BLISTER PACK (50268-406-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651041401","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-414-01","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"HYDROCORTISONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-414-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762007401","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0074-1","proprietary_name":"Hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-0074-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687058201","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-582-01","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-582-01) / 1 TABLET in 1 BLISTER PACK (60687-582-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687058211","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135055290","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-552-90","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET in 1 BOTTLE (62135-552-90)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380097106","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-971-06","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-971-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954005310","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-053-10","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-053-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930007912","name":"HYDROCORTISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-079-12","proprietary_name":"hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-079-12)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155092681","name":"HYDROCORTISONE 100 MG/60 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-926-81","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"SUSPENSION","route":"RECTAL","strength":"100 mg/60mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc","package_description":"7 BOTTLE in 1 CARTON (23155-926-81) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135002007","name":"HYDROCORTISONE 100 MG/60 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-020-07","proprietary_name":"Hydrocortisone Rectal Suspension (Retention)","nonproprietary_name":"Hydrocortisone","dosage_form":"SUSPENSION","route":"RECTAL","strength":"100 mg/60mL","labeler":"Chartwell RX LLC","package_description":"7 BOTTLE in 1 CARTON (62135-020-07) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559013807","name":"HYDROCORTISONE 100 MG/60 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-138-07","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"ENEMA","route":"RECTAL","strength":"100 mg/60mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"7 BOTTLE in 1 BOX (62559-138-07) / 60 mL in 1 BOTTLE (62559-138-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.14111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168008016","name":"HYDROCORTISONE 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0080-16","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"454 g in 1 JAR (0168-0080-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168008031","name":"HYDROCORTISONE 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0080-31","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"30 g in 1 TUBE (0168-0080-31)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.09185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802000402","name":"HYDROCORTISONE 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-004-02","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-004-02) / 20 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802000403","name":"HYDROCORTISONE 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-004-03","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-004-03) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.09548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672300302","name":"HYDROCORTISONE 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-3003-2","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-3003-2) / 28.35 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62559043130","name":"HYDROCORTISONE 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-431-30","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-431-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802093716","name":"HYDROCORTISONE 2.5% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-937-16","proprietary_name":"hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"LOTION","route":"TOPICAL","strength":"25 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"59 mL in 1 BOTTLE (45802-937-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.21098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802093726","name":"HYDROCORTISONE 2.5% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-937-26","proprietary_name":"hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"LOTION","route":"TOPICAL","strength":"25 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"118 mL in 1 BOTTLE (45802-937-26)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168014630","name":"HYDROCORTISONE 2.5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0146-30","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"29 g in 1 TUBE (0168-0146-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.09549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802001402","name":"HYDROCORTISONE 2.5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-014-02","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-014-02) / 20 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802001405","name":"HYDROCORTISONE 2.5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-014-05","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"454 g in 1 JAR (45802-014-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00115170001","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1700-01","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0115-1700-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268040711","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268040715","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-407-15","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-407-15) / 1 TABLET in 1 BLISTER PACK (50268-407-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651041501","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-415-01","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"HYDROCORTISONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-415-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762007501","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0075-1","proprietary_name":"Hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-0075-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135018660","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-186-60","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-186-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380097206","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-972-06","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-972-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954005410","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-054-10","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-054-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930008012","name":"HYDROCORTISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-080-12","proprietary_name":"hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-080-12)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.30056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115169606","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1696-06","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"50 TABLET in 1 BOTTLE, PLASTIC (0115-1696-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268040511","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268040515","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-405-15","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-405-15) / 1 TABLET in 1 BLISTER PACK (50268-405-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651041350","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-413-50","proprietary_name":"HYDROCORTISONE","nonproprietary_name":"HYDROCORTISONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET in 1 BOTTLE (59651-413-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762007301","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0073-1","proprietary_name":"Hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"50 TABLET in 1 BOTTLE (59762-0073-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687084411","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687084421","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-844-21","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-844-21) / 1 TABLET in 1 BLISTER PACK (60687-844-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135055160","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-551-60","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 TABLET in 1 BOTTLE (62135-551-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380097025","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-970-25","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"50 TABLET in 1 BOTTLE, PLASTIC (64380-970-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954005210","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-052-10","proprietary_name":"Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"50 TABLET in 1 BOTTLE (70954-052-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71930007850","name":"HYDROCORTISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-078-50","proprietary_name":"hydrocortisone","nonproprietary_name":"hydrocortisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Eywa Pharma Inc","package_description":"50 TABLET in 1 BOTTLE (71930-078-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672407401","name":"HYDROCORTISONE BUTY 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4074-1","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4074-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.40113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672407406","name":"HYDROCORTISONE BUTY 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4074-6","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4074-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.36296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180095102","name":"HYDROCORTISONE BUTYR 0.1% LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68180-951-02","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-951-02) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.69995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83148001204","name":"HYDROCORTISONE BUTYR 0.1% LOTN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83148-012-04","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"The J. Molner Company LLC","package_description":"1 BOTTLE in 1 CARTON (83148-012-04) / 118 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.69995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672408301","name":"HYDROCORTISONE BUTYR 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-4083-1","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4083-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.04178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672408306","name":"HYDROCORTISONE BUTYR 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4083-6","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4083-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.17956,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672406104","name":"HYDROCORTISONE BUTYR 0.1% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-4061-4","proprietary_name":"Hydrocortisone Butyrate","nonproprietary_name":"Hydrocortisone Butyrate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4061-4) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.17643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505641100","name":"HYDROCORTISONE SS 100 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6411-0","proprietary_name":"Hydrocortisone sodium succinate","nonproprietary_name":"Hydrocortisone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/2mL","labeler":"Apotex Corp.","package_description":"1 VIAL in 1 CARTON (60505-6411-0) / 2 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":14.61713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocortisone Sod Succinate|Hydrocortisone Sod Succinate","basis":"generic"},"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (60505-6411-0) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69097000467","name":"HYDROCORTISONE SS 100 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-004-67","proprietary_name":"Hydrocortisone sodium succinate","nonproprietary_name":"Hydrocortisone sodium succinate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/2mL","labeler":"Cipla USA Inc.","package_description":"1 VIAL in 1 CARTON (69097-004-67) / 2 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":14.61713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocortisone Sod Succinate|Hydrocortisone Sod Succinate","basis":"generic"},"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (69097-004-67) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70710190701","name":"HYDROCORTISONE SS 100 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1907-1","proprietary_name":"Hydrocortisone sodium succinate","nonproprietary_name":"Hydrocortisone sodium succinate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/2mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (70710-1907-1) / 2 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":14.61713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydrocortisone Sod Succinate|Hydrocortisone Sod Succinate","basis":"generic"},"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70710-1907-1) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00713072015","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0720-15","proprietary_name":"HYDROCORTISONE VALERATE","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0720-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713072037","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0720-37","proprietary_name":"HYDROCORTISONE VALERATE","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0720-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713072060","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0720-60","proprietary_name":"HYDROCORTISONE VALERATE","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0720-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672129001","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1290-1","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"Hydrocortisone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1290-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672129003","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1290-3","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"Hydrocortisone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1290-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672129006","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1290-6","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"Hydrocortisone Valerate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1290-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"68180095401","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-954-01","proprietary_name":"HYDROCORTISONE VALERATE","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-954-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.37436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"68180095402","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-954-02","proprietary_name":"HYDROCORTISONE VALERATE","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-954-02) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"68180095403","name":"HYDROCORTISONE VAL 0.2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-954-03","proprietary_name":"HYDROCORTISONE VALERATE","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-954-03) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713056015","name":"HYDROCORTISONE VAL 0.2% OINTMT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0560-15","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0560-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.2936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713056037","name":"HYDROCORTISONE VAL 0.2% OINTMT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0560-37","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0560-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.5784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00713056060","name":"HYDROCORTISONE VAL 0.2% OINTMT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0560-60","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"HYDROCORTISONE VALERATE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0560-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.16044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672129201","name":"HYDROCORTISONE VAL 0.2% OINTMT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1292-1","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"Hydrocortisone Valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1292-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.2936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672129203","name":"HYDROCORTISONE VAL 0.2% OINTMT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1292-3","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"Hydrocortisone Valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1292-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.16044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"51672129206","name":"HYDROCORTISONE VAL 0.2% OINTMT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1292-6","proprietary_name":"Hydrocortisone Valerate","nonproprietary_name":"Hydrocortisone Valerate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1292-6) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.5784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Hydrocortisone Valerate|Hydrocortisone Valerate","basis":"generic"},"part_b":null}, {"ndc":"00536140795","name":"HYDROCORTISONE-ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1407-95","proprietary_name":"Hydrocortisone Cream with Aloe","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1407-95) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672201301","name":"HYDROCORTISONE-ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2013-1","proprietary_name":"Hydrocortisone with Aloe","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2013-1) / 14.2 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672201302","name":"HYDROCORTISONE-ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2013-2","proprietary_name":"Hydrocortisone with Aloe","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2013-2) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672533001","name":"HYDROCORTISONE-ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-5330-1","proprietary_name":"Hydrocortisone with Aloe","nonproprietary_name":"Hydrocortisone Cream 1%","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-5330-1) / 14.2 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672533002","name":"HYDROCORTISONE-ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-5330-2","proprietary_name":"Hydrocortisone with Aloe","nonproprietary_name":"Hydrocortisone Cream 1%","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-5330-2) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000066201","name":"HYDROCORTISONE-ALOE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0662-1","proprietary_name":"Hydrocortisone Cream with Aloe","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Cardinal Health 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0662-1) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122033443","name":"HYDROGEN PEROXIDE 3% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.01814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68599230106","name":"HYDROGEN PEROXIDE 3% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68599-2301-6","proprietary_name":"Hydrogen Peroxide","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"SOLUTION","route":"TOPICAL","strength":"30 mg/mL","labeler":"McKesson Medical-Surgical Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (68599-2301-6)"},"nadac":{"value":0.01814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000002201","name":"HYDROGEN PEROXIDE 3% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0022-1","proprietary_name":"Hydrogen Peroxide","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"3 mL/100mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"236 mL in 1 BOTTLE, PLASTIC (70000-0022-1)"},"nadac":{"value":0.00634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000002203","name":"HYDROGEN PEROXIDE 3% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0022-3","proprietary_name":"Hydrogen Peroxide","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"3 mL/100mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"236 mL in 1 BOTTLE, SPRAY (70000-0022-3)"},"nadac":{"value":0.00634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000050001","name":"HYDROGEN PEROXIDE 3% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0500-1","proprietary_name":"Hydrogen Peroxide 3 Percent","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"3 mL/100mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"946 mL in 1 BOTTLE, PLASTIC (70000-0500-1)"},"nadac":{"value":0.00153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000050002","name":"HYDROGEN PEROXIDE 3% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0500-2","proprietary_name":"Hydrogen Peroxide 3 Percent","nonproprietary_name":"Hydrogen Peroxide","dosage_form":"LIQUID","route":"TOPICAL","strength":"3 mL/100mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"473 mL in 1 BOTTLE, PLASTIC (70000-0500-2)"},"nadac":{"value":0.01814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054038663","name":"HYDROMORPHONE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0386-63","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"473 mL in 1 BOTTLE (0054-0386-63)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00703001801","name":"HYDROMORPHONE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0703-0018-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"HYDROMORPHONE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"1 VIAL in 1 CARTON (0703-0018-01) / 50 mL in 1 VIAL","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.56628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0703-0018-01) / 50 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00406324301","name":"HYDROMORPHONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-3243-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-3243-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107010701","name":"HYDROMORPHONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-107-01","proprietary_name":"HYDROMORPHONE HYDROCHLORIDE","nonproprietary_name":"HYDROMORPHONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-107-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030101","name":"HYDROMORPHONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-301-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-301-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030125","name":"HYDROMORPHONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-301-25","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 BLISTER PACK in 1 CARTON (42858-301-25) / 25 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687057901","name":"HYDROMORPHONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-579-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-579-01) / 1 TABLET in 1 BLISTER PACK (60687-579-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687057911","name":"HYDROMORPHONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641615125","name":"HYDROMORPHONE 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6151-25","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (0641-6151-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6151-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.74032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (0641-6151-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6151-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323085325","name":"HYDROMORPHONE 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-853-25","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (63323-853-25) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-853-03)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.74032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (63323-853-25) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-853-03)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00406324401","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-3244-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-3244-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107010801","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-108-01","proprietary_name":"HYDROMORPHONE HYDROCHLORIDE","nonproprietary_name":"HYDROMORPHONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-108-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030201","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-302-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-302-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030225","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-302-25","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 BLISTER PACK in 1 CARTON (42858-302-25) / 25 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030250","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-302-50","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (42858-302-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687059001","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-590-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-590-01) / 1 TABLET in 1 BLISTER PACK (60687-590-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687059011","name":"HYDROMORPHONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030416","name":"HYDROMORPHONE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-304-16","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Rhodes Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (42858-304-16)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409263405","name":"HYDROMORPHONE 50 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-2634-05","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-05) / 5 mL in 1 VIAL, SINGLE-DOSE (0409-2634-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.56628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-05) / 5 mL in 1 VIAL, SINGLE-DOSE (0409-2634-25)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00703011303","name":"HYDROMORPHONE 50 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0703-0113-03","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"HYDROMORPHONE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"10 VIAL in 1 CARTON (0703-0113-03) / 5 mL in 1 VIAL (0703-0113-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.56628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0703-0113-03) / 5 mL in 1 VIAL (0703-0113-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323085115","name":"HYDROMORPHONE 50 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-851-15","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (63323-851-15) / 5 mL in 1 VIAL, SINGLE-DOSE (63323-851-07)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.56628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (63323-851-15) / 5 mL in 1 VIAL, SINGLE-DOSE (63323-851-07)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409263450","name":"HYDROMORPHONE 500 MG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-2634-50","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-50) / 50 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.56628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-50) / 50 mL in 1 VIAL, SINGLE-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323085150","name":"HYDROMORPHONE 500 MG/50 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-851-50","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"50 mL in 1 VIAL, SINGLE-DOSE (63323-851-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.56628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1171","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1171 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 mL in 1 VIAL, SINGLE-DOSE (63323-851-50)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00406324901","name":"HYDROMORPHONE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-3249-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-3249-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.56093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107010901","name":"HYDROMORPHONE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-109-01","proprietary_name":"HYDROMORPHONE HYDROCHLORIDE","nonproprietary_name":"HYDROMORPHONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-109-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.56093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858030301","name":"HYDROMORPHONE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-303-01","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-303-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.56093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574029401","name":"HYDROMORPHONE HCL ER 12 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0294-01","proprietary_name":"hydromorphone hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0574-0294-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.42125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070210","name":"HYDROMORPHONE HCL ER 12 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-702-10","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-702-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.42125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012001","name":"HYDROMORPHONE HCL ER 12 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-120-01","proprietary_name":"hydromorphone hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-120-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.42125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"00574029501","name":"HYDROMORPHONE HCL ER 16 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0295-01","proprietary_name":"hydromorphone hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"16 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0574-0295-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":12.38018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070310","name":"HYDROMORPHONE HCL ER 16 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-703-10","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"16 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-703-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":12.38018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012101","name":"HYDROMORPHONE HCL ER 16 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-121-01","proprietary_name":"hydromorphone hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"16 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-121-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":12.38018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"00574029301","name":"HYDROMORPHONE HCL ER 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0293-01","proprietary_name":"hydromorphone hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0574-0293-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":5.7288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070110","name":"HYDROMORPHONE HCL ER 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-701-10","proprietary_name":"Hydromorphone Hydrochloride","nonproprietary_name":"Hydromorphone Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-701-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":5.7288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722011901","name":"HYDROMORPHONE HCL ER 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-119-01","proprietary_name":"hydromorphone hydrochloride","nonproprietary_name":"hydromorphone hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-119-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":5.7288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydromorphone ER|Hydromorphone HCl","basis":"generic"},"part_b":null}, {"ndc":"42192015101","name":"HYDROQUINONE 4% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-151-01","proprietary_name":"HYDROQUINONE 4%","nonproprietary_name":"Hydroquinone","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (42192-151-01) / 28.35 g in 1 TUBE","pharm_classes":["Depigmenting Activity [PE]","Melanin Synthesis Inhibitor [EPC]","Melanin Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.51304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367017401","name":"HYDROQUINONE 4% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-174-01","proprietary_name":"Hydroquinone","nonproprietary_name":"Hydroquinone","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-174-01) / 28.35 g in 1 TUBE","pharm_classes":["Depigmenting Activity [PE]","Melanin Synthesis Inhibitor [EPC]","Melanin Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.51304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75834013701","name":"HYDROQUINONE 4% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-137-01","proprietary_name":"Hydroquinone 4%","nonproprietary_name":"Hydroquinone","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (75834-137-01) / 28.4 g in 1 TUBE","pharm_classes":["Depigmenting Activity [PE]","Melanin Synthesis Inhibitor [EPC]","Melanin Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.46127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591288830","name":"HYDROXOCOBALAMIN 1,000 MCG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0591-2888-30","proprietary_name":"Hydroxocobalamin","nonproprietary_name":"Hydroxocobalamin","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 ug/mL","labeler":"Actavis Pharma, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0591-2888-30) / 30 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Antidote [EPC]"]},"nadac":{"value":0.8144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3425","bill_units_per_package":{"value":3000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3425 (10 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0591-2888-30) / 30 mL in 1 VIAL, MULTI-DOSE) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598013301","name":"HYDROXYCHLOROQUINE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-133-01","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-133-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00093240101","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2401-01","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-2401-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904704606","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7046-06","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7046-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904704661","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7046-61","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7046-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16571011201","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-112-01","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-112-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16571011250","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-112-50","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-112-50)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16571068701","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16714011001","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-110-01","proprietary_name":"Hydroxychloroquine sulfate","nonproprietary_name":"Hydroxychloroquine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-110-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16714011002","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-110-02","proprietary_name":"Hydroxychloroquine sulfate","nonproprietary_name":"Hydroxychloroquine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-110-02)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16729048501","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-485-01","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Accord Healthcare, Inc.,","package_description":"100 TABLET in 1 BOTTLE (16729-485-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"16729048516","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-485-16","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Accord Healthcare, Inc.,","package_description":"500 TABLET in 1 BOTTLE (16729-485-16)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43598072101","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-721-01","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-721-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43598072105","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-721-05","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-721-05)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"50268041211","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"50268041215","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-412-15","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-412-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-412-11)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"59651088901","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-889-01","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59651-889-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"59651088905","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-889-05","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59651-889-05)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62135075290","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-752-90","proprietary_name":"Hydroxychloroquine","nonproprietary_name":"Hydroxychloroquine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-752-90)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084026901","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-269-01","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-269-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-269-11)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084026911","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68382009601","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-096-01","proprietary_name":"Hydroxychloroquine sulfate","nonproprietary_name":"Hydroxychloroquine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-096-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68382009605","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-096-05","proprietary_name":"Hydroxychloroquine sulfate","nonproprietary_name":"Hydroxychloroquine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-096-05)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69238154401","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1544-1","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69238-1544-1)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"69238154405","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1544-5","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69238-1544-5)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"76385014401","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"76385014450","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"82009004505","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-045-05","proprietary_name":"Hydroxychloroquine sulfate","nonproprietary_name":"Hydroxychloroquine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-045-05)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"83980000101","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-001-01","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (83980-001-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"83980000105","name":"HYDROXYCHLOROQUINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-001-05","proprietary_name":"Hydroxychloroquine Sulfate","nonproprietary_name":"Hydroxychloroquine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ipca Laboratories Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (83980-001-05)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.14901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43598013201","name":"HYDROXYCHLOROQUINE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-132-01","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-132-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.53021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43598013101","name":"HYDROXYCHLOROQUINE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-131-01","proprietary_name":"HYDROXYCHLOROQUINE SULFATE","nonproprietary_name":"HYDROXYCHLOROQUINE SULFATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-131-01)","pharm_classes":["Antimalarial [EPC]","Antirheumatic Agent [EPC]"]},"nadac":{"value":0.66981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxychloroquine Sulfate|Hydroxychloroquine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00555088202","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0882-02","proprietary_name":"HYDROXYUREA","nonproprietary_name":"Hydroxyurea","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0882-02)","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"00904693961","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6939-61","proprietary_name":"Hydroxyurea","nonproprietary_name":"Hydroxyurea","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6939-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"49884072401","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-724-01","proprietary_name":"Hydroxyurea","nonproprietary_name":"Hydroxyurea","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (49884-724-01)","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"68084028401","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-284-01","proprietary_name":"Hydroxyurea","nonproprietary_name":"Hydroxyurea","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-284-01) / 1 CAPSULE in 1 BLISTER PACK (68084-284-11)","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"68084028411","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"69315016401","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-164-01","proprietary_name":"HYDROXYUREA","nonproprietary_name":"HYDROXYUREA","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (69315-164-01)","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"70069082001","name":"HYDROXYUREA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-820-01","proprietary_name":"HYDROXYUREA","nonproprietary_name":"HYDROXYUREA","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"100 CAPSULE in 1 BOTTLE (70069-820-01)","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":0.18364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyurea|Hydroxyurea","basis":"generic"},"part_b":null}, {"ndc":"69452039588","name":"HYDROXYZINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-395-88","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride Oral","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Bionpharma Inc.","package_description":"473 mL in 1 BOTTLE (69452-395-88)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954091210","name":"HYDROXYZINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-912-10","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (70954-912-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83745023216","name":"HYDROXYZINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-232-16","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"HYDROXYZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"473 mL in 1 BOTTLE (83745-232-16)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121103416","name":"HYDROXYZINE 10 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1034-16","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-1034-16)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838050280","name":"HYDROXYZINE 10 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-502-80","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Lannett Company, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (54838-502-80)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135050247","name":"HYDROXYZINE 10 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-502-47","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-502-47)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135075047","name":"HYDROXYZINE 10 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-750-47","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"HYDROXYZINE HYDROCHLORIDE","dosage_form":"SYRUP","route":"ORAL","strength":"10 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-750-47)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093506001","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5060-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5060-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093506005","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5060-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-5060-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702001001","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-010-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (10702-010-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702001050","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-010-50","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (10702-010-50)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011301","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-113-01","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-113-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011350","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-113-50","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-113-50)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008110","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-081-10","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-081-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008111","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-081-11","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-081-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050001","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-500-01","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-500-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050005","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-500-05","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-500-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050010","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-500-10","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-500-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"24658078105","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-781-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (24658-781-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651049901","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-499-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-499-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651049905","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-499-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-499-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687066401","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-664-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-664-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-664-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687066411","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-664","inner_of":["60687-664-01"]},"part_b":null}, {"ndc":"62135057305","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-573-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-573-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057312","name":"HYDROXYZINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-573-12","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-573-12)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.02867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093506101","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5061-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5061-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093506105","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5061-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-5061-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093506110","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5061-10","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-5061-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904737840","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7378-40","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-7378-40)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904737880","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7378-80","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET in 1 BOTTLE (0904-7378-80)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702001101","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-011-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (10702-011-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702001110","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-011-10","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (10702-011-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702001150","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-011-50","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (10702-011-50)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011401","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-114-01","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-114-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011410","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-114-10","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-114-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011450","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-114-50","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-114-50)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008210","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-082-10","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-082-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008211","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-082-11","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Northstar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-082-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008212","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-082-12","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Northstar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (16714-082-12)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050101","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-501-01","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-501-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050105","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-501-05","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-501-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050110","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-501-10","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-501-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"24658078210","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-782-10","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (24658-782-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651050001","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-500-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-500-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651050005","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-500-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-500-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651050099","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-500-99","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-500-99)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687067501","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-675-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-675-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-675-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687067511","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-675","inner_of":["60687-675-01"]},"part_b":null}, {"ndc":"62135057405","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-574-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-574-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057412","name":"HYDROXYZINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-574-12","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-574-12)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.03255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093506201","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5062-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5062-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093506205","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5062-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-5062-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904737940","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7379-40","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-7379-40)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904737980","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7379-80","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET in 1 BOTTLE (0904-7379-80)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011501","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-115-01","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-115-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011510","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-115-10","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-115-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571011550","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-115-50","proprietary_name":"HYDROXYZINE HYDROCHLORIDE","nonproprietary_name":"hydroxyzine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-115-50)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008310","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-083-10","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Northstar RxLLC","package_description":"100 TABLET in 1 BOTTLE (16714-083-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714008311","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-083-11","proprietary_name":"HydrOXYzine Hydrochloride","nonproprietary_name":"HydrOXYzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Northstar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-083-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050201","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-502-01","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-502-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050205","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-502-05","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-502-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155050210","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-502-10","proprietary_name":"Hydroxyzine hydrochloride","nonproprietary_name":"Hydroxyzine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-502-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"24658078310","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-783-10","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (24658-783-10)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651050101","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-501-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-501-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651050105","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-501-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-501-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651050199","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-501-99","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-501-99)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687087501","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-875-01","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-875-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-875-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687087511","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-875","inner_of":["60687-875-01"]},"part_b":null}, {"ndc":"62135057505","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-575-05","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-575-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057512","name":"HYDROXYZINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-575-12","proprietary_name":"Hydroxyzine Hydrochloride","nonproprietary_name":"Hydroxyzine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-575-12)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.05575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine HCl*|Hydroxyzine HCl","basis":"generic"},"part_b":null}, {"ndc":"00555032402","name":"HYDROXYZINE PAM 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0324-02","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0324-02)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.42607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00115180301","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1803-01","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0115-1803-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00115180302","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1803-02","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (0115-1803-02)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00185067401","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0674-01","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0185-0674-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00185067405","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0674-05","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"500 CAPSULE in 1 BOTTLE (0185-0674-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00555032302","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0323-02","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0323-02)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00555032304","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0323-04","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0555-0323-04)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00904706561","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7065-61","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7065-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"14539067401","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"14539-674-01","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 CONTAINER (14539-674-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"14539067405","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"14539-674-05","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 CONTAINER (14539-674-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"50268039811","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"50268039850","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-398-50","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-398-50) / 1 CAPSULE in 1 BLISTER PACK (50268-398-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"60687069601","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-696-01","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-696-01) / 1 CAPSULE in 1 BLISTER PACK (60687-696-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"60687069611","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"62135081612","name":"HYDROXYZINE PAM 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-816-12","proprietary_name":"Hydroxyzine pamoate","nonproprietary_name":"Hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE in 1 BOTTLE (62135-816-12)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00115180401","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1804-01","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0115-1804-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00115180402","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1804-02","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (0115-1804-02)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00185067601","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0676-01","proprietary_name":"Hydroxyzine pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0185-0676-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00185067605","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0676-05","proprietary_name":"Hydroxyzine pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"500 CAPSULE in 1 BOTTLE (0185-0676-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00555030202","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0302-02","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0555-0302-02)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00555030204","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0302-04","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0555-0302-04)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"14539067501","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"14539-675-01","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 CONTAINER (14539-675-01)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"14539067505","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"14539-675-05","proprietary_name":"hydroxyzine pamoate","nonproprietary_name":"hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 CONTAINER (14539-675-05)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"50268039911","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"50268039950","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-399-50","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-399-50) / 1 CAPSULE in 1 BLISTER PACK (50268-399-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"60687070701","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-707-01","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-707-01) / 1 CAPSULE in 1 BLISTER PACK (60687-707-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"60687070711","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"60687070765","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-707-65","proprietary_name":"Hydroxyzine Pamoate","nonproprietary_name":"Hydroxyzine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-707-65) / 1 CAPSULE in 1 BLISTER PACK (60687-707-11)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"62135081712","name":"HYDROXYZINE PAM 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-817-12","proprietary_name":"Hydroxyzine pamoate","nonproprietary_name":"Hydroxyzine pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE in 1 BOTTLE (62135-817-12)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hydroxyzine Pamoate|Hydroxyzine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"18657011704","name":"HYLENEX 150 UNITS/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"18657-117-04","proprietary_name":"HYLENEX Recombinant","nonproprietary_name":"Hyaluronidase","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"150 [USP'U]/mL","labeler":"Antares Pharma, Inc.","package_description":"4 BOX in 1 CARTON (18657-117-04) / 1 VIAL in 1 BOX (18657-117-02) / 1 mL in 1 VIAL (18657-117-01)","pharm_classes":["Endoglycosidase [EPC]","Glycoside Hydrolases [CS]"]},"nadac":{"value":53.68773,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3473","bill_units_per_package":{"value":600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3473 (1 USP UNIT) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (4 BOX in 1 CARTON (18657-117-04) / 1 VIAL in 1 BOX (18657-117-02) / 1 mL in 1 VIAL (18657-117-01)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":4,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42192033801","name":"HYOSCYAMINE 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-338-01","proprietary_name":"Hyoscyamine Sulfate ODT","nonproprietary_name":"hyoscyamine sulfate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (42192-338-01)"},"nadac":{"value":0.14421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135085812","name":"HYOSCYAMINE 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-858-12","proprietary_name":"Hyoscyamine sulfate","nonproprietary_name":"Hyoscyamine sulfate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62135-858-12)"},"nadac":{"value":0.14421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559042201","name":"HYOSCYAMINE 0.125 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-422-01","proprietary_name":"Hyoscyamine Sulfate","nonproprietary_name":"Hyoscyamine Sulfate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62559-422-01)"},"nadac":{"value":0.14421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033901","name":"HYOSCYAMINE 0.125 MG TAB SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-339-01","proprietary_name":"Hyoscyamine Sulfate SL","nonproprietary_name":"hyoscyamine sulfate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".125 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-339-01)"},"nadac":{"value":0.17066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135085912","name":"HYOSCYAMINE 0.125 MG TAB SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-859-12","proprietary_name":"Hyoscyamine sulfate Sublingual","nonproprietary_name":"Hyoscyamine sulfate","dosage_form":"TABLET","route":"ORAL; SUBLINGUAL","strength":".125 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-859-12)"},"nadac":{"value":0.17066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyoscyamine Sulfate*|Hyoscyamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62559042401","name":"HYOSCYAMINE 0.125 MG TAB SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-424-01","proprietary_name":"Hyoscyamine Sulfate","nonproprietary_name":"Hyoscyamine Sulfate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-424-01)"},"nadac":{"value":0.17066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559042301","name":"HYOSCYAMINE ER 0.375 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-423-01","proprietary_name":"Hyoscyamine Sulfate","nonproprietary_name":"Hyoscyamine Sulfate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62559-423-01)"},"nadac":{"value":0.53556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyoscyamine Sulfate ER|Hyoscyamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42192034001","name":"HYOSCYAMINE SULF 0.125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-340-01","proprietary_name":"Hyoscyamine Sulfate TAB","nonproprietary_name":"hyoscyamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-340-01)"},"nadac":{"value":0.14589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyoscyamine Sulfate*|Hyoscyamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62135051212","name":"HYOSCYAMINE SULF 0.125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-512-12","proprietary_name":"Hyoscyamine sulfate","nonproprietary_name":"Hyoscyamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET in 1 BOTTLE (62135-512-12)"},"nadac":{"value":0.14589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyoscyamine Sulfate*|Hyoscyamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62559042101","name":"HYOSCYAMINE SULF 0.125 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-421-01","proprietary_name":"Hyoscyamine Sulfate","nonproprietary_name":"Hyoscyamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-421-01)"},"nadac":{"value":0.14589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyoscyamine Sulfate*|Hyoscyamine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"59011027160","name":"HYSINGLA ER 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-271-60","proprietary_name":"Hysingla ER","nonproprietary_name":"hydrocodone bitartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Knoa Pharma LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (59011-271-60)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":13.30734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hysingla ER|Hydrocodone Bitartrate","basis":"brand"},"part_b":null}, {"ndc":"59011027260","name":"HYSINGLA ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-272-60","proprietary_name":"Hysingla ER","nonproprietary_name":"hydrocodone bitartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Knoa Pharma LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (59011-272-60)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":19.365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hysingla ER|Hydrocodone Bitartrate","basis":"brand"},"part_b":null}, {"ndc":"59011027360","name":"HYSINGLA ER 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-273-60","proprietary_name":"Hysingla ER","nonproprietary_name":"hydrocodone bitartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Knoa Pharma LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (59011-273-60)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":26.16144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hysingla ER|Hydrocodone Bitartrate","basis":"brand"},"part_b":null}, {"ndc":"59011027460","name":"HYSINGLA ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-274-60","proprietary_name":"Hysingla ER","nonproprietary_name":"hydrocodone bitartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Knoa Pharma LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (59011-274-60)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":36.17463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hysingla ER|Hydrocodone Bitartrate","basis":"brand"},"part_b":null}, {"ndc":"59011027560","name":"HYSINGLA ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59011-275-60","proprietary_name":"Hysingla ER","nonproprietary_name":"hydrocodone bitartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Knoa Pharma LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (59011-275-60)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":48.65502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hysingla ER|Hydrocodone Bitartrate","basis":"brand"},"part_b":null}, {"ndc":"78206014001","name":"HYZAAR 100-12.5 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-140-01","proprietary_name":"HYZAAR","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-140-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.81999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyzaar|Losartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"78206014002","name":"HYZAAR 100-12.5 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-140-02","proprietary_name":"HYZAAR","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-140-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.81999,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyzaar|Losartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"78206014101","name":"HYZAAR 100-25 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-141-01","proprietary_name":"HYZAAR","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-141-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.7968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyzaar|Losartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"78206014102","name":"HYZAAR 100-25 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-141-02","proprietary_name":"HYZAAR","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-141-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":6.7968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyzaar|Losartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"78206013901","name":"HYZAAR 50-12.5 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-139-01","proprietary_name":"HYZAAR","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-139-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":5.00845,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyzaar|Losartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"78206013902","name":"HYZAAR 50-12.5 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-139-02","proprietary_name":"HYZAAR","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-139-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":5.00845,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Hyzaar|Losartan/Hydrochlorothiazide","basis":"brand"},"part_b":null}, {"ndc":"55150019183","name":"IBANDRONATE 3 MG/3 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-191-83","proprietary_name":"Ibandronate Sodium","nonproprietary_name":"Ibandronate Sodium","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"3 mg/3mL","labeler":"Eugia US LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (55150-191-83) / 3 mL in 1 SYRINGE, GLASS","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":52.64778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1740","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1740 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (55150-191-83) / 3 mL in 1 SYRINGE, GLASS) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60505609700","name":"IBANDRONATE 3 MG/3 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6097-0","proprietary_name":"Ibandronate Sodium","nonproprietary_name":"ibandronate sodium","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"3 mg/3mL","labeler":"Apotex Corp.","package_description":"1 SYRINGE, GLASS in 1 CARTON (60505-6097-0) / 3 mL in 1 SYRINGE, GLASS","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":52.64778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1740","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1740 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (60505-6097-0) / 3 mL in 1 SYRINGE, GLASS) gives 3 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"33342015001","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342015052","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-150-52","proprietary_name":"IBANDRONATE SODIUM","nonproprietary_name":"IBANDRONATE SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-150-52) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342015053","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-150-53","proprietary_name":"IBANDRONATE SODIUM","nonproprietary_name":"IBANDRONATE SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"3 CARTON in 1 BOX (33342-150-53) / 1 BLISTER PACK in 1 CARTON (33342-150-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111057511","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111057543","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-575-43","proprietary_name":"Ibandronate sodium","nonproprietary_name":"Ibandronate sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BLISTER PACK in 1 CARTON (55111-575-43) / 3 TABLET in 1 BLISTER PACK (55111-575-13)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505279500","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862023703","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-237-03","proprietary_name":"Ibandronate Sodium","nonproprietary_name":"Ibandronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-237-03) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452037874","name":"IBANDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-378-74","proprietary_name":"IBANDRONATE SODIUM","nonproprietary_name":"IBANDRONATE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-378-74) / 3 TABLET in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":2.67507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73154005060","name":"IBSRELA 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73154-050-60","proprietary_name":"IBSRELA","nonproprietary_name":"tenapanor hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"53.2 mg/1","labeler":"Ardelyx, Inc.","package_description":"60 TABLET in 1 BOTTLE (73154-050-60)","pharm_classes":["Organic Anion Transporting Polypeptide 2B1 Inhibitors [MoA]","Sodium-Hydrogen Exchanger 3 Inhibitor [EPC]","Sodium-Hydrogen Exchanger 3 Inhibitors [MoA]"]},"nadac":{"value":32.54473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibsrela|Tenapanor HCl","basis":"brand"},"part_b":null}, {"ndc":"55111068201","name":"IBU 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-682-01","proprietary_name":"IBU","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-682-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibu|Ibuprofen","basis":"brand"},"part_b":null}, {"ndc":"55111068205","name":"IBU 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-682-05","proprietary_name":"IBU","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-682-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibu|Ibuprofen","basis":"brand"},"part_b":null}, {"ndc":"55111068301","name":"IBU 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-683-01","proprietary_name":"IBU","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-683-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibu|Ibuprofen","basis":"brand"},"part_b":null}, {"ndc":"55111068305","name":"IBU 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-683-05","proprietary_name":"IBU","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-683-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibu|Ibuprofen","basis":"brand"},"part_b":null}, {"ndc":"55111068401","name":"IBU 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-684-01","proprietary_name":"IBU","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-684-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibu|Ibuprofen","basis":"brand"},"part_b":null}, {"ndc":"55111068405","name":"IBU 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-684-05","proprietary_name":"IBU","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (55111-684-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibu|Ibuprofen","basis":"brand"},"part_b":null}, {"ndc":"00904791459","name":"IBU-200 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7914-59","proprietary_name":"Ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-7914-59) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00472200216","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-2002-16","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Actavis Pharma, Inc.","package_description":"473 mL in 1 BOTTLE (0472-2002-16)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00472200294","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-2002-94","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (0472-2002-94) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802095226","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-952-26","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-952-26) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802095243","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-952-43","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"473 mL in 1 BOTTLE (45802-952-43)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672138508","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1385-8","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1385-8) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672138509","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1385-9","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"473 mL in 1 BOTTLE (51672-1385-9)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651003212","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-032-12","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-032-12) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651003247","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-032-47","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-032-47) / 473 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380099703","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-997-03","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strides Pharma Science Limited","package_description":"1 BOTTLE in 1 CARTON (64380-997-03) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380099704","name":"IBUPROFEN 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-997-04","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strides Pharma Science Limited","package_description":"473 mL in 1 BOTTLE (64380-997-04)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.02461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904791251","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7912-51","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7912-51) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904791259","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7912-59","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7912-59) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385005878","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-058-78","proprietary_name":"Good Neighbor Pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-058-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385064771","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-647-71","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-647-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385064778","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-647-78","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-647-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000000301","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0003-1","proprietary_name":"leader ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0003-1) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017601","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0176-1","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0176-1) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017604","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0176-4","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0176-4) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017605","name":"IBUPROFEN 200 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0176-5","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0176-5) / 500 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536114730","name":"IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1147-30","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"80 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0536-1147-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000057101","name":"IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0571-1","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70000-0571-1) / 20 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000057102","name":"IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0571-2","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"1 BOTTLE, PLASTIC in 1 BOX (70000-0571-2) / 40 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000057103","name":"IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0571-3","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"80 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70000-0571-3)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674724","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6747-24","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6747-24) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674740","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6747-40","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0904-6747-40)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674751","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6747-51","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6747-51) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674759","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6747-59","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6747-59) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674770","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6747-70","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6747-70) / 250 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904674780","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6747-80","proprietary_name":"ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0904-6747-80)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904791461","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7914-61","proprietary_name":"Ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-7914-61) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385060471","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-604-71","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-604-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385060478","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-604-78","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-604-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385060485","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-604-85","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amerisource Bergen","package_description":"250 TABLET, FILM COATED in 1 BOTTLE (24385-604-85)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483060101","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-601-01","proprietary_name":"IBUPROFEN","nonproprietary_name":"IBUPROFEN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"TIME CAP LABORATORIES,INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49483-601-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483060110","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599805104","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-8051-4","proprietary_name":"McKesson Ibuprofen 200 mg","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"McKesson Medical-Surgical","package_description":"200 PACKET in 1 BOX (68599-8051-4) / 2 TABLET, COATED in 1 PACKET","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017501","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0175-1","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0175-1) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017502","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0175-2","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0175-2) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017503","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0175-3","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0175-3) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017505","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0175-5","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70000-0175-5)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017508","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0175-8","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0175-8) / 200 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000029101","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0291-1","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0291-1) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000059701","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0597-1","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"CARDINAL HEALTH","package_description":"1 BOTTLE in 1 CARTON (70000-0597-1) / 50 TABLET in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000059702","name":"IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0597-2","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"CARDINAL HEALTH","package_description":"1 BOTTLE in 1 CARTON (70000-0597-2) / 100 TABLET in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904585340","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5853-40","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-5853-40)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585360","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5853-60","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (0904-5853-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585361","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5853-61","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5853-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904758740","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7587-40","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0904-7587-40)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904758759","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7587-59","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0904-7587-59)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"11788000801","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-008-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (11788-008-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"11788000805","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-008-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (11788-008-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"42543096607","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"49483060201","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-602-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49483-602-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"49483060250","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-602-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (49483-602-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"59651036001","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-360-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-360-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"59651036005","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-360-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-360-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"60687044601","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-446-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-446-01) / 1 TABLET in 1 BLISTER PACK (60687-446-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"60687044611","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"62135040012","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-400-12","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 PACKAGE (62135-400-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"64380080906","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-809-06","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64380-809-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"64380080907","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-809-07","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64380-809-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046410","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-464-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-464-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046450","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-464-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-464-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877031901","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-319-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-319-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877031905","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-319-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-319-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367039401","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-394-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-394-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367039405","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-394-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-394-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367044701","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-447-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-447-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367044705","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-447-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-447-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006601","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-066-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70010-066-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006605","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-066-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-066-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071210","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-712-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-712-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071246","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-712-46","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"100 BLISTER PACK in 1 CARTON (76282-712-46) / 10 TABLET, FILM COATED in 1 BLISTER PACK (76282-712-45)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071250","name":"IBUPROFEN 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-712-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-712-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03899,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585440","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5854-40","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-5854-40)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585460","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5854-60","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (0904-5854-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585461","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5854-61","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5854-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904758840","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7588-40","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0904-7588-40)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904758859","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7588-59","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0904-7588-59)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"11788000901","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-009-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (11788-009-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"11788000905","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-009-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (11788-009-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"49483060301","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-603-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49483-603-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"49483060350","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-603-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (49483-603-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"59651036101","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-361-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-361-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"59651036105","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-361-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-361-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"60687045701","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-457-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-457-01) / 1 TABLET in 1 BLISTER PACK (60687-457-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"60687045711","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"62135040112","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-401-12","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 PACKAGE (62135-401-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"64380080806","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-808-06","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64380-808-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"64380080807","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-808-07","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64380-808-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046510","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-465-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-465-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046550","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-465-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-465-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032001","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-320-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-320-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032005","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-320-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-320-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032030","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-320-30","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-320-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032050","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-320-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (67877-320-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"68645056259","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-562-59","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68645-562-59)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367039501","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-395-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-395-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367039505","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-395-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-395-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367044801","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-448-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-448-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-14","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367044805","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-448-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-448-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-14","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006701","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-067-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70010-067-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006705","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-067-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-067-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006710","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-067-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70010-067-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071310","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-713-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-713-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071350","name":"IBUPROFEN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-713-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-713-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.0472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585540","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5855-40","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (0904-5855-40)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585560","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5855-60","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (0904-5855-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"00904585561","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5855-61","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5855-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"11788001001","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-010-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (11788-010-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"11788001005","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-010-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (11788-010-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"49483060401","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-604-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49483-604-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"49483060450","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-604-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (49483-604-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"59651036201","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-362-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-362-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"59651036205","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-362-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-362-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"60687046801","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-468-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-468-01) / 1 TABLET in 1 BLISTER PACK (60687-468-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"60687046811","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"62135040212","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-402-12","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 PACKAGE (62135-402-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"64380080706","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-807-06","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64380-807-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"64380080707","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-807-07","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64380-807-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046609","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-466-09","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-466-09)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046610","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-466-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-466-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"65162046650","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-466-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-466-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032101","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-321-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-321-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032105","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-321-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-321-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032130","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-321-30","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-321-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"67877032150","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-321-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (67877-321-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"68645056354","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-563-54","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68645-563-54)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367039601","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-396-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-396-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367039605","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-396-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-396-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367044901","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-449-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-449-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"69367044905","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-449-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-449-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006801","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-068-01","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70010-068-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006805","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-068-05","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-068-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70010006810","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-068-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70010-068-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"70512078010","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-780-10","proprietary_name":"Ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"SOLA Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (70512-780-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071410","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-714-10","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-714-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071430","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-714-30","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-714-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071446","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-714-46","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"100 BLISTER PACK in 1 CARTON (76282-714-46) / 10 TABLET, FILM COATED in 1 BLISTER PACK (76282-714-45)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071450","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-714-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-714-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"76282071490","name":"IBUPROFEN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-714-90","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (76282-714-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen|Ibuprofen","basis":"generic"},"part_b":null}, {"ndc":"24385046560","name":"IBUPROFEN COLD-SINUS CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":0.15171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000023901","name":"IBUPROFEN JR STR 100 MG TB CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0239-1","proprietary_name":"Leader Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"100 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0239-1) / 24 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.1544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000015703","name":"IBUPROFEN PM 200-38 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0157-3","proprietary_name":"Leader Ibuprofen PM","nonproprietary_name":"diphenhydramine citrate, ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"38 mg/1; 200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0157-3) / 20 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722031590","name":"IBUPROFEN-FAMOTIDIN 800-26.6 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-315-90","proprietary_name":"IBUPROFEN AND FAMOTIDINE","nonproprietary_name":"Ibuprofen and famotidine","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 26.6 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-315-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen-Famotidine|Ibuprofen/FAmotidine","basis":"generic"},"part_b":null}, {"ndc":"49884036609","name":"IBUPROFEN-FAMOTIDIN 800-26.6 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-366-09","proprietary_name":"Ibuprofen and famotidine","nonproprietary_name":"Ibuprofen and famotidine","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 26.6 mg/1","labeler":"Par Health USA, LLC","package_description":"90 TABLET in 1 BOTTLE (49884-366-09)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen-Famotidine|Ibuprofen/FAmotidine","basis":"generic"},"part_b":null}, {"ndc":"67877062690","name":"IBUPROFEN-FAMOTIDIN 800-26.6 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-626-90","proprietary_name":"Ibuprofen and famotidine","nonproprietary_name":"Ibuprofen and famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1; 26.6 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-626-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen-Famotidine|Ibuprofen/FAmotidine","basis":"generic"},"part_b":null}, {"ndc":"72578021416","name":"IBUPROFEN-FAMOTIDIN 800-26.6 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-214-16","proprietary_name":"Ibuprofen and Famotidine","nonproprietary_name":"Ibuprofen and Famotidine","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 26.6 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (72578-214-16)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.71383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ibuprofen-Famotidine|Ibuprofen/FAmotidine","basis":"generic"},"part_b":null}, {"ndc":"70000026001","name":"ICE BLUE 2% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0260-1","proprietary_name":"Leader Ice Blue Analgesic","nonproprietary_name":"Menthol, Unspecified Form","dosage_form":"GEL","route":"TOPICAL","strength":"20 mg/g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"226.8 g in 1 JAR (70000-0260-1)"},"nadac":{"value":0.01005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00054062127","name":"ICOSAPENT ETHYL 0.5 GM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0621-27","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":".5 g/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"240 CAPSULE in 1 BOTTLE (0054-0621-27)"},"nadac":{"value":0.33423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"31722029824","name":"ICOSAPENT ETHYL 0.5 GM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-298-24","proprietary_name":"ICOSAPENT ETHYL","nonproprietary_name":"Icosapent ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":".5 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"240 CAPSULE in 1 BOTTLE (31722-298-24)"},"nadac":{"value":0.33423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"43598074672","name":"ICOSAPENT ETHYL 0.5 GM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-746-72","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"240 CAPSULE in 1 BOTTLE (43598-746-72)"},"nadac":{"value":0.33423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"00054050823","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0508-23","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 CAPSULE in 1 BOTTLE (0054-0508-23)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"00480012789","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-0127-89","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (0480-0127-89)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"16714063601","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-636-01","proprietary_name":"ICOSAPENT ETHYL","nonproprietary_name":"Icosapent ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Northstar Rx LLC","package_description":"120 CAPSULE in 1 BOTTLE (16714-636-01)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"31722029912","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-299-12","proprietary_name":"ICOSAPENT ETHYL","nonproprietary_name":"Icosapent ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 CAPSULE in 1 BOTTLE (31722-299-12)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"42806056012","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-560-12","proprietary_name":"ICOSAPENT ETHYL","nonproprietary_name":"icosapent ethyl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"EPIC PHARMA, LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (42806-560-12)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"43598026704","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-267-04","proprietary_name":"Icosapent","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1000 mg/1","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"120 CAPSULE in 1 BOTTLE (43598-267-04)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"60505403301","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4033-1","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Apotex Corp","package_description":"120 CAPSULE in 1 BOTTLE (60505-4033-1)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"60687076411","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"60687076421","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-764-21","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-764-21) / 1 CAPSULE in 1 BLISTER PACK (60687-764-11)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"69238259808","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2598-8","proprietary_name":"Icosapent ethyl","nonproprietary_name":"Icosapent ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"120 CAPSULE in 1 BOTTLE (69238-2598-8)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"69680018692","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-186-92","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"120 CAPSULE in 1 BOTTLE (69680-186-92)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"70710159207","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1592-7","proprietary_name":"icosapent ethyl","nonproprietary_name":"icosapent ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"120 CAPSULE in 1 BOTTLE (70710-1592-7)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"72603012901","name":"ICOSAPENT ETHYL 1 GRAM CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-129-01","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE","route":"ORAL","strength":"1 g/1","labeler":"Northstar Rx LLC","package_description":"120 CAPSULE in 1 BOTTLE (72603-129-01)"},"nadac":{"value":0.44081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"00480012649","name":"ICOSAPENT ETHYL 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-0126-49","proprietary_name":"Icosapent Ethyl","nonproprietary_name":"Icosapent Ethyl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"240 CAPSULE, LIQUID FILLED in 1 BOTTLE (0480-0126-49)"},"nadac":{"value":0.33423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Icosapent Ethyl|Icosapent Ethyl","basis":"generic"},"part_b":null}, {"ndc":"00078074303","name":"ILEVRO 0.3% OPHTH DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":121.14312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ilevro|Nepafenac","basis":"brand"},"part_b":null}, {"ndc":"82667040003","name":"ILEVRO 0.3% OPHTH DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82667-400-03","proprietary_name":"ILEVRO","nonproprietary_name":"nepafenac","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (82667-400-03) / 3 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":121.14312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ilevro|Nepafenac","basis":"brand"},"part_b":null}, {"ndc":"00093762998","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7629-98","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-7629-98)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378224577","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2245-77","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"imatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2245-77)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00832053209","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0532-09","proprietary_name":"imatinib mesylate","nonproprietary_name":"imatinib mesylate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (0832-0532-09)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904690104","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6901-04","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6901-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722029690","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-296-90","proprietary_name":"IMATINIB MESYLATE","nonproprietary_name":"IMATINIB MESYLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-296-90)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"42292004301","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"42292004303","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-043-03","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"imatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc","package_description":"30 BLISTER PACK in 1 CARTON (42292-043-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK (42292-043-01)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598034431","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598034479","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651024090","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-240-90","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-240-90)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505290009","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2900-9","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (60505-2900-9)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687088211","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60687088221","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-882-21","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-882-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-882-11)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135065890","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-658-90","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-658-90)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68001062205","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-622-05","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68001-622-05)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"82009008690","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-086-90","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-086-90)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"82249002090","name":"IMATINIB MESYLATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-020-90","proprietary_name":"IMATINIB MESYLATE","nonproprietary_name":"IMATINIB MESYLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Civica Script LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82249-020-90)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":0.62435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00093763056","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7630-56","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7630-56)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00378224693","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2246-93","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"imatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2246-93)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00832053303","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0533-03","proprietary_name":"imatinib mesylate","nonproprietary_name":"imatinib mesylate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (0832-0533-03)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00904662104","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6621-04","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6621-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"31722029730","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-297-30","proprietary_name":"IMATINIB MESYLATE","nonproprietary_name":"IMATINIB MESYLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-297-30)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"42292004401","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"42292004403","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-044-03","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"imatinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Mylan Institutional Inc","package_description":"30 BLISTER PACK in 1 CARTON (42292-044-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK (42292-044-01)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598034531","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43598034579","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59651024130","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-241-30","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-241-30)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"60505290103","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2901-3","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-2901-3)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135065930","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-659-30","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-659-30)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"68001062304","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-623-04","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68001-623-04)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"82009008730","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-087-30","proprietary_name":"Imatinib Mesylate","nonproprietary_name":"Imatinib Mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82009-087-30)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"82249002130","name":"IMATINIB MESYLATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82249-021-30","proprietary_name":"IMATINIB MESYLATE","nonproprietary_name":"IMATINIB MESYLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Civica Script LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82249-021-30)","pharm_classes":["Bcr-Abl Tyrosine Kinase Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":2.67707,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imatinib Mesylate|Imatinib Mesylate","basis":"generic"},"part_b":null}, {"ndc":"64380016901","name":"IMIPRAMINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-169-01","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-169-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.06983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380016902","name":"IMIPRAMINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-169-02","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-169-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.06983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315013301","name":"IMIPRAMINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-133-01","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69315-133-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.06983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315013310","name":"IMIPRAMINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-133-10","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69315-133-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.06983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584042510","name":"IMIPRAMINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-425-10","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-425-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.06983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584042590","name":"IMIPRAMINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-425-90","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-425-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.06983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380017001","name":"IMIPRAMINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-170-01","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-170-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380017002","name":"IMIPRAMINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-170-02","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-170-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315013401","name":"IMIPRAMINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-134-01","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69315-134-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315013410","name":"IMIPRAMINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-134-10","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69315-134-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584042610","name":"IMIPRAMINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-426-10","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-426-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584042690","name":"IMIPRAMINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-426-90","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-426-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380017101","name":"IMIPRAMINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-171-01","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-171-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"64380017102","name":"IMIPRAMINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-171-02","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-171-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315013501","name":"IMIPRAMINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-135-01","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69315-135-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315013510","name":"IMIPRAMINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-135-10","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69315-135-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584042710","name":"IMIPRAMINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-427-10","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-427-10)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584042790","name":"IMIPRAMINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-427-90","proprietary_name":"Imipramine Hydrochloride","nonproprietary_name":"Imipramine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-427-90)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine HCl|Imipramine HCl","basis":"generic"},"part_b":null}, {"ndc":"00054027413","name":"IMIPRAMINE PAMOATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0274-13","proprietary_name":"Imipramine Pamoate","nonproprietary_name":"Imipramine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 CAPSULE in 1 BOTTLE (0054-0274-13)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":3.65022,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine Pamoate|Imipramine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"68180031506","name":"IMIPRAMINE PAMOATE 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-315-06","proprietary_name":"Imipramine Pamoate","nonproprietary_name":"Imipramine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-315-06)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":3.65022,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine Pamoate|Imipramine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00054027613","name":"IMIPRAMINE PAMOATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0276-13","proprietary_name":"Imipramine Pamoate","nonproprietary_name":"Imipramine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 CAPSULE in 1 BOTTLE (0054-0276-13)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":2.6911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine Pamoate|Imipramine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"68180031706","name":"IMIPRAMINE PAMOATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-317-06","proprietary_name":"Imipramine Pamoate","nonproprietary_name":"Imipramine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-317-06)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":2.6911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine Pamoate|Imipramine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"00054027313","name":"IMIPRAMINE PAMOATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0273-13","proprietary_name":"Imipramine Pamoate","nonproprietary_name":"Imipramine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 CAPSULE in 1 BOTTLE (0054-0273-13)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":3.23863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine Pamoate|Imipramine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"68180031406","name":"IMIPRAMINE PAMOATE 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-314-06","proprietary_name":"Imipramine Pamoate","nonproprietary_name":"Imipramine Pamoate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-314-06)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":3.23863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imipramine Pamoate|Imipramine Pamoate","basis":"generic"},"part_b":null}, {"ndc":"51672417406","name":"IMIQUIMOD 3.75% CREAM","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4174-6","proprietary_name":"Imiquimod","nonproprietary_name":"Imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"37.5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"28 PACKET in 1 CARTON (51672-4174-6) / .25 g in 1 PACKET (51672-4174-8)","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":36.22845,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093313331","name":"IMIQUIMOD 3.75% CREAM PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3133-31","proprietary_name":"Imiquimod","nonproprietary_name":"imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"37.5 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0093-3133-31) / 7.5 g in 1 BOTTLE, PUMP","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":113.12147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672417409","name":"IMIQUIMOD 3.75% CREAM PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4174-9","proprietary_name":"Imiquimod","nonproprietary_name":"Imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"37.5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-4174-9) / 7.5 g in 1 BOTTLE, PUMP","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":113.12147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802036853","name":"IMIQUIMOD 5% CREAM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-368-53","proprietary_name":"Imiquimod","nonproprietary_name":"Imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"12.5 mg/.25g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"12 PACKET in 1 CARTON (45802-368-53) / .25 g in 1 PACKET","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":12.16546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802036862","name":"IMIQUIMOD 5% CREAM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-368-62","proprietary_name":"Imiquimod","nonproprietary_name":"Imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"12.5 mg/.25g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"24 PACKET in 1 CARTON (45802-368-62) / .25 g in 1 PACKET","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":0.60994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672414506","name":"IMIQUIMOD 5% CREAM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4145-6","proprietary_name":"Imiquimod","nonproprietary_name":"Imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"24 PACKET in 1 CARTON (51672-4145-6) / .25 g in 1 PACKET (51672-4145-8)","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":0.60994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462053670","name":"IMIQUIMOD 5% CREAM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-536-70","proprietary_name":"Imiquimod","nonproprietary_name":"Imiquimod","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"24 PACKET in 1 CARTON (68462-536-70) / .25 g in 1 PACKET (68462-536-01)","pharm_classes":["Increased Cytokine Activity [PE]","Increased Cytokine Production [PE]","Interferon Inducers [MoA]"]},"nadac":{"value":0.60994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00173073701","name":"IMITREX 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0737-01","proprietary_name":"IMITREX","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"1 CARTON in 1 CARTON (0173-0737-01) / 1 BLISTER PACK in 1 CARTON / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":72.39673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00173073900","name":"IMITREX 4 MG/0.5 ML PEN INJECT","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0739-00","proprietary_name":"IMITREX","nonproprietary_name":"sumatriptan","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"4 mg/.5mL","labeler":"GlaxoSmithKline LLC","package_description":"2 SYRINGE in 1 PACKAGE (0173-0739-00) / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":463.07333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00173047800","name":"IMITREX 6 MG/0.5 ML CARTRIDGES","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0478-00","proprietary_name":"IMITREX","nonproprietary_name":"sumatriptan","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"GlaxoSmithKline LLC","package_description":"2 SYRINGE in 1 CARTON (0173-0478-00) / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":436.79714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00173047900","name":"IMITREX 6 MG/0.5 ML PEN INJECT","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0479-00","proprietary_name":"IMITREX","nonproprietary_name":"sumatriptan","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"GlaxoSmithKline LLC","package_description":"2 SYRINGE in 1 PACKAGE (0173-0479-00) / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":460.05429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":61.41234,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50261011008","name":"IMVEXXY 10 MCG MAINTENANCE PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":27.09018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imvexxy|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68308074808","name":"IMVEXXY 10 MCG MAINTENANCE PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":27.09018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imvexxy|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50261011018","name":"IMVEXXY 10 MCG STARTER PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":27.05529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imvexxy|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68308074818","name":"IMVEXXY 10 MCG STARTER PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":27.05529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imvexxy|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68308074708","name":"IMVEXXY 4 MCG MAINTENANCE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":27.09623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imvexxy|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68308074718","name":"IMVEXXY 4 MCG STARTER PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":27.10903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Imvexxy|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862092528","name":"INCASSIA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-925-28","proprietary_name":"Incassia","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-925-28) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Incassia|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"65862092585","name":"INCASSIA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-925-85","proprietary_name":"Incassia","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-925-85) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Incassia|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"00173087306","name":"INCRUSE ELLIPTA 62.5 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0873-06","proprietary_name":"Incruse Ellipta","nonproprietary_name":"umeclidinium","dosage_form":"AEROSOL, POWDER","route":"ORAL","strength":"62.5 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0873-06) / 1 INHALER in 1 TRAY / 7 AEROSOL, POWDER in 1 INHALER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":10.27714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Incruse Ellipta|Umeclidinium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00173087310","name":"INCRUSE ELLIPTA 62.5 MCG INH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0873-10","proprietary_name":"Incruse Ellipta","nonproprietary_name":"umeclidinium","dosage_form":"AEROSOL, POWDER","route":"ORAL","strength":"62.5 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0873-10) / 1 INHALER in 1 TRAY / 30 AEROSOL, POWDER in 1 INHALER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":11.29916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.35063,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Incruse Ellipta|Umeclidinium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00228259711","name":"INDAPAMIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2597-11","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0228-2597-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"00228259796","name":"INDAPAMIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2597-96","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0228-2597-96)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"16571087501","name":"INDAPAMIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-875-01","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET","route":"ORAL","strength":"1.25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-875-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"62559051001","name":"INDAPAMIDE 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-510-01","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62559-510-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"00228257111","name":"INDAPAMIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2571-11","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0228-2571-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"00228257196","name":"INDAPAMIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2571-96","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0228-2571-96)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"16571087601","name":"INDAPAMIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-876-01","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-876-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"62559051101","name":"INDAPAMIDE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-511-01","proprietary_name":"Indapamide","nonproprietary_name":"Indapamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62559-511-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.10761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indapamide|Indapamide","basis":"generic"},"part_b":null}, {"ndc":"62559060030","name":"INDERAL XL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-600-30","proprietary_name":"Inderal XL","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62559-600-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":68.70376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Inderal XL|Propranolol HCl","basis":"brand"},"part_b":null}, {"ndc":"31722054201","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-542-01","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-542-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"50268043011","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-430","inner_of":["50268-430-15"]},"part_b":null}, {"ndc":"50268043015","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-430-15","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-430-15) / 1 CAPSULE in 1 BLISTER PACK (50268-430-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"62135006718","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-067-18","proprietary_name":"INDOMETHACIN","nonproprietary_name":"INDOMETHACIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 CAPSULE in 1 BOTTLE (62135-067-18)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"62135006790","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-067-90","proprietary_name":"INDOMETHACIN","nonproprietary_name":"INDOMETHACIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-067-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462040601","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-406-01","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-406-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462040610","name":"INDOMETHACIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-406-10","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 CAPSULE in 1 BOTTLE (68462-406-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.09341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"31722054301","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-543-01","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-543-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"50268043111","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-431","inner_of":["50268-431-15"]},"part_b":null}, {"ndc":"50268043115","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-431-15","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-431-15) / 1 CAPSULE in 1 BLISTER PACK (50268-431-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"62135006818","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-068-18","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 CAPSULE in 1 BOTTLE (62135-068-18)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"62135006890","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-068-90","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-068-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462030201","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-302-01","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-302-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462030205","name":"INDOMETHACIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-302-05","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 CAPSULE in 1 BOTTLE (68462-302-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.13013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin*|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"10702001601","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-016-01","proprietary_name":"INDOMETHACIN","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10702-016-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"31722056501","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-565-01","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-565-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"31722056560","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-565-60","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-565-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68084041111","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68084041121","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-411-21","proprietary_name":"Indomethacin","nonproprietary_name":"Indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-411-21) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (68084-411-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462032501","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-325-01","proprietary_name":"indomethacin","nonproprietary_name":"indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-325-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462032560","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-325-60","proprietary_name":"indomethacin","nonproprietary_name":"indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-325-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"68462032590","name":"INDOMETHACIN ER 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-325-90","proprietary_name":"indomethacin","nonproprietary_name":"indomethacin","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-325-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Indomethacin ER|Indomethacin","basis":"generic"},"part_b":null}, {"ndc":"00536142677","name":"INF ACETAMINOPHEN 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1426-77","proprietary_name":"rugby infants acetaminophen","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1426-77) / 59 mL in 1 BOTTLE"},"nadac":{"value":0.05781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122054703","name":"INFANT GAS RLF 20 MG/0.3 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-547-03","proprietary_name":"INFANT GAS RELIEF","nonproprietary_name":"Simethicone","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"20 mg/.3mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"1 BOTTLE, DROPPER in 1 CARTON (46122-547-03) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904546335","name":"INFANT IBUPROFEN 50 MG/1.25 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5463-35","proprietary_name":"ibuprofen","nonproprietary_name":"ibuprofen","dosage_form":"SUSPENSION","route":"ORAL","strength":"50 mg/1.25mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-5463-35) / 15 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.32528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385055010","name":"INFANT IBUPROFEN 50 MG/1.25 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-550-10","proprietary_name":"good neighbor pharmacy ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"50 mg/1.25mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-550-10) / 30 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000029801","name":"INFANT IBUPROFEN 50 MG/1.25 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0298-1","proprietary_name":"leader infants ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"50 mg/1.25mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0298-1) / 30 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000047201","name":"INFANT PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.05781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000067401","name":"INFANT PAIN-FEVER 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0674-1","proprietary_name":"leader infants pain and fever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0674-1) / 59 mL in 1 BOTTLE"},"nadac":{"value":0.05781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001703","name":"INFANT'S GAS RLF 20 MG/0.3 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0017-3","proprietary_name":"SIMETHICONE INFANT Gas Relief Drops","nonproprietary_name":"Simethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"20 mg/.3mL","labeler":"AARNA USA Inc.","package_description":"1 BOTTLE in 1 PACKAGE (82568-0017-3) / 30 mL in 1 BOTTLE","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000005101","name":"INFANTS' GAS RLF 20 MG/0.3 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0051-1","proprietary_name":"Cardinal Health Infants Gas Relief","nonproprietary_name":"Simethicone","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"20 mg/.3mL","labeler":"CARDINAL HEALTH","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70000-0051-1) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536130375","name":"INFANTS' SIMETHICONE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1303-75","proprietary_name":"Infants","nonproprietary_name":"Simethicone","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"20 mg/.3mL","labeler":"RUGBY LABORATORIES","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0536-1303-75) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023608210","name":"INFED 100 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6082-10","proprietary_name":"INFeD","nonproprietary_name":"Iron Dextran","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Allergan, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0023-6082-10) / 2 mL in 1 VIAL, SINGLE-DOSE (0023-6082-01)","pharm_classes":["Iron [CS]","Parenteral Iron Replacement [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":18.88981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1750","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1750 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0023-6082-10) / 2 mL in 1 VIAL, SINGLE-DOSE (0023-6082-01)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70370204001","name":"INGREZZA 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70370-2040-1","proprietary_name":"INGREZZA","nonproprietary_name":"Valbenazine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Neurocrine Biosciences, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70370-2040-1)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":258.94167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ingrezza|Valbenazine Tosylate","basis":"brand"},"part_b":null}, {"ndc":"70370106001","name":"INGREZZA 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70370-1060-1","proprietary_name":"INGREZZA","nonproprietary_name":"Valbenazine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Neurocrine Biosciences, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70370-1060-1)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":283.324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ingrezza|Valbenazine Tosylate","basis":"brand"},"part_b":null}, {"ndc":"70370108001","name":"INGREZZA 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70370-1080-1","proprietary_name":"INGREZZA","nonproprietary_name":"Valbenazine","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Neurocrine Biosciences, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70370-1080-1)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":283.324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ingrezza|Valbenazine Tosylate","basis":"brand"},"part_b":null}, {"ndc":"62559059030","name":"INNOPRAN XL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-590-30","proprietary_name":"InnoPran XL","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62559-590-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":68.70376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Innopran XL|Propranolol HCl","basis":"brand"},"part_b":null}, {"ndc":"70183022130","name":"INPEFA 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70183-221-30","proprietary_name":"INPEFA","nonproprietary_name":"sotagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Lexicon Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70183-221-30)","pharm_classes":["P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":20.36936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Inpefa|Sotagliflozin","basis":"brand"},"part_b":null}, {"ndc":"70183022131","name":"INPEFA 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70183-221-31","proprietary_name":"INPEFA","nonproprietary_name":"sotagliflozin","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Lexicon Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (70183-221-31) / 3 BLISTER PACK in 1 BLISTER PACK / 10 TABLET in 1 BLISTER PACK","pharm_classes":["P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":20.36936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Inpefa|Sotagliflozin","basis":"brand"},"part_b":null}, {"ndc":"51672210403","name":"INSTALAX POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2104-3","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"InstaLax Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"765 g in 1 CAN (51672-2104-3)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"73070010011","name":"INSULIN ASPART 100 UNIT/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-100-11","proprietary_name":"Insulin Aspart","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (73070-100-11) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.95482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Aspart|Insulin Aspart","basis":"generic"},"part_b":null}, {"ndc":"73070010315","name":"INSULIN ASPART FLEXPEN 100 UNIT/ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-103-15","proprietary_name":"Insulin Aspart","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (73070-103-15) / 3 mL in 1 SYRINGE, PLASTIC (73070-103-10)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.96069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73070010215","name":"INSULIN ASPART PENFILL 100 UNIT/ML CARTRIDGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-102-15","proprietary_name":"Insulin Aspart","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"5 CARTRIDGE in 1 CARTON (73070-102-15) / 3 mL in 1 CARTRIDGE (73070-102-10)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.57063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73070020315","name":"INSULIN ASPART PROTAMINE-INSULIN ASPART MIX 70-30 FLEXPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-203-15","proprietary_name":"Insulin Aspart Protamine and Insulin Aspart Mix 70/30","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (73070-203-15) / 3 mL in 1 SYRINGE, PLASTIC (73070-203-10)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.9345,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73070020011","name":"INSULIN ASPART PROTAMINE-INSULIN ASPART MIX 70-30 VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-200-11","proprietary_name":"Insulin Aspart Protamine and Insulin Aspart Mix 70/30","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (73070-200-11) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.95452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73070040011","name":"INSULIN DEGLUDEC 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-400-11","proprietary_name":"Insulin Degludec","nonproprietary_name":"insulin degludec","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 U/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (73070-400-11) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":11.3401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Degludec|Insulin Degludec","basis":"generic"},"part_b":null}, {"ndc":"73070040315","name":"INSULIN DEGLUDEC FLEXTOUCH 100 UNIT/ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-403-15","proprietary_name":"Insulin Degludec","nonproprietary_name":"insulin degludec","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 U/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (73070-403-15) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":11.39045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Degludec Pen (U-100)|Insulin Degludec","basis":"generic"},"part_b":null}, {"ndc":"73070050315","name":"INSULIN DEGLUDEC FLEXTOUCH 200 UNIT/ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73070-503-15","proprietary_name":"Insulin Degludec","nonproprietary_name":"insulin degludec","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 U/mL","labeler":"Novo Nordisk Pharma, Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (73070-503-15) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":22.74083,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Degludec Pen (U-200)|Insulin Degludec","basis":"generic"},"part_b":null}, {"ndc":"00955290002","name":"INSULIN GLARGINE MAX SOLO U300","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-2900-02","proprietary_name":"Insulin glargine U-300 Max","nonproprietary_name":"insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"300 [iU]/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE in 1 CARTON (0955-2900-02) / 3 mL in 1 SYRINGE (0955-2900-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":27.00687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00955390003","name":"INSULIN GLARGINE SOLOSTAR U300","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0955-3900-03","proprietary_name":"Insulin glargine U-300","nonproprietary_name":"insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"300 [iU]/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"3 SYRINGE in 1 CARTON (0955-3900-03) / 1.5 mL in 1 SYRINGE (0955-3900-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":27.00543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72572042205","name":"INSULIN GLARGINE-YFGN U100 PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-422-05","proprietary_name":"INSULIN GLARGINE","nonproprietary_name":"insulin glargine-yfgn","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Civica, Inc.","package_description":"5 SYRINGE in 1 CARTON (72572-422-05) / 3 mL in 1 SYRINGE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":2.89708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72572042405","name":"INSULIN GLARGINE-YFGN U100 PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-424-05","proprietary_name":"INSULIN GLARGINE","nonproprietary_name":"insulin glargine-yfgn","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Civica, Inc.","package_description":"5 SYRINGE in 1 CARTON (72572-424-05) / 3 mL in 1 SYRINGE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":2.89708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83257001532","name":"INSULIN GLARGINE-YFGN U100 PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-015-32","proprietary_name":"Insulin Glargine","nonproprietary_name":"insulin Glargine-yfgn","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Biocon Biologics Inc.","package_description":"5 SYRINGE in 1 CARTON (83257-015-32) / 3 mL in 1 SYRINGE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":5.92491,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83257001411","name":"INSULIN GLARGINE-YFGN U100 VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-014-11","proprietary_name":"Insulin Glargine","nonproprietary_name":"insulin Glargine-yfgn","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Biocon Biologics Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (83257-014-11) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.08105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002822259","name":"INSULIN LISPRO 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8222-59","proprietary_name":"Insulin Lispro KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8222-59) / 3 mL in 1 SYRINGE (0002-8222-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.19333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Lispro Kwikpen U-100|Insulin Lispro","basis":"generic"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 SYRINGE in 1 CARTON (0002-8222-59) / 3 mL in 1 SYRINGE (0002-8222-01)) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002773701","name":"INSULIN LISPRO 100 UNIT/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7737-01","proprietary_name":"Insulin Lispro","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL in 1 CARTON (0002-7737-01) / 10 mL in 1 VIAL","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":2.40265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Lispro|Insulin Lispro","basis":"generic"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0002-7737-01) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002775205","name":"INSULIN LISPRO JR 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7752-05","proprietary_name":"Insulin Lispro Junior KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-7752-05) / 3 mL in 1 SYRINGE (0002-7752-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.19937,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Insulin Lispro Junior Kwikpen|Insulin Lispro","basis":"generic"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 SYRINGE in 1 CARTON (0002-7752-05) / 3 mL in 1 SYRINGE (0002-7752-01)) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002823305","name":"INSULIN LISPRO MIX 75-25 KWKPN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8233-05","proprietary_name":"Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25 KwikPen","nonproprietary_name":"Insulin lispro","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8233-05) / 3 mL in 1 SYRINGE (0002-8233-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.20743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52747071130","name":"INTEGRA F CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52747-711-30","proprietary_name":"Integra F","nonproprietary_name":"Ferrous Fumarate and Polysacchride Iron Complex and Folic Acid","dosage_form":"CAPSULE","route":"ORAL","strength":"62.5 mg/1; 62.5 mg/1; 1 mg/1; 40 mg/1; 3 mg/1","labeler":"U.S. Pharmaceutical Corporation","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (52747-711-30)","pharm_classes":["Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin C [EPC]"]},"nadac":{"value":0.61854,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52747071160","name":"INTEGRA F CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52747-711-60","proprietary_name":"Integra F","nonproprietary_name":"Ferrous Fumarate and Polysacchride Iron Complex and Folic Acid","dosage_form":"CAPSULE","route":"ORAL","strength":"62.5 mg/1; 62.5 mg/1; 1 mg/1; 40 mg/1; 3 mg/1","labeler":"U.S. Pharmaceutical Corporation","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (52747-711-60)","pharm_classes":["Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin C [EPC]"]},"nadac":{"value":0.56994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52747071230","name":"INTEGRA PLUS CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52747-712-30","proprietary_name":"Integra Plus","nonproprietary_name":"Ferrous Fumarate and Polysacchride Iron Vitamin Mineral Complex Supplement","dosage_form":"CAPSULE","route":"ORAL","strength":"62.5 mg/1; 62.5 mg/1; 1 mg/1; 210 mg/1; 20 mg/1; 5 mg/1; 5 mg/1; 5 mg/1; 25 mg/1; 300 ug/1","labeler":"U.S. Pharmaceutical Corporation","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (52747-712-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.76501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52747071260","name":"INTEGRA PLUS CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52747-712-60","proprietary_name":"Integra Plus","nonproprietary_name":"Ferrous Fumarate and Polysacchride Iron Vitamin Mineral Complex Supplement","dosage_form":"CAPSULE","route":"ORAL","strength":"62.5 mg/1; 62.5 mg/1; 1 mg/1; 210 mg/1; 20 mg/1; 5 mg/1; 5 mg/1; 5 mg/1; 25 mg/1; 300 ug/1","labeler":"U.S. Pharmaceutical Corporation","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (52747-712-60)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.72097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59676057101","name":"INTELENCE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59676-571-01","proprietary_name":"Intelence","nonproprietary_name":"etravirine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Janssen Products LP","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (59676-571-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":24.30324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Intelence|Etravirine","basis":"brand"},"part_b":null}, {"ndc":"72495040128","name":"INTRAROSA 6.5 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72495-401-28","proprietary_name":"Intrarosa","nonproprietary_name":"Prasterone","dosage_form":"INSERT","route":"VAGINAL","strength":"6.5 mg/1","labeler":"Millicent US, Inc.","package_description":"1 BOX in 1 BOX (72495-401-28) / 28 BLISTER PACK in 1 BOX / 1 INSERT in 1 BLISTER PACK"},"nadac":{"value":10.98244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Intrarosa|Prasterone (Dhea)","basis":"brand"},"part_b":null}, {"ndc":"70700020888","name":"INTROVALE 0.15-0.03 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-208-88","proprietary_name":"INTROVALE","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-208-88) / 1 BLISTER PACK in 1 POUCH (70700-208-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092051302","name":"INTUNIV ER 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-513-02","proprietary_name":"Intuniv","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (54092-513-02)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13256,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092051502","name":"INTUNIV ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-515-02","proprietary_name":"Intuniv","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (54092-515-02)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.26199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14767,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092051702","name":"INTUNIV ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-517-02","proprietary_name":"Intuniv","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (54092-517-02)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16584,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092051902","name":"INTUNIV ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-519-02","proprietary_name":"Intuniv","nonproprietary_name":"guanfacine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (54092-519-02)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.26984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17621,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458055001","name":"INVEGA ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50458-550-01","proprietary_name":"INVEGA","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-550-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":12.45301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458055101","name":"INVEGA ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-551-01","proprietary_name":"INVEGA","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-551-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":12.34881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458055201","name":"INVEGA ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-552-01","proprietary_name":"INVEGA","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50458-552-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":18.64123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458061101","name":"INVEGA HAFYERA 1,092 MG/3.5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-611-01","proprietary_name":"INVEGA HAFYERA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"1092 mg/3.5mL","labeler":"Janssen Pharmaceuticals, Inc","package_description":"1 SYRINGE in 1 CARTON (50458-611-01) / 3.5 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4047.70905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Hafyera|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2427","bill_units_per_package":{"value":1092,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2427 (1MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1092 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (50458-611-01) / 3.5 mL in 1 SYRINGE) gives 3.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458061201","name":"INVEGA HAFYERA 1,560 MG/5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50458-612-01","proprietary_name":"INVEGA HAFYERA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"1560 mg/5mL","labeler":"Janssen Pharmaceuticals, Inc","package_description":"1 SYRINGE in 1 CARTON (50458-612-01) / 5 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4233.40151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Hafyera|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2427","bill_units_per_package":{"value":1560,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2427 (1MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1560 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (50458-612-01) / 5 mL in 1 SYRINGE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458056201","name":"INVEGA SUSTENNA 117 MG/0.75 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-562-01","proprietary_name":"INVEGA SUSTENNA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"117 mg/.75mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 KIT (50458-562-01) / .75 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2339.66855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Sustenna|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2426","bill_units_per_package":{"value":117,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2426 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (117 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.75,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 KIT (50458-562-01) / .75 mL in 1 SYRINGE) gives 0.75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458056301","name":"INVEGA SUSTENNA 156 MG/ML SYRG","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-563-01","proprietary_name":"INVEGA SUSTENNA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"156 mg/mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 KIT (50458-563-01) / 1 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2337.70833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Sustenna|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2426","bill_units_per_package":{"value":156,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2426 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (156 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 KIT (50458-563-01) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458056401","name":"INVEGA SUSTENNA 234 MG/1.5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-564-01","proprietary_name":"INVEGA SUSTENNA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"234 mg/1.5mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 KIT (50458-564-01) / 1.5 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2338.47458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Sustenna|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2426","bill_units_per_package":{"value":234,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2426 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (234 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 KIT (50458-564-01) / 1.5 mL in 1 SYRINGE) gives 1.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458056001","name":"INVEGA SUSTENNA 39 MG/0.25 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-560-01","proprietary_name":"INVEGA SUSTENNA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"39 mg/.25mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 KIT (50458-560-01) / .25 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2338.748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Sustenna|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2426","bill_units_per_package":{"value":39,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2426 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (39 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 KIT (50458-560-01) / .25 mL in 1 SYRINGE) gives 0.25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458056101","name":"INVEGA SUSTENNA 78 MG/0.5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-561-01","proprietary_name":"INVEGA SUSTENNA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"78 mg/.5mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 KIT (50458-561-01) / .5 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2337.04833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Sustenna|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2426","bill_units_per_package":{"value":78,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2426 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (78 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 KIT (50458-561-01) / .5 mL in 1 SYRINGE) gives 0.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50458060601","name":"INVEGA TRINZA 273 MG/0.88 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-606-01","proprietary_name":"INVEGA TRINZA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"273 mg/.88mL","labeler":"Janssen Pharmaceuticals, Inc","package_description":"1 SYRINGE in 1 KIT (50458-606-01) / 1 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":3950.94887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Trinza|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2427","bill_units_per_package":{"value":273,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2427 (1MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (273 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.875,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"50458060701","name":"INVEGA TRINZA 410 MG/1.32 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-607-01","proprietary_name":"INVEGA TRINZA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"410 mg/1.32mL","labeler":"Janssen Pharmaceuticals, Inc","package_description":"1 SYRINGE in 1 KIT (50458-607-01) / 1 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":3959.46212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Trinza|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2427","bill_units_per_package":{"value":410,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2427 (1MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (410 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1.315,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"50458060801","name":"INVEGA TRINZA 546 MG/1.75 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-608-01","proprietary_name":"INVEGA TRINZA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"546 mg/1.75mL","labeler":"Janssen Pharmaceuticals, Inc","package_description":"1 SYRINGE in 1 KIT (50458-608-01) / 1 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":3993.63408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Trinza|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2427","bill_units_per_package":{"value":546,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2427 (1MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (546 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1.75,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"50458060901","name":"INVEGA TRINZA 819 MG/2.63 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-609-01","proprietary_name":"INVEGA TRINZA","nonproprietary_name":"paliperidone palmitate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"819 mg/2.63mL","labeler":"Janssen Pharmaceuticals, Inc","package_description":"1 SYRINGE in 1 KIT (50458-609-01) / 1 mL in 1 SYRINGE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":3997.97064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Invega Trinza|Paliperidone Palmitate","basis":"brand"},"part_b":{"hcpcs":"J2427","bill_units_per_package":{"value":819,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2427 (1MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (819 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.625,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"71571012128","name":"INVELTYS 1% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":103.11071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Inveltys|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"50458054360","name":"INVOKAMET 150-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-543-60","proprietary_name":"INVOKAMET","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 1000 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50458-543-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.57542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458054260","name":"INVOKAMET 150-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-542-60","proprietary_name":"INVOKAMET","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 500 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50458-542-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.60887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458054160","name":"INVOKAMET 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-541-60","proprietary_name":"INVOKAMET","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50458-541-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.53833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458054060","name":"INVOKAMET 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-540-60","proprietary_name":"INVOKAMET","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50458-540-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.56363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458094301","name":"INVOKAMET XR 150-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-943-01","proprietary_name":"INVOKAMET XR","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1; 1000 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50458-943-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.53579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet XR|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458094201","name":"INVOKAMET XR 150-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-942-01","proprietary_name":"INVOKAMET XR","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1; 500 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50458-942-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.56119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet XR|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458094101","name":"INVOKAMET XR 50-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-941-01","proprietary_name":"INVOKAMET XR","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50458-941-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.68763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet XR|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458094001","name":"INVOKAMET XR 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50458-940-01","proprietary_name":"INVOKAMET XR","nonproprietary_name":"canagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50458-940-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.67753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokamet XR|Canagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"50458014030","name":"INVOKANA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-140-30","proprietary_name":"INVOKANA","nonproprietary_name":"canagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50458-140-30)","pharm_classes":["P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.12691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokana|Canagliflozin","basis":"brand"},"part_b":null}, {"ndc":"50458014090","name":"INVOKANA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-140-90","proprietary_name":"INVOKANA","nonproprietary_name":"canagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50458-140-90)","pharm_classes":["P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.12691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokana|Canagliflozin","basis":"brand"},"part_b":null}, {"ndc":"50458014130","name":"INVOKANA 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-141-30","proprietary_name":"INVOKANA","nonproprietary_name":"canagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50458-141-30)","pharm_classes":["P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.12476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokana|Canagliflozin","basis":"brand"},"part_b":null}, {"ndc":"50458014190","name":"INVOKANA 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-141-90","proprietary_name":"INVOKANA","nonproprietary_name":"canagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50458-141-90)","pharm_classes":["P-Glycoprotein Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.12476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Invokana|Canagliflozin","basis":"brand"},"part_b":null}, {"ndc":"70954052210","name":"INZIRQO 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-522-10","proprietary_name":"INZIRQO","nonproprietary_name":"hydrochlorothiazide","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"80 mL in 1 BOTTLE (70954-522-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.46172,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000039901","name":"IODIDES TINCTURE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0399-1","proprietary_name":"Leader Decolorized Iodine","nonproprietary_name":"Alcohol Liquid","dosage_form":"LIQUID","route":"TOPICAL","strength":".48 mL/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"59 mL in 1 CONTAINER (70000-0399-1)"},"nadac":{"value":0.0722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24385021310","name":"IODINE 2% MILD TINCTURE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-213-10","proprietary_name":"GNP Idoinde Tincture 2% Mild","nonproprietary_name":"Iodine and Sodium Iodide and Alcohol","dosage_form":"LIQUID","route":"TOPICAL","strength":"20 mg/mL; 20.4 mg/mL; 470 mg/mL","labeler":"Amerisource Bergen","package_description":"30 mL in 1 BOTTLE, PLASTIC (24385-213-10)"},"nadac":{"value":0.07191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000040101","name":"IODINE 2% MILD TINCTURE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0401-1","proprietary_name":"LEADER 2% Mild Iodine Tincture","nonproprietary_name":"Iodine and Sodium Iodide and Alcohol Liquid","dosage_form":"LIQUID","route":"TOPICAL","strength":"24 mg/mL; 20 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"30 mL in 1 BOTTLE, PLASTIC (70000-0401-1)"},"nadac":{"value":0.07191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054004544","name":"IPRATROPIUM 0.03% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0045-44","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SPRAY","route":"NASAL","strength":"21 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0054-0045-44) / 345 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.36783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714052601","name":"IPRATROPIUM 0.03% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-526-01","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"21 ug/1","labeler":"NORTHSTAR RX LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (16714-526-01) / 345 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.36783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505082601","name":"IPRATROPIUM 0.03% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0826-1","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"21 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-0826-1) / 345 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.36783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238201603","name":"IPRATROPIUM 0.03% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2016-3","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SPRAY","route":"NASAL","strength":"21 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (69238-2016-3) / 345 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.36783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748033601","name":"IPRATROPIUM 0.03% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-336-01","proprietary_name":"IPRATROPIUM BROMIDE","nonproprietary_name":"IPRATROPIUM BROMIDE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"21 ug/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70748-336-01) / 345 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.36783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888014938","name":"IPRATROPIUM 0.03% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-149-38","proprietary_name":"IPRATROPIUM BROMIDE","nonproprietary_name":"IPRATROPIUM BROMIDE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"21 ug/1","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-149-38) / 345 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.36783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054004641","name":"IPRATROPIUM 0.06% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0046-41","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SPRAY","route":"NASAL","strength":"42 ug/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0054-0046-41) / 165 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.77751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714052701","name":"IPRATROPIUM 0.06% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-527-01","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"ipratropium bromide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"42 ug/1","labeler":"NORTHSTAR RX LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (16714-527-01) / 165 SPRAY, METERED in 1 BOTTLE, PUMP","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.77751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505082701","name":"IPRATROPIUM 0.06% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0827-1","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"ipratropium bromide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"42 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, PUMP in 1 CARTON (60505-0827-1) / 165 SPRAY, METERED in 1 BOTTLE, PUMP","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.77751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238201702","name":"IPRATROPIUM 0.06% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2017-2","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SPRAY","route":"NASAL","strength":"42 ug/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (69238-2017-2) / 165 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.77751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748033701","name":"IPRATROPIUM 0.06% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-337-01","proprietary_name":"IPRATROPIUM BROMIDE","nonproprietary_name":"IPRATROPIUM BROMIDE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"42 ug/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70748-337-01) / 165 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.77751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888014837","name":"IPRATROPIUM 0.06% SPRAY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-148-37","proprietary_name":"IPRATROPIUM BROMIDE","nonproprietary_name":"IPRATROPIUM BROMIDE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"42 ug/1","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-148-37) / 165 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.77751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378797052","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7970-52","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-7970-52) / 25 AMPULE in 1 POUCH (0378-7970-62) / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.10402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-7970-52) / 25 AMPULE in 1 POUCH (0378-7970-62) / 2.5 mL in 1 AMPULE) gives 62.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378797055","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7970-55","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-7970-55) / 1 AMPULE in 1 POUCH (0378-7970-31) / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0378-7970-55) / 1 AMPULE in 1 POUCH (0378-7970-31) / 2.5 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378797091","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7970-91","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 POUCH in 1 CARTON (0378-7970-91) / 30 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (0378-7970-91) / 30 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE) gives 150 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378797093","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7970-93","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-7970-93) / 30 AMPULE in 1 POUCH (0378-7970-64) / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-7970-93) / 30 AMPULE in 1 POUCH (0378-7970-64) / 2.5 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487980101","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9801-01","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-9801-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-9801-01) / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487980125","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9801-25","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"1 POUCH in 1 CARTON (0487-9801-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.10402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0487-9801-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 62.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487980130","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9801-30","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"1 POUCH in 1 CARTON (0487-9801-30) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0487-9801-30) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487980160","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-9801-60","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"2 POUCH in 1 CARTON (0487-9801-60) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (0487-9801-60) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 150 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60687039483","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-394-83","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-394-83) / 1 AMPULE in 1 POUCH (60687-394-79) / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (60687-394-83) / 1 AMPULE in 1 POUCH (60687-394-79) / 2.5 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64980064002","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-640-02","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 POUCH in 1 CARTON (64980-640-02) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.10402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (64980-640-02) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 62.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64980064003","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-640-03","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 POUCH in 1 CARTON (64980-640-03) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (64980-640-03) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64980064006","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-640-06","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"2 POUCH in 1 CARTON (64980-640-06) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (64980-640-06) / 30 VIAL, SINGLE-DOSE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-DOSE) gives 150 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204010001","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-100-01","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-100-01) / 1 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-100-01) / 1 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204010025","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-100-25","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-100-25) / 25 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.10402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-100-25) / 25 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE) gives 62.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204010030","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-100-30","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-100-30) / 30 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":15,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-100-30) / 30 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204010060","name":"IPRATROPIUM BR 0.02% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-100-60","proprietary_name":"Ipratropium Bromide","nonproprietary_name":"Ipratropium Bromide","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2.5mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"2 POUCH in 1 CARTON (76204-100-60) / 30 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.1099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium Bromide*|Ipratropium Bromide","basis":"generic"},"part_b":{"hcpcs":"J7644","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7644 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (76204-100-60) / 30 AMPULE in 1 POUCH / 2.5 mL in 1 AMPULE) gives 150 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"17270040100","name":"IPRATROPIUM BR 17 MCG HFA INH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17270-0401-0","proprietary_name":"Ipratropium Bromide Inhalation","nonproprietary_name":"Ipratropium Bromide Inhalation","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"17 ug/1","labeler":"Armstrong Pharmaceuticals, Inc.","package_description":"1 CANISTER in 1 CARTON (17270-0401-0) / 200 AEROSOL in 1 CANISTER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":22.10952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378967130","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9671-30","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-9671-30) / 30 AMPULE in 1 POUCH (0378-9671-64) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-9671-30) / 30 AMPULE in 1 POUCH (0378-9671-64) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378967160","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9671-60","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 POUCH in 1 CARTON (0378-9671-60) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (0378-9671-60) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378967164","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00378967193","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9671-93","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9671-93) / 1 AMPULE in 1 POUCH (0378-9671-31) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0378-9671-93) / 1 AMPULE in 1 POUCH (0378-9671-31) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487020101","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-0201-01","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 3 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"30 POUCH in 1 CARTON (0487-0201-01) / 1 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (0487-0201-01) / 1 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487020103","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-0201-03","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 3 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"6 POUCH in 1 CARTON (0487-0201-03) / 5 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0487-0201-03) / 5 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00487020160","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0487-0201-60","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 3 mg/3mL","labeler":"Nephron Pharmaceuticals Corporation","package_description":"12 POUCH in 1 CARTON (0487-0201-60) / 5 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (0487-0201-60) / 5 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335075649","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-756-49","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"6 POUCH in 1 CARTON (47335-756-49) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (47335-756-49) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335075652","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-756-52","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"12 POUCH in 1 CARTON (47335-756-52) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (47335-756-52) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60687040583","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-405-83","proprietary_name":"IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-405-83) / 1 AMPULE in 1 POUCH (60687-405-79) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (60687-405-83) / 1 AMPULE in 1 POUCH (60687-405-79) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"64980064503","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-645-03","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 3 mg/3mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 POUCH in 1 CARTON (64980-645-03) / 5 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"64980064506","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-645-06","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 3 mg/3mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 POUCH in 1 CARTON (64980-645-06) / 5 VIAL, SINGLE-USE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"69097017353","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-173-53","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Cipla USA Inc.","package_description":"6 POUCH in 1 CARTON (69097-173-53) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (69097-173-53) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097017364","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-173-64","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Cipla USA Inc.","package_description":"12 POUCH in 1 CARTON (69097-173-64) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (69097-173-64) / 5 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097084053","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-840-53","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Cipla USA Inc.","package_description":"30 POUCH in 1 CARTON (69097-840-53) / 1 VIAL in 1 POUCH (69097-840-34) / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (69097-840-53) / 1 VIAL in 1 POUCH (69097-840-34) / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097084064","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-840-64","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Cipla USA Inc.","package_description":"2 POUCH in 1 CARTON (69097-840-64) / 30 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (69097-840-64) / 30 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097084087","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-840-87","proprietary_name":"Ipratropium Bromide and Albuterol Sulfate","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/3mL; 2.5 mg/3mL","labeler":"Cipla USA Inc.","package_description":"1 POUCH in 1 CARTON (69097-840-87) / 30 VIAL in 1 POUCH / 3 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (69097-840-87) / 30 VIAL in 1 POUCH / 3 mL in 1 VIAL) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204060001","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-600-01","proprietary_name":"IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-600-01) / 1 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-600-01) / 1 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204060005","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-600-05","proprietary_name":"IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"6 POUCH in 1 CARTON (76204-600-05) / 5 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (76204-600-05) / 5 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204060012","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-600-12","proprietary_name":"IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"12 POUCH in 1 CARTON (76204-600-12) / 5 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CARTON (76204-600-12) / 5 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204060030","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-600-30","proprietary_name":"IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-600-30) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-600-30) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204060060","name":"IPRATROPIUM-ALBUTEROL 0.5-3(2.5) MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-600-60","proprietary_name":"IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE","nonproprietary_name":"Ipratropium Bromide and Albuterol Sulfate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"2.5 mg/3mL; .5 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"2 POUCH in 1 CARTON (76204-600-60) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ipratropium-Albuterol|Ipratropium/Albuterol Sulfate","basis":"generic"},"part_b":{"hcpcs":"J7620","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7620 (2.5 MG/0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (2 POUCH in 1 CARTON (76204-600-60) / 30 AMPULE in 1 POUCH / 3 mL in 1 AMPULE) gives 180 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"29300021313","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-213-13","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-213-13)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"29300021319","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-213-19","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-213-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722073005","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-730-05","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-730-05)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722073030","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-730-30","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-730-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722073090","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-730-90","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-730-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"33342004807","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-048-07","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-048-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"33342004810","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-048-10","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-048-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"42658012204","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42658-122-04","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Hisun Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42658-122-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027803","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027809","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027850","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037503","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-375-03","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-375-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037509","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-375-09","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"90 TABLET in 1 BOTTLE (43547-375-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037550","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-375-50","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-375-50)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004230","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-042-30","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-042-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004271","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-042-71","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-042-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004290","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-042-90","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-042-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72205032830","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-328-30","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-328-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72205032890","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-328-90","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-328-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72603067101","name":"IRBESARTAN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-671-01","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-671-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"29300021413","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-214-13","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-214-13)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"29300021419","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-214-19","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-214-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722073105","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-731-05","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-731-05)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722073130","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-731-30","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-731-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722073190","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-731-90","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-731-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"33342004907","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-049-07","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-049-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"33342004910","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-049-10","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-049-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"42658012304","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42658-123-04","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Hisun Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42658-123-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027903","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027909","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027950","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037603","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-376-03","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-376-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037609","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-376-09","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"90 TABLET in 1 BOTTLE (43547-376-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037650","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-376-50","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-376-50)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004330","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-043-30","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-043-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004371","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-043-71","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-043-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004390","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-043-90","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-043-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72205032990","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-329-90","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-329-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72603067201","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-672-01","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-672-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72603067202","name":"IRBESARTAN 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-672-02","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-672-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"29300021213","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-212-13","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (29300-212-13)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"29300021219","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-212-19","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-212-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722072930","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-729-30","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-729-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"31722072990","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-729-90","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-729-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"33342004707","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-047-07","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-047-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"33342004710","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-047-10","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-047-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027703","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547027709","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037403","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-374-03","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET in 1 BOTTLE (43547-374-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037409","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-374-09","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"90 TABLET in 1 BOTTLE (43547-374-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"43547037450","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-374-50","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-374-50)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62135097630","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-976-30","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-976-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004130","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-041-30","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-041-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"62332004190","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-041-90","proprietary_name":"IRBESARTAN","nonproprietary_name":"IRBESARTAN","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-041-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72205032730","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-327-30","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-327-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72205032790","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-327-90","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-327-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"72603067001","name":"IRBESARTAN 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-670-01","proprietary_name":"Irbesartan","nonproprietary_name":"Irbesartan","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-670-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan|Irbesartan","basis":"generic"},"part_b":null}, {"ndc":"00093823856","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8238-56","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-8238-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093823898","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8238-98","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-8238-98)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005707","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-057-07","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-057-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005710","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-057-10","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-057-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547033003","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-330-03","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-330-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547033009","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-330-09","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-330-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005130","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-051-30","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-051-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005190","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-051-90","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-051-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.14881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093823256","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8232-56","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-8232-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093823298","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8232-98","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-8232-98)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005807","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-058-07","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-058-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005810","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-058-10","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-058-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547033103","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-331-03","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-331-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547033109","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-331-09","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-331-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005230","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-052-30","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-052-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005290","name":"IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-052-90","proprietary_name":"Irbesartan and Hydrochlorothiazide","nonproprietary_name":"Irbesartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-052-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Irbesartan-Hydrochlorothiazide|Irbesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00006022761","name":"ISENTRESS 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0227-61","proprietary_name":"ISENTRESS","nonproprietary_name":"RALTEGRAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-0227-61)","pharm_classes":["HIV Integrase Inhibitors [MoA]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]"]},"nadac":{"value":34.53888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isentress|Raltegravir Potassium","basis":"brand"},"part_b":null}, {"ndc":"00006308001","name":"ISENTRESS HD 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-3080-01","proprietary_name":"ISENTRESS","nonproprietary_name":"RALTEGRAVIR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-3080-01)","pharm_classes":["HIV Integrase Inhibitors [MoA]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]"]},"nadac":{"value":34.51502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700011384","name":"ISIBLOOM 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isibloom|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700011385","name":"ISIBLOOM 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-113-85","proprietary_name":"Isibloom","nonproprietary_name":"desogestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-113-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isibloom|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555006602","name":"ISONIAZID 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0555-0066-02","proprietary_name":"Isoniazid","nonproprietary_name":"Isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0066-02)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.73222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"64950021610","name":"ISONIAZID 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64950-216-10","proprietary_name":"Isoniazid","nonproprietary_name":"isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Genus Lifesciences","package_description":"100 TABLET in 1 BOTTLE (64950-216-10)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.73222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"81665010710","name":"ISONIAZID 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"81665-107-10","proprietary_name":"isoniazid","nonproprietary_name":"isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (81665-107-10)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.73222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"00555007101","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0071-01","proprietary_name":"Isoniazid","nonproprietary_name":"Isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE, UNIT-DOSE (0555-0071-01)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"00555007102","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0071-02","proprietary_name":"Isoniazid","nonproprietary_name":"Isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0071-02)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"51079008301","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"51079008320","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-083-20","proprietary_name":"Isoniazid","nonproprietary_name":"Isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-083-20) / 1 TABLET in 1 BLISTER PACK (51079-083-01)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"62135070990","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-709-90","proprietary_name":"Isoniazid","nonproprietary_name":"Isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-709-90)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"64950021703","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-217-03","proprietary_name":"Isoniazid","nonproprietary_name":"isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Genus Lifesciences","package_description":"30 TABLET in 1 BOTTLE (64950-217-03)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"64950021710","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-217-10","proprietary_name":"Isoniazid","nonproprietary_name":"isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Genus Lifesciences","package_description":"100 TABLET in 1 BOTTLE (64950-217-10)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"81665010810","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-108-10","proprietary_name":"isoniazid","nonproprietary_name":"isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (81665-108-10)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"81665010830","name":"ISONIAZID 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-108-30","proprietary_name":"isoniazid","nonproprietary_name":"isoniazid","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (81665-108-30)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":3.40199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isoniazid|Isoniazid","basis":"generic"},"part_b":null}, {"ndc":"00143177101","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1771-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0143-1771-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00143177110","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1771-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0143-1771-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00781155601","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1556-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET in 1 BOTTLE (0781-1556-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00781155610","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1556-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc.","package_description":"1000 TABLET in 1 BOTTLE (0781-1556-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00904661961","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6619-61","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6619-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"16714000801","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-008-01","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-008-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884002101","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-021-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-021-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884002110","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-021-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (49884-021-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"50268044811","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"50268044815","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-448-15","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-448-15) / 1 TABLET in 1 BLISTER PACK (50268-448-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68001037400","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-374-00","proprietary_name":"Isosorbide","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (68001-374-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68084008201","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-082-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-082-01) / 1 TABLET in 1 BLISTER PACK (68084-082-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68084008211","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"70710114901","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1149-1","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1149-1)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008200","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-082-00","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-082-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008201","name":"ISOSORBIDE DINITRATE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-082-01","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-082-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.15421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00143177201","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1772-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0143-1772-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00143177210","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1772-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0143-1772-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00781169501","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1695-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET in 1 BOTTLE (0781-1695-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00781169510","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1695-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc.","package_description":"1000 TABLET in 1 BOTTLE (0781-1695-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00904662061","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6620-61","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6620-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"16714000901","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-009-01","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-009-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884002201","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-022-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-022-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884002210","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-022-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (49884-022-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"50268044911","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"50268044915","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-449-15","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-449-15) / 1 TABLET in 1 BLISTER PACK (50268-449-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68001037500","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-375-00","proprietary_name":"Isosorbide","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (68001-375-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68084008301","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-083-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-083-01) / 1 TABLET in 1 BLISTER PACK (68084-083-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68084008311","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"70710115001","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1150-1","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1150-1)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008300","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-083-00","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-083-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008301","name":"ISOSORBIDE DINITRATE 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-083-01","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-083-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.19894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"16714001001","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-010-01","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-010-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884000901","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-009-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-009-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884000910","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-009-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (49884-009-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68001056200","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-562-00","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-562-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"70710115101","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1151-1","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1151-1)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008400","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-084-00","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-084-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008401","name":"ISOSORBIDE DINITRATE 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-084-01","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-084-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.2808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884055601","name":"ISOSORBIDE DINITRATE 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-556-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-556-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":3.3103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"70710115201","name":"ISOSORBIDE DINITRATE 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1152-1","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1152-1)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":3.3103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008501","name":"ISOSORBIDE DINITRATE 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-085-01","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-085-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":3.3103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00143176901","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1769-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0143-1769-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00143176910","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1769-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0143-1769-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00781163501","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1635-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET in 1 BOTTLE (0781-1635-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00781163510","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-1635-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc.","package_description":"1000 TABLET in 1 BOTTLE (0781-1635-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"16714000701","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-007-01","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-007-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884002001","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-020-01","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-020-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"49884002010","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-020-10","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (49884-020-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"50268044711","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"50268044715","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-447-15","proprietary_name":"Isosorbide Dinitrate","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-447-15) / 1 TABLET in 1 BLISTER PACK (50268-447-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"68001037300","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-373-00","proprietary_name":"Isosorbide","nonproprietary_name":"Isosorbide Dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (68001-373-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"70710114801","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1148-1","proprietary_name":"Isosorbide dinitrate","nonproprietary_name":"Isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1148-1)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008100","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-081-00","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-081-00)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"72888008101","name":"ISOSORBIDE DINITRATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-081-01","proprietary_name":"ISOSORBIDE DINITRATE","nonproprietary_name":"isosorbide dinitrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-081-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.17675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Dinitrate|Isosorbide Dinitrate","basis":"generic"},"part_b":null}, {"ndc":"00228263111","name":"ISOSORBIDE MONONIT 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2631-11","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2631-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.40398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"62559025201","name":"ISOSORBIDE MONONIT 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-252-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-252-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.40398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"64950025001","name":"ISOSORBIDE MONONIT 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-250-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Genus Lifesciences Inc.","package_description":"100 TABLET in 1 BOTTLE (64950-250-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.40398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"81665010210","name":"ISOSORBIDE MONONIT 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-102-10","proprietary_name":"isosorbide mononitrate","nonproprietary_name":"isosorbide mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"100 TABLET in 1 BOTTLE (81665-102-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.40398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"00228262011","name":"ISOSORBIDE MONONIT 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2620-11","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0228-2620-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"62559025301","name":"ISOSORBIDE MONONIT 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-253-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-253-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"64950025101","name":"ISOSORBIDE MONONIT 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-251-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Genus Lifesciences Inc.","package_description":"100 TABLET in 1 BOTTLE (64950-251-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"81665010310","name":"ISOSORBIDE MONONIT 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-103-10","proprietary_name":"isosorbide mononitrate","nonproprietary_name":"isosorbide mononitrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"100 TABLET in 1 BOTTLE (81665-103-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"13668010601","name":"ISOSORBIDE MONONIT ER 120 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-106-01","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-106-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.16621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"23155062801","name":"ISOSORBIDE MONONIT ER 120 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799096001","name":"ISOSORBIDE MONONIT ER 120 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-960-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42799-960-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.16621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"50742017701","name":"ISOSORBIDE MONONIT ER 120 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-177-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-177-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.16621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"59651054101","name":"ISOSORBIDE MONONIT ER 120 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-541-01","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-541-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.16621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"62135058890","name":"ISOSORBIDE MONONIT ER 120 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-588-90","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-588-90)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.16621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"00904644961","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6449-61","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6449-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"13668010401","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-104-01","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-104-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"13668010410","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-104-10","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-104-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"23155051901","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155051905","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799095801","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-958-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42799-958-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"42799095802","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-958-02","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42799-958-02)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"50742017501","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-175-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-175-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"50742017505","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-175-05","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-175-05)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"59651053901","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-539-01","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-539-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"59651053905","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-539-05","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-539-05)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"60687078301","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-783-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-783-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-783-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"60687078311","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"62135058690","name":"ISOSORBIDE MONONIT ER 30 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-586-90","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-586-90)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"00904645061","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6450-61","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6450-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"13668010501","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-105-01","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-105-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"13668010510","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-105-10","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-105-10)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"23155017801","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155017805","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799095901","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-959-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42799-959-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"42799095902","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-959-02","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42799-959-02)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"50742017601","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-176-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-176-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"50742017605","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-176-05","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-176-05)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"59651054001","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-540-01","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-540-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"59651054005","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-540-05","proprietary_name":"ISOSORBIDE MONONITRATE","nonproprietary_name":"ISOSORBIDE MONONITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-540-05)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"60687079401","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-794-01","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-794-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-794-11)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"60687079411","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"62135058790","name":"ISOSORBIDE MONONIT ER 60 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-587-90","proprietary_name":"Isosorbide Mononitrate","nonproprietary_name":"Isosorbide Mononitrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-587-90)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.09688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isosorbide Mononitrate ER|Isosorbide Mononitrate","basis":"generic"},"part_b":null}, {"ndc":"50742024690","name":"ISOSORBIDE-HYDRALAZINE 20-37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-246-90","proprietary_name":"Isosorbide dinitrate and hydralazine hydrochloride","nonproprietary_name":"Isosorbide dinitrate and hydralazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 20 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (50742-246-90)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]","Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.7138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536000609","name":"ISOSORBIDE-HYDRALAZINE 20-37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-006-09","proprietary_name":"isosorbide dinitrate and hydralazine hydrochloride","nonproprietary_name":"hydralazine hydrochloride and isosorbide dinitrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 20 mg/1","labeler":"Wilshire Pharmaceuticals","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (52536-006-09)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]","Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.7138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72319001203","name":"ISOSORBIDE-HYDRALAZINE 20-37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-012-03","proprietary_name":"isosorbide dinitrate and hydralazine hydrochloride","nonproprietary_name":"isosorbide dinitrate and hydralazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 37.5 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72319-012-03)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]","Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.7138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245057001","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0570-01","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0245-0570-01) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0245-0570-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057089","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243315","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0591-2433-15","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0591-2433-15) / 10 CAPSULE in 1 BLISTER PACK (0591-2433-45)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243345","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830130","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-8301-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0832-8301-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0832-8301-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830189","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"57664002097","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57664-020-97","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (57664-020-97) / 10 CAPSULE in 1 BLISTER PACK (57664-020-98)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063103","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-631-03","proprietary_name":"ISOTRETINOIN","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (59651-631-03) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063110","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057001","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057030","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68308-570-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-570-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-570-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078101","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078130","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-781-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-781-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-781-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238117401","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238117403","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1174-3","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"3 BLISTER PACK in 1 CARTON (69238-1174-3) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (69238-1174-1)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710102208","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1022-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1022-8) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157402","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157408","name":"ISOTRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1574-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1574-8) / 10 CAPSULE in 1 BLISTER PACK (70710-1574-2)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057101","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0571-01","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0245-0571-01) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0245-0571-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057189","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243415","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2434-15","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0591-2434-15) / 10 CAPSULE in 1 BLISTER PACK (0591-2434-45)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243445","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830230","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-8302-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0832-8302-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0832-8302-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830289","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"57664002197","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-021-97","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (57664-021-97) / 10 CAPSULE in 1 BLISTER PACK (57664-021-98)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063203","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-632-03","proprietary_name":"ISOTRETINOIN","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (59651-632-03) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063210","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057101","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057130","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-571-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-571-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-571-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078201","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078230","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-782-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-782-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-782-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238117501","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238117503","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1175-3","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"3 BLISTER PACK in 1 CARTON (69238-1175-3) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (69238-1175-1)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710102308","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1023-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1023-8) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157502","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157508","name":"ISOTRETINOIN 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1575-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1575-8) / 10 CAPSULE in 1 BLISTER PACK (70710-1575-2)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.25389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591245115","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2451-15","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0591-2451-15) / 10 CAPSULE in 1 BLISTER PACK (0591-2451-45)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591245145","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"57664002297","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-022-97","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (57664-022-97) / 10 CAPSULE in 1 BLISTER PACK (57664-022-98)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063303","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-633-03","proprietary_name":"ISOTRETINOIN","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (59651-633-03) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063310","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157602","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157608","name":"ISOTRETINOIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1576-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1576-8) / 10 CAPSULE in 1 BLISTER PACK (70710-1576-2)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":10.55124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057301","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0573-01","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0245-0573-01) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0245-0573-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057389","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243515","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2435-15","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0591-2435-15) / 10 CAPSULE in 1 BLISTER PACK (0591-2435-45)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243545","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830330","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-8303-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0832-8303-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0832-8303-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830389","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"57664002397","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-023-97","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (57664-023-97) / 10 CAPSULE in 1 BLISTER PACK (57664-023-98)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063403","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-634-03","proprietary_name":"ISOTRETINOIN","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (59651-634-03) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063410","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057301","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057330","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-573-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-573-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-573-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078301","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078330","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-783-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-783-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-783-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238101701","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238101703","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1017-3","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"3 BLISTER PACK in 1 CARTON (69238-1017-3) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (69238-1017-1)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710102408","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1024-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1024-8) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157702","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157708","name":"ISOTRETINOIN 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1577-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1577-8) / 10 CAPSULE in 1 BLISTER PACK (70710-1577-2)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":4.4724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057501","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0575-01","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0245-0575-01) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0245-0575-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00245057589","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243615","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2436-15","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0591-2436-15) / 10 CAPSULE in 1 BLISTER PACK (0591-2436-45)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00591243645","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830430","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-8304-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"3 BLISTER PACK in 1 BOX (0832-8304-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0832-8304-89)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"00832830489","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"57664002597","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-025-97","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 BOX (57664-025-97) / 10 CAPSULE in 1 BLISTER PACK (57664-025-98)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063603","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-636-03","proprietary_name":"ISOTRETINOIN","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (59651-636-03) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651063610","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057501","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308057530","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-575-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-575-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-575-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078401","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"68308078430","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-784-30","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Mayne Pharma","package_description":"3 BLISTER PACK in 1 BOX (68308-784-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68308-784-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238117601","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"69238117603","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1176-3","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"3 BLISTER PACK in 1 CARTON (69238-1176-3) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (69238-1176-1)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710102508","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1025-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1025-8) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157902","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"70710157908","name":"ISOTRETINOIN 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1579-8","proprietary_name":"Isotretinoin","nonproprietary_name":"Isotretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70710-1579-8) / 10 CAPSULE in 1 BLISTER PACK (70710-1579-2)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.6653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isotretinoin|Isotretinoin","basis":"generic"},"part_b":null}, {"ndc":"16252053901","name":"ISRADIPINE 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16252-539-01","proprietary_name":"Isradipine","nonproprietary_name":"Isradipine","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16252-539-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.13676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isradipine|Isradipine","basis":"generic"},"part_b":null}, {"ndc":"64850091001","name":"ISRADIPINE 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-910-01","proprietary_name":"Isradipine","nonproprietary_name":"Isradipine","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-910-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.13676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isradipine|Isradipine","basis":"generic"},"part_b":null}, {"ndc":"16252054001","name":"ISRADIPINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16252-540-01","proprietary_name":"Isradipine","nonproprietary_name":"Isradipine","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16252-540-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.70236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isradipine|Isradipine","basis":"generic"},"part_b":null}, {"ndc":"64850091101","name":"ISRADIPINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-911-01","proprietary_name":"Isradipine","nonproprietary_name":"Isradipine","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-911-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.70236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Isradipine|Isradipine","basis":"generic"},"part_b":null}, {"ndc":"24208000401","name":"ISTALOL 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-004-01","proprietary_name":"Istalol","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-004-01) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":79.76333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":21.80573,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Istalol|Timolol Maleate","basis":"brand"},"part_b":null}, {"ndc":"24208000403","name":"ISTALOL 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-004-03","proprietary_name":"Istalol","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-004-03) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":80.01457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":22.28973,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Istalol|Timolol Maleate","basis":"brand"},"part_b":null}, {"ndc":"45802035803","name":"ITCH RELIEF 2%-0.1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-358-03","proprietary_name":"diphenhydramine hcl and zinc acetate","nonproprietary_name":"Diphenhydramine Hydrochloride, Zinc Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g; .1 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-358-03) / 28 g in 1 TUBE","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000002301","name":"ITCH RELIEF 2%-0.1% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0023-1","proprietary_name":"Itch Relief","nonproprietary_name":"Diphenhydramine HCl, Zinc Acetate","dosage_form":"SPRAY","route":"TOPICAL","strength":"20 mg/mL; 1 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"59 mL in 1 BOTTLE, SPRAY (70000-0023-1)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722000631","name":"ITRACONAZOLE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-006-31","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (31722-006-31) / 150 mL in 1 BOTTLE, GLASS","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.13566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162008774","name":"ITRACONAZOLE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-087-74","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"150 mL in 1 BOTTLE, GLASS (65162-087-74)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":1.13566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"10147170003","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10147-1700-3","proprietary_name":"itraconazole","nonproprietary_name":"ITRACONAZOLE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Patriot Pharmaceuticals","package_description":"30 CAPSULE in 1 BOTTLE (10147-1700-3)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668046330","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-463-30","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 CAPSULE in 1 BOTTLE (13668-463-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571024503","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-245-03","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (16571-245-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714074302","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-743-02","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, COATED PELLETS in 1 BOTTLE (16714-743-02)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268045011","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268045012","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-450-12","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-450-12) / 1 CAPSULE in 1 BLISTER PACK (50268-450-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687029925","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-299-25","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-299-25) / 1 CAPSULE in 1 BLISTER PACK (60687-299-95)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687029995","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332020404","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-204-04","proprietary_name":"ITRACONAZOLE","nonproprietary_name":"itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"28 CAPSULE in 1 CARTON (62332-204-04)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332020430","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-204-30","proprietary_name":"ITRACONAZOLE","nonproprietary_name":"itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-204-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162063003","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-630-03","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE in 1 BOTTLE (65162-630-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877045430","name":"ITRACONAZOLE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-454-30","proprietary_name":"Itraconazole","nonproprietary_name":"Itraconazole","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-454-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722005360","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-053-60","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-053-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742036260","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-362-60","proprietary_name":"IVABRADINE","nonproprietary_name":"IVABRADINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50742-362-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687086211","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687086221","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-862-21","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-862-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-862-11)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332067960","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-679-60","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-679-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452019017","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-190-17","proprietary_name":"ivabradine","nonproprietary_name":"ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69452-190-17)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710147106","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1471-6","proprietary_name":"ivabradine","nonproprietary_name":"ivabradine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (70710-1471-6)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205033660","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-336-60","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-336-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603093401","name":"IVABRADINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-934-01","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Northstar Rx LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72603-934-01)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.76068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722005460","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-054-60","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-054-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742036360","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-363-60","proprietary_name":"IVABRADINE","nonproprietary_name":"IVABRADINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50742-363-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332068060","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-680-60","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-680-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452019117","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-191-17","proprietary_name":"ivabradine","nonproprietary_name":"ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Bionpharma Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69452-191-17)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710147206","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1472-6","proprietary_name":"ivabradine","nonproprietary_name":"ivabradine","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (70710-1472-6)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205033760","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-337-60","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-337-60)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603093501","name":"IVABRADINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-935-01","proprietary_name":"Ivabradine","nonproprietary_name":"Ivabradine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Northstar Rx LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72603-935-01)","pharm_classes":["Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA]","Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker [EPC]"]},"nadac":{"value":0.63998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"IVabradine HCl|IVabradine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672423008","name":"IVERMECTIN 0.5% LOTION","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4230-8","proprietary_name":"Ivermectin","nonproprietary_name":"Ivermectin","dosage_form":"LOTION","route":"TOPICAL","strength":"5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4230-8) / 117 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":1.23937,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591405289","name":"IVERMECTIN 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4052-89","proprietary_name":"Ivermectin","nonproprietary_name":"Ivermectin","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0591-4052-89) / 45 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":2.74609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802010284","name":"IVERMECTIN 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-102-84","proprietary_name":"Ivermectin","nonproprietary_name":"Ivermectin","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-102-84) / 45 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":2.74609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308070145","name":"IVERMECTIN 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-701-45","proprietary_name":"IVERMECTIN","nonproprietary_name":"IVERMECTIN","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 TUBE in 1 CARTON (68308-701-45) / 45 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":2.74609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578012008","name":"IVERMECTIN 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-120-08","proprietary_name":"ivermectin","nonproprietary_name":"ivermectin","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-120-08) / 45 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":2.74609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42799080601","name":"IVERMECTIN 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-806-01","proprietary_name":"Ivermectin","nonproprietary_name":"Ivermectin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"2 BLISTER PACK in 1 CARTON (42799-806-01) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888020608","name":"IVERMECTIN 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888020666","name":"IVERMECTIN 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-206-66","proprietary_name":"Ivermectin","nonproprietary_name":"Ivermectin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Advagen Pharma Ltd","package_description":"2 BLISTER PACK in 1 CARTON (72888-206-66) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907016721","name":"IVERMECTIN 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-167-21","proprietary_name":"IVERMECTIN","nonproprietary_name":"ivermectin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"DR. REDDY'S LABORATORIES, INC.","package_description":"2 BLISTER PACK in 1 CARTON (75907-167-21) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888020708","name":"IVERMECTIN 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.80491,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888020766","name":"IVERMECTIN 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-207-66","proprietary_name":"Ivermectin","nonproprietary_name":"Ivermectin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Advagen Pharma Ltd","package_description":"2 BLISTER PACK in 1 CARTON (72888-207-66) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":9.80491,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82584000330","name":"IYUZEH 0.005% EYE DROP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82584-003-30","proprietary_name":"IYUZEH","nonproprietary_name":"Latanoprost Ophthalmic Solution 0.005%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Thea Pharma Inc.","package_description":"30 POUCH in 1 CARTON (82584-003-30) / .2 mL in 1 POUCH"},"nadac":{"value":10.12265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Iyuzeh|Latanoprost/PF","basis":"brand"},"part_b":null}, {"ndc":"70700012387","name":"JAIMIESS 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-123-87","proprietary_name":"JAIMIESS","nonproprietary_name":"levonorgestrel / ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"1 BLISTER PACK in 1 BOX (70700-123-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jaimiess|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"70700020687","name":"JAIMIESS 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jaimiess|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"70700020693","name":"JAIMIESS 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-206-93","proprietary_name":"JAIMIESS","nonproprietary_name":"levonorgestrel and ethinyl estradiol and ethinyl estradiol tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"2 POUCH in 1 CARTON (70700-206-93) / 1 BLISTER PACK in 1 POUCH (70700-206-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jaimiess|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"00832121100","name":"JANTOVEN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1211-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1211-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121101","name":"JANTOVEN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1211-01","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-1211-01) / 1 TABLET in 1 BLISTER PACK (0832-1211-89)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121110","name":"JANTOVEN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1211-10","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1211-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121189","name":"JANTOVEN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121900","name":"JANTOVEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1219-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1219-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121200","name":"JANTOVEN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1212-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1212-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121210","name":"JANTOVEN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1212-10","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1212-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121300","name":"JANTOVEN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1213-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1213-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121310","name":"JANTOVEN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1213-10","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1213-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121400","name":"JANTOVEN 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1214-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1214-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121410","name":"JANTOVEN 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1214-10","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1214-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121500","name":"JANTOVEN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1215-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1215-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121510","name":"JANTOVEN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1215-10","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1215-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121600","name":"JANTOVEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1216-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1216-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121601","name":"JANTOVEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1216-01","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0832-1216-01) / 1 TABLET in 1 BLISTER PACK (0832-1216-89)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121610","name":"JANTOVEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1216-10","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-1216-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121689","name":"JANTOVEN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121700","name":"JANTOVEN 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1217-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1217-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121800","name":"JANTOVEN 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1218-00","proprietary_name":"Jantoven","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-1218-00)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00832121889","name":"JANTOVEN 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jantoven|Warfarin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00006057761","name":"JANUMET 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0577-61","proprietary_name":"JANUMET","nonproprietary_name":"SITAGLIPTIN and METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-0577-61)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006057762","name":"JANUMET 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0577-62","proprietary_name":"JANUMET","nonproprietary_name":"SITAGLIPTIN and METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0006-0577-62)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006057782","name":"JANUMET 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0577-82","proprietary_name":"JANUMET","nonproprietary_name":"SITAGLIPTIN and METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0006-0577-82)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006057561","name":"JANUMET 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0575-61","proprietary_name":"JANUMET","nonproprietary_name":"SITAGLIPTIN and METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-0575-61)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.28403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006057562","name":"JANUMET 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0575-62","proprietary_name":"JANUMET","nonproprietary_name":"SITAGLIPTIN and METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0006-0575-62)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.28403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006057582","name":"JANUMET 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0575-82","proprietary_name":"JANUMET","nonproprietary_name":"SITAGLIPTIN and METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0006-0575-82)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.28403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006008131","name":"JANUMET XR 100-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0081-31","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0081-31)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006008154","name":"JANUMET XR 100-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0081-54","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0081-54)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006008182","name":"JANUMET XR 100-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0081-82","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0081-82)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006008061","name":"JANUMET XR 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0080-61","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0080-61)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006008062","name":"JANUMET XR 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0080-62","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0080-62)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006008082","name":"JANUMET XR 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0080-82","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0080-82)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.27807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006007861","name":"JANUMET XR 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0078-61","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0078-61)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006007862","name":"JANUMET XR 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0078-62","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0078-62)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006007882","name":"JANUMET XR 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0078-82","proprietary_name":"JANUMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0006-0078-82)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Janumet XR|Sitagliptin Phos/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00006027701","name":"JANUVIA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.55179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006027728","name":"JANUVIA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0277-28","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"100 BLISTER PACK in 1 CARTON (0006-0277-28) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0006-0277-01)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006027731","name":"JANUVIA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0277-31","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-0277-31)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006027754","name":"JANUVIA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0277-54","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-0277-54)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006027782","name":"JANUVIA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0277-82","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0006-0277-82)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006022101","name":"JANUVIA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.54364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006022128","name":"JANUVIA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0221-28","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"100 BLISTER PACK in 1 CARTON (0006-0221-28) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0006-0221-01)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.54364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006022131","name":"JANUVIA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0221-31","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-0221-31)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.54364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006022154","name":"JANUVIA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0221-54","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-0221-54)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.54364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006011201","name":"JANUVIA 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.55215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006011228","name":"JANUVIA 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0112-28","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"100 BLISTER PACK in 1 CARTON (0006-0112-28) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0006-0112-01)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006011231","name":"JANUVIA 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0112-31","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-0112-31)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00006011254","name":"JANUVIA 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-0112-54","proprietary_name":"JANUVIA","nonproprietary_name":"sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-0112-54)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.55215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Januvia|Sitagliptin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00597015230","name":"JARDIANCE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0152-30","proprietary_name":"Jardiance","nonproprietary_name":"Empagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0597-0152-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.18929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jardiance|Empagliflozin","basis":"brand"},"part_b":null}, {"ndc":"00597015237","name":"JARDIANCE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0152-37","proprietary_name":"Jardiance","nonproprietary_name":"Empagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0597-0152-37) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.18929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jardiance|Empagliflozin","basis":"brand"},"part_b":null}, {"ndc":"00597015290","name":"JARDIANCE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0152-90","proprietary_name":"Jardiance","nonproprietary_name":"Empagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0597-0152-90)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.18929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jardiance|Empagliflozin","basis":"brand"},"part_b":null}, {"ndc":"00597015330","name":"JARDIANCE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0153-30","proprietary_name":"Jardiance","nonproprietary_name":"Empagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0597-0153-30)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.1897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jardiance|Empagliflozin","basis":"brand"},"part_b":null}, {"ndc":"00597015337","name":"JARDIANCE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0153-37","proprietary_name":"Jardiance","nonproprietary_name":"Empagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0597-0153-37) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.1897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jardiance|Empagliflozin","basis":"brand"},"part_b":null}, {"ndc":"00597015390","name":"JARDIANCE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0153-90","proprietary_name":"Jardiance","nonproprietary_name":"Empagliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0597-0153-90)","pharm_classes":["Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.1897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jardiance|Empagliflozin","basis":"brand"},"part_b":null}, {"ndc":"50102024001","name":"JASMIEL 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jasmiel|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"50102024021","name":"JASMIEL 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jasmiel|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"50102024023","name":"JASMIEL 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-240-23","proprietary_name":"Jasmiel","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 POUCH in 1 CARTON (50102-240-23) / 1 BLISTER PACK in 1 POUCH (50102-240-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jasmiel|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"69087015812","name":"JATENZO 158 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69087-158-12","proprietary_name":"Jatenzo","nonproprietary_name":"testosterone undecanoate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"158 mg/1","labeler":"TOLMAR Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69087-158-12)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":8.97187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jatenzo|Testosterone Undecanoate","basis":"brand"},"part_b":null}, {"ndc":"69087019812","name":"JATENZO 198 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69087-198-12","proprietary_name":"Jatenzo","nonproprietary_name":"testosterone undecanoate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"198 mg/1","labeler":"TOLMAR Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69087-198-12)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":8.9534,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jatenzo|Testosterone Undecanoate","basis":"brand"},"part_b":null}, {"ndc":"69087023712","name":"JATENZO 237 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69087-237-12","proprietary_name":"Jatenzo","nonproprietary_name":"testosterone undecanoate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"237 mg/1","labeler":"TOLMAR Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69087-237-12)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":17.93094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jatenzo|Testosterone Undecanoate","basis":"brand"},"part_b":null}, {"ndc":"24338011501","name":"JAVADIN 0.02 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-115-01","proprietary_name":"JAVADIN","nonproprietary_name":"clonidine hydrochloride oral","dosage_form":"SOLUTION","route":"ORAL","strength":"20 ug/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (24338-115-01) / 250 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":1.52934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180087771","name":"JENCYCLA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jencycla|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"68180087773","name":"JENCYCLA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-877-73","proprietary_name":"Jencycla","nonproprietary_name":"norethindrone","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-877-73) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jencycla|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"00597014818","name":"JENTADUETO 2.5 MG-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0148-18","proprietary_name":"Jentadueto","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0597-0148-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.4388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597014860","name":"JENTADUETO 2.5 MG-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0148-60","proprietary_name":"Jentadueto","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0597-0148-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.4388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597014618","name":"JENTADUETO 2.5 MG-500 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0146-18","proprietary_name":"Jentadueto","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0597-0146-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.44289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597014660","name":"JENTADUETO 2.5 MG-500 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0146-60","proprietary_name":"Jentadueto","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0597-0146-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.44289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597014718","name":"JENTADUETO 2.5 MG-850 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0147-18","proprietary_name":"Jentadueto","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 850 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0597-0147-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.45431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597014760","name":"JENTADUETO 2.5 MG-850 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0147-60","proprietary_name":"Jentadueto","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 850 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0597-0147-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.45431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597027073","name":"JENTADUETO XR 2.5 MG-1,000 MG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0270-73","proprietary_name":"Jentadueto XR","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0597-0270-73)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.46945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto XR|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597027094","name":"JENTADUETO XR 2.5 MG-1,000 MG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0270-94","proprietary_name":"Jentadueto XR","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0597-0270-94)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":8.46945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto XR|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597027533","name":"JENTADUETO XR 5 MG-1,000 MG TB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0275-33","proprietary_name":"Jentadueto XR","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0597-0275-33)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":16.94698,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto XR|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597027581","name":"JENTADUETO XR 5 MG-1,000 MG TB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0275-81","proprietary_name":"Jentadueto XR","nonproprietary_name":"linagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0597-0275-81)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":16.94698,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jentadueto XR|Linagliptin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00093312228","name":"JINTELI 1 MG-5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jinteli|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093312242","name":"JINTELI 1 MG-5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3122-42","proprietary_name":"Jinteli","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; 5 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (0093-3122-42) / 28 TABLET in 1 BLISTER PACK (0093-3122-28)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jinteli|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093312298","name":"JINTELI 1 MG-5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3122-98","proprietary_name":"Jinteli","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; 5 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-3122-98)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jinteli|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555912366","name":"JOLESSA 0.15 MG-0.03 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9123-66","proprietary_name":"Jolessa","nonproprietary_name":"Levonorgestrel / Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9123-66) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jolessa|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"71376020503","name":"JORNAY PM 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71376-205-03","proprietary_name":"JORNAY PM Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ironshore Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (71376-205-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.39596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jornay PM|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"71376020103","name":"JORNAY PM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71376-201-03","proprietary_name":"JORNAY PM Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Ironshore Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (71376-201-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.39302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jornay PM|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"71376020203","name":"JORNAY PM 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71376-202-03","proprietary_name":"JORNAY PM Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Ironshore Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (71376-202-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.40511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jornay PM|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"71376020303","name":"JORNAY PM 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71376-203-03","proprietary_name":"JORNAY PM Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Ironshore Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (71376-203-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.40191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jornay PM|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"71376020403","name":"JORNAY PM 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71376-204-03","proprietary_name":"JORNAY PM Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Ironshore Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (71376-204-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":15.40151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Jornay PM|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"51167054830","name":"JOURNAVX 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51167-548-30","proprietary_name":"JOURNAVX","nonproprietary_name":"Suzetrigine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Vertex Pharmaceuticals Incorporated","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51167-548-30)","pharm_classes":["Cytochrome P450 3A Inducers [MoA]","Sodium Channel Antagonists [MoA]","Sodium Channel Blocker [EPC]"]},"nadac":{"value":15.413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51167054831","name":"JOURNAVX 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51167-548-31","proprietary_name":"JOURNAVX","nonproprietary_name":"Suzetrigine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Vertex Pharmaceuticals Incorporated","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51167-548-31)","pharm_classes":["Cytochrome P450 3A Inducers [MoA]","Sodium Channel Antagonists [MoA]","Sodium Channel Blocker [EPC]"]},"nadac":{"value":15.413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51167054834","name":"JOURNAVX 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51167-548-34","proprietary_name":"JOURNAVX","nonproprietary_name":"Suzetrigine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Vertex Pharmaceuticals Incorporated","package_description":"10 BLISTER PACK in 1 CARTON (51167-548-34) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 3A Inducers [MoA]","Sodium Channel Antagonists [MoA]","Sodium Channel Blocker [EPC]"]},"nadac":{"value":15.413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700017784","name":"JOYEAUX-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Joyeaux|Levonorgest/Eth.Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"70700017785","name":"JOYEAUX-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-177-85","proprietary_name":"Joyeaux","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC","package_description":"3 BLISTER PACK in 1 CARTON (70700-177-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Joyeaux|Levonorgest/Eth.Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"61314024063","name":"JUBBONTI 60 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-240-63","proprietary_name":"JUBBONTI","nonproprietary_name":"denosumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/mL","labeler":"Sandoz Inc","package_description":"1 SYRINGE in 1 CARTON (61314-240-63) / 1 mL in 1 SYRINGE","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":1536.90512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5136","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5136 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (61314-240-63) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714046401","name":"JULEBER 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-464-01","proprietary_name":"Juleber","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-464-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Juleber|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714046404","name":"JULEBER 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-464-04","proprietary_name":"Juleber","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-464-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Juleber|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"49702024213","name":"JULUCA 50-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49702-242-13","proprietary_name":"Juluca","nonproprietary_name":"dolutegravir sodium and rilpivirine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"ViiV Healthcare Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49702-242-13)","pharm_classes":["HIV Integrase Inhibitors [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":121.86639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Juluca|Dolutegravir/Rilpivirine","basis":"brand"},"part_b":null}, {"ndc":"00555902542","name":"JUNEL 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9025-42","proprietary_name":"Junel 21 Day","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; 20 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9025-42) / 1 BLISTER PACK in 1 POUCH / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Junel|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555902742","name":"JUNEL 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9027-42","proprietary_name":"Junel 21 Day","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1; 30 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9027-42) / 1 BLISTER PACK in 1 POUCH / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Junel|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555902658","name":"JUNEL FE 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9026-58","proprietary_name":"Junel Fe 28 Day","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9026-58) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555902858","name":"JUNEL FE 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9028-58","proprietary_name":"Junel Fe 28 Day","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9028-58) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093532828","name":"JUNEL FE 24 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093532862","name":"JUNEL FE 24 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5328-62","proprietary_name":"Junel Fe 24","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0093-5328-62) / 1 BLISTER PACK in 1 POUCH (0093-5328-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00486113401","name":"K-PHOS #2 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0486-1134-01","proprietary_name":"K-Phos No. 2","nonproprietary_name":"Potassium Phosphate, Monobasic and Sodium Phosphate, Monobasic, Anhydrous","dosage_form":"TABLET, COATED","route":"ORAL","strength":"305 mg/1; 700 mg/1","labeler":"Beach Products, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0486-1134-01)"},"nadac":{"value":1.06554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"K-Phos No.2|Sod Phos,M-B/K Phos,Monob","basis":"brand"},"part_b":null}, {"ndc":"00486112501","name":"K-PHOS NEUTRAL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0486-1125-01","proprietary_name":"K Phos Neutral","nonproprietary_name":"Sodium Phosphate, Dibasic, Anhydrous, Potassium Phosphate, Monobasic, and Sodium Phosphate, Monobasic, Monohydrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"852 mg/1; 155 mg/1; 130 mg/1","labeler":"Beach Products, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (0486-1125-01)"},"nadac":{"value":0.39756,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00486112505","name":"K-PHOS NEUTRAL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0486-1125-05","proprietary_name":"K Phos Neutral","nonproprietary_name":"Sodium Phosphate, Dibasic, Anhydrous, Potassium Phosphate, Monobasic, and Sodium Phosphate, Monobasic, Monohydrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"852 mg/1; 155 mg/1; 130 mg/1","labeler":"Beach Products, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (0486-1125-05)"},"nadac":{"value":0.39756,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00486111101","name":"K-PHOS ORIGINAL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0486-1111-01","proprietary_name":"K Phos Original","nonproprietary_name":"Potassium Phosphate, Monobasic","dosage_form":"TABLET, SOLUBLE","route":"ORAL","strength":"500 mg/1","labeler":"Beach Products, Inc.","package_description":"100 TABLET, SOLUBLE in 1 BOTTLE (0486-1111-01)"},"nadac":{"value":0.55581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"K-Phos Original|Potassium Phosphate,Monobasic","basis":"brand"},"part_b":null}, {"ndc":"00486111105","name":"K-PHOS ORIGINAL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0486-1111-05","proprietary_name":"K Phos Original","nonproprietary_name":"Potassium Phosphate, Monobasic","dosage_form":"TABLET, SOLUBLE","route":"ORAL","strength":"500 mg/1","labeler":"Beach Products, Inc.","package_description":"500 TABLET, SOLUBLE in 1 BOTTLE (0486-1111-05)"},"nadac":{"value":0.55581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"K-Phos Original|Potassium Phosphate,Monobasic","basis":"brand"},"part_b":null}, {"ndc":"68180090371","name":"KAITLIB FE 0.8-0.025 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.40353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kaitlib Fe|Noreth-Ethinyl Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"68180090373","name":"KAITLIB FE 0.8-0.025 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-903-73","proprietary_name":"Kaitlib Fe","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-903-73) / 1 KIT in 1 BLISTER PACK * 24 TABLET, CHEWABLE in 1 BLISTER PACK (68180-356-74) * 4 TABLET, CHEWABLE in 1 BLISTER PACK (68180-358-74)"},"nadac":{"value":1.40353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kaitlib Fe|Noreth-Ethinyl Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"10631001030","name":"KAPSPARGO SPRINKLE 100 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-010-30","proprietary_name":"KAPSPARGO","nonproprietary_name":"Metoprolol Succinate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10631-010-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.29279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10631000830","name":"KAPSPARGO SPRINKLE 25 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-008-30","proprietary_name":"KAPSPARGO","nonproprietary_name":"Metoprolol Succinate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10631-008-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.88783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10631000930","name":"KAPSPARGO SPRINKLE 50 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-009-30","proprietary_name":"KAPSPARGO","nonproprietary_name":"Metoprolol Succinate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10631-009-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.88748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23594010105","name":"KARBINAL ER 4 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23594-101-05","proprietary_name":"Karbinal ER","nonproprietary_name":"Carbinoxamine Maleate","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/5mL","labeler":"Aytu Therapeutics, LLC","package_description":"480 mL in 1 BOTTLE, PLASTIC (23594-101-05)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":1.19216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.04689,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00555905058","name":"KARIVA 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9050-58","proprietary_name":"Kariva","nonproprietary_name":"Desogestrel/Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9050-58) / 1 BLISTER PACK in 1 POUCH (0555-9050-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kariva|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555905079","name":"KARIVA 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kariva|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"52652500101","name":"KATERZIA 1 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-5001-1","proprietary_name":"Katerzia","nonproprietary_name":"Amlodipine","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52652-5001-1) / 150 mL in 1 BOTTLE","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":4.20321,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Katerzia|Amlodipine Benzoate","basis":"brand"},"part_b":null}, {"ndc":"00555906458","name":"KELNOR 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9064-58","proprietary_name":"Kelnor 1/35","nonproprietary_name":"Ethynodiol Diacetate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9064-58) / 1 BLISTER PACK in 1 POUCH (0555-9064-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.37904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555906479","name":"KELNOR 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00003049420","name":"KENALOG-10 50 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0494-20","proprietary_name":"KENALOG-10","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL","strength":"10 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0003-0494-20) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.3256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kenalog-10|Triamcinolone Acetonide","basis":"brand"},"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0003-0494-20) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00003029320","name":"KENALOG-40 200 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0293-20","proprietary_name":"KENALOG-40","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0003-0293-20) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.1454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kenalog-40|Triamcinolone Acetonide","basis":"brand"},"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0003-0293-20) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00003029305","name":"KENALOG-40 40 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0293-05","proprietary_name":"KENALOG-40","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0003-0293-05) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.00182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kenalog-40|Triamcinolone Acetonide","basis":"brand"},"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":4,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0003-0293-05) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00003029328","name":"KENALOG-40 400 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0293-28","proprietary_name":"KENALOG-40","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0003-0293-28) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.78651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kenalog-40|Triamcinolone Acetonide","basis":"brand"},"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0003-0293-28) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00003031505","name":"KENALOG-80 80 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-0315-05","proprietary_name":"KENALOG-80","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"80 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0003-0315-05) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":17.86667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kenalog-80|Triamcinolone Acetonide","basis":"brand"},"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":8,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0003-0315-05) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50474059766","name":"KEPPRA 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-597-66","proprietary_name":"Keppra","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50474-597-66)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":19.8712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474000148","name":"KEPPRA 100 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-001-48","proprietary_name":"Keppra","nonproprietary_name":"levetiracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"UCB, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (50474-001-48)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.91893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50474059440","name":"KEPPRA 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-594-40","proprietary_name":"Keppra","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"UCB, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50474-594-40)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":8.07857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474059540","name":"KEPPRA 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-595-40","proprietary_name":"Keppra","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"UCB, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50474-595-40)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.91702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474059640","name":"KEPPRA 750 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-596-40","proprietary_name":"Keppra","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"UCB, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50474-596-40)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":13.46136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474059866","name":"KEPPRA XR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-598-66","proprietary_name":"Keppra XR","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50474-598-66)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.0242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Keppra XR|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"50474059966","name":"KEPPRA XR 750 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-599-66","proprietary_name":"Keppra XR","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50474-599-66)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":13.48131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Keppra XR|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"50419054001","name":"KERENDIA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-540-01","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50419-540-01)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.85554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054002","name":"KERENDIA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-540-02","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50419-540-02)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.85554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054005","name":"KERENDIA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.85554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054006","name":"KERENDIA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-540-06","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"10 TABLET, FILM COATED in 1 BLISTER PACK (50419-540-06)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.85554,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054101","name":"KERENDIA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-541-01","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50419-541-01)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.85154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054102","name":"KERENDIA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-541-02","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (50419-541-02)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.85154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054105","name":"KERENDIA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.85154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054106","name":"KERENDIA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-541-06","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"10 TABLET, FILM COATED in 1 BLISTER PACK (50419-541-06)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.85154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054201","name":"KERENDIA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-542-01","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (50419-542-01)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.86426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054202","name":"KERENDIA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-542-02","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (50419-542-02)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.86426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054205","name":"KERENDIA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.86426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"50419054206","name":"KERENDIA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-542-06","proprietary_name":"Kerendia","nonproprietary_name":"finerenone","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"10 TABLET in 1 BLISTER PACK (50419-542-06)","pharm_classes":["Mineralocorticoid Receptor Antagonists [MoA]","Nonsteroidal Mineralocorticoid-Receptor Antagonist [EPC]"]},"nadac":{"value":22.86426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kerendia|Finerenone","basis":"brand"},"part_b":null}, {"ndc":"00078100768","name":"KESIMPTA 20 MG/0.4 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-1007-68","proprietary_name":"KESIMPTA","nonproprietary_name":"ofatumumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/.4mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 SYRINGE, GLASS in 1 CARTON (0078-1007-68) / .4 mL in 1 SYRINGE, GLASS","pharm_classes":["CD20-directed Antibody Interactions [MoA]","CD20-directed Cytolytic Antibody [EPC]"]},"nadac":{"value":24369.36944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kesimpta Pen|Ofatumumab","basis":"brand"},"part_b":null}, {"ndc":"42023011410","name":"KETALAR 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-114-10","proprietary_name":"Ketalar","nonproprietary_name":"ketamine hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Par Health USA, LLC","package_description":"10 VIAL in 1 CARTON (42023-114-10) / 10 mL in 1 VIAL","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.67242,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143950810","name":"KETAMINE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9508-10","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 BOX (0143-9508-10) / 10 mL in 1 VIAL (0143-9508-01)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409205310","name":"KETAMINE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2053-10","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION, SOLUTION, CONCENTRATE","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (0409-2053-10) / 10 mL in 1 VIAL, MULTI-DOSE (0409-2053-20)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021068310","name":"KETAMINE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-683-10","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-683-10) / 10 mL in 1 VIAL","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150043910","name":"KETAMINE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-439-10","proprietary_name":"KETAMINE HYDROCHLORIDE","nonproprietary_name":"KETAMINE HYDROCHLORIDE","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (55150-439-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65219018810","name":"KETAMINE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-188-10","proprietary_name":"ketamine hydrochloride","nonproprietary_name":"ketamine hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL in 1 TRAY (65219-188-10) / 10 mL in 1 VIAL (65219-188-01)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72572032010","name":"KETAMINE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-320-10","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"Civica, Inc.","package_description":"10 VIAL in 1 BOX (72572-320-10) / 10 mL in 1 VIAL (72572-320-01)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.5563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143950910","name":"KETAMINE 500 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9509-10","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 BOX (0143-9509-10) / 5 mL in 1 VIAL (0143-9509-01)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":1.78037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409004010","name":"KETAMINE 500 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.78037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409205105","name":"KETAMINE 500 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2051-05","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION, SOLUTION, CONCENTRATE","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 BOX (0409-2051-05) / 5 mL in 1 VIAL, MULTI-DOSE (0409-2051-15)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":1.78037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021068405","name":"KETAMINE 500 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-684-05","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-684-05) / 5 mL in 1 VIAL","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":1.78037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65219018605","name":"KETAMINE 500 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-186-05","proprietary_name":"ketamine hydrochloride","nonproprietary_name":"ketamine hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL in 1 TRAY (65219-186-05) / 5 mL in 1 VIAL (65219-186-01)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":1.78037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72572032110","name":"KETAMINE 500 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-321-10","proprietary_name":"Ketamine Hydrochloride","nonproprietary_name":"Ketamine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Civica, Inc.","package_description":"10 VIAL in 1 BOX (72572-321-10) / 5 mL in 1 VIAL (72572-321-01)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":1.78037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093321915","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3219-15","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-3219-15) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093321930","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3219-30","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-3219-30) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.24861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093321992","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3219-92","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-3219-92) / 60 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168009915","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0099-15","proprietary_name":"ketoconazole","nonproprietary_name":"ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0099-15) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168009930","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0099-30","proprietary_name":"ketoconazole","nonproprietary_name":"ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0099-30) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.24861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168009960","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0099-60","proprietary_name":"ketoconazole","nonproprietary_name":"ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0099-60) / 60 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714095501","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-955-01","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-955-01) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714095502","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-955-02","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-955-02) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.24861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714095503","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-955-03","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-955-03) / 60 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002504","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-025-04","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole Cream, 2%","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-025-04) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002505","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-025-05","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole Cream, 2%","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-025-05) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.24861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002507","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-025-07","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole Cream, 2%","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-025-07) / 60 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129801","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1298-1","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1298-1) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.28477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129802","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1298-2","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1298-2) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.24861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672129803","name":"KETOCONAZOLE 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1298-3","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1298-3) / 60 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802053232","name":"KETOCONAZOLE 2% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-532-32","proprietary_name":"ketoconazole","nonproprietary_name":"ketoconazole","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CANISTER in 1 CARTON (45802-532-32) / 50 g in 1 CANISTER","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":5.59715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802053233","name":"KETOCONAZOLE 2% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-532-33","proprietary_name":"ketoconazole","nonproprietary_name":"ketoconazole","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 CANISTER in 1 CARTON (45802-532-33) / 100 g in 1 CANISTER","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":3.44062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700016019","name":"KETOCONAZOLE 2% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-160-19","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole Foam","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Xiromed, LLC","package_description":"50 g in 1 CAN (70700-160-19)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":5.59715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700016020","name":"KETOCONAZOLE 2% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-160-20","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole Foam","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Xiromed, LLC","package_description":"100 g in 1 CAN (70700-160-20)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":3.44062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713059204","name":"KETOCONAZOLE 2% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0592-04","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"SHAMPOO, SUSPENSION","route":"TOPICAL","strength":"20 mg/mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (0713-0592-04)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802046564","name":"KETOCONAZOLE 2% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-465-64","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"SHAMPOO, SUSPENSION","route":"TOPICAL","strength":"20 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"120 mL in 1 BOTTLE (45802-465-64)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63646001004","name":"KETOCONAZOLE 2% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.07537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954066210","name":"KETOCONAZOLE 2% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-662-10","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"20 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 mL in 1 BOTTLE, PLASTIC (70954-662-10)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72578015612","name":"KETOCONAZOLE 2% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-156-12","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"20 mg/mL","labeler":"Viona Pharmaceuticals Inc","package_description":"120 mL in 1 BOTTLE (72578-156-12)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603087801","name":"KETOCONAZOLE 2% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-878-01","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"SHAMPOO, SUSPENSION","route":"TOPICAL","strength":"20 mg/mL","labeler":"Northstar Rx LLC","package_description":"120 mL in 1 BOTTLE (72603-878-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07537,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"35573043302","name":"KETOCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-433-02","proprietary_name":"KETOCONAZOLE","nonproprietary_name":"ketoconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (35573-433-02)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.64566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573043330","name":"KETOCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-433-30","proprietary_name":"KETOCONAZOLE","nonproprietary_name":"ketoconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (35573-433-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.64566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672402601","name":"KETOCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4026-1","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4026-1)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.64566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672402606","name":"KETOCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.64566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380082706","name":"KETOCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-827-06","proprietary_name":"KETOCONAZOLE","nonproprietary_name":"KETOCONAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-827-06)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.64566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292022401","name":"KETOCONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-224-01","proprietary_name":"Ketoconazole","nonproprietary_name":"Ketoconazole","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Amici Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69292-224-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.64566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43538053010","name":"KETODAN 2% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43538-530-10","proprietary_name":"Ketodan","nonproprietary_name":"ketoconazole","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Medimetriks Pharmaceuticals, Inc.","package_description":"1 CAN in 1 CARTON (43538-530-10) / 100 g in 1 CAN","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 3A4 Inhibitors [MoA]","Cytochrome P450 3A5 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":3.44062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ketodan|Ketoconazole","basis":"brand"},"part_b":null}, {"ndc":"00378820001","name":"KETOPROFEN ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-8200-01","proprietary_name":"Ketoprofen","nonproprietary_name":"ketoprofen","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0378-8200-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":6.46184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60758077305","name":"KETOROLAC 0.4% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-773-05","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-773-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":12.67371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571013725","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-137-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Micro Labs Limited","package_description":"5 mL in 1 BOTTLE (42571-137-25)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.45085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571013726","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-137-26","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Micro Labs Limited","package_description":"10 mL in 1 BOTTLE (42571-137-26)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.33836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505100301","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1003-1","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-1003-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.45085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505100302","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1003-2","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-1003-2) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.33836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314012605","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-126-05","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-126-05) / 5 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.45085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314012610","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-126-10","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-126-10) / 10 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.33836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145013901","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-139-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-139-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.45085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145014001","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-140-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-140-01) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.33836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032205","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-322-05","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-322-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.45085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032210","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-322-10","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-322-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.33836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70512079005","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-790-05","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70512-790-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.45085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70512079010","name":"KETOROLAC 0.5% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-790-10","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70512-790-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.33836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093031401","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0314-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0314-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378113401","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1134-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-1134-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904730304","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7303-04","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7303-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241031601","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-316-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (27241-316-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722068601","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-686-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-686-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598013901","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-139-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"DR. REDDY'S LABORATORIES, INC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-139-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687010411","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687010421","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-104-21","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-104-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-104-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135081160","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-811-60","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-811-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292065001","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-650-01","proprietary_name":"ketorolac tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amici Pharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69292-650-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315026001","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-260-01","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69315-260-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452027520","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-275-20","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-275-20)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710171001","name":"KETOROLAC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1710-1","proprietary_name":"ketorolac tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70710-1710-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.16448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00338007225","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0338-0072-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"25 VIAL in 1 CARTON (0338-0072-25) / 1 mL in 1 VIAL","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0338-0072-25) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409379501","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00409379525","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3795-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (0409-3795-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-3795-19)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (0409-3795-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-3795-19)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641604225","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6042-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6042-25) / 1 mL in 1 VIAL (0641-6042-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021070101","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-701-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-701-01) / 1 mL in 1 VIAL","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-701-01) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"31722030625","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-306-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (31722-306-25) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332060025","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-600-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (62332-600-25) / 1 mL in 1 VIAL (62332-600-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (62332-600-25) / 1 mL in 1 VIAL (62332-600-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016201","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-162-01","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-USE in 1 TRAY (63323-162-01) / 1 mL in 1 VIAL, SINGLE-USE (63323-162-00)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 TRAY (63323-162-01) / 1 mL in 1 VIAL, SINGLE-USE (63323-162-00)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016212","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-162-12","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-162-12) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-162-23)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (63323-162-12) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-162-23)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016216","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-162-16","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-USE in 1 TRAY (63323-162-16) / 1 mL in 1 VIAL, SINGLE-USE (63323-162-43)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 TRAY (63323-162-16) / 1 mL in 1 VIAL, SINGLE-USE (63323-162-43)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145014525","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-145-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Caplin Steriles Limited","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (65145-145-25) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-145-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (65145-145-25) / 1 mL in 1 VIAL, SINGLE-DOSE (65145-145-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68462075625","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-756-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (68462-756-25) / 1 mL in 1 VIAL, SINGLE-DOSE (68462-756-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (68462-756-25) / 1 mL in 1 VIAL, SINGLE-DOSE (68462-756-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70512084325","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-843-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"25 VIAL in 1 CARTON (70512-843-25) / 1 mL in 1 VIAL (70512-843-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70512-843-25) / 1 mL in 1 VIAL (70512-843-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266011825","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-118-25","proprietary_name":"ketorolac tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"FOSUN PHARMA USA INC","package_description":"25 VIAL in 1 CARTON (72266-118-25) / 1 mL in 1 VIAL (72266-118-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72266-118-25) / 1 mL in 1 VIAL (72266-118-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572035525","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-355-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (72572-355-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72572-355-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (72572-355-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72572-355-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572035725","name":"KETOROLAC 30 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-357-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-357-25) / 1 mL in 1 VIAL (72572-357-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.01747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409379625","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3796-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"60 mg/2mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (0409-3796-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-3796-19)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (0409-3796-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-3796-19)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021070102","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-701-02","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-701-02) / 2 mL in 1 VIAL","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-701-02) / 2 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"31722030725","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-307-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"60 mg/2mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (31722-307-25) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332060125","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-601-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"60 mg/2mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (62332-601-25) / 2 mL in 1 VIAL (62332-601-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (62332-601-25) / 2 mL in 1 VIAL (62332-601-02)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016202","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-162-02","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-USE in 1 TRAY (63323-162-02) / 2 mL in 1 VIAL, SINGLE-USE (63323-162-03)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 TRAY (63323-162-02) / 2 mL in 1 VIAL, SINGLE-USE (63323-162-03)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016214","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-162-14","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-162-14) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-162-25)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (63323-162-14) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-162-25)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323016226","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-162-26","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"KETOROLAC TROMETHAMINE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-USE in 1 TRAY (63323-162-26) / 2 mL in 1 VIAL, SINGLE-USE (63323-162-45)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 TRAY (63323-162-26) / 2 mL in 1 VIAL, SINGLE-USE (63323-162-45)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145014725","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-147-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"60 mg/2mL","labeler":"Caplin Steriles Limited","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (65145-147-25) / 2 mL in 1 VIAL, SINGLE-DOSE (65145-147-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (65145-147-25) / 2 mL in 1 VIAL, SINGLE-DOSE (65145-147-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68462075725","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-757-25","proprietary_name":"KETOROLAC TROMETHAMINE","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"60 mg/2mL","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (68462-757-25) / 2 mL in 1 VIAL, SINGLE-DOSE (68462-757-02)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (68462-757-25) / 2 mL in 1 VIAL, SINGLE-DOSE (68462-757-02)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70512084425","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-844-25","proprietary_name":"Ketorolac Tromethamine","nonproprietary_name":"Ketorolac Tromethamine","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"25 VIAL in 1 CARTON (70512-844-25) / 2 mL in 1 VIAL (70512-844-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70512-844-25) / 2 mL in 1 VIAL (70512-844-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266011925","name":"KETOROLAC 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-119-25","proprietary_name":"ketorolac tromethamine","nonproprietary_name":"ketorolac tromethamine","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"30 mg/mL","labeler":"FOSUN PHARMA USA INC","package_description":"25 VIAL in 1 CARTON (72266-119-25) / 2 mL in 1 VIAL (72266-119-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitor [EPC]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.55237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1885","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1885 (15 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72266-119-25) / 2 mL in 1 VIAL (72266-119-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70244004101","name":"KETOTIFEN 0.025% (0.035%) DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-041-01","proprietary_name":"Ketotifen Fumarate Ophthalmic Solution","nonproprietary_name":"Ketotifen Fumarate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Sentiss Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70244-041-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":1.29403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485061710","name":"KETOTIFEN 0.025% (0.035%) DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-617-10","proprietary_name":"Ketotifen Fumarate Ophthalmic Solution","nonproprietary_name":"Ketotifen Fumarate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-617-10) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":1.29403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76385010617","name":"KETOTIFEN 0.025% (0.035%) DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-106-17","proprietary_name":"KETOTIFEN FUMARATE","nonproprietary_name":"KETOTIFEN FUMARATE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (76385-106-17) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":1.29403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024592201","name":"KEVZARA 200 MG/1.14 ML PEN INJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5922-01","proprietary_name":"KEVZARA","nonproprietary_name":"sarilumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 mg/1.14mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE in 1 PACKAGE (0024-5922-01) / 1.14 mL in 1 SYRINGE (0024-5922-00)","pharm_classes":["Interleukin 6 Receptor Antagonists [MoA]","Interleukin-6 Receptor Antagonist [EPC]"]},"nadac":{"value":2075.29678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kevzara|Sarilumab","basis":"brand"},"part_b":null}, {"ndc":"00024591001","name":"KEVZARA 200 MG/1.14 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5910-01","proprietary_name":"KEVZARA","nonproprietary_name":"sarilumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 mg/1.14mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE in 1 PACKAGE (0024-5910-01) / 1.14 mL in 1 SYRINGE (0024-5910-00)","pharm_classes":["Interleukin 6 Receptor Antagonists [MoA]","Interleukin-6 Receptor Antagonist [EPC]"]},"nadac":{"value":2068.06403,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kevzara|Sarilumab","basis":"brand"},"part_b":null}, {"ndc":"62559035601","name":"KIONEX 15 GM/60 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-356-01","proprietary_name":"Kionex","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"SUSPENSION","route":"ORAL","strength":"15 g/60mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"10 BOTTLE in 1 CASE (62559-356-01) / 60 mL in 1 BOTTLE (62559-356-60)"},"nadac":{"value":0.30564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Kionex|Sodium Polystyrene Sulfon/Sorb","basis":"brand"},"part_b":null}, {"ndc":"00078086714","name":"KISQALI 400 MG DAILY DOSE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":346.94686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kisqali|Ribociclib Succinate","basis":"brand"},"part_b":null}, {"ndc":"00078086742","name":"KISQALI 400 MG DAILY DOSE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0867-42","proprietary_name":"KISQALI","nonproprietary_name":"ribociclib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"3 BLISTER PACK in 1 CARTON (0078-0867-42) / 14 TABLET, FILM COATED in 1 BLISTER PACK (0078-0867-14)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Kinase Inhibitor [EPC]","Kinase Inhibitors [MoA]"]},"nadac":{"value":346.94686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kisqali|Ribociclib Succinate","basis":"brand"},"part_b":null}, {"ndc":"00078087421","name":"KISQALI 600 MG DAILY DOSE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":289.71673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kisqali|Ribociclib Succinate","basis":"brand"},"part_b":null}, {"ndc":"00078087463","name":"KISQALI 600 MG DAILY DOSE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0874-63","proprietary_name":"KISQALI","nonproprietary_name":"ribociclib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"3 BLISTER PACK in 1 CARTON (0078-0874-63) / 21 TABLET, FILM COATED in 1 BLISTER PACK (0078-0874-21)","pharm_classes":["Cytochrome P450 3A Inhibitors [MoA]","Kinase Inhibitor [EPC]","Kinase Inhibitors [MoA]"]},"nadac":{"value":289.71673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kisqali|Ribociclib Succinate","basis":"brand"},"part_b":null}, {"ndc":"42806018615","name":"KLAYESTA 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-186-15","proprietary_name":"KLAYESTA","nonproprietary_name":"Nystatin Topical Powder","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 U/g","labeler":"Epic Pharma, LLC","package_description":"15 g in 1 BOTTLE (42806-186-15)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Klayesta|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"42806018630","name":"KLAYESTA 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-186-30","proprietary_name":"KLAYESTA","nonproprietary_name":"Nystatin Topical Powder","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 U/g","labeler":"Epic Pharma, LLC","package_description":"30 g in 1 BOTTLE (42806-186-30)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Klayesta|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"42806018660","name":"KLAYESTA 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-186-60","proprietary_name":"KLAYESTA","nonproprietary_name":"Nystatin Topical Powder","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 U/g","labeler":"Epic Pharma, LLC","package_description":"60 g in 1 BOTTLE (42806-186-60)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Klayesta|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"61269060510","name":"KLONOPIN 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-605-10","proprietary_name":"Klonopin","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"H2-Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (61269-605-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.67886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01961,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Klonopin|Clonazepam","basis":"brand"},"part_b":null}, {"ndc":"61269061010","name":"KLONOPIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-610-10","proprietary_name":"Klonopin","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"H2-Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (61269-610-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":3.05375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02438,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Klonopin|Clonazepam","basis":"brand"},"part_b":null}, {"ndc":"61269062010","name":"KLONOPIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-620-10","proprietary_name":"Klonopin","nonproprietary_name":"Clonazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"H2-Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (61269-620-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":4.24702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04017,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Klonopin|Clonazepam","basis":"brand"},"part_b":null}, {"ndc":"00245083601","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0836-01","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"10 BLISTER PACK in 1 CARTON (0245-0836-01) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245083611","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0836-11","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-0836-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245083615","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0836-15","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-0836-15)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245083689","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531601","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5316-01","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 BLISTER PACK (0245-5316-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (0245-5316-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531611","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5316-11","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-5316-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531615","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5316-15","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-5316-15)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531689","name":"KLOR-CON 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.12092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245036001","name":"KLOR-CON 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0360-01","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 PACKET in 1 CARTON (0245-0360-01) / 1 POWDER, FOR SOLUTION in 1 PACKET (0245-0360-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.47003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245036030","name":"KLOR-CON 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0360-30","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (0245-0360-30) / 1 POWDER, FOR SOLUTION in 1 PACKET (0245-0360-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.47003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245036089","name":"KLOR-CON 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.47003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245083515","name":"KLOR-CON 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0835-15","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-0835-15)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.11807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531501","name":"KLOR-CON 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-5315-01","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 BLISTER PACK (0245-5315-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (0245-5315-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.11807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531511","name":"KLOR-CON 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-5315-11","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-5315-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.11807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531515","name":"KLOR-CON 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-5315-15","proprietary_name":"KLOR-CON","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0245-5315-15)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.11807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531589","name":"KLOR-CON 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.11807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531701","name":"KLOR-CON M10 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5317-01","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0245-5317-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0245-5317-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13269,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531710","name":"KLOR-CON M10 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5317-10","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5317-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13269,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531711","name":"KLOR-CON M10 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5317-11","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5317-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13269,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531789","name":"KLOR-CON M10 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.13269,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531790","name":"KLOR-CON M10 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5317-90","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5317-90)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13269,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531801","name":"KLOR-CON M15 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5318-01","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1125 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0245-5318-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0245-5318-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.49604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531811","name":"KLOR-CON M15 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5318-11","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1125 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5318-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.49604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531889","name":"KLOR-CON M15 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.49604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531901","name":"KLOR-CON M20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5319-01","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0245-5319-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0245-5319-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531910","name":"KLOR-CON M20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5319-10","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5319-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531911","name":"KLOR-CON M20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5319-11","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5319-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531915","name":"KLOR-CON M20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5319-15","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5319-15)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531989","name":"KLOR-CON M20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.14218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245531990","name":"KLOR-CON M20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-5319-90","proprietary_name":"KLOR-CON M","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (0245-5319-90)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245532601","name":"KLOR-CON-EF 25 MEQ TAB EFF","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-5326-01","proprietary_name":"KLOR-Con/EF","nonproprietary_name":"Potassium Bicarbonate","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"978 mg/1","labeler":"Upsher-Smith Laboratories, Inc.","package_description":"100 POUCH in 1 CARTON (0245-5326-01) / 1 TABLET, EFFERVESCENT in 1 POUCH (0245-5326-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.85942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Klor-Con-Ef|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"00245532630","name":"KLOR-CON-EF 25 MEQ TAB EFF","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-5326-30","proprietary_name":"KLOR-Con/EF","nonproprietary_name":"Potassium Bicarbonate","dosage_form":"TABLET, EFFERVESCENT","route":"ORAL","strength":"978 mg/1","labeler":"Upsher-Smith Laboratories, Inc.","package_description":"30 POUCH in 1 CARTON (0245-5326-30) / 1 TABLET, EFFERVESCENT in 1 POUCH (0245-5326-89)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.85942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Klor-Con-Ef|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"00245532689","name":"KLOR-CON-EF 25 MEQ TAB EFF","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.85942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Klor-Con-Ef|Potassium Bicarbonate/Cit Ac","basis":"brand"},"part_b":null}, {"ndc":"59467067901","name":"KLOXXADO 8 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59467-679-01","proprietary_name":"KLOXXADO","nonproprietary_name":"Naloxone HCL","dosage_form":"SPRAY","route":"NASAL","strength":"8 mg/.1mL","labeler":"Hikma Specialty USA Inc.","package_description":".1 mL in 1 VIAL, SINGLE-DOSE (59467-679-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":59.77417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kloxxado|Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"65628027003","name":"KONVOMEP 2-84 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Konvomep|Omeprazole/Sodium Bicarbonate","basis":"brand"},"part_b":null}, {"ndc":"65628027005","name":"KONVOMEP 2-84 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Konvomep|Omeprazole/Sodium Bicarbonate","basis":"brand"},"part_b":null}, {"ndc":"65628027010","name":"KONVOMEP 2-84 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.2442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Konvomep|Omeprazole/Sodium Bicarbonate","basis":"brand"},"part_b":null}, {"ndc":"65628027203","name":"KONVOMEP 2-84 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65628-272-03","proprietary_name":"Konvomep","nonproprietary_name":"omeprazole and sodium bicarbonate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (65628-272-03) * 150 mL in 1 BOTTLE (65628-270-05) * 300 mL in 1 BOTTLE (65628-270-10) * 150 mL in 1 BOTTLE (65628-271-05) * 300 mL in 1 BOTTLE (65628-271-10) * 90 mL in 1 BOTTLE (65628-271-03) * 90 mL in 1 BOTTLE (65628-270-03)"},"nadac":{"value":2.085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Konvomep|Omeprazole/Sodium Bicarbonate","basis":"brand"},"part_b":null}, {"ndc":"65628027205","name":"KONVOMEP 2-84 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65628-272-05","proprietary_name":"Konvomep","nonproprietary_name":"omeprazole and sodium bicarbonate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (65628-272-05) * 150 mL in 1 BOTTLE (65628-270-05) * 300 mL in 1 BOTTLE (65628-270-10) * 150 mL in 1 BOTTLE (65628-271-05) * 300 mL in 1 BOTTLE (65628-271-10) * 90 mL in 1 BOTTLE (65628-271-03) * 90 mL in 1 BOTTLE (65628-270-03)"},"nadac":{"value":1.762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Konvomep|Omeprazole/Sodium Bicarbonate","basis":"brand"},"part_b":null}, {"ndc":"65628027210","name":"KONVOMEP 2-84 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65628-272-10","proprietary_name":"Konvomep","nonproprietary_name":"omeprazole and sodium bicarbonate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (65628-272-10) * 150 mL in 1 BOTTLE (65628-270-05) * 300 mL in 1 BOTTLE (65628-270-10) * 150 mL in 1 BOTTLE (65628-271-05) * 300 mL in 1 BOTTLE (65628-271-10) * 90 mL in 1 BOTTLE (65628-271-03) * 90 mL in 1 BOTTLE (65628-270-03)"},"nadac":{"value":1.2442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Konvomep|Omeprazole/Sodium Bicarbonate","basis":"brand"},"part_b":null}, {"ndc":"66220071901","name":"KRISTALOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":9.59114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kristalose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"66220071930","name":"KRISTALOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66220-719-30","proprietary_name":"KRISTALOSE","nonproprietary_name":"lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"10 g/10g","labeler":"Cumberland Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (66220-719-30) / 10 g in 1 POUCH (66220-719-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":9.59114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kristalose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"66220072901","name":"KRISTALOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":9.96221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kristalose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"66220072930","name":"KRISTALOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66220-729-30","proprietary_name":"KRISTALOSE","nonproprietary_name":"lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"20 g/20g","labeler":"Cumberland Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (66220-729-30) / 20 g in 1 POUCH (66220-729-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":9.96221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kristalose|Lactulose","basis":"brand"},"part_b":null}, {"ndc":"68180084471","name":"KURVELO-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kurvelo|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180084473","name":"KURVELO-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-844-73","proprietary_name":"Kurvelo","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-844-73) / 1 KIT in 1 BLISTER PACK * 21 TABLET in 1 BLISTER PACK (68180-841-74) * 7 TABLET in 1 BLISTER PACK (68180-842-74)"},"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Kurvelo|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00904745161","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7451-61","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7451-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072301","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-723-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-723-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072305","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-723-05","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-723-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300025201","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-252-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-252-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657060201","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-602-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (58657-602-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657060250","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-602-50","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (58657-602-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657090601","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-906-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-906-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (58657-906-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657090610","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043901","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-439-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-439-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-439-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043911","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135079160","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-791-60","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-791-60)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001038100","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-381-00","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-381-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001038103","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-381-03","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-381-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001070000","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-700-00","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-700-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001070003","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-700-03","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-700-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079801","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-798-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-798-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079805","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-798-05","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-798-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006012","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-060-12","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70377-060-12)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006013","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-060-13","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Biocon Pharma Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70377-060-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603090201","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-902-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-902-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603090202","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-902-02","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-902-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888012001","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-120-01","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-120-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888012005","name":"LABETALOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-120-05","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-120-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143932001","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9320-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 BOX, UNIT-DOSE (0143-9320-01) / 20 mL in 1 VIAL","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX, UNIT-DOSE (0143-9320-01) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143962201","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9622-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 BOX, UNIT-DOSE (0143-9622-01) / 20 mL in 1 VIAL","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX, UNIT-DOSE (0143-9622-01) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409012501","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021031720","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-317-20","proprietary_name":"labetalol hydrochloride","nonproprietary_name":"labetalol hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 VIAL in 1 CARTON (25021-317-20) / 20 mL in 1 VIAL","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (25021-317-20) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"36000032201","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"36000032202","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-322-02","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"1 VIAL in 1 CARTON (36000-322-02) / 20 mL in 1 VIAL (36000-322-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (36000-322-02) / 20 mL in 1 VIAL (36000-322-01)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145012401","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-124-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (65145-124-01) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (65145-124-01) / 20 mL in 1 VIAL, MULTI-DOSE) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266010201","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-102-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (72266-102-01) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (72266-102-01) / 20 mL in 1 VIAL, MULTI-DOSE) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572035001","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-350-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"Civica, Inc.","package_description":"1 VIAL in 1 BOX, UNIT-DOSE (72572-350-01) / 20 mL in 1 VIAL","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX, UNIT-DOSE (72572-350-01) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603014601","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-146-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (72603-146-01) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1920","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1920 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (72603-146-01) / 20 mL in 1 VIAL, MULTI-DOSE) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"83301005801","name":"LABETALOL HCL 100 MG/20 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0058-1","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"100 mg/20mL","labeler":"Mullan Pharmaceutical Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (83301-0058-1) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.1852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904745261","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7452-61","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7452-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072401","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-724-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-724-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072405","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-724-05","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-724-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657060301","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-603-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (58657-603-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657060350","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-603-50","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (58657-603-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657090701","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-907-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-907-01) / 100 TABLET, FILM COATED in 1 BLISTER PACK (58657-907-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657090710","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687045001","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-450-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-450-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-450-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687045011","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135079260","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-792-60","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-792-60)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001038200","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-382-00","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-382-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001038203","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-382-03","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-382-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001070100","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-701-00","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-701-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001070103","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-701-03","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-701-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079901","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-799-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-799-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382079905","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-799-05","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-799-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006112","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-061-12","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70377-061-12)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006113","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-061-13","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Biocon Pharma Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70377-061-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603090301","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-903-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-903-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603090302","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-903-02","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-903-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888012101","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-121-01","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-121-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888012105","name":"LABETALOL HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-121-05","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-121-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904745361","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7453-61","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7453-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072501","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-725-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-725-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072505","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-725-05","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-725-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300025401","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-254-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (29300-254-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657060401","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-604-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (58657-604-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657060450","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-604-50","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (58657-604-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657090801","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-908-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-908-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (58657-908-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657090810","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687046101","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-461-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-461-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-461-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687046111","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135080060","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-800-60","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-800-60)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001038300","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-383-00","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68001-383-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001038303","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-383-03","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-383-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001070200","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-702-00","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-702-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001070203","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-702-03","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-702-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382080001","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-800-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-800-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382080005","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-800-05","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-800-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006212","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-062-12","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70377-062-12)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006213","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-062-13","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Biocon Pharma Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70377-062-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603090401","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-904-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-904-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603090402","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-904-02","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-904-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888012201","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-122-01","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-122-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888012205","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-122-05","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-122-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046801","name":"LABETALOL HCL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-468-01","proprietary_name":"LABETALOL HYDROCHLORIDE","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-468-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.21462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155072601","name":"LABETALOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-726-01","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-726-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.55254,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006311","name":"LABETALOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-063-11","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-063-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.55254,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377006312","name":"LABETALOL HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-063-12","proprietary_name":"Labetalol Hydrochloride","nonproprietary_name":"Labetalol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70377-063-12)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.55254,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722062726","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-627-26","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-627-26) / 200 mL in 1 BOTTLE","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651001602","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-016-02","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"200 mL in 1 BOTTLE, PLASTIC (59651-016-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877073295","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-732-95","proprietary_name":"Lacosamide Oral Solution","nonproprietary_name":"Lacosamide Oral Solution","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"200 mL in 1 BOTTLE (67877-732-95)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68462094086","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-940-86","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Glenmark Pharmaceuticals Limited","package_description":"200 mL in 1 BOTTLE, PLASTIC (68462-940-86)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315031820","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-318-20","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Leading Pharma, LLC","package_description":"200 mL in 1 BOTTLE, PLASTIC (69315-318-20)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954048810","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-488-10","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"200 mL in 1 BOTTLE, PLASTIC (70954-488-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71921041171","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-411-71","proprietary_name":"Lacosamide Oral Solution","nonproprietary_name":"Lacosamide Oral","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE in 1 CARTON (71921-411-71) / 200 mL in 1 BOTTLE","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205003474","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-034-74","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"200 mL in 1 BOTTLE, PLASTIC (72205-034-74)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603030501","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-305-01","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"NorthStar Rx LLC","package_description":"200 mL in 1 BOTTLE, PLASTIC (72603-305-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81033042802","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-428-02","proprietary_name":"Lacosamide Oral Solution","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Kesin Pharma Corporation","package_description":"200 mL in 1 BOTTLE, PLASTIC (81033-428-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82983042731","name":"LACOSAMIDE 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82983-427-31","proprietary_name":"Lacosamide Oral Solution","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Ajenat Pharmaceuticals LLC","package_description":"200 mL in 1 BOTTLE, PLASTIC (82983-427-31)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904724568","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7245-68","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"60 BLISTER PACK in 1 CARTON (0904-7245-68) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714054901","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-549-01","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET in 1 BOTTLE (16714-549-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300036516","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-365-16","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (29300-365-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722081360","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-813-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-813-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342030309","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-303-09","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-303-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335092286","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-922-86","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-922-86)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228019360","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-193-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50228-193-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991034905","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-349-05","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-349-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991034906","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-349-06","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (51991-349-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687068711","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687068757","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-687-57","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-687-57) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-687-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332017260","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-172-60","proprietary_name":"Lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-172-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862074860","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-748-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-748-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877073460","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-734-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-734-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462067960","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-679-60","proprietary_name":"lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-679-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367034960","name":"LACOSAMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-349-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-349-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135088523","name":"LACOSAMIDE 100 MG/10 ML CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-885-23","proprietary_name":"Lacosamide Oral Solution","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Chartwell RX, LLC","package_description":"2 TRAY in 1 BOX (62135-885-23) / 10 CUP in 1 TRAY / 10 mL in 1 CUP (62135-885-10)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904724668","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7246-68","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"60 BLISTER PACK in 1 CARTON (0904-7246-68) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714055001","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-550-01","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET in 1 BOTTLE (16714-550-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300036616","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-366-16","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (29300-366-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722081460","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-814-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-814-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342030409","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-304-09","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-304-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335094386","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-943-86","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-943-86)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228019460","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-194-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50228-194-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991035005","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-350-05","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-350-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991035006","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-350-06","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (51991-350-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332017360","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-173-60","proprietary_name":"Lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-173-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862074960","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-749-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-749-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877073560","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-735-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-735-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068060","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-680-60","proprietary_name":"lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-680-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367035060","name":"LACOSAMIDE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-350-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-350-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904724768","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7247-68","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"60 BLISTER PACK in 1 CARTON (0904-7247-68) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714055201","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-552-01","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET in 1 BOTTLE (16714-552-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300036716","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-367-16","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (29300-367-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722081560","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-815-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-815-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342030509","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-305-09","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-305-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335098086","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-980-86","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-980-86)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228019560","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-195-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50228-195-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991035105","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-351-05","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-351-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991035106","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-351-06","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (51991-351-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687069811","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687069857","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-698-57","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-698-57) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-698-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332017460","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-174-60","proprietary_name":"Lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-174-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862075060","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-750-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-750-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877073660","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-736-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-736-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068160","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-681-60","proprietary_name":"lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-681-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367035160","name":"LACOSAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-351-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-351-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121404895","name":"LACOSAMIDE 200 MG/20 ML CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-4048-95","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"200 mg/20mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"1 TRAY in 1 CASE (0121-4048-95) / 10 CUP, UNIT-DOSE in 1 TRAY / 20 mL in 1 CUP, UNIT-DOSE (0121-4048-74)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60687084753","name":"LACOSAMIDE 200 MG/20 ML CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60687084782","name":"LACOSAMIDE 200 MG/20 ML CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-847-82","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"American Health Packaging","package_description":"1 TRAY in 1 CASE (60687-847-82) / 10 CUP, UNIT-DOSE in 1 TRAY (60687-847-53) / 20 mL in 1 CUP, UNIT-DOSE (60687-847-24)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81033042718","name":"LACOSAMIDE 200 MG/20 ML CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-427-18","proprietary_name":"Lacosamide Oral Solution","nonproprietary_name":"Lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Kesin Pharmaceutical Corporation","package_description":"10 CUP, UNIT-DOSE in 1 CARTON (81033-427-18) / 20 mL in 1 CUP, UNIT-DOSE (81033-427-20)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904724468","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7244-68","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"60 BLISTER PACK in 1 CARTON (0904-7244-68) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714054801","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-548-01","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET in 1 BOTTLE (16714-548-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300036416","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-364-16","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (29300-364-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722081260","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-812-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-812-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342030209","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-302-09","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-302-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335091886","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-918-86","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-918-86)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228019260","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-192-60","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50228-192-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991034805","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-348-05","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-348-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991034806","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-348-06","proprietary_name":"LACOSAMIDE","nonproprietary_name":"LACOSAMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (51991-348-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687067611","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687067657","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-676-57","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-676-57) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-676-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332017160","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-171-60","proprietary_name":"Lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-171-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862074760","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-747-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-747-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877073360","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-733-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-733-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462067860","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-678-60","proprietary_name":"lacosamide","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc. USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-678-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367034860","name":"LACOSAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-348-60","proprietary_name":"Lacosamide","nonproprietary_name":"Lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-348-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00338960012","name":"LACTATED RINGERS 1,000 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":12,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":12,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00264775000","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0264-7750-00","proprietary_name":"Lactated Ringers","nonproprietary_name":"Sodium Chloride, Sodium Lactate, Potassium Chloride, and Calcium Chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":".6 g/100mL; .31 g/100mL; .03 g/100mL; .02 g/100mL","labeler":"B. Braun Medical Inc.","package_description":"12 CONTAINER in 1 CASE (0264-7750-00) / 1000 mL in 1 CONTAINER","pharm_classes":["Acidifying Activity [MoA]","Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":12,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 CONTAINER in 1 CASE (0264-7750-00) / 1000 mL in 1 CONTAINER) gives 12000 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":12,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00264775007","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0264-7750-07","proprietary_name":"Lactated Ringers","nonproprietary_name":"Sodium Chloride, Sodium Lactate, Potassium Chloride, and Calcium Chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":".6 g/100mL; .31 g/100mL; .03 g/100mL; .02 g/100mL","labeler":"B. Braun Medical Inc.","package_description":"12 CONTAINER in 1 CASE (0264-7750-07) / 1000 mL in 1 CONTAINER","pharm_classes":["Acidifying Activity [MoA]","Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":12,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 CONTAINER in 1 CASE (0264-7750-07) / 1000 mL in 1 CONTAINER) gives 12000 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":12,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00264775010","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0264-7750-10","proprietary_name":"Lactated Ringers","nonproprietary_name":"Sodium Chloride, Sodium Lactate, Potassium Chloride, and Calcium Chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":".6 g/100mL; .31 g/100mL; .03 g/100mL; .02 g/100mL","labeler":"B. Braun Medical Inc.","package_description":"24 CONTAINER in 1 CASE (0264-7750-10) / 500 mL in 1 CONTAINER","pharm_classes":["Acidifying Activity [MoA]","Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":24,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (24 CONTAINER in 1 CASE (0264-7750-10) / 500 mL in 1 CONTAINER) gives 12000 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":24,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00338011703","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0338-0117-03","proprietary_name":"Lactated Ringers","nonproprietary_name":"Sodium chloride, potassium chloride, sodium lactate and calcium chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"600 mg/100mL; 310 mg/100mL; 30 mg/100mL; 20 mg/100mL","labeler":"Baxter Healthcare Company","package_description":"500 mL in 1 BAG (0338-0117-03)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 mL in 1 BAG (0338-0117-03)) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00338011704","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0338-0117-04","proprietary_name":"Lactated Ringers","nonproprietary_name":"Sodium chloride, potassium chloride, sodium lactate and calcium chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"600 mg/100mL; 310 mg/100mL; 30 mg/100mL; 20 mg/100mL","labeler":"Baxter Healthcare Company","package_description":"1000 mL in 1 BAG (0338-0117-04)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00201,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 mL in 1 BAG (0338-0117-04)) gives 1000 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00990795303","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0990-7953-03","proprietary_name":"Lactated Ringers","nonproprietary_name":"SODIUM CHLORIDE, SODIUM LACTATE, POTASSIUM CHLORIDE, and CALCIUM CHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"600 mg/100mL; 310 mg/100mL; 30 mg/100mL; 20 mg/100mL","labeler":"ICU Medical Inc.","package_description":"24 POUCH in 1 CASE (0990-7953-03) / 1 BAG in 1 POUCH / 500 mL in 1 BAG","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":24,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (24 POUCH in 1 CASE (0990-7953-03) / 1 BAG in 1 POUCH / 500 mL in 1 BAG) gives 12000 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":24,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00990795309","name":"LACTATED RINGERS INJECTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0990-7953-09","proprietary_name":"Lactated Ringers","nonproprietary_name":"SODIUM CHLORIDE, SODIUM LACTATE, POTASSIUM CHLORIDE, and CALCIUM CHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"600 mg/100mL; 310 mg/100mL; 30 mg/100mL; 20 mg/100mL","labeler":"ICU Medical Inc.","package_description":"12 POUCH in 1 CASE (0990-7953-09) / 1 BAG in 1 POUCH / 1000 mL in 1 BAG","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.00384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7120","bill_units_per_package":{"value":12,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7120 (1000 CC) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (12 POUCH in 1 CASE (0990-7953-09) / 1 BAG in 1 POUCH / 1000 mL in 1 BAG) gives 12000 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":12,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00121096501","name":"LACTULOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121096530","name":"LACTULOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0965-30","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"10 g/10g","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"30 POUCH in 1 CARTON (0121-0965-30) / 10 g in 1 POUCH (0121-0965-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352090001","name":"LACTULOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352090015","name":"LACTULOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-900-15","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"10 g/10g","labeler":"Trifluent Pharma, Inc.","package_description":"15 POUCH in 1 CARTON (73352-900-15) / 10 g in 1 POUCH (73352-900-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"85592081901","name":"LACTULOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"85592081930","name":"LACTULOSE 10 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85592-819-30","proprietary_name":"LACTULOSE Crystalline","nonproprietary_name":"lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"10 g/10g","labeler":"Cumberland Assured Products Inc.","package_description":"30 POUCH in 1 CARTON (85592-819-30) / 10 g in 1 POUCH (85592-819-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":8.22014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00116400508","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4005-08","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Xttrium Laboratories, Inc.","package_description":"237 mL in 1 BOTTLE (0116-4005-08)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116400516","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4005-16","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Xttrium Laboratories, Inc.","package_description":"473 mL in 1 BOTTLE (0116-4005-16)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116400532","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4005-32","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Xttrium Laboratories, Inc.","package_description":"946 mL in 1 BOTTLE (0116-4005-32)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121087316","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0873-16","proprietary_name":"LACTULOSE","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0873-16)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121087332","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0873-32","proprietary_name":"LACTULOSE","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"946 mL in 1 BOTTLE (0121-0873-32)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527512570","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-5125-70","proprietary_name":"LACTULOSE","nonproprietary_name":"LACTULOSE","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Lannett Company, Inc.","package_description":"473 mL in 1 BOTTLE (0527-5125-70)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527512578","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-5125-78","proprietary_name":"LACTULOSE","nonproprietary_name":"LACTULOSE","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Lannett Company, Inc.","package_description":"946 mL in 1 BOTTLE (0527-5125-78)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672424309","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4243-9","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4243-9) / 473 mL in 1 BOTTLE","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135000237","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-002-37","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Chartwell RX, LLC","package_description":"237 mL in 1 PACKAGE (62135-002-37)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135000247","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-002-47","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 PACKAGE (62135-002-47)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135000294","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-002-94","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"Chartwell RX, LLC","package_description":"946 mL in 1 PACKAGE (62135-002-94)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980059248","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-592-48","proprietary_name":"Lactulose Solution","nonproprietary_name":"Lactulose Solution USP, 10 g/15 mL","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (64980-592-48)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980059295","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-592-95","proprietary_name":"Lactulose Solution","nonproprietary_name":"Lactulose Solution USP, 10 g/15 mL","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"946 mL in 1 BOTTLE (64980-592-95)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.0125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81033024132","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-241-32","proprietary_name":"Lactulose Solution","nonproprietary_name":"Lactulose Solution USP, 10 g/15 mL","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"Kesin Pharma Corporation","package_description":"946 mL in 1 BOTTLE, PLASTIC (81033-241-32)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.0125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83745024916","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-249-16","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"473 mL in 1 BOTTLE (83745-249-16)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01304,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83745024932","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-249-32","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL; RECTAL","strength":"10 g/15mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"946 mL in 1 BOTTLE (83745-249-32)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.0125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83745040508","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.01947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83745040516","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-405-16","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"473 mL in 1 BOTTLE (83745-405-16)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83745040532","name":"LACTULOSE 10 GM/15 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83745-405-32","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"SOLUTION","route":"ORAL","strength":"10 g/15mL","labeler":"APOZEAL PHARMACEUTICALS INC","package_description":"946 mL in 1 BOTTLE (83745-405-32)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121193001","name":"LACTULOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121193030","name":"LACTULOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1930-30","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"20 g/20g","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"30 POUCH in 1 CARTON (0121-1930-30) / 20 g in 1 POUCH (0121-1930-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352090501","name":"LACTULOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352090515","name":"LACTULOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-905-15","proprietary_name":"Lactulose","nonproprietary_name":"Lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"20 g/20g","labeler":"Trifluent Pharma, Inc.","package_description":"15 POUCH in 1 CARTON (73352-905-15) / 20 g in 1 POUCH (73352-905-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"85592082901","name":"LACTULOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"85592082930","name":"LACTULOSE 20 GM PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85592-829-30","proprietary_name":"LACTULOSE Crystalline","nonproprietary_name":"lactulose","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"20 g/20g","labeler":"Cumberland Assured Products Inc.","package_description":"30 POUCH in 1 CARTON (85592-829-30) / 20 g in 1 POUCH (85592-829-01)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":8.51402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00116400541","name":"LACTULOSE 20 GM/30 ML SOLUTION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.0512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121115440","name":"LACTULOSE 20 GM/30 ML SOLUTION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0121-1154-40","proprietary_name":"LACTULOSE","nonproprietary_name":"LACTULOSE","dosage_form":"SOLUTION","route":"ORAL","strength":"20 g/30mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"4 TRAY in 1 CASE (0121-1154-40) / 10 CUP, UNIT-DOSE in 1 TRAY / 30 mL in 1 CUP, UNIT-DOSE (0121-1154-30)","pharm_classes":["Acidifying Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.0512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00173064255","name":"LAMICTAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0642-55","proprietary_name":"LAMICTAL","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"100 TABLET in 1 BOTTLE (0173-0642-55)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":10.91795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173064360","name":"LAMICTAL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0643-60","proprietary_name":"LAMICTAL","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"60 TABLET in 1 BOTTLE (0173-0643-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.4684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173064460","name":"LAMICTAL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0644-60","proprietary_name":"LAMICTAL","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"60 TABLET in 1 BOTTLE (0173-0644-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.05122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173052700","name":"LAMICTAL 25 MG DISPER TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0527-00","proprietary_name":"LAMICTAL","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FOR SUSPENSION","route":"ORAL","strength":"25 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"100 TABLET, FOR SUSPENSION in 1 BOTTLE (0173-0527-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.18289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1473,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173063302","name":"LAMICTAL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0633-02","proprietary_name":"LAMICTAL","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"100 TABLET in 1 BOTTLE (0173-0633-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":10.29501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173077602","name":"LAMICTAL ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0776-02","proprietary_name":"LAMICTAL ODT","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"1 DOSE PACK in 1 CARTON (0173-0776-02) / 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":14.63582,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal ODT|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173077702","name":"LAMICTAL ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0777-02","proprietary_name":"LAMICTAL ODT","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"1 DOSE PACK in 1 CARTON (0173-0777-02) / 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":17.48893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal ODT|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173077202","name":"LAMICTAL ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0772-02","proprietary_name":"LAMICTAL ODT","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"1 DOSE PACK in 1 CARTON (0173-0772-02) / 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":12.81313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal ODT|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173077402","name":"LAMICTAL ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0173-0774-02","proprietary_name":"LAMICTAL ODT","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"1 DOSE PACK in 1 CARTON (0173-0774-02) / 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":13.65287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal ODT|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173075600","name":"LAMICTAL XR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0756-00","proprietary_name":"LAMICTAL XR","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0173-0756-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":30.40041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal XR|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173075700","name":"LAMICTAL XR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0757-00","proprietary_name":"LAMICTAL XR","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0173-0757-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":32.33073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal XR|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173075400","name":"LAMICTAL XR 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0754-00","proprietary_name":"LAMICTAL XR","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0173-0754-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":14.2042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal XR|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173078100","name":"LAMICTAL XR 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0781-00","proprietary_name":"LAMICTAL XR","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0173-0781-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":44.21042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal XR|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173076100","name":"LAMICTAL XR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0761-00","proprietary_name":"LAMICTAL XR","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0173-0761-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":48.64677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal XR|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"00173075500","name":"LAMICTAL XR 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0755-00","proprietary_name":"LAMICTAL XR","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0173-0755-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":28.35003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamictal XR|Lamotrigine","basis":"brand"},"part_b":null}, {"ndc":"54838056670","name":"LAMIVUDINE 10 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.21763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237027424","name":"LAMIVUDINE 10 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57237-274-24","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"240 mL in 1 BOTTLE (57237-274-24)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135070637","name":"LAMIVUDINE 10 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-706-37","proprietary_name":"lamivudine","nonproprietary_name":"lamivudine oral","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Chartwell RX, LLC","package_description":"240 mL in 1 BOTTLE, PLASTIC (62135-706-37)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862005524","name":"LAMIVUDINE 10 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65862-055-24","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"240 mL in 1 BOTTLE (65862-055-24)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.21763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904658304","name":"LAMIVUDINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6583-04","proprietary_name":"LAMIVUDINE","nonproprietary_name":"lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6583-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.48868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342000109","name":"LAMIVUDINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-001-09","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-001-09)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.48868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505325106","name":"LAMIVUDINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3251-6","proprietary_name":"LAMIVUDINE","nonproprietary_name":"lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-3251-6)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.48868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072011","name":"LAMIVUDINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.48868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072021","name":"LAMIVUDINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-720-21","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-720-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-720-11)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.48868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380071003","name":"LAMIVUDINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-710-03","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (64380-710-03)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.48868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342000207","name":"LAMIVUDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-002-07","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-002-07)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.40117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505325203","name":"LAMIVUDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3252-3","proprietary_name":"LAMIVUDINE","nonproprietary_name":"lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3252-3)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.40117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380071104","name":"LAMIVUDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-711-04","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64380-711-04)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.40117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505325006","name":"LAMIVUDINE HBV 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3250-6","proprietary_name":"Lamivudine","nonproprietary_name":"Lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-3250-6)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":9.47647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722050660","name":"LAMIVUDINE-ZIDOVUDINE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-506-60","proprietary_name":"LAMIVUDINE and ZIDOVUDINE","nonproprietary_name":"LAMIVUDINE and ZIDOVUDINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-506-60)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.77072,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamivudine-Zidovudine|Lamivudine/Zidovudine","basis":"generic"},"part_b":null}, {"ndc":"33342000309","name":"LAMIVUDINE-ZIDOVUDINE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-003-09","proprietary_name":"Lamivudine and Zidovudine","nonproprietary_name":"Lamivudine and Zidovudine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1; 300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-003-09)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.77072,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamivudine-Zidovudine|Lamivudine/Zidovudine","basis":"generic"},"part_b":null}, {"ndc":"65862003660","name":"LAMIVUDINE-ZIDOVUDINE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-036-60","proprietary_name":"Lamivudine and Zidovudine","nonproprietary_name":"Lamivudine and Zidovudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-036-60)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.77072,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamivudine-Zidovudine|Lamivudine/Zidovudine","basis":"generic"},"part_b":null}, {"ndc":"00904700861","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7008-61","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7008-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004701","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-047-01","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-047-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004705","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-047-05","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-047-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714019501","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-195-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET in 1 BOTTLE (16714-195-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011201","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-112-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-112-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011205","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-112-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-112-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011210","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-112-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-112-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672413101","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4131-1","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4131-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024601","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-246-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59746-246-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024610","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-246-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59746-246-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332003831","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-038-31","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-038-31)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862022801","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-228-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-228-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68084031901","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-319-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-319-01) / 1 TABLET in 1 BLISTER PACK (68084-319-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68084031911","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382000801","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-008-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-008-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382000810","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-008-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-008-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002600","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-026-00","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (72888-026-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002601","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-026-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-026-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002605","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-026-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-026-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"82009013210","name":"LAMOTRIGINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-132-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-132-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004801","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-048-01","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-048-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004805","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-048-05","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-048-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004860","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-048-60","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-048-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714019601","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-196-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Northstar Rx LLC.","package_description":"60 TABLET in 1 BOTTLE (16714-196-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011305","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-113-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-113-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011316","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-113-16","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-113-16)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672413204","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4132-4","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET in 1 BOTTLE (51672-4132-4)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024705","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-247-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59746-247-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024760","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-247-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (59746-247-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"60687069301","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-693-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-693-01) / 1 TABLET in 1 BLISTER PACK (60687-693-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"60687069311","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332003960","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-039-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (62332-039-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862022901","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-229-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-229-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862022960","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-229-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-229-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382000905","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-009-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-009-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382000914","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-009-14","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (68382-009-14)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002705","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-027-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-027-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002760","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-027-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (72888-027-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"82009013305","name":"LAMOTRIGINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-133-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-133-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004905","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-049-05","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-049-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004960","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-049-60","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-049-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714019701","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-197-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC.","package_description":"60 TABLET in 1 BOTTLE (16714-197-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011405","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-114-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-114-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011416","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-114-16","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-114-16)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672413304","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4133-4","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET in 1 BOTTLE (51672-4133-4)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024805","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-248-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59746-248-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024860","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-248-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (59746-248-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"60687070401","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-704-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-704-01) / 1 TABLET in 1 BLISTER PACK (60687-704-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"60687070411","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332004060","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-040-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (62332-040-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862023001","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-230-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-230-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862023060","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-230-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-230-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862023099","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-230-99","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-230-99)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382001005","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-010-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-010-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382001014","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-010-14","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (68382-010-14)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002805","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-028-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-028-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002860","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-028-60","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Advagen Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (72888-028-60)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"82009013405","name":"LAMOTRIGINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-134-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-134-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16571078601","name":"LAMOTRIGINE 25 MG DISPER TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-786-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (16571-786-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.1473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111022605","name":"LAMOTRIGINE 25 MG DISPER TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-226-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"500 TABLET, CHEWABLE in 1 BOTTLE (55111-226-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.1473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332009631","name":"LAMOTRIGINE 25 MG DISPER TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-096-31","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FOR SUSPENSION","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FOR SUSPENSION in 1 BOTTLE (62332-096-31)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.1473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862036201","name":"LAMOTRIGINE 25 MG DISPER TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-362-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (65862-362-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.1473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68462022901","name":"LAMOTRIGINE 25 MG DISPER TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-229-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (68462-229-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.1473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00904700761","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7007-61","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7007-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004501","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-045-01","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-045-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668004505","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-045-05","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-045-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714019401","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-194-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC.","package_description":"100 TABLET in 1 BOTTLE (16714-194-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011101","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-111-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (29300-111-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011105","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-111-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (29300-111-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"29300011110","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-111-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-111-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672413001","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4130-1","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4130-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024501","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-245-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59746-245-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"59746024505","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-245-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59746-245-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332003731","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-037-31","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-037-31)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862022701","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-227-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-227-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862022799","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-227-99","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (65862-227-99)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68084031801","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-318-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-318-01) / 1 TABLET in 1 BLISTER PACK (68084-318-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68084031811","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382000601","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-006-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-006-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382000610","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-006-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-006-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002500","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-025-00","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (72888-025-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002501","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-025-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-025-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"72888002505","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-025-05","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-025-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"82009013110","name":"LAMOTRIGINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-131-10","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-131-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16571078501","name":"LAMOTRIGINE 5 MG DISPER TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-785-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (16571-785-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332009531","name":"LAMOTRIGINE 5 MG DISPER TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-095-31","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine","dosage_form":"TABLET, FOR SUSPENSION","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FOR SUSPENSION in 1 BOTTLE (62332-095-31)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65862036101","name":"LAMOTRIGINE 5 MG DISPER TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-361-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (65862-361-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68462022801","name":"LAMOTRIGINE 5 MG DISPER TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-228-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (68462-228-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.16729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00228142203","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-1422-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-1422-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668034130","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-341-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-341-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714062501","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-625-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-625-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"31722024230","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-242-30","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine extended-release","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-242-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111071930","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-719-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-719-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65162095803","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-958-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65162-958-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382098106","name":"LAMOTRIGINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-981-06","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-981-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.67287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00228145303","name":"LAMOTRIGINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-1453-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-1453-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714062601","name":"LAMOTRIGINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-626-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-626-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"31722024330","name":"LAMOTRIGINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-243-30","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine extended-release","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-243-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111072030","name":"LAMOTRIGINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-720-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-720-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65162098603","name":"LAMOTRIGINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-986-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65162-986-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382098206","name":"LAMOTRIGINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-982-06","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-982-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.60851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00228141003","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668033930","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-339-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-339-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714062301","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-623-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-623-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"31722024030","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-240-30","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine extended-release","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-240-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111071730","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-717-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-717-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65162094903","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-949-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65162-949-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382097906","name":"LAMOTRIGINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-979-06","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-979-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.27513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00228163803","name":"LAMOTRIGINE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-1638-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-1638-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714089301","name":"LAMOTRIGINE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-893-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-893-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"31722024430","name":"LAMOTRIGINE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-244-30","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine extended-release","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-244-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111041930","name":"LAMOTRIGINE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-419-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-419-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65162098803","name":"LAMOTRIGINE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-988-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65162-988-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382098306","name":"LAMOTRIGINE ER 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-983-06","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"250 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-983-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00228158003","name":"LAMOTRIGINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-1580-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-1580-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714062701","name":"LAMOTRIGINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-627-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-627-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"31722024530","name":"LAMOTRIGINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-245-30","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine extended-release","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-245-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111042830","name":"LAMOTRIGINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-428-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-428-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65162099003","name":"LAMOTRIGINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-990-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65162-990-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382098406","name":"LAMOTRIGINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-984-06","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-984-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.25965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00228143503","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668034030","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-340-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13668-340-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"16714062401","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-624-01","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-624-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"31722024130","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-241-30","proprietary_name":"lamotrigine","nonproprietary_name":"lamotrigine extended-release","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-241-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"55111071830","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-718-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-718-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"65162095603","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-956-03","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65162-956-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"68382098006","name":"LAMOTRIGINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-980-06","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-980-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.59413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ER|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00115994101","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9941-01","proprietary_name":"Lamotrigine","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0115-9941-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668069530","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-695-30","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-695-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"27241018530","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-185-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (27241-185-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"43598055230","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-552-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (43598-552-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048611","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-486-11","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK (49884-486-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048654","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672425406","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4254-6","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4254-6)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332077230","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-772-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62332-772-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"69918037030","name":"LAMOTRIGINE ODT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-370-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (69918-370-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.62503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00115994201","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9942-01","proprietary_name":"Lamotrigine","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0115-9942-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668069630","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-696-30","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-696-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"27241018630","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-186-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (27241-186-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"43598055330","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-553-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (43598-553-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048711","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-487-11","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK (49884-487-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048754","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672425506","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4255-6","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4255-6)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332077330","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-773-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62332-773-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"69918038030","name":"LAMOTRIGINE ODT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-380-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (69918-380-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.64336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00115993901","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9939-01","proprietary_name":"Lamotrigine","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0115-9939-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668069330","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-693-30","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-693-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"27241018330","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-183-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (27241-183-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"43598055030","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-550-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (43598-550-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048411","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-484-11","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK (49884-484-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048454","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672425206","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4252-6","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4252-6)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332077030","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-770-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62332-770-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"69918035030","name":"LAMOTRIGINE ODT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-350-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (69918-350-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.29941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"00115994001","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9940-01","proprietary_name":"Lamotrigine","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (0115-9940-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"13668069430","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-694-30","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-694-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"27241018430","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-184-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (27241-184-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"43598055130","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-551-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (43598-551-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884048511","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-485-11","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK (49884-485-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"51672425306","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4253-6","proprietary_name":"LAMOTRIGINE","nonproprietary_name":"lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (51672-4253-6)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"62332077130","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-771-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62332-771-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"69918036030","name":"LAMOTRIGINE ODT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-360-30","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (69918-360-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.27096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"49884088299","name":"LAMOTRIGINE ODT KIT (ORANGE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-882-99","proprietary_name":"Lamotrigine","nonproprietary_name":"Lamotrigine","dosage_form":"KIT","route":null,"strength":null,"labeler":"Par Health USA, LLC","package_description":"1 BLISTER PACK in 1 PACKAGE, COMBINATION (49884-882-99) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":9.43986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lamotrigine ODT (Orange)|Lamotrigine","basis":"generic"},"part_b":null}, {"ndc":"57237000101","name":"LANSOPRAZOL-AMOXICIL-CLARITHRO","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":6.04223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lansoprazol-Amoxicil-Clarithro|Lansoprazole/Amoxiciln/Clarith","basis":"brand"},"part_b":null}, {"ndc":"57237000114","name":"LANSOPRAZOL-AMOXICIL-CLARITHRO","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57237-001-14","proprietary_name":"Lansoprazole, Amoxicillin, Clarithromycin","nonproprietary_name":"Lansoprazole, Amoxicillin, Clarithromycin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Rising Pharma Holdings, Inc.","package_description":"14 BLISTER PACK in 1 CARTON (57237-001-14) / 1 KIT in 1 BLISTER PACK (57237-001-01)"},"nadac":{"value":6.04223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lansoprazol-Amoxicil-Clarithro|Lansoprazole/Amoxiciln/Clarith","basis":"brand"},"part_b":null}, {"ndc":"00093735056","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7350-56","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0093-7350-56)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378801593","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8015-93","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-8015-93)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136813","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1368-13","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Rugby Laboratories, Inc","package_description":"3 BOTTLE in 1 CARTON (0536-1368-13) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136888","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571069703","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571074242","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722057030","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-570-30","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-570-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722057090","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-570-90","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-570-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802087801","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-878-01","proprietary_name":"lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-878-01) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802087802","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-878-02","proprietary_name":"lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"2 BOTTLE in 1 CARTON (45802-878-02) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802087803","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-878-03","proprietary_name":"lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 BOTTLE in 1 CARTON (45802-878-03) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039830","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-398-30","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Dr.Reddy's Laboratories Ltd.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-398-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039890","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-398-90","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Dr.Reddy's Laboratories Ltd.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-398-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687011111","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687011121","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-111-21","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-111-21) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (60687-111-11)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877027430","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-274-30","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-274-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001011104","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-111-04","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-111-04)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001011105","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-111-05","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"BluePoint Laboratories","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-111-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756080630","name":"LANSOPRAZOLE DR 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-806-30","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Lifestar Pharma LLC.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70756-806-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.14737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093300819","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093300893","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3008-93","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0093-3008-93) / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (0093-3008-19)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378698132","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378698185","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378698188","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6981-88","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 CARTON in 1 BOX (0378-6981-88) / 5 BLISTER PACK in 1 CARTON (0378-6981-85) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (0378-6981-32)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862089510","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862089578","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-895-78","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"10 BLISTER PACK in 1 CARTON (65862-895-78) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (65862-895-10)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382077130","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382077177","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-771-77","proprietary_name":"LANSOPRAZOLE","nonproprietary_name":"LANSOPRAZOLE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68382-771-77) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68382-771-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603031301","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603031310","name":"LANSOPRAZOLE DR 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-313-10","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar Rx LLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-313-10) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (72603-313-01)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093735156","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7351-56","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0093-7351-56)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378803005","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8030-05","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-8030-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378803077","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8030-77","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-8030-77)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378803093","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8030-93","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, DELAYED RELEASE PELLETS in 1 BOTTLE, PLASTIC (0378-8030-93)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904666245","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6662-45","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6662-45) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571069803","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571069809","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571069850","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722057105","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-571-05","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-571-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722057130","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-571-30","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-571-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722057190","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-571-90","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (31722-571-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079012101","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079012108","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-121-08","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE PELLETS","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Institutional Inc.","package_description":"80 BLISTER PACK in 1 CARTON (51079-121-08) / 1 CAPSULE, DELAYED RELEASE PELLETS in 1 BLISTER PACK (51079-121-01)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039905","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-399-05","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Dr.Reddy's Laboratories Ltd.","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-399-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039930","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-399-30","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Dr.Reddy's Laboratories Ltd.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-399-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039990","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-399-90","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Dr.Reddy's Laboratories Ltd.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-399-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687012301","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-123-01","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-123-01) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (60687-123-11)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687012311","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877027590","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-275-90","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (67877-275-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001011203","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-112-03","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-112-03)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001011204","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-112-04","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-112-04)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001011205","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-112-05","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68001-112-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700026305","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-263-05","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Xiromed LLC","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-263-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700026330","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-263-30","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Xiromed LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-263-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700026390","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-263-90","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Xiromed LLC","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-263-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756080751","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-807-51","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lifestar Pharma LLC.","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70756-807-51)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756080790","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-807-90","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lifestar Pharma LLC.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70756-807-90)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009003905","name":"LANSOPRAZOLE DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-039-05","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-039-05)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093300919","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093300993","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3009-93","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0093-3009-93) / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (0093-3009-19)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378698232","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378698285","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378698288","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6982-88","proprietary_name":"Lansoprazole","nonproprietary_name":"lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"2 CARTON in 1 BOX (0378-6982-88) / 5 BLISTER PACK in 1 CARTON (0378-6982-85) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (0378-6982-32)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598056179","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862089610","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862089678","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-896-78","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"10 BLISTER PACK in 1 CARTON (65862-896-78) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (65862-896-10)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382077230","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382077277","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-772-77","proprietary_name":"LANSOPRAZOLE","nonproprietary_name":"LANSOPRAZOLE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68382-772-77) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68382-772-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603031401","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603031410","name":"LANSOPRAZOLE DR 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-314-10","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar Rx LLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-314-10) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (72603-314-01)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093594040","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00093594098","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5940-98","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"Lanthanum carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"9 BOTTLE in 1 CARTON (0093-5940-98) / 10 TABLET, CHEWABLE in 1 BOTTLE (0093-5940-40)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"66993042475","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"66993042485","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-424-85","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"LANTHANUM CARBONATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Prasco Laboratories","package_description":"9 BOTTLE in 1 PACKAGE (66993-424-85) / 10 TABLET, CHEWABLE in 1 BOTTLE (66993-424-75)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"67877025890","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-258-90","proprietary_name":"Lanthanum Carbonate","nonproprietary_name":"Lanthanum Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"9 BOTTLE in 1 CARTON (67877-258-90) / 10 TABLET, CHEWABLE in 1 BOTTLE (67877-258-11)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68180082110","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68180082147","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-821-47","proprietary_name":"Lanthanum Carbonate","nonproprietary_name":"Lanthanum Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"9 BOTTLE in 1 PACKAGE (68180-821-47) / 10 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69097093665","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69097093698","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-936-98","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"LANTHANUM CARBONATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Cipla USA Inc.","package_description":"9 BOTTLE in 1 PACKAGE (69097-936-98) / 10 TABLET, CHEWABLE in 1 BOTTLE (69097-936-65)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"76282047813","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"76282047890","name":"LANTHANUM CARB 1,000 MG TB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-478-90","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"LANTHANUM CARBONATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"9 BOTTLE in 1 PACKAGE (76282-478-90) / 10 TABLET, CHEWABLE in 1 BOTTLE (76282-478-13)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.15131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00093593854","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00093593898","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5938-98","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"Lanthanum carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 BOTTLE in 1 CARTON (0093-5938-98) / 45 TABLET, CHEWABLE in 1 BOTTLE (0093-5938-54)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"67877025645","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"67877025690","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-256-90","proprietary_name":"Lanthanum Carbonate","nonproprietary_name":"Lanthanum Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"2 BOTTLE in 1 CARTON (67877-256-90) / 45 TABLET, CHEWABLE in 1 BOTTLE (67877-256-45)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68180081942","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-819-42","proprietary_name":"Lanthanum Carbonate","nonproprietary_name":"Lanthanum Carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"2 BOTTLE in 1 PACKAGE (68180-819-42) / 45 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68180081952","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69097093457","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69097093498","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-934-98","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"LANTHANUM CARBONATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Cipla USA Inc.","package_description":"2 BOTTLE in 1 PACKAGE (69097-934-98) / 45 TABLET, CHEWABLE in 1 BOTTLE (69097-934-57)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"76282047645","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"76282047690","name":"LANTHANUM CARB 500 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-476-90","proprietary_name":"Lanthanum carbonate","nonproprietary_name":"LANTHANUM CARBONATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"2 BOTTLE in 1 PACKAGE (76282-476-90) / 45 TABLET, CHEWABLE in 1 BOTTLE (76282-476-45)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":3.18293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lanthanum Carbonate|Lanthanum Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00088222033","name":"LANTUS 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0088-2220-33","proprietary_name":"Lantus","nonproprietary_name":"insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"sanofi-aventis U.S. LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0088-2220-33) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.15227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lantus|Insulin Glargine,Hum.Rec.Anlog","basis":"brand"},"part_b":null}, {"ndc":"00088221905","name":"LANTUS SOLOSTAR 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0088-2219-05","proprietary_name":"Lantus Solostar","nonproprietary_name":"insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"sanofi-aventis U.S. LLC","package_description":"5 SYRINGE in 1 CARTON (0088-2219-05) / 3 mL in 1 SYRINGE (0088-2219-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.16506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lantus Solostar|Insulin Glargine,Hum.Rec.Anlog","basis":"brand"},"part_b":null}, {"ndc":"16714040701","name":"LARIN 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-407-01","proprietary_name":"Larin 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-407-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714040703","name":"LARIN 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-407-03","proprietary_name":"Larin 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-407-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714040801","name":"LARIN 21 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-408-01","proprietary_name":"Larin 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-408-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714040803","name":"LARIN 21 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-408-03","proprietary_name":"Larin 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-408-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714041601","name":"LARIN 24 FE 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-416-01","proprietary_name":"Larin 24 Fe","nonproprietary_name":"Norethindrone acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-416-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714041603","name":"LARIN 24 FE 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-416-03","proprietary_name":"Larin 24 Fe","nonproprietary_name":"Norethindrone acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-416-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714040601","name":"LARIN FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-406-01","proprietary_name":"Larin Fe 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-406-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Larin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"16714040604","name":"LARIN FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-406-04","proprietary_name":"Larin Fe 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-406-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Larin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"16714040501","name":"LARIN FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-405-01","proprietary_name":"Larin Fe 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-405-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Larin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"16714040504","name":"LARIN FE 1.5-30 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-405-04","proprietary_name":"Larin Fe 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-405-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Larin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"30698006701","name":"LASIX 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-067-01","proprietary_name":"Lasix","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Validus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (30698-067-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.74852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02602,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lasix|Furosemide","basis":"brand"},"part_b":null}, {"ndc":"30698006001","name":"LASIX 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-060-01","proprietary_name":"Lasix","nonproprietary_name":"FUROSEMIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Validus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (30698-060-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":1.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0291,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lasix|Furosemide","basis":"brand"},"part_b":null}, {"ndc":"00023429105","name":"LASTACAFT ONCE DAILY 0.25% DRP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-4291-05","proprietary_name":"LASTACAFT","nonproprietary_name":"alcaftadine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0023-4291-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":2.83327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208046325","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-463-25","proprietary_name":"Latanoprost","nonproprietary_name":"latanoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-463-25) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"25021000102","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-001-02","proprietary_name":"Latanoprost","nonproprietary_name":"Latanoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (25021-001-02) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"42571049906","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-499-06","proprietary_name":"Latanoprost","nonproprietary_name":"Latanoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-499-06) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"59762033302","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0333-2","proprietary_name":"Latanoprost","nonproprietary_name":"Latanoprost","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (59762-0333-2) / 2.5 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"61314054701","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-547-01","proprietary_name":"Latanoprost","nonproprietary_name":"Latanoprost","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-547-01) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"61314054703","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-547-03","proprietary_name":"Latanoprost","nonproprietary_name":"Latanoprost","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Sandoz Inc","package_description":"3 BOTTLE in 1 CARTON (61314-547-03) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.23775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"64980051625","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-516-25","proprietary_name":"LATANOPROST","nonproprietary_name":"latanoprost","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (64980-516-25) / 2.5 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"68462094403","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-944-03","proprietary_name":"latanoprost","nonproprietary_name":"latanoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"GLENMARK PHARMACEUTICALS INC","package_description":"1 BOTTLE in 1 CARTON (68462-944-03) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"70069042101","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-421-01","proprietary_name":"LATANOPROST","nonproprietary_name":"LATANOPROST","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-421-01) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"70069042103","name":"LATANOPROST 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-421-03","proprietary_name":"LATANOPROST","nonproprietary_name":"LATANOPROST","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Somerset Therapeutics, LLC","package_description":"3 BOTTLE in 1 CARTON (70069-421-03) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":1.23775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Latanoprost|Latanoprost","basis":"generic"},"part_b":null}, {"ndc":"00023361605","name":"LATISSE 0.03% EYELASH SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3616-05","proprietary_name":"LATISSE","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3616-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":31.49063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":20.64928,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023361670","name":"LATISSE 0.03% EYELASH SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3616-70","proprietary_name":"LATISSE","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".3 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3616-70) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":40.97569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":26.27422,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63402031230","name":"LATUDA 120 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-312-30","proprietary_name":"Latuda","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (63402-312-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":69.27954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Latuda|Lurasidone HCl","basis":"brand"},"part_b":null}, {"ndc":"63402030230","name":"LATUDA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-302-30","proprietary_name":"Latuda","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (63402-302-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":46.45672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Latuda|Lurasidone HCl","basis":"brand"},"part_b":null}, {"ndc":"63402030430","name":"LATUDA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-304-30","proprietary_name":"Latuda","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (63402-304-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":47.11307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Latuda|Lurasidone HCl","basis":"brand"},"part_b":null}, {"ndc":"63402030630","name":"LATUDA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-306-30","proprietary_name":"Latuda","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (63402-306-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":46.81093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Latuda|Lurasidone HCl","basis":"brand"},"part_b":null}, {"ndc":"63402030830","name":"LATUDA 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63402-308-30","proprietary_name":"Latuda","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Sumitomo Pharma America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (63402-308-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":46.36946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Latuda|Lurasidone HCl","basis":"brand"},"part_b":null}, {"ndc":"70000044301","name":"LAXATIVE 15 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0443-1","proprietary_name":"Laxative","nonproprietary_name":"Sennosides","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"15 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0443-1) / 15 TABLET, SUGAR COATED in 1 BLISTER PACK"},"nadac":{"value":0.0673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000007701","name":"LAXATIVE 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0077-1","proprietary_name":"MAXIMUM STRENGTH LAXATIVE","nonproprietary_name":"SENNOSIDES","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"CARDINAL HEALTH","package_description":"24 TABLET in 1 BLISTER PACK (70000-0077-1)"},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483000301","name":"LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-003-01","proprietary_name":"STIMULANT LAXATIVE","nonproprietary_name":"BISACODYL","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (49483-003-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483000310","name":"LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-003-10","proprietary_name":"STIMULANT LAXATIVE","nonproprietary_name":"BISACODYL","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (49483-003-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155004303","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-043-03","proprietary_name":"leflunomide","nonproprietary_name":"leflunomide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (23155-043-03)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"35573044730","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-447-30","proprietary_name":"Leflunomide","nonproprietary_name":"leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (35573-447-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"50268047711","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"50268047715","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-477-15","proprietary_name":"LEFLUNOMIDE","nonproprietary_name":"LEFLUNOMIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-477-15) / 1 TABLET in 1 BLISTER PACK (50268-477-11)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"59651034830","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-348-30","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-348-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"60505250201","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2502-1","proprietary_name":"LEFLUNOMIDE","nonproprietary_name":"LEFLUNOMIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-2502-1)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"62135079330","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-793-30","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-793-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"62332006130","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-061-30","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-061-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"70710115703","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1157-3","proprietary_name":"leflunomide","nonproprietary_name":"leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1157-3)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"70748012906","name":"LEFLUNOMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-129-06","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70748-129-06)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.32368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"23155004403","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-044-03","proprietary_name":"leflunomide","nonproprietary_name":"leflunomide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (23155-044-03)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"35573044830","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-448-30","proprietary_name":"Leflunomide","nonproprietary_name":"leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (35573-448-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"50268047811","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"50268047815","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-478-15","proprietary_name":"LEFLUNOMIDE","nonproprietary_name":"LEFLUNOMIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-478-15) / 1 TABLET in 1 BLISTER PACK (50268-478-11)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"59651034930","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-349-30","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-349-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"60505250301","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2503-1","proprietary_name":"LEFLUNOMIDE","nonproprietary_name":"LEFLUNOMIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-2503-1)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"62135079430","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-794-30","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-794-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"62332006230","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-062-30","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-062-30)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"70710115803","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1158-3","proprietary_name":"leflunomide","nonproprietary_name":"leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1158-3)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"70748013006","name":"LEFLUNOMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-130-06","proprietary_name":"Leflunomide","nonproprietary_name":"Leflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70748-130-06)","pharm_classes":["Antirheumatic Agent [EPC]"]},"nadac":{"value":0.29435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leflunomide|Leflunomide","basis":"generic"},"part_b":null}, {"ndc":"66758021131","name":"LESCOL XL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66758-211-31","proprietary_name":"Lescol XL","nonproprietary_name":"fluvastatin sodium","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (66758-211-31)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":13.06433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.87934,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lescol XL|Fluvastatin Sodium","basis":"brand"},"part_b":null}, {"ndc":"00555901467","name":"LESSINA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9014-67","proprietary_name":"Lessina","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9014-67) / 1 BLISTER PACK in 1 POUCH (0555-9014-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lessina|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555901479","name":"LESSINA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lessina|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093762056","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7620-56","proprietary_name":"Letrozole","nonproprietary_name":"Letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7620-56)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"16729003410","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-034-10","proprietary_name":"Letrozole","nonproprietary_name":"letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-034-10)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"16729003415","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-034-15","proprietary_name":"Letrozole","nonproprietary_name":"letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16729-034-15)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"23155087503","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-875-03","proprietary_name":"Letrozole","nonproprietary_name":"Letrozole Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-875-03)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"23155087509","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-875-09","proprietary_name":"Letrozole","nonproprietary_name":"Letrozole Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (23155-875-09)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"23155087510","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-875-10","proprietary_name":"Letrozole","nonproprietary_name":"Letrozole Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (23155-875-10)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"50268047611","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"50268047615","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-476-15","proprietary_name":"LETROZOLE","nonproprietary_name":"LETROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-476-15) / 1 TABLET in 1 BLISTER PACK (50268-476-11)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"51991075910","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-759-10","proprietary_name":"LETROZOLE","nonproprietary_name":"LETROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51991-759-10)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"51991075933","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-759-33","proprietary_name":"LETROZOLE","nonproprietary_name":"LETROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (51991-759-33)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"51991075990","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-759-90","proprietary_name":"LETROZOLE","nonproprietary_name":"LETROZOLE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"90 TABLET in 1 BOTTLE (51991-759-90)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"59651018030","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-180-30","proprietary_name":"Letrozole","nonproprietary_name":"Letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-180-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"62135049130","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-491-30","proprietary_name":"LETROZOLE","nonproprietary_name":"Letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-491-30)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"62135049190","name":"LETROZOLE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-491-90","proprietary_name":"LETROZOLE","nonproprietary_name":"Letrozole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-491-90)","pharm_classes":["Aromatase Inhibitor [EPC]","Aromatase Inhibitors [MoA]"]},"nadac":{"value":0.14498,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Letrozole|Letrozole","basis":"generic"},"part_b":null}, {"ndc":"00054449705","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4497-05","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"12 TABLET in 1 BOTTLE (0054-4497-05)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054449710","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4497-10","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"24 TABLET in 1 BOTTLE (0054-4497-10)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42806013321","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-133-21","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Epic Pharma LLC","package_description":"12 TABLET in 1 BOTTLE (42806-133-21)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42806013324","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-133-24","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Epic Pharma LLC","package_description":"24 TABLET in 1 BOTTLE (42806-133-24)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50742018212","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-182-12","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"12 TABLET in 1 BOTTLE (50742-182-12)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50742018224","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-182-24","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"24 TABLET in 1 BOTTLE (50742-182-24)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69315018512","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-185-12","proprietary_name":"LEUCOVORIN CALCIUM","nonproprietary_name":"LEUCOVORIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"12 TABLET in 1 BOTTLE (69315-185-12)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69315018524","name":"LEUCOVORIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-185-24","proprietary_name":"LEUCOVORIN CALCIUM","nonproprietary_name":"LEUCOVORIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"24 TABLET in 1 BOTTLE (69315-185-24)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":2.07783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054449810","name":"LEUCOVORIN CALCIUM 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4498-10","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"24 TABLET in 1 BOTTLE (0054-4498-10)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.58667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42806013424","name":"LEUCOVORIN CALCIUM 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-134-24","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Epic Pharma LLC","package_description":"24 TABLET in 1 BOTTLE (42806-134-24)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.58667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50742018324","name":"LEUCOVORIN CALCIUM 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-183-24","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"24 TABLET in 1 BOTTLE (50742-183-24)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.58667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69315018624","name":"LEUCOVORIN CALCIUM 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-186-24","proprietary_name":"LEUCOVORIN CALCIUM","nonproprietary_name":"LEUCOVORIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Leading Pharma, LLC","package_description":"24 TABLET in 1 BOTTLE (69315-186-24)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.58667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054449911","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4499-11","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 TABLET in 1 BOTTLE (0054-4499-11)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00555048527","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0485-27","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"25 TABLET in 1 BOTTLE (0555-0485-27)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00904758410","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7584-10","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7584-10) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42806035925","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-359-25","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Epic Pharma LLC","package_description":"25 TABLET in 1 BOTTLE (42806-359-25)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50742018425","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-184-25","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"25 TABLET in 1 BOTTLE (50742-184-25)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687022711","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-227","inner_of":["60687-227-94"]},"part_b":null}, {"ndc":"60687022794","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-227-94","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-227-94) / 1 TABLET in 1 BLISTER PACK (60687-227-11)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69315018725","name":"LEUCOVORIN CALCIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-187-25","proprietary_name":"LEUCOVORIN CALCIUM","nonproprietary_name":"LEUCOVORIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Leading Pharma, LLC","package_description":"25 TABLET in 1 BOTTLE (69315-187-25)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":1.60475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054449613","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4496-13","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (0054-4496-13)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054449625","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4496-25","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-4496-25)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00054849619","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8496-19","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"5 BLISTER PACK in 1 CARTON (0054-8496-19) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00555048401","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0484-01","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0555-0484-01)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00555048402","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0484-02","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0484-02)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42806035801","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-358-01","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Epic Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (42806-358-01)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"42806035830","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-358-30","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Epic Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (42806-358-30)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50742018101","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-181-01","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-181-01)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50742018130","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-181-30","proprietary_name":"Leucovorin Calcium","nonproprietary_name":"Leucovorin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (50742-181-30)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69315018401","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-184-01","proprietary_name":"LEUCOVORIN CALCIUM","nonproprietary_name":"LEUCOVORIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-184-01)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69315018403","name":"LEUCOVORIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-184-03","proprietary_name":"LEUCOVORIN CALCIUM","nonproprietary_name":"LEUCOVORIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Leading Pharma, LLC","package_description":"30 TABLET in 1 BOTTLE (69315-184-03)","pharm_classes":["Folate Analog [EPC]","Folic Acid [CS]"]},"nadac":{"value":0.33003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leucovorin Calcium*|Leucovorin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00121210602","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0121-2106-02","proprietary_name":"leuprolide acetate","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"1 KIT in 1 CARTON (0121-2106-02) * 1 VIAL, MULTI-DOSE in 1 CARTON (0121-1053-02) / 2.8 mL in 1 VIAL, MULTI-DOSE * 1 mL in 1 PACKET (0121-2105-01)"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"00781400332","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-4003-32","proprietary_name":"Leuprolide Acetate","nonproprietary_name":"Leuprolide Acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sandoz Inc","package_description":"1 KIT in 1 CARTON (0781-4003-32) * 1 VIAL, MULTI-DOSE in 1 CARTON (0781-3006-42) / 2.8 mL in 1 VIAL, MULTI-DOSE * 1 mL in 1 PACKET"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"47335093640","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"47335-936-40","proprietary_name":"leuprolide acetate","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 KIT in 1 CARTON (47335-936-40) * 1 VIAL, MULTI-DOSE in 1 CARTON / 2.8 mL in 1 VIAL, MULTI-DOSE * 1 mL in 1 PACKET"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-27","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"55150047801","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-478-01","proprietary_name":"LEUPROLIDE ACETATE","nonproprietary_name":"LEUPROLIDE ACETATE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Eugia US LLC","package_description":"1 KIT in 1 CARTON (55150-478-01) * 1 VIAL, MULTI-DOSE in 1 CARTON (55150-338-01) / 2.8 mL in 1 VIAL, MULTI-DOSE * 1 mL in 1 PACKET (60913-006-01)"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"70121253706","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70121-2537-6","proprietary_name":"leuprolide acetate","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"Amneal Pharmaceuticals LLC","package_description":"1 KIT in 1 CARTON (70121-2537-6) * 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1695-2) / 2.8 mL in 1 VIAL, MULTI-DOSE * 1 mL in 1 PACKET (70121-2538-9)"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"70710176903","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1769-3","proprietary_name":"LEUPROLIDE ACETATE","nonproprietary_name":"LEUPROLIDE ACETATE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 KIT in 1 CARTON (70710-1769-3) * 1 VIAL, MULTI-DOSE in 1 CARTON (70710-1768-1) / 2.8 mL in 1 VIAL, MULTI-DOSE * 1 mL in 1 PACKET (70710-1897-8)"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-03","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"71288056990","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-569-90","proprietary_name":"Leuprolide Acetate","nonproprietary_name":"Leuprolide Acetate","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"Meitheal Pharmaceuticals Inc","package_description":"1 KIT in 1 CARTON (71288-569-90) * 1 VIAL, MULTI-DOSE in 1 CARTON (71288-565-03) / 2.8 mL in 1 VIAL, MULTI-DOSE * .5 mL in 1 PACKET (71288-350-91)"},"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Leuprolide Acetate|Leuprolide Acetate","basis":"generic"},"part_b":null}, {"ndc":"83634045461","name":"LEUPROLIDE 2WK 14 MG/2.8 ML KT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":197.606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093414556","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4145-56","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".31 mg/3mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-4145-56) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-4145-45) / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.31404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":19,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.62 per item) x PKG QTY is 18.6; CMS prints the whole number 19.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0093-4145-56) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-4145-45) / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00115993076","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115993078","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9930-78","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".31 mg/3mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 POUCH in 1 CARTON (0115-9930-78) / 25 AMPULE in 1 POUCH (0115-9930-76) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.62 per item) x PKG QTY is 15.5; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0115-9930-78) / 25 AMPULE in 1 POUCH (0115-9930-76) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378969052","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9690-52","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".31 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-9690-52) / 25 AMPULE in 1 POUCH (0378-9690-62) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.62 per item) x PKG QTY is 15.5; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-9690-52) / 25 AMPULE in 1 POUCH (0378-9690-62) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378969062","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"35573044325","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-443-25","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".31 mg/3mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"25 POUCH in 1 CARTON (35573-443-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.62 per item) x PKG QTY is 15.5; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"76204070001","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-700-01","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".31 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-700-01) / 1 AMPULE in 1 POUCH (76204-700-11) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.31404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":19,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.62 per item) x PKG QTY is 18.6; CMS prints the whole number 19.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-700-01) / 1 AMPULE in 1 POUCH (76204-700-11) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204070015","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204070025","name":"LEVALBUTEROL 0.31 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-700-25","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".31 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-700-25) / 25 AMPULE in 1 POUCH (76204-700-15) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.26246,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":16,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.62 per item) x PKG QTY is 15.5; CMS prints the whole number 16.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-700-25) / 25 AMPULE in 1 POUCH (76204-700-15) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093414656","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4146-56","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-4146-56) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-4146-45) / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.31237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":38,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 37.5; CMS prints the whole number 38.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0093-4146-56) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-4146-45) / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00115993176","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115993178","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9931-78","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 POUCH in 1 CARTON (0115-9931-78) / 25 AMPULE in 1 POUCH (0115-9931-76) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0115-9931-78) / 25 AMPULE in 1 POUCH (0115-9931-76) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378969152","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9691-52","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-9691-52) / 25 AMPULE in 1 POUCH (0378-9691-62) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-9691-52) / 25 AMPULE in 1 POUCH (0378-9691-62) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378969162","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"35573044425","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-444-25","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"25 POUCH in 1 CARTON (35573-444-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"76204080001","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-800-01","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-800-01) / 1 AMPULE in 1 POUCH (76204-800-11) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.31237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":38,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 37.5; CMS prints the whole number 38.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-800-01) / 1 AMPULE in 1 POUCH (76204-800-11) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204080015","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204080025","name":"LEVALBUTEROL 0.63 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-800-25","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":".63 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-800-25) / 25 AMPULE in 1 POUCH (76204-800-15) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.24802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":32,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (1.25 per item) x PKG QTY is 31.25; CMS prints the whole number 32.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-800-25) / 25 AMPULE in 1 POUCH (76204-800-15) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093414856","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4148-56","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-4148-56) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-4148-45) / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0093-4148-56) / 5 VIAL, SINGLE-DOSE in 1 POUCH (0093-4148-45) / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00115993276","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115993278","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-9932-78","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1 POUCH in 1 CARTON (0115-9932-78) / 25 AMPULE in 1 POUCH (0115-9932-76) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0115-9932-78) / 25 AMPULE in 1 POUCH (0115-9932-76) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378969252","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9692-52","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 POUCH in 1 CARTON (0378-9692-52) / 25 AMPULE in 1 POUCH (0378-9692-62) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (0378-9692-52) / 25 AMPULE in 1 POUCH (0378-9692-62) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378969262","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"35573044525","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-445-25","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Burel Pharmaceuticals, LLC","package_description":"25 POUCH in 1 CARTON (35573-445-25) / 25 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"76204090001","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-900-01","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"30 POUCH in 1 CARTON (76204-900-01) / 1 AMPULE in 1 POUCH (76204-900-11) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (76204-900-01) / 1 AMPULE in 1 POUCH (76204-900-11) / 3 mL in 1 AMPULE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204090015","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76204090025","name":"LEVALBUTEROL 1.25 MG/3 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-900-25","proprietary_name":"Levalbuterol","nonproprietary_name":"Levalbuterol Hydrochloride","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/3mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"1 POUCH in 1 CARTON (76204-900-25) / 25 AMPULE in 1 POUCH (76204-900-15) / 3 mL in 1 AMPULE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.27307,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7614","bill_units_per_package":{"value":63,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7614 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (2.5 per item) x PKG QTY is 62.5; CMS prints the whole number 63.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 POUCH in 1 CARTON (76204-900-25) / 25 AMPULE in 1 POUCH (76204-900-15) / 3 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378699393","name":"LEVALBUTEROL CONC 1.25 MG/0.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6993-93","proprietary_name":"Levalbuterol","nonproprietary_name":"levalbuterol","dosage_form":"SOLUTION, CONCENTRATE","route":"RESPIRATORY (INHALATION)","strength":"1.25 mg/.5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-6993-93) / 1 VIAL in 1 POUCH (0378-6993-31) / .5 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":5.21877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7612","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7612 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00591292754","name":"LEVALBUTEROL TAR HFA 45 MCG INH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2927-54","proprietary_name":"Levalbuterol tartrate HFA inhalation","nonproprietary_name":"levalbuterol tartrate","dosage_form":"AEROSOL, METERED","route":"ORAL","strength":"45 ug/1","labeler":"Actavis Pharma, Inc.","package_description":"1 INHALER in 1 CARTON (0591-2927-54) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":3.54974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Levalbuterol Tartrate HFA|Levalbuterol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378561991","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5619-91","proprietary_name":"Levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5619-91)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16571079006","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714031001","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-310-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (16714-310-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026601","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-266-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (27808-266-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053960","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-539-60","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-539-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"42385095760","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547022406","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-224-06","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (43547-224-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047360","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-473-60","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50228-473-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"60687066801","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-668-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-668-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-668-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"60687066811","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-668","inner_of":["60687-668-01"]},"part_b":null}, {"ndc":"64980060706","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-607-06","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (64980-607-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"65862031560","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-315-60","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-315-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877077160","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-771-60","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-771-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040506","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-405-06","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68001-405-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011507","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-115-07","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68180-115-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"72205009760","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-097-60","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72205-097-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"82009012460","name":"LEVETIRACETAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-124-60","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (82009-124-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.15968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00121079916","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0799-16","proprietary_name":"Levetiracetam","nonproprietary_name":"LEVETIRACETAM","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0799-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00472023516","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0235-16","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Actavis Pharma, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (0472-0235-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904742016","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7420-16","proprietary_name":"levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"MAJOR PHARMACEUTICALS","package_description":"473 mL in 1 BOTTLE, PLASTIC (0904-7420-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714035801","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-358-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (16714-358-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722057447","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-574-47","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam oral","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (31722-574-47)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135054847","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-548-47","proprietary_name":"LEVETIRACETAM solution","nonproprietary_name":"LEVETIRACETAM","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-548-47)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862025047","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-250-47","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"473 mL in 1 BOTTLE, PLASTIC (65862-250-47)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452041288","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-412-88","proprietary_name":"LEVETIRACETAM","nonproprietary_name":"LEVETIRACETAM","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Bionpharma Inc.","package_description":"473 mL in 1 BOTTLE (69452-412-88)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752020312","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-203-12","proprietary_name":"LEVETIRACETAM","nonproprietary_name":"LEVETIRACETAM","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"473 mL in 1 BOTTLE (70752-203-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71093014413","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205003772","name":"LEVETIRACETAM 100 MG/ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-037-72","proprietary_name":"levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (72205-037-72)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904712361","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7123-61","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7123-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16571078712","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571078750","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714003401","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-034-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar RxLLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (16714-034-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16714003402","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-034-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-034-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026301","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-263-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (27808-263-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026302","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-263-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (27808-263-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053605","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-536-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-536-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053612","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-536-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-536-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"42385095412","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547022115","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-221-15","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (43547-221-15)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047005","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-470-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-470-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047012","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-470-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (50228-470-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"64980060412","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-604-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (64980-604-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"64980060450","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-604-50","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64980-604-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"65862024508","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-245-08","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (65862-245-08)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877076805","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-768-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-768-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877076812","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-768-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (67877-768-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040203","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-402-03","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-402-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040207","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-402-07","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68001-402-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68084085901","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-859-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-859-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-859-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68084085911","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-859","inner_of":["68084-859-01"]},"part_b":null}, {"ndc":"68180011202","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-112-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-112-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011209","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-112-09","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-112-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011216","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-112-16","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68180-112-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"72205009492","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-094-92","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72205-094-92)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"82009012105","name":"LEVETIRACETAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-121-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-121-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00378561505","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5615-05","proprietary_name":"Levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5615-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00378561578","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5615-78","proprietary_name":"Levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5615-78)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00904712461","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7124-61","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7124-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16571078812","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571078850","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714003501","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-035-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar RxLLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (16714-035-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16714003502","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-035-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-035-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026401","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-264-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (27808-264-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026402","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-264-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (27808-264-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053705","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-537-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-537-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053712","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-537-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-537-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"42385095505","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42385095512","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547022211","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-222-11","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-222-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"43547022215","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-222-15","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (43547-222-15)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"43547022250","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-222-50","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43547-222-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047105","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-471-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-471-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047112","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-471-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (50228-471-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"51079082101","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-821","inner_of":["51079-821-20"]},"part_b":null}, {"ndc":"51079082120","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-821-20","proprietary_name":"Levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-821-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-821-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"60687065701","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-657-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-657-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-657-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"60687065711","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-657","inner_of":["60687-657-01"]},"part_b":null}, {"ndc":"64980060512","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-605-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (64980-605-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"64980060550","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-605-50","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64980-605-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"65862024605","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-246-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-246-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"65862024608","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-246-08","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (65862-246-08)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877076905","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-769-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-769-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877076912","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-769-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (67877-769-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040303","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-403-03","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-403-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040307","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-403-07","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68001-403-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011302","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-113-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-113-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011309","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-113-09","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-113-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011316","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-113-16","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68180-113-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"72205009592","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-095-92","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72205-095-92)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"82009012205","name":"LEVETIRACETAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-122-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-122-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00378561705","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5617-05","proprietary_name":"Levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5617-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00378561778","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5617-78","proprietary_name":"Levetiracetam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5617-78)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"00904712561","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7125-61","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7125-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16571078912","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571078950","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714053701","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-537-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"NorthStar RxLLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (16714-537-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"16714053702","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-537-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-537-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026501","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-265-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (27808-265-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"27808026502","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-265-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (27808-265-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053805","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-538-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-538-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"31722053812","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-538-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-538-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"42385095612","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547022315","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-223-15","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (43547-223-15)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047205","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-472-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-472-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228047212","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-472-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (50228-472-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"64980060612","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-606-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (64980-606-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"64980060650","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-606-50","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (64980-606-50)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"65862024708","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-247-08","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (65862-247-08)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877077005","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-770-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-770-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"67877077012","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-770-12","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (67877-770-12)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040403","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-404-03","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68001-404-03)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001040407","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-404-07","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68001-404-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68084088201","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-882-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-882-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-882-11)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68084088211","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-882","inner_of":["68084-882-01"]},"part_b":null}, {"ndc":"68180011402","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-114-02","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-114-02)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011409","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-114-09","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-114-09)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011416","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-114-16","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68180-114-16)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"72205009692","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-096-92","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72205-096-92)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"82009012305","name":"LEVETIRACETAM 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-123-05","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-123-05)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam*|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"43547034506","name":"LEVETIRACETAM ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-345-06","proprietary_name":"LEVETIRACETAM","nonproprietary_name":"LEVETIRACETAM","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-345-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228018960","name":"LEVETIRACETAM ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-189-60","proprietary_name":"Levetiracetam Extended-Release","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-189-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"60505328006","name":"LEVETIRACETAM ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3280-6","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-3280-6)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001011306","name":"LEVETIRACETAM ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-113-06","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-113-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011707","name":"LEVETIRACETAM ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-117-07","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-117-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"69367033260","name":"LEVETIRACETAM ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-332-60","proprietary_name":"Levetiracetam ER","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69367-332-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.17377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"43547034606","name":"LEVETIRACETAM ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-346-06","proprietary_name":"LEVETIRACETAM","nonproprietary_name":"LEVETIRACETAM","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43547-346-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"50228019060","name":"LEVETIRACETAM ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-190-60","proprietary_name":"Levetiracetam Extended-Release","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-190-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"60505351706","name":"LEVETIRACETAM ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3517-6","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-3517-6)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68001011406","name":"LEVETIRACETAM ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-114-06","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-114-06)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"68180011807","name":"LEVETIRACETAM ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-118-07","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-118-07)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"69367033360","name":"LEVETIRACETAM ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-333-60","proprietary_name":"Levetiracetam ER","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69367-333-60)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levetiracetam ER|Levetiracetam","basis":"generic"},"part_b":null}, {"ndc":"55466010811","name":"LEVO-T 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010819","name":"LEVO-T 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010911","name":"LEVO-T 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011011","name":"LEVO-T 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011019","name":"LEVO-T 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011111","name":"LEVO-T 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011211","name":"LEVO-T 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011311","name":"LEVO-T 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011411","name":"LEVO-T 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010411","name":"LEVO-T 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010419","name":"LEVO-T 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466011511","name":"LEVO-T 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010511","name":"LEVO-T 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010519","name":"LEVO-T 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010611","name":"LEVO-T 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010619","name":"LEVO-T 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"55466010711","name":"LEVO-T 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levo-T|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"24208050505","name":"LEVOBUNOLOL 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-505-05","proprietary_name":"Levobunolol Hydrochloride","nonproprietary_name":"Levobunolol Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-505-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.81863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Levobunolol HCl|Levobunolol HCl","basis":"generic"},"part_b":null}, {"ndc":"52817083004","name":"LEVOCARNITINE 1 G/10 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-830-04","proprietary_name":"Levocarnitine","nonproprietary_name":"Levocarnitine","dosage_form":"SOLUTION","route":"ORAL","strength":"1 g/10mL","labeler":"TRUPHARMA, LLC","package_description":"118 mL in 1 BOTTLE (52817-830-04)","pharm_classes":["Carnitine Analog [EPC]","Carnitine [CS]"]},"nadac":{"value":0.14503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980050312","name":"LEVOCARNITINE 1 G/10 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-503-12","proprietary_name":"Levocarnitine","nonproprietary_name":"Levocarnitine","dosage_form":"SOLUTION","route":"ORAL","strength":"1 g/10mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118 mL in 1 BOTTLE, PLASTIC (64980-503-12)","pharm_classes":["Carnitine Analog [EPC]","Carnitine [CS]"]},"nadac":{"value":0.14503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954013910","name":"LEVOCARNITINE 1 G/10 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-139-10","proprietary_name":"Levocarnitine","nonproprietary_name":"Levocarnitine","dosage_form":"SOLUTION","route":"ORAL","strength":"1 g/10mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"118 mL in 1 BOTTLE (70954-139-10)","pharm_classes":["Carnitine Analog [EPC]","Carnitine [CS]"]},"nadac":{"value":0.14503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571076209","name":"LEVOCARNITINE 330 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-762-09","proprietary_name":"Levocarnitine","nonproprietary_name":"Levocarnitine","dosage_form":"TABLET","route":"ORAL","strength":"330 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"9 BLISTER PACK in 1 CARTON (16571-762-09) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Carnitine Analog [EPC]","Carnitine [CS]"]},"nadac":{"value":0.67062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954049210","name":"LEVOCARNITINE 330 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-492-10","proprietary_name":"Levocarnitine","nonproprietary_name":"Levocarnitine","dosage_form":"TABLET","route":"ORAL","strength":"330 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 BLISTER PACK in 1 CARTON (70954-492-10) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Carnitine Analog [EPC]","Carnitine [CS]"]},"nadac":{"value":0.67062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954014010","name":"LEVOCARNITINE SF 1 G/10 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-140-10","proprietary_name":"Levocarnitine","nonproprietary_name":"Levocarnitine","dosage_form":"SOLUTION","route":"ORAL","strength":"1 g/10mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"118 mL in 1 BOTTLE (70954-140-10)","pharm_classes":["Carnitine Analog [EPC]","Carnitine [CS]"]},"nadac":{"value":0.25217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722065931","name":"LEVOCETIRIZINE 2.5 MG/5 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-659-31","proprietary_name":"levocetirizine dihydrochloride","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"2.5 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-659-31) / 148 mL in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802068028","name":"LEVOCETIRIZINE 2.5 MG/5 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-680-28","proprietary_name":"levocetirizine dihydrochloride","nonproprietary_name":"Levocetirizine dihydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":".5 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"148 mL in 1 BOTTLE (45802-680-28)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135091738","name":"LEVOCETIRIZINE 2.5 MG/5 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-917-38","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":".5 mg/mL","labeler":"Chartwell RX, LLC","package_description":"148 mL in 1 BOTTLE (62135-917-38)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093770198","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7701-98","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-7701-98)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722055190","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-551-90","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-551-90)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342020010","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-200-10","proprietary_name":"LEVOCETIRIZINE DIHYDROCHLORIDE","nonproprietary_name":"LEVOCETIRIZINE DIHYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-200-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571012290","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-122-90","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"levocetirizine Dihydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Micro Labs Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42571-122-90)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228013630","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-136-30","proprietary_name":"levocetirizine dihydrochloride","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (50228-136-30)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228013690","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-136-90","proprietary_name":"levocetirizine dihydrochloride","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (50228-136-90)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462034690","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-346-90","proprietary_name":"LEVOCETIRIZINE DIHYDROCHLORIDE","nonproprietary_name":"levocetirizine dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-346-90)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032110","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-321-10","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69230-321-10)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032131","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-321-31","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-321-31) / 35 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032133","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-321-33","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-321-33) / 80 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032134","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-321-34","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-321-34) / 180 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367023809","name":"LEVOCETIRIZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-238-09","proprietary_name":"Levocetirizine Dihydrochloride","nonproprietary_name":"Levocetirizine Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (69367-238-09)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527194866","name":"LEVOFLOXACIN 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1948-66","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Lannett Company, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0527-1948-66) / 100 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":1.47062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527194868","name":"LEVOFLOXACIN 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1948-68","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Lannett Company, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0527-1948-68) / 200 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":1.78878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954085210","name":"LEVOFLOXACIN 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-852-10","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 mL in 1 BOTTLE (70954-852-10)"},"nadac":{"value":1.47062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954085220","name":"LEVOFLOXACIN 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-852-20","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"200 mL in 1 BOTTLE (70954-852-20)"},"nadac":{"value":1.78878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904635161","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6351-61","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6351-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722072150","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-721-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (31722-721-50)"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342053108","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-531-08","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (33342-531-08)"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111027950","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-279-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (55111-279-50)"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135065514","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-655-14","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"14 TABLET in 1 BOTTLE (62135-655-14)"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862053650","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-536-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (65862-536-50)"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578009818","name":"LEVOFLOXACIN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-098-18","proprietary_name":"levofloxacin","nonproprietary_name":"levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (72578-098-18)"},"nadac":{"value":0.1086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904635261","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6352-61","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6352-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722072250","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-722-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (31722-722-50)"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342053208","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-532-08","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (33342-532-08)"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111028050","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-280-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (55111-280-50)"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135065650","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-656-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"50 TABLET in 1 BOTTLE (62135-656-50)"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862053750","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-537-50","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (65862-537-50)"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578009918","name":"LEVOFLOXACIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-099-18","proprietary_name":"levofloxacin","nonproprietary_name":"levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (72578-099-18)"},"nadac":{"value":0.13317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904635361","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6353-61","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6353-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722072320","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-723-20","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (31722-723-20)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342053332","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-533-32","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (33342-533-32)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111028130","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-281-30","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-281-30)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135065714","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-657-14","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Chartwell RX, LLC","package_description":"14 TABLET in 1 BOTTLE (62135-657-14)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135065720","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-657-20","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET in 1 BOTTLE (62135-657-20)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862053820","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-538-20","proprietary_name":"Levofloxacin","nonproprietary_name":"Levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (65862-538-20)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010006","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-100-06","proprietary_name":"levofloxacin","nonproprietary_name":"levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-100-06)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010092","name":"LEVOFLOXACIN 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-100-92","proprietary_name":"levofloxacin","nonproprietary_name":"levofloxacin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (72578-100-92)"},"nadac":{"value":0.25858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714034001","name":"LEVONEST-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-340-01","proprietary_name":"Levonest","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-340-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.32363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levonest|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714034004","name":"LEVONEST-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-340-04","proprietary_name":"Levonest","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-340-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.32363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levonest|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462063729","name":"LEVONOR-ETH ESTRA 0.09-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-637-29","proprietary_name":"Levonorgestrel and Ethinyl Estradiol","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"90 ug/1; 20 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-637-29) / 1 BLISTER PACK in 1 POUCH (68462-637-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":1.13572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462063784","name":"LEVONOR-ETH ESTRA 0.09-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.13572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722094432","name":"LEVONOR-ETH ESTRAD 0.1-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-944-32","proprietary_name":"Levonorgetsrel and Ethinyl Estradiol","nonproprietary_name":"Levonorgetsrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Camber Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (31722-944-32) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180085471","name":"LEVONOR-ETH ESTRAD 0.1-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180085473","name":"LEVONOR-ETH ESTRAD 0.1-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-854-73","proprietary_name":"Levonorgestrel and Ethinyl Estradiol","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-854-73) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180085771","name":"LEVONOR-ETH ESTRAD TRIPHASIC","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180085773","name":"LEVONOR-ETH ESTRAD TRIPHASIC","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-857-73","proprietary_name":"Levonorgestrel and Ethinyl Estradiol","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 CARTON in 1 CARTON (68180-857-73) / 1 KIT in 1 CARTON"},"nadac":{"value":0.32363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536114263","name":"LEVONORGESTREL 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536143363","name":"LEVONORGESTREL 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1433-63","proprietary_name":"Levonorgestrel","nonproprietary_name":"Levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Rugby Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (0536-1433-63) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700016406","name":"LEVONORGESTREL 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-164-06","proprietary_name":"Levonorgestrel","nonproprietary_name":"Levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Xiromed LLC","package_description":"1 BLISTER PACK in 1 CARTON (70700-164-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180084311","name":"LEVONORGESTREL-ETH ESTRAD 0.15 MG-0.03 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180084313","name":"LEVONORGESTREL-ETH ESTRAD 0.15 MG-0.03 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-843-13","proprietary_name":"Levonorgestrel and Ethinyl Estradiol","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-843-13) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462067291","name":"LEVONORGESTREL-ETH ESTRAD 0.15 MG-0.03 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462067295","name":"LEVONORGESTREL-ETH ESTRAD 0.15 MG-0.03 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-672-95","proprietary_name":"levonorgestrel and ethinyl estradiol","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-672-95) / 1 BLISTER PACK in 1 POUCH (68462-672-91) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192062303","name":"LEVONORGESTREL-ETH ESTRADIOL-FE BISGLYC 0.1-0.02-36.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-623-03","proprietary_name":"levonorgestrel and ethinyl estradiol","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Acella Pharmaceuticals","package_description":"3 BLISTER PACK in 1 CARTON (42192-623-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192062328","name":"LEVONORGESTREL-ETH ESTRADIOL-FE BISGLYC 0.1-0.02-36.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-623-28","proprietary_name":"levonorgestrel and ethinyl estradiol","nonproprietary_name":"levonorgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Acella Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (42192-623-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054043825","name":"LEVORPHANOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0054-0438-25","proprietary_name":"LEVORPHANOL TARTRATE","nonproprietary_name":"LEVORPHANOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-0438-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.6456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levorphanol Tartrate|Levorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00406222401","name":"LEVORPHANOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0406-2224-01","proprietary_name":"Levorphanol Tartrate","nonproprietary_name":"Levorphanol Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0406-2224-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.6456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levorphanol Tartrate|Levorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00527323637","name":"LEVORPHANOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0527-3236-37","proprietary_name":"Levorphanol Tartrate","nonproprietary_name":"Levorphanol Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-3236-37)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.6456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levorphanol Tartrate|Levorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57664076288","name":"LEVORPHANOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57664-762-88","proprietary_name":"Levorphanol Tartrate","nonproprietary_name":"Levorphanol Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-762-88)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.6456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levorphanol Tartrate|Levorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72989041710","name":"LEVORPHANOL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72989-417-10","proprietary_name":"Levorphanol Tartrate","nonproprietary_name":"Levorphanol Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ACERTIS PHARMACEUTICALS, LLC","package_description":"100 TABLET in 1 BOTTLE (72989-417-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.6456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levorphanol Tartrate|Levorphanol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378180910","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1809-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1809-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180977","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1809-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1809-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328443","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3284-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3284-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328446","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3284-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3284-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695361","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6953-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6953-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045115","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-451-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-451-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045117","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-451-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-451-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028810","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-288-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-288-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028890","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-288-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-288-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039710","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-397-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-397-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039711","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-397-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-397-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039744","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-397-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-397-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065110","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-651-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-651-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065190","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-651-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-651-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079044201","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-442","inner_of":["51079-442-20"]},"part_b":null}, {"ndc":"51079044220","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-442-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-442-20) / 1 TABLET in 1 BLISTER PACK (51079-442-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687049701","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-497-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-497-01) / 1 TABLET in 1 BLISTER PACK (60687-497-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687049711","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-497","inner_of":["60687-497-01"]},"part_b":null}, {"ndc":"68180096901","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-969-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-969-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096903","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-969-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-969-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096909","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-969-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-969-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183401","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1834-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1834-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183407","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1834-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1834-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066401","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-664-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-664-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066402","name":"LEVOTHYROXINE 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-664-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-664-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181110","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1811-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1811-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181177","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1811-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1811-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480870410","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8704-10","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-8704-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480870498","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8704-98","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (0480-8704-98)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328543","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3285-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3285-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328546","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3285-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3285-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695461","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6954-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6954-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045215","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-452-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-452-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045217","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-452-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-452-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028910","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-289-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-289-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028990","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-289-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-289-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039810","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-398-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-398-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039811","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-398-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-398-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039844","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-398-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-398-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42292003901","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"42292-039","inner_of":["42292-039-20"]},"part_b":null}, {"ndc":"42292003920","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-039-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (42292-039-20) / 1 TABLET in 1 BLISTER PACK (42292-039-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065410","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-654-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-654-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065490","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-654-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-654-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781072110","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-721-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-721-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781072190","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-721-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-721-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687050801","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-508-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-508-01) / 1 TABLET in 1 BLISTER PACK (60687-508-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687050811","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-508","inner_of":["60687-508-01"]},"part_b":null}, {"ndc":"68180097001","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-970-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-970-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097003","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-970-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-970-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097009","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-970-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-970-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183501","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1835-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1835-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183507","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1835-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".112 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1835-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066501","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-665-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-665-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066502","name":"LEVOTHYROXINE 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-665-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-665-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181310","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1813-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1813-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181377","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1813-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1813-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328643","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3286-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3286-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328646","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3286-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3286-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695561","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6955-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6955-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045315","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-453-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-453-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045317","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-453-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-453-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029010","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-290-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-290-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029090","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-290-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-290-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039910","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-399-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-399-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039911","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-399-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-399-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039944","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-399-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-399-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065710","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-657-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-657-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065790","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-657-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-657-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079044301","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-443","inner_of":["51079-443-20"]},"part_b":null}, {"ndc":"51079044320","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-443-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-443-20) / 1 TABLET in 1 BLISTER PACK (51079-443-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687051901","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-519-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-519-01) / 1 TABLET in 1 BLISTER PACK (60687-519-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687051911","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-519","inner_of":["60687-519-01"]},"part_b":null}, {"ndc":"68180097101","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-971-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-971-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097103","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-971-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-971-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097109","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-971-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-971-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183601","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1836-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1836-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183607","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1836-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1836-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066601","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-666-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-666-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066602","name":"LEVOTHYROXINE 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-666-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-666-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378182310","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1823-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1823-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378182377","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1823-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1823-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480871010","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8710-10","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-8710-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480871098","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8710-98","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (0480-8710-98)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328743","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3287-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3287-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328746","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3287-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3287-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045415","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-454-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-454-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045417","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-454-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-454-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029110","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-291-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-291-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029190","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-291-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-291-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040010","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-400-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-400-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040011","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-400-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-400-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040044","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-400-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-400-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42292004101","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"42292-041","inner_of":["42292-041-20"]},"part_b":null}, {"ndc":"42292004120","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-041-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (42292-041-20) / 1 TABLET in 1 BLISTER PACK (42292-041-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065910","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-659-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-659-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781065990","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-659-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-659-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687056301","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-563-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX (60687-563-01) / 1 TABLET in 1 BLISTER PACK (60687-563-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687056311","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-563","inner_of":["60687-563-01"]},"part_b":null}, {"ndc":"68180097201","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-972-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-972-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097203","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-972-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-972-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097209","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-972-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-972-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183701","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1837-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1837-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183707","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1837-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".137 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1837-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066701","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-667-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-667-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066702","name":"LEVOTHYROXINE 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-667-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-667-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181510","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1815-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1815-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181577","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1815-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1815-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328843","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3288-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3288-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328846","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3288-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3288-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695661","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6956-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6956-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045515","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-455-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-455-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045517","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-455-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-455-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029210","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-292-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-292-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029290","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-292-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-292-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040110","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-401-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-401-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040111","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-401-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-401-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040144","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-401-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-401-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781066210","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-662-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-662-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781066290","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-662-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-662-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079044501","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-445","inner_of":["51079-445-20"]},"part_b":null}, {"ndc":"51079044520","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-445-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-445-20) / 1 TABLET in 1 BLISTER PACK (51079-445-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687053001","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-530-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX (60687-530-01) / 1 TABLET in 1 BLISTER PACK (60687-530-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687053011","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-530","inner_of":["60687-530-01"]},"part_b":null}, {"ndc":"68180097301","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-973-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-973-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097303","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-973-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-973-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097309","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-973-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-973-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183801","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1838-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1838-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183807","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1838-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".15 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1838-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066801","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-668-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-668-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066802","name":"LEVOTHYROXINE 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-668-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-668-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181710","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1817-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1817-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181777","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1817-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, GLASS (0378-1817-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480871810","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8718-10","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-8718-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480871898","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8718-98","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (0480-8718-98)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328943","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3289-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3289-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328946","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3289-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3289-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695761","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6957-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6957-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045615","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-456-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-456-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045617","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-456-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-456-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029310","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-293-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-293-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029390","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-293-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-293-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040210","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-402-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-402-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040211","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-402-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-402-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040244","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-402-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-402-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42292004001","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"42292-040","inner_of":["42292-040-20"]},"part_b":null}, {"ndc":"42292004020","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-040-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (42292-040-20) / 1 TABLET in 1 BLISTER PACK (42292-040-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781066510","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-665-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-665-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781066590","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-665-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-665-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781072890","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-728-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-728-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687054101","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-541-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-541-01) / 1 TABLET in 1 BLISTER PACK (60687-541-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687054111","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-541","inner_of":["60687-541-01"]},"part_b":null}, {"ndc":"68180097401","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-974-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-974-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097403","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-974-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-974-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097409","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-974-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-974-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183901","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1839-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1839-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183907","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1839-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".175 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1839-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066901","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-669-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-669-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066902","name":"LEVOTHYROXINE 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-669-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-669-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181910","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1819-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1819-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378181977","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1819-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1819-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480872210","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8722-10","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-8722-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480872298","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8722-98","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (0480-8722-98)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527329043","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3290-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3290-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527329046","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3290-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3290-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045715","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-457-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-457-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045717","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-457-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-457-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029410","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-294-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-294-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029490","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-294-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-294-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040310","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-403-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-403-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040311","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-403-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-403-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040344","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-403-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-403-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781066810","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-668-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-668-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781066890","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-668-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-668-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687055201","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-552-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-552-01) / 1 TABLET in 1 BLISTER PACK (60687-552-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687055211","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-552","inner_of":["60687-552-01"]},"part_b":null}, {"ndc":"68180097501","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-975-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-975-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097503","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-975-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-975-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097509","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-975-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-975-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238184001","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1840-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1840-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238184007","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1840-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1840-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603070101","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-701-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-701-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603070102","name":"LEVOTHYROXINE 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-701-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-701-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180010","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1800-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1800-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180077","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1800-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1800-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328043","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3280-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3280-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328046","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3280-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3280-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904694961","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6949-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6949-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729044715","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-447-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-447-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729044717","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-447-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-447-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028410","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-284-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-284-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028490","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-284-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-284-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039310","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-393-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-393-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039311","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-393-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-393-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039344","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-393-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-393-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064010","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-640-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-640-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064090","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-640-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-640-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079044401","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-444","inner_of":["51079-444-20"]},"part_b":null}, {"ndc":"51079044420","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-444-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-444-20) / 1 TABLET in 1 BLISTER PACK (51079-444-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687045301","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-453-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-453-01) / 1 TABLET in 1 BLISTER PACK (60687-453-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687045311","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-453","inner_of":["60687-453-01"]},"part_b":null}, {"ndc":"68180096501","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-965-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-965-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096503","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-965-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-965-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096509","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-965-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-965-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183001","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1830-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1830-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183007","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1830-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".025 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1830-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066001","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-660-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-660-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066002","name":"LEVOTHYROXINE 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-660-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-660-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378182177","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1821-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1821-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527329146","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3291-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3291-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045815","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-458-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-458-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029510","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-295-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-295-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722029590","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-295-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-295-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040410","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-404-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-404-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040411","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-404-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-404-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342040444","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-404-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-404-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781067190","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-671-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-671-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097601","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-976-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-976-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097603","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-976-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-976-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180097609","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-976-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-976-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238184101","name":"LEVOTHYROXINE 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1841-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".3 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1841-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180310","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1803-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1803-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180377","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1803-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1803-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328143","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3281-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3281-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328146","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3281-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3281-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695061","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6950-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6950-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729044815","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-448-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-448-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729044817","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-448-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-448-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028510","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-285-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-285-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028590","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-285-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-285-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039410","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-394-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-394-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039411","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-394-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-394-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039444","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-394-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-394-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064310","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-643-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-643-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064390","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-643-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-643-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079044001","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-440","inner_of":["51079-440-20"]},"part_b":null}, {"ndc":"51079044020","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-440-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-440-20) / 1 TABLET in 1 BLISTER PACK (51079-440-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687046401","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-464-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-464-01) / 1 TABLET in 1 BLISTER PACK (60687-464-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687046411","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-464","inner_of":["60687-464-01"]},"part_b":null}, {"ndc":"68180096601","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-966-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-966-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096603","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-966-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-966-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096609","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-966-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-966-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183101","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1831-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1831-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183107","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1831-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".05 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1831-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066101","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-661-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-661-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066102","name":"LEVOTHYROXINE 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-661-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-661-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180510","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1805-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1805-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180577","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1805-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1805-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480869010","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8690-10","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-8690-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480869098","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8690-98","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (0480-8690-98)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328243","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3282-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3282-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328246","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3282-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3282-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695161","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6951-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6951-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729044915","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-449-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-449-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729044917","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-449-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-449-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028610","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-286-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-286-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028690","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-286-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-286-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039510","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-395-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-395-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039511","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-395-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-395-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039544","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-395-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-395-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064610","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-646-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-646-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064690","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-646-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-646-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"51079044101","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-441","inner_of":["51079-441-20"]},"part_b":null}, {"ndc":"51079044120","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-441-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-441-20) / 1 TABLET in 1 BLISTER PACK (51079-441-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687047501","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-475-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-475-01) / 1 TABLET in 1 BLISTER PACK (60687-475-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687047511","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-475","inner_of":["60687-475-01"]},"part_b":null}, {"ndc":"68180096701","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-967-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-967-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096703","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-967-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-967-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096709","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-967-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-967-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183201","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1832-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1832-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183207","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1832-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1832-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066201","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-662-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-662-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066202","name":"LEVOTHYROXINE 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-662-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-662-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180710","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1807-10","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-1807-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378180777","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1807-77","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-1807-77)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480869310","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8693-10","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0480-8693-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480869398","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-8693-98","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (0480-8693-98)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328343","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3283-43","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Lannett Company, Inc","package_description":"1000 TABLET in 1 BOTTLE (0527-3283-43)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00527328346","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3283-46","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Lannett Company, Inc","package_description":"90 TABLET in 1 BOTTLE (0527-3283-46)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904695261","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6952-61","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6952-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045015","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-450-15","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET in 1 BOTTLE (16729-450-15)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16729045017","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-450-17","proprietary_name":"Levothyroxine sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Accord Healthcare Inc.","package_description":"1000 TABLET in 1 BOTTLE (16729-450-17)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028710","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-287-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-287-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722028790","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-287-90","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-287-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039610","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-396-10","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-396-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039611","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-396-11","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-396-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342039644","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-396-44","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (33342-396-44)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42292003801","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"42292-038","inner_of":["42292-038-20"]},"part_b":null}, {"ndc":"42292003820","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-038-20","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (42292-038-20) / 1 TABLET in 1 BLISTER PACK (42292-038-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064910","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-649-10","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Alvogen, Inc.","package_description":"1000 TABLET in 1 BOTTLE (47781-649-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781064990","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-649-90","proprietary_name":"levothyroxine sodium","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Alvogen, Inc.","package_description":"90 TABLET in 1 BOTTLE (47781-649-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687048601","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-486-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-486-01) / 1 TABLET in 1 BLISTER PACK (60687-486-11)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687048611","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-486","inner_of":["60687-486-01"]},"part_b":null}, {"ndc":"68180096801","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-968-01","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-968-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096803","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-968-03","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-968-03)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68180096809","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-968-09","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-968-09)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183301","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1833-1","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69238-1833-1)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"69238183307","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1833-7","proprietary_name":"Levothyroxine Sodium","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":".088 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (69238-1833-7)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066301","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-663-01","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET in 1 BOTTLE (72603-663-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603066302","name":"LEVOTHYROXINE 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-663-02","proprietary_name":"LEVOTHYROXINE SODIUM","nonproprietary_name":"LEVOTHYROXINE SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-663-02)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levothyroxine Sodium*|Levothyroxine Sodium","basis":"generic"},"part_b":null}, {"ndc":"60793085401","name":"LEVOXYL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-854-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-854-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.9697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085410","name":"LEVOXYL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-854-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-854-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.9697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085501","name":"LEVOXYL 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-855-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-855-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.11616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085510","name":"LEVOXYL 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-855-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-855-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.11616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085601","name":"LEVOXYL 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-856-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-856-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.12965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085610","name":"LEVOXYL 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-856-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-856-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.12965,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085701","name":"LEVOXYL 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-857-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-857-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.15032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085710","name":"LEVOXYL 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-857-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-857-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.15032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085801","name":"LEVOXYL 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-858-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-858-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.16868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085810","name":"LEVOXYL 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-858-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-858-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.16868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085901","name":"LEVOXYL 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-859-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-859-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.38792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085910","name":"LEVOXYL 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-859-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-859-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.38792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793086001","name":"LEVOXYL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-860-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-860-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.34463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793086010","name":"LEVOXYL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-860-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-860-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.34463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085001","name":"LEVOXYL 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-850-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-850-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.75283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085010","name":"LEVOXYL 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-850-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-850-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.75283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085101","name":"LEVOXYL 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-851-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-851-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.85394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085110","name":"LEVOXYL 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-851-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-851-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.85394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085201","name":"LEVOXYL 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-852-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-852-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.94482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085210","name":"LEVOXYL 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-852-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-852-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.94482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085301","name":"LEVOXYL 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-853-01","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (60793-853-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.95932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60793085310","name":"LEVOXYL 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60793-853-10","proprietary_name":"LEVOXYL","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1000 TABLET in 1 BOTTLE (60793-853-10)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":0.95932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levoxyl|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"68220011210","name":"LEVSIN 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68220-112-10","proprietary_name":"Levsin","nonproprietary_name":"hyoscyamine sulfate","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE (68220-112-10)"},"nadac":{"value":2.65588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levsin*|Hyoscyamine Sulfate","basis":"brand"},"part_b":null}, {"ndc":"68220011310","name":"LEVSIN-SL 0.125 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68220-113-10","proprietary_name":"Levsin SL","nonproprietary_name":"hyoscyamine sulfate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".125 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (68220-113-10)"},"nadac":{"value":2.7044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Levsin-Sl|Hyoscyamine Sulfate","basis":"brand"},"part_b":null}, {"ndc":"00456201001","name":"LEXAPRO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2010-01","proprietary_name":"Lexapro","nonproprietary_name":"ESCITALOPRAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0456-2010-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":15.41264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03945,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lexapro|Escitalopram Oxalate","basis":"brand"},"part_b":null}, {"ndc":"00456202001","name":"LEXAPRO 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2020-01","proprietary_name":"Lexapro","nonproprietary_name":"ESCITALOPRAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0456-2020-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":16.09413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06316,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lexapro|Escitalopram Oxalate","basis":"brand"},"part_b":null}, {"ndc":"00456200501","name":"LEXAPRO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0456-2005-01","proprietary_name":"Lexapro","nonproprietary_name":"ESCITALOPRAM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Allergan, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0456-2005-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":14.74325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04157,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lexapro|Escitalopram Oxalate","basis":"brand"},"part_b":null}, {"ndc":"54092047601","name":"LIALDA DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-476-01","proprietary_name":"Lialda","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (54092-476-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":8.94652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092047602","name":"LIALDA DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-476-02","proprietary_name":"Lialda","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"12 BOTTLE in 1 CARTON (54092-476-02) / 120 TABLET, DELAYED RELEASE in 1 BOTTLE (54092-476-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":8.94652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092047612","name":"LIALDA DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-476-12","proprietary_name":"Lialda","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (54092-476-12)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":8.94652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904734920","name":"LICE KILLING SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7349-20","proprietary_name":"Major Lice Killing","nonproprietary_name":"Piperonyl Butoxide, Pyrethrum Extract","dosage_form":"SHAMPOO","route":"TOPICAL","strength":".33 g/100mL; 4 g/100mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7349-20) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.04662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409000710","name":"LIDOCAINE 1%-EPI 1:100,000","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-0007-10","proprietary_name":"Lidocaine Hydrochloride and Epinephrine","nonproprietary_name":"LIDOCAINE HYDROCHLORIDE and EPINEPHRINE","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL; 10 ug/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (0409-0007-10) / 20 mL in 1 VIAL, MULTI-DOSE (0409-0007-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Catecholamine [EPC]","Catecholamines [CS]","Local Anesthesia [PE]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054350049","name":"LIDOCAINE 2% VISCOUS SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3500-49","proprietary_name":"Lidocaine Viscous","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL; TOPICAL","strength":"20 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (0054-3500-49) / 100 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.08249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121095003","name":"LIDOCAINE 2% VISCOUS SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0950-03","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"12 BOTTLE in 1 CASE (0121-0950-03) / 100 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.08249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135071242","name":"LIDOCAINE 2% VISCOUS SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-712-42","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"OROPHARYNGEAL","strength":"20 mg/mL","labeler":"Chartwell RX, LLC","package_description":"100 mL in 1 BOTTLE (62135-712-42)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.08249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888012526","name":"LIDOCAINE 2% VISCOUS SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-125-26","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"SOLUTION","route":"ORAL; TOPICAL","strength":"20 mg/mL","labeler":"Advagen Pharma Ltd","package_description":"100 mL in 1 BOTTLE (72888-125-26)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.08249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367020201","name":"LIDOCAINE 3% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-202-01","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"30 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-202-01) / 28.35 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.5593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367020285","name":"LIDOCAINE 3% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-202-85","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"30 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-202-85) / 85 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.36487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536126720","name":"LIDOCAINE 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1267-20","proprietary_name":"4 Lidocaine Topical Anesthetic","nonproprietary_name":"LIDOCAINE","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g","labeler":"RUGBY LABORATORIES","package_description":"15 g in 1 BOX (0536-1267-20)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.63452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536135795","name":"LIDOCAINE 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1357-95","proprietary_name":"Rugby Lidocaine","nonproprietary_name":"Lidocaine 4%","dosage_form":"CREAM","route":"TOPICAL","strength":"4 g/100g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 BOX (0536-1357-95) / 28 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.42761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"39328002415","name":"LIDOCAINE 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-024-15","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g","labeler":"Patrin Pharma Inc.","package_description":"1 TUBE in 1 CARTON (39328-024-15) / 15 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.63452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"39328002430","name":"LIDOCAINE 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-024-30","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g","labeler":"Patrin Pharma Inc.","package_description":"1 TUBE in 1 CARTON (39328-024-30) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.48988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83720052301","name":"LIDOCAINE 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83720-523-01","proprietary_name":"Lidocaine 4% Topical Anesthetic Cream","nonproprietary_name":"Lidocaine 4%","dosage_form":"CREAM","route":"TOPICAL","strength":"4 g/100g","labeler":"Oncor Pharmaceuticals","package_description":"1 TUBE in 1 CARTON (83720-523-01) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.48988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001062589","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001062593","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-625-93","proprietary_name":"Lidocaine Pain Relieving Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/g","labeler":"BluePoint Laboratories","package_description":"5 PATCH in 1 BOX (68001-625-93) / 1 g in 1 PATCH (68001-625-89)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001062595","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-625-95","proprietary_name":"Lidocaine Pain Relieving Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/g","labeler":"BluePoint Laboratories","package_description":"30 PATCH in 1 BOX (68001-625-95) / 1 g in 1 PATCH (68001-625-89)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70512001430","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-014-30","proprietary_name":"Lidocaine 4% Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/g","labeler":"SOLA Pharmaceuticals","package_description":"6 POUCH in 1 BOX (70512-014-30) / 5 g in 1 POUCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70512081201","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70512081230","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-812-30","proprietary_name":"Lidocaine 4% Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/g","labeler":"SOLA Pharmaceuticals","package_description":"30 POUCH in 1 BOX (70512-812-30) / 1 g in 1 POUCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"85477030210","name":"LIDOCAINE 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85477-302-10","proprietary_name":"Lidocaine 4% Patch","nonproprietary_name":"Lidocaine 4%","dosage_form":"PATCH","route":"TOPICAL","strength":"40 mg/g","labeler":"Oncora Pharma, LLC","package_description":"10 POUCH in 1 BOX (85477-302-10) / 1 g in 1 POUCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00168020437","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0204-37","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0204-37) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714087801","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-878-01","proprietary_name":"lidocaine","nonproprietary_name":"lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CARTON (16714-878-01) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714087802","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-878-02","proprietary_name":"lidocaine","nonproprietary_name":"lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Northstar Rx LLC","package_description":"50 g in 1 JAR (16714-878-02)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342040530","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-405-30","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-405-30) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.15356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342040535","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-405-35","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-405-35) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342040550","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-405-50","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-405-50) / 50 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672300805","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-3008-5","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 JAR in 1 CARTON (51672-3008-5) / 50 g in 1 JAR","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672302002","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-3020-2","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-3020-2) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.15356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672302009","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-3020-9","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-3020-9) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332042430","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-424-30","proprietary_name":"LIDOCAINE","nonproprietary_name":"LIDOCAINE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-424-30) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.15356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332042435","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-424-35","proprietary_name":"LIDOCAINE","nonproprietary_name":"LIDOCAINE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-424-35) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332042450","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-424-50","proprietary_name":"LIDOCAINE","nonproprietary_name":"LIDOCAINE","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"50 g in 1 JAR (62332-424-50)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162091838","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-918-38","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (65162-918-38) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162091853","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-918-53","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Amneal Pharmaceuticals LLC","package_description":"50 g in 1 JAR (65162-918-53)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877047379","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877047380","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462041820","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-418-20","proprietary_name":"lidocaine","nonproprietary_name":"lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-418-20) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462041827","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-418-27","proprietary_name":"lidocaine","nonproprietary_name":"lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"50 g in 1 JAR (68462-418-27)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69680012035","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70752011303","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-113-03","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 TUBE in 1 CARTON (70752-113-03) / 35.44 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.16213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70752011304","name":"LIDOCAINE 5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-113-04","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"OINTMENT","route":"TOPICAL","strength":"50 mg/g","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"50 g in 1 JAR (70752-113-04)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.14563,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591267911","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591267930","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2679-30","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"PATCH","route":"TOPICAL","strength":"50 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"30 POUCH in 1 CARTON (0591-2679-30) / 1 g in 1 POUCH (0591-2679-11)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591352511","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591352530","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3525-30","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"PATCH","route":"TOPICAL","strength":"50 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"30 POUCH in 1 CARTON (0591-3525-30) / 1 g in 1 POUCH (0591-3525-11)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603188010","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lidocaine|Lidocaine","basis":"generic"},"part_b":null}, {"ndc":"00603188016","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-1880-16","proprietary_name":"Lidocaine","nonproprietary_name":"lidocaine","dosage_form":"PATCH","route":"CUTANEOUS","strength":"50 mg/g","labeler":"Par Health USA, LLC","package_description":"30 POUCH in 1 CARTON (0603-1880-16) / .7 g in 1 POUCH (0603-1880-10)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lidocaine|Lidocaine","basis":"generic"},"part_b":null}, {"ndc":"59088039654","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59088039682","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162079104","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162079108","name":"LIDOCAINE 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-791-08","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine","dosage_form":"PATCH","route":"TOPICAL","strength":"700 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 POUCH in 1 CARTON (65162-791-08) / 1 PATCH in 1 POUCH (65162-791-04)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"39328002515","name":"LIDOCAINE ANORECTAL 5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-025-15","proprietary_name":"Lidocaine Anorectal","nonproprietary_name":"Lidocaine","dosage_form":"CREAM","route":"RECTAL","strength":"50 mg/g","labeler":"Patrin Pharma, Inc","package_description":"1 TUBE in 1 CARTON (39328-025-15) / 15 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.24873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"39328002530","name":"LIDOCAINE ANORECTAL 5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-025-30","proprietary_name":"Lidocaine Anorectal","nonproprietary_name":"Lidocaine","dosage_form":"CREAM","route":"RECTAL","strength":"50 mg/g","labeler":"Patrin Pharma, Inc","package_description":"1 TUBE in 1 CARTON (39328-025-30) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.39868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75834014130","name":"LIDOCAINE ANORECTAL 5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.39868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75834033330","name":"LIDOCAINE ANORECTAL 5% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-333-30","proprietary_name":"lidocaine","nonproprietary_name":"lidocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"30 g in 1 TUBE (75834-333-30)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.39868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"55150025124","name":"LIDOCAINE HCL 1% 100 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-251-24","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-251-24) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.13782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634065110","name":"LIDOCAINE HCL 1% 100 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-651-10","proprietary_name":"lidocaine hydrochloride","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Avenacy, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (83634-651-10) / 10 mL in 1 VIAL, MULTI-DOSE (83634-651-41)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.13782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011731","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-117-31","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (31722-117-31) / 2 mL in 1 VIAL, SINGLE-DOSE (31722-117-02)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011734","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-117-34","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (31722-117-34) / 2 mL in 1 VIAL, SINGLE-DOSE (31722-117-02)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.83792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016102","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-161-02","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-161-02) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.83792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016109","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-161-09","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-161-09) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.83792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756064025","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-640-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"25 VIAL in 1 CARTON (70756-640-25) / 2 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603035010","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-350-10","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"NorthStar RxLLC","package_description":"10 VIAL in 1 CARTON (72603-350-10) / 2 mL in 1 VIAL (72603-350-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.83792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603035025","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-350-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL in 1 CARTON (72603-350-25) / 2 mL in 1 VIAL (72603-350-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634065302","name":"LIDOCAINE HCL 1% 20 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-653-02","proprietary_name":"lidocaine hydrochloride","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Avenacy, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (83634-653-02) / 2 mL in 1 VIAL, SINGLE-DOSE (83634-653-41)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155094041","name":"LIDOCAINE HCL 1% 200 MG/20 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-940-41","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (23155-940-41) / 20 mL in 1 VIAL, MULTI-DOSE (23155-940-31)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150025224","name":"LIDOCAINE HCL 1% 200 MG/20 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-252-24","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-252-24) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603072225","name":"LIDOCAINE HCL 1% 200 MG/20 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-722-25","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72603-722-25) / 20 mL in 1 VIAL, MULTI-DOSE (72603-722-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634065120","name":"LIDOCAINE HCL 1% 200 MG/20 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-651-20","proprietary_name":"lidocaine hydrochloride","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Avenacy, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (83634-651-20) / 20 mL in 1 VIAL, MULTI-DOSE (83634-651-42)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409427916","name":"LIDOCAINE HCL 1% 300 MG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.06812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011730","name":"LIDOCAINE HCL 1% 300 MG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.06812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016300","name":"LIDOCAINE HCL 1% 300 MG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-163-00","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (55150-163-00) / 30 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016330","name":"LIDOCAINE HCL 1% 300 MG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-163-30","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (55150-163-30) / 30 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634065343","name":"LIDOCAINE HCL 1% 300 MG/30 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.06812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016205","name":"LIDOCAINE HCL 1% 50 MG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-162-05","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-162-05) / 5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011735","name":"LIDOCAINE HCL 1% 50 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-117-35","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (31722-117-35) / 5 mL in 1 VIAL, SINGLE-DOSE (31722-117-05)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016209","name":"LIDOCAINE HCL 1% 50 MG/5 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-162-09","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-162-09) / 5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.33305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603073225","name":"LIDOCAINE HCL 1% 500 MG/50 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-732-25","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72603-732-25) / 50 mL in 1 VIAL, MULTI-DOSE (72603-732-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634065150","name":"LIDOCAINE HCL 1% 500 MG/50 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83634-651-50","proprietary_name":"lidocaine hydrochloride","nonproprietary_name":"lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Avenacy, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (83634-651-50) / 50 mL in 1 VIAL, MULTI-DOSE (83634-651-43)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143957710","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9577-10","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 PACKAGE (0143-9577-10) / 50 mL in 1 VIAL, MULTI-DOSE (0143-9577-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409427601","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4276-01","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"LIDOCAINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0409-4276-01) / 20 mL in 1 VIAL, MULTI-DOSE (0409-4276-16)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409427602","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-4276-02","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"LIDOCAINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0409-4276-02) / 50 mL in 1 VIAL, MULTI-DOSE (0409-4276-17)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011631","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-116-31","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (31722-116-31) / 20 mL in 1 VIAL, MULTI-DOSE (31722-116-20)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011633","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-116-33","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (31722-116-33) / 50 mL in 1 VIAL, MULTI-DOSE (31722-116-50)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011634","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-116-34","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (31722-116-34) / 50 mL in 1 VIAL, MULTI-DOSE (31722-116-50)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150025110","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-251-10","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-251-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.13782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150025220","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-252-20","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-252-20) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150025350","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-253-50","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-253-50) / 50 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63323020110","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-201-10","proprietary_name":"Lidocaine","nonproprietary_name":"LIDOCAINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-201-10) / 10 mL in 1 VIAL (63323-201-03)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.13782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756064525","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-645-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"25 VIAL in 1 CARTON (70756-645-25) / 10 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.13782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756064625","name":"LIDOCAINE HCL 1% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-646-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"10 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"25 VIAL in 1 CARTON (70756-646-25) / 20 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.06996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603082510","name":"LIDOCAINE HCL 2% 1,000 MG/50 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-825-10","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"NorthStar RxLLC","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (72603-825-10) / 50 mL in 1 VIAL, MULTI-DOSE (72603-825-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409206605","name":"LIDOCAINE HCL 2% 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-2066-05","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2066-05) / 5 mL in 1 VIAL, SINGLE-DOSE (0409-2066-10)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011834","name":"LIDOCAINE HCL 2% 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-118-34","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (31722-118-34) / 5 mL in 1 VIAL, SINGLE-DOSE (31722-118-05)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016505","name":"LIDOCAINE HCL 2% 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-165-05","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-165-05) / 5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150016509","name":"LIDOCAINE HCL 2% 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-165-09","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-165-09) / 5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603050510","name":"LIDOCAINE HCL 2% 100 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-505-10","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"NorthStar RxLLC","package_description":"10 VIAL in 1 CARTON (72603-505-10) / 5 mL in 1 VIAL (72603-505-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722011831","name":"LIDOCAINE HCL 2% 40 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-118-31","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (31722-118-31) / 2 mL in 1 VIAL, SINGLE-DOSE (31722-118-02)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756064225","name":"LIDOCAINE HCL 2% 40 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70756-642-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"25 VIAL in 1 CARTON (70756-642-25) / 2 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603041025","name":"LIDOCAINE HCL 2% 40 MG/2 ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-410-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"EPIDURAL; INFILTRATION; INTRACAUDAL; PERINEURAL","strength":"20 mg/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL in 1 CARTON (72603-410-25) / 2 mL in 1 VIAL (72603-410-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.34867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150025524","name":"LIDOCAINE HCL 2% 400 MG/20 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-255-24","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-255-24) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603074425","name":"LIDOCAINE HCL 2% 400 MG/20 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-744-25","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"NorthStar RxLLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72603-744-25) / 20 mL in 1 VIAL, MULTI-DOSE (72603-744-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76329301105","name":"LIDOCAINE HCL 2% JEL UROJET AC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76329-3011-5","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"JELLY","route":"TOPICAL","strength":"20 mg/mL","labeler":"International Medication Systems, Limited","package_description":"25 VIAL, SINGLE-USE in 1 BOX (76329-3011-5) / 5 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.16656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485061130","name":"LIDOCAINE HCL 2% JELLY","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-611-30","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"JELLY","route":"TOPICAL","strength":"20 mg/mL","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (72485-611-30) / 30 mL in 1 TUBE, WITH APPLICATOR","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":3.2257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76329301205","name":"LIDOCAINE HCL 2% JELLY URO-JET","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76329-3012-5","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"JELLY","route":"TOPICAL","strength":"20 mg/mL","labeler":"International Medication Systems, Limited","package_description":"25 VIAL, SINGLE-USE in 1 BOX (76329-3012-5) / 5 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.16656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76329301305","name":"LIDOCAINE HCL 2% JELLY URO-JET","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"76329-3013-5","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"JELLY","route":"TOPICAL","strength":"20 mg/mL","labeler":"International Medication Systems, Limited","package_description":"25 VIAL, SINGLE-USE in 1 BOX (76329-3013-5) / 10 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.70396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143957510","name":"LIDOCAINE HCL 2% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9575-10","proprietary_name":"Lidocaine","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 PACKAGE (0143-9575-10) / 50 mL in 1 VIAL, MULTI-DOSE (0143-9575-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409427701","name":"LIDOCAINE HCL 2% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4277-01","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"LIDOCAINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0409-4277-01) / 20 mL in 1 VIAL, MULTI-DOSE (0409-4277-16)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722021731","name":"LIDOCAINE HCL 2% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-217-31","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (31722-217-31) / 20 mL in 1 VIAL, MULTI-DOSE (31722-217-20)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722021733","name":"LIDOCAINE HCL 2% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-217-33","proprietary_name":"Lidocaine hydrochloride","nonproprietary_name":"Lidocaine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (31722-217-33) / 50 mL in 1 VIAL, MULTI-DOSE (31722-217-50)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150025520","name":"LIDOCAINE HCL 2% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-255-20","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-255-20) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756064825","name":"LIDOCAINE HCL 2% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-648-25","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INFILTRATION; PERINEURAL","strength":"20 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"25 VIAL in 1 CARTON (70756-648-25) / 20 mL in 1 VIAL","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.07624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000009801","name":"LIDOCAINE HCL 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0098-1","proprietary_name":"Leader","nonproprietary_name":"Lidocaine HCL","dosage_form":"CREAM","route":"TOPICAL","strength":"4 g/100g","labeler":"Cardinal Health","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0098-1) / 76.5 g in 1 BOTTLE, PLASTIC","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"87137010107","name":"LIDOCAINE HCL 4% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"87137-101-07","proprietary_name":"Lidocaine HCL","nonproprietary_name":"Lidocaine HCL","dosage_form":"CREAM","route":"TOPICAL","strength":"4 g/100g","labeler":"Matthias Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (87137-101-07) / 76.5 g in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.05211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00054350547","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3505-47","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"50 mL in 1 BOTTLE (0054-3505-47)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116402550","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4025-50","proprietary_name":"LIDOCAINE HYDROCHLORIDE","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Xttrium Laboratories, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (0116-4025-50) / 50 mL in 1 BOTTLE, GLASS","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121097251","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0972-51","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"1 BOTTLE, GLASS in 1 CARTON (0121-0972-51) / 50 mL in 1 BOTTLE, GLASS","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527600480","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-6004-80","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"40 mg/mL","labeler":"Lannett Company, Inc.","package_description":"1 BOTTLE in 1 CARTON (0527-6004-80) / 50 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672141103","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1411-3","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-1411-3) / 50 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63739099764","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63739-997-64","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"McKesson Corporation dba SKY Packaging","package_description":"1 BOTTLE in 1 CARTON (63739-997-64) / 50 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954051810","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-518-10","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"Novitium Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70954-518-10) / 50 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83148004350","name":"LIDOCAINE HCL 4% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83148-043-50","proprietary_name":"Lidocaine Hydrochloride","nonproprietary_name":"Lidocaine Hydrochloride","dosage_form":"SOLUTION","route":"TOPICAL","strength":"40 mg/mL","labeler":"The J. Molner Company LLC","package_description":"1 BOTTLE in 1 CARTON (83148-043-50) / 50 mL in 1 BOTTLE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.22203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121097001","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121097030","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0970-30","proprietary_name":"Lidocaine Pain Relief","nonproprietary_name":"Lidocaine Pain Relief","dosage_form":"PATCH","route":"TOPICAL","strength":"560 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"6 CARTON in 1 CASE (0121-0970-30) / 30 POUCH in 1 CARTON / 1 PATCH in 1 POUCH (0121-0970-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536120207","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1202-07","proprietary_name":"Rugby PAIN RELIEF PATCHES","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"RUGBY LABORATORIES","package_description":"30 PATCH in 1 CARTON (0536-1202-07) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536120215","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1202-15","proprietary_name":"Rugby PAIN RELIEF PATCHES","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"RUGBY LABORATORIES","package_description":"5 PATCH in 1 CARTON (0536-1202-15) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536120229","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1202-29","proprietary_name":"Rugby PAIN RELIEF PATCHES","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"RUGBY LABORATORIES","package_description":"100 PATCH in 1 CARTON (0536-1202-29) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122045021","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-450-21","proprietary_name":"PAIN RELIEF PATCHES","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Amerisource Bergen","package_description":"5 PATCH in 1 CARTON (46122-450-21) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000036601","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0366-1","proprietary_name":"Leader PAIN RELIEF PATCHES","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"5 PATCH in 1 CARTON (70000-0366-1) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000055701","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0557-1","proprietary_name":"Leader PAIN RELIEF PATCHES","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"6 PATCH in 1 CARTON (70000-0557-1) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000074001","name":"LIDOCAINE PAIN RELIEF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0740-1","proprietary_name":"Lidocaine Pain Relief","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"6 PATCH in 1 CARTON (70000-0740-1) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367039701","name":"LIDOCAINE-HC 3-0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-397-01","proprietary_name":"Lidocaine Hydrochloride and Hydrocortisone Acetate","nonproprietary_name":"Lidocaine Hydrochloride and Hydrocortisone Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"30 mg/g; 5 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-397-01) / 28.35 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.64217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367039785","name":"LIDOCAINE-HC 3-0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69367-397-85","proprietary_name":"Lidocaine Hydrochloride and Hydrocortisone Acetate","nonproprietary_name":"Lidocaine Hydrochloride and Hydrocortisone Acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"30 mg/g; 5 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-397-85) / 85 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.22373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168035730","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0357-30","proprietary_name":"Lidocaine and Prilocaine","nonproprietary_name":"lidocaine and prilocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0357-30) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.2317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"00168035755","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0168-0357-55","proprietary_name":"Lidocaine and Prilocaine","nonproprietary_name":"lidocaine and prilocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0357-55) / 5 g in 1 TUBE (0168-0357-05)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.33527,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"00574204230","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2042-30","proprietary_name":"LIDOCAINE AND PRILOCAINE","nonproprietary_name":"Lidocaine and Prilocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2042-30) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.2317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"21922007605","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-076-05","proprietary_name":"LIDOCAINE AND PRILOCAINE LIDOCAINE AND PRILOCAINE","nonproprietary_name":"LIDOCAINE AND PRILOCAINE","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-076-05) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.2317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"62332058204","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-582-04","proprietary_name":"Lidocaine and Prilocaine","nonproprietary_name":"Lidocaine and Prilocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-582-04) / 5 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.33527,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"62332058231","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-582-31","proprietary_name":"Lidocaine and Prilocaine","nonproprietary_name":"Lidocaine and Prilocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-582-31) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.2317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"72578016506","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-165-06","proprietary_name":"Lidocaine and prilocaine","nonproprietary_name":"Lidocaine and prilocaine","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g; 25 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-165-06) / 30 g in 1 TUBE","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":0.2317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"81033002551","name":"LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":1.33527,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lidocaine-Prilocaine|Lidocaine/Prilocaine","basis":"generic"},"part_b":null}, {"ndc":"59088091054","name":"LIDOCAN IV 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59088-910-54","proprietary_name":"Lidocan IV","nonproprietary_name":"Lidocaine 5%","dosage_form":"PATCH","route":"TOPICAL","strength":"50 mg/g","labeler":"PURETEK CORPORATION","package_description":"30 POUCH in 1 PACKAGE (59088-910-54) / 14 g in 1 POUCH (59088-910-84)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lidocan IV|Lidocaine","basis":"brand"},"part_b":null}, {"ndc":"59088091084","name":"LIDOCAN IV 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lidocan IV|Lidocaine","basis":"brand"},"part_b":null}, {"ndc":"71656006620","name":"LIKMEZ 500 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-066-20","proprietary_name":"LIKMEZ","nonproprietary_name":"Metronidazole Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"200 mL in 1 BOTTLE (71656-066-20)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.60822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656006675","name":"LIKMEZ 500 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-066-75","proprietary_name":"LIKMEZ","nonproprietary_name":"Metronidazole Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"75 mL in 1 BOTTLE (71656-066-75)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.60124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054031950","name":"LINEZOLID 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0319-50","proprietary_name":"Linezolid","nonproprietary_name":"linezolid","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"150 mL in 1 BOTTLE (0054-0319-50)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":2.73583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722086525","name":"LINEZOLID 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-865-25","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (31722-865-25) / 150 mL in 1 BOTTLE, GLASS","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":2.73583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762130804","name":"LINEZOLID 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1308-4","proprietary_name":"Linezolid","nonproprietary_name":"linezolid","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"150 mL in 1 BOTTLE (59762-1308-4)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":2.73583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60687075405","name":"LINEZOLID 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-754-05","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"American Health Packaging","package_description":"1 BOTTLE, GLASS in 1 CARTON (60687-754-05) / 150 mL in 1 BOTTLE, GLASS","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":2.73583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904655304","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6553-04","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6553-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722074920","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-749-20","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (31722-749-20)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687030911","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687030921","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-309-21","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-309-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-309-11)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135044220","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-442-20","proprietary_name":"linezolid","nonproprietary_name":"linezolid","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET in 1 BOTTLE (62135-442-20)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056102","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-561-02","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"20 TABLET in 1 BOTTLE (64980-561-02)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980056103","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-561-03","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-561-03)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877041920","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-419-20","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (67877-419-20)","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877041933","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-419-33","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1 BLISTER PACK in 1 CARTON (67877-419-33) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877041984","name":"LINEZOLID 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-419-84","proprietary_name":"Linezolid","nonproprietary_name":"Linezolid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"3 BLISTER PACK in 1 CARTON (67877-419-84) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":1.44111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00456120130","name":"LINZESS 145 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1201-30","proprietary_name":"Linzess","nonproprietary_name":"linaclotide","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"145 ug/1","labeler":"Allergan, Inc.","package_description":"1 BOTTLE in 1 CARTON (0456-1201-30) / 30 CAPSULE, GELATIN COATED in 1 BOTTLE","pharm_classes":["Guanylate Cyclase Activators [MoA]","Guanylate Cyclase-C Agonist [EPC]"]},"nadac":{"value":9.01992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Linzess|Linaclotide","basis":"brand"},"part_b":null}, {"ndc":"00456120230","name":"LINZESS 290 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1202-30","proprietary_name":"Linzess","nonproprietary_name":"linaclotide","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"290 ug/1","labeler":"Allergan, Inc.","package_description":"1 BOTTLE in 1 CARTON (0456-1202-30) / 30 CAPSULE, GELATIN COATED in 1 BOTTLE","pharm_classes":["Guanylate Cyclase Activators [MoA]","Guanylate Cyclase-C Agonist [EPC]"]},"nadac":{"value":9.01543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Linzess|Linaclotide","basis":"brand"},"part_b":null}, {"ndc":"00456120330","name":"LINZESS 72 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1203-30","proprietary_name":"Linzess","nonproprietary_name":"linaclotide","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"72 ug/1","labeler":"Allergan, Inc.","package_description":"1 BOTTLE in 1 CARTON (0456-1203-30) / 30 CAPSULE, GELATIN COATED in 1 BOTTLE","pharm_classes":["Guanylate Cyclase Activators [MoA]","Guanylate Cyclase-C Agonist [EPC]"]},"nadac":{"value":9.01079,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Linzess|Linaclotide","basis":"brand"},"part_b":null}, {"ndc":"42794013212","name":"LIOMNY 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-132-12","proprietary_name":"Liomny","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"90 TABLET in 1 BOTTLE (42794-132-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794013112","name":"LIOMNY 5 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-131-12","proprietary_name":"Liomny","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"90 TABLET in 1 BOTTLE (42794-131-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794013312","name":"LIOMNY 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-133-12","proprietary_name":"Liomny","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"90 TABLET in 1 BOTTLE (42794-133-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093217801","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2178-01","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2178-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714016701","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-167-01","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-167-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794001902","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-019-02","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE (42794-019-02)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794001906","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-019-06","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"1000 TABLET in 1 BOTTLE (42794-019-06)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794001912","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-019-12","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"90 TABLET in 1 BOTTLE (42794-019-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"59762120701","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1207-1","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1207-1)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"62756059088","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-590-88","proprietary_name":"liothyronine sodium","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (62756-590-88)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68382058301","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-583-01","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-583-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377011512","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-115-12","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (70377-115-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"75907000101","name":"LIOTHYRONINE SOD 25 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-001-01","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75907-001-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.29408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093217901","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2179-01","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2179-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714016601","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-166-01","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-166-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794001802","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-018-02","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE (42794-018-02)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794001806","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-018-06","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"1000 TABLET in 1 BOTTLE (42794-018-06)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794001812","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-018-12","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"90 TABLET in 1 BOTTLE (42794-018-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"59762120601","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1206-1","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1206-1)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"62756058988","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-589-88","proprietary_name":"liothyronine sodium","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (62756-589-88)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68382058201","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-582-01","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-582-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377011412","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-114-12","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (70377-114-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"75907003901","name":"LIOTHYRONINE SOD 5 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-039-01","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 ug/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75907-039-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093218001","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2180-01","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2180-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714016801","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-168-01","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-168-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794002002","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-020-02","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE (42794-020-02)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"42794002012","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-020-12","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"SIGMAPHARM LABORATORIES, LLC","package_description":"90 TABLET in 1 BOTTLE (42794-020-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"59762120801","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1208-1","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-1208-1)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"62756059188","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-591-88","proprietary_name":"liothyronine sodium","nonproprietary_name":"liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (62756-591-88)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"68382058401","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-584-01","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-584-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377011612","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-116-12","proprietary_name":"Liothyronine sodium","nonproprietary_name":"Liothyronine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Biocon Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (70377-116-12)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"75907000401","name":"LIOTHYRONINE SOD 50 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-004-01","proprietary_name":"Liothyronine Sodium","nonproprietary_name":"Liothyronine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75907-004-01)","pharm_classes":["Triiodothyronine [CS]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.36222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Liothyronine Sodium*|Liothyronine Sodium","basis":"generic"},"part_b":null}, {"ndc":"58151015577","name":"LIPITOR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-155-77","proprietary_name":"Lipitor","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (58151-155-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":13.40831,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02283,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lipitor|Atorvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"58151015677","name":"LIPITOR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-156-77","proprietary_name":"Lipitor","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (58151-156-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":19.07256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02792,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lipitor|Atorvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"58151015777","name":"LIPITOR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-157-77","proprietary_name":"Lipitor","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (58151-157-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":19.11383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03743,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lipitor|Atorvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"58151015877","name":"LIPITOR 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-158-77","proprietary_name":"Lipitor","nonproprietary_name":"atorvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (58151-158-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":19.00394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06926,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lipitor|Atorvastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"70000059901","name":"LIQUID BANDAGE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0599-1","proprietary_name":"Leader Liquid Bandage","nonproprietary_name":"Benzethonium chloride Dyclonine hydrochloride","dosage_form":"LIQUID","route":"TOPICAL","strength":".2 mg/10mL; .75 mg/10mL","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"10 mL in 1 BOTTLE, WITH APPLICATOR (70000-0599-1)"},"nadac":{"value":0.11824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000033201","name":"LIQUID CORN-CALLUS REMOVER","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0332-1","proprietary_name":"Salicylic Acid","nonproprietary_name":"Liquid Corn and Callus Remover","dosage_form":"LIQUID","route":"TOPICAL","strength":"17 g/100mL","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (70000-0332-1) / 9.8 mL in 1 BOTTLE, WITH APPLICATOR"},"nadac":{"value":0.26427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122036229","name":"LIQUID WART REMOVER 17% LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-362-29","proprietary_name":"Salicylic Acid","nonproprietary_name":"Liquid Wart Remover","dosage_form":"LIQUID","route":"TOPICAL","strength":".17 g/9mL","labeler":"AmerisourceBergen","package_description":"9 mL in 1 BOTTLE, WITH APPLICATOR (46122-362-29)"},"nadac":{"value":0.36632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143914402","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9144-02","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (0143-9144-02) / 3 mL in 1 SYRINGE, PLASTIC (0143-9144-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"00480366720","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3667-20","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (0480-3667-20) / 3 mL in 1 SYRINGE, PLASTIC (0480-3667-19)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"69097092067","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-920-67","proprietary_name":"LIRAGLUTIDE","nonproprietary_name":"LIRAGLUTIDE","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Cipla USA Inc.","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (69097-920-67) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"70377009452","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-094-52","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Biocon Pharma Inc.","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (70377-094-52) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"70748034602","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-346-02","proprietary_name":"Liraglutide","nonproprietary_name":"Liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (70748-346-02) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"71288056385","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-563-85","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (71288-563-85) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"72603074502","name":"LIRAGLUTIDE 2-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-745-02","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"NorthStar Rx LLC","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (72603-745-02) / 3 mL in 1 SYRINGE, PLASTIC (72603-745-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"00143914403","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9144-03","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (0143-9144-03) / 3 mL in 1 SYRINGE, PLASTIC (0143-9144-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"00480366722","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3667-22","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (0480-3667-22) / 3 mL in 1 SYRINGE, PLASTIC (0480-3667-19)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"69097092068","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-920-68","proprietary_name":"LIRAGLUTIDE","nonproprietary_name":"LIRAGLUTIDE","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Cipla USA Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (69097-920-68) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"70377009453","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-094-53","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Biocon Pharma Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (70377-094-53) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"70748034603","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-346-03","proprietary_name":"Liraglutide","nonproprietary_name":"Liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (70748-346-03) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"71288056384","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-563-84","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (71288-563-84) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"72603074503","name":"LIRAGLUTIDE 3-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-745-03","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"NorthStar Rx LLC","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (72603-745-03) / 3 mL in 1 SYRINGE, PLASTIC (72603-745-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"00480725046","name":"LIRAGLUTIDE 5-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7250-46","proprietary_name":"Liraglutide","nonproprietary_name":"Liraglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Teva Pharmaceuticals, Inc.","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0480-7250-46) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":49.24809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"69097091055","name":"LIRAGLUTIDE 5-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-910-55","proprietary_name":"liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Cipla USA Inc.","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (69097-910-55) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":49.24809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"70377009553","name":"LIRAGLUTIDE 5-PAK 18 MG/3 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-095-53","proprietary_name":"Liraglutide","nonproprietary_name":"liraglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Biocon Pharma Inc.","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (70377-095-53) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":49.24809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Liraglutide|Liraglutide","basis":"generic"},"part_b":null}, {"ndc":"00054066025","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0660-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0660-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378685477","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6854-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6854-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511101","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5111-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5111-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480356501","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3565-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3565-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466137","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4661-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4661-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781229901","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2299-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2299-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035001","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-350-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-350-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016101","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-161-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-161-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060210","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-602-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-602-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056201","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-562-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-562-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664004688","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-046-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-046-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505473901","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4739-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4739-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055001","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-550-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-550-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010020601","name":"LISDEXAMFETAMINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-206-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-206-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406512401","name":"LISDEXAMFETAMINE 10 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5124-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0406-5124-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480973701","name":"LISDEXAMFETAMINE 10 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9737-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0480-9737-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722032101","name":"LISDEXAMFETAMINE 10 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-321-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-321-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664008388","name":"LISDEXAMFETAMINE 10 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-083-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (57664-083-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021401","name":"LISDEXAMFETAMINE 10 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-214-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70010-214-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"72205013291","name":"LISDEXAMFETAMINE 10 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-132-91","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (72205-132-91)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00054037025","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0370-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0370-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378685577","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6855-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6855-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511201","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5112-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5112-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480356601","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3566-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3566-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466237","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4662-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4662-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781247601","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2476-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2476-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035101","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-351-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-351-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016201","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-162-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-162-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060310","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-603-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-603-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056301","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-563-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-563-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664004788","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-047-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-047-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505474001","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4740-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4740-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687089611","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687089621","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-896-21","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-896-21) / 1 CAPSULE in 1 BLISTER PACK (60687-896-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055101","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-551-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-551-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"65162002309","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-023-09","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-023-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010020701","name":"LISDEXAMFETAMINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-207-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-207-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406512501","name":"LISDEXAMFETAMINE 20 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5125-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0406-5125-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480973801","name":"LISDEXAMFETAMINE 20 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9738-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0480-9738-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722032201","name":"LISDEXAMFETAMINE 20 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-322-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-322-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664008488","name":"LISDEXAMFETAMINE 20 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-084-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (57664-084-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021501","name":"LISDEXAMFETAMINE 20 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-215-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70010-215-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"72205013391","name":"LISDEXAMFETAMINE 20 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-133-91","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (72205-133-91)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00054037125","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0371-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0371-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378685677","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6856-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6856-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511301","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5113-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5113-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480356701","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3567-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3567-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466337","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4663-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4663-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781247701","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2477-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2477-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035201","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-352-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-352-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016301","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-163-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-163-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060410","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-604-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-604-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056401","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-564-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-564-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664004888","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-048-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-048-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505474101","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4741-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4741-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687090711","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687090721","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-907-21","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-907-21) / 1 CAPSULE in 1 BLISTER PACK (60687-907-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055201","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-552-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-552-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"65162002409","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-024-09","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-024-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010020801","name":"LISDEXAMFETAMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-208-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-208-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406512601","name":"LISDEXAMFETAMINE 30 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5126-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0406-5126-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480973901","name":"LISDEXAMFETAMINE 30 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9739-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0480-9739-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722032301","name":"LISDEXAMFETAMINE 30 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-323-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-323-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664008588","name":"LISDEXAMFETAMINE 30 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-085-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (57664-085-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021601","name":"LISDEXAMFETAMINE 30 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-216-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70010-216-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"72205013491","name":"LISDEXAMFETAMINE 30 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-134-91","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (72205-134-91)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00054037225","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0372-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0372-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378685777","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6857-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6857-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511401","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5114-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5114-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480356801","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3568-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3568-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466437","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4664-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4664-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781247801","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2478-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2478-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035301","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-353-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-353-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016401","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-164-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-164-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060510","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-605-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-605-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056501","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-565-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-565-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664004988","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-049-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-049-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505474201","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4742-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4742-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687091811","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687091821","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-918-21","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-918-21) / 1 CAPSULE in 1 BLISTER PACK (60687-918-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055301","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-553-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-553-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"65162002509","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-025-09","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-025-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010020901","name":"LISDEXAMFETAMINE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-209-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-209-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406512701","name":"LISDEXAMFETAMINE 40 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5127-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0406-5127-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480974101","name":"LISDEXAMFETAMINE 40 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9741-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0480-9741-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722032401","name":"LISDEXAMFETAMINE 40 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-324-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-324-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664008688","name":"LISDEXAMFETAMINE 40 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-086-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (57664-086-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021701","name":"LISDEXAMFETAMINE 40 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-217-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70010-217-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"72205013591","name":"LISDEXAMFETAMINE 40 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-135-91","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (72205-135-91)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00054037325","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0373-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0373-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378685877","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6858-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6858-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511501","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5115-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5115-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480356901","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3569-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3569-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466537","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4665-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4665-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781247901","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2479-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2479-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035401","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-354-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-354-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016501","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-165-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-165-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060610","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-606-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-606-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056601","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-566-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-566-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664005088","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-050-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-050-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505474301","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4743-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4743-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687092911","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687092921","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-929-21","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-929-21) / 1 CAPSULE in 1 BLISTER PACK (60687-929-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055401","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-554-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-554-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"65162002609","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-026-09","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-026-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021001","name":"LISDEXAMFETAMINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-210-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-210-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406512801","name":"LISDEXAMFETAMINE 50 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5128-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0406-5128-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480974201","name":"LISDEXAMFETAMINE 50 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9742-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0480-9742-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722032501","name":"LISDEXAMFETAMINE 50 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-325-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-325-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664008788","name":"LISDEXAMFETAMINE 50 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-087-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (57664-087-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021801","name":"LISDEXAMFETAMINE 50 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-218-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70010-218-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"72205013691","name":"LISDEXAMFETAMINE 50 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-136-91","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (72205-136-91)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00054037425","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0374-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0374-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378685977","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6859-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6859-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511601","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5116-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5116-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480357001","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3570-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3570-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466637","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4666-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4666-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781248001","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2480-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2480-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035501","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-355-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-355-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016601","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-166-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-166-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060710","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-607-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-607-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056701","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-567-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-567-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664005188","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-051-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-051-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505474401","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4744-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4744-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687094011","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687094021","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-940-21","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-940-21) / 1 CAPSULE in 1 BLISTER PACK (60687-940-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055501","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-555-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-555-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"65162002709","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-027-09","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-027-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021101","name":"LISDEXAMFETAMINE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-211-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-211-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406512901","name":"LISDEXAMFETAMINE 60 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5129-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0406-5129-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480974401","name":"LISDEXAMFETAMINE 60 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9744-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0480-9744-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722032601","name":"LISDEXAMFETAMINE 60 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-326-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-326-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664008888","name":"LISDEXAMFETAMINE 60 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-088-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (57664-088-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021901","name":"LISDEXAMFETAMINE 60 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-219-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (70010-219-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"72205013791","name":"LISDEXAMFETAMINE 60 MG TB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-137-91","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (72205-137-91)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00054037525","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0375-25","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0375-25)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00378686077","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6860-77","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (0378-6860-77)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00406511701","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5117-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-5117-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00480356401","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3564-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0480-3564-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00527466737","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4667-37","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0527-4667-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00781248101","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2481-01","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2481-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"31722035601","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-356-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-356-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"42858016701","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-167-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (42858-167-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"43547060810","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-608-10","proprietary_name":"Lisdexamfetamine dimesylate","nonproprietary_name":"Lisdexamfetamine dimesylate capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 CAPSULE in 1 BOTTLE (43547-608-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"47781056801","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-568-01","proprietary_name":"lisdexamfetamine dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-568-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"57664005288","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-052-88","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57664-052-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60505474501","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4745-1","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine Dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Apotex Corp.","package_description":"100 CAPSULE in 1 BOTTLE (60505-4745-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687095111","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"60687095121","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-951-21","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"Lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-951-21) / 1 CAPSULE in 1 BLISTER PACK (60687-951-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"64850055601","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-556-01","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-556-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"65162002809","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-028-09","proprietary_name":"Lisdexamfetamine Dimesylate","nonproprietary_name":"Lisdexamfetamine","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (65162-028-09)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"70010021201","name":"LISDEXAMFETAMINE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-212-01","proprietary_name":"LISDEXAMFETAMINE DIMESYLATE","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-212-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisdexamfetamine Dimesylate|Lisdexamfetamine Dimesylate","basis":"generic"},"part_b":null}, {"ndc":"00591040701","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0407-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0407-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040710","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0407-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0407-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00904679861","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6798-61","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6798-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087801","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-878-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"100 TABLET in 1 BOTTLE (23155-878-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087810","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-878-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"1000 TABLET in 1 BOTTLE (23155-878-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017701","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-177-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-177-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017710","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-177-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-177-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035310","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-353-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-353-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035311","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-353-11","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-353-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041610","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-416-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-416-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041611","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-416-11","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-416-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687032501","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-325-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-325-01) / 1 TABLET in 1 BLISTER PACK (60687-325-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687032511","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064231","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-642-31","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-642-31)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064290","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-642-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-642-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033400","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-334-00","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-334-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033408","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-334-08","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-334-08)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098001","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-980-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-980-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098003","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-980-03","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-980-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098030","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-980-30","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-980-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645055254","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645058754","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645061090","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-610-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-610-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041901","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-419-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-419-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041910","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-419-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-419-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041945","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-419-45","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"45 TABLET in 1 BOTTLE (76282-419-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041950","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-419-50","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"5000 TABLET in 1 BOTTLE (76282-419-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041990","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-419-90","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-419-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073001","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-730-01","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (76282-730-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073010","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-730-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"1000 TABLET in 1 BOTTLE (76282-730-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073045","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-730-45","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"45 TABLET in 1 BOTTLE (76282-730-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073050","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-730-50","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"5000 TABLET in 1 BOTTLE (76282-730-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073090","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-730-90","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"90 TABLET in 1 BOTTLE (76282-730-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"82009006410","name":"LISINOPRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-064-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-064-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040501","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0405-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0405-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040505","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0405-05","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0405-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087601","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-876-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"100 TABLET in 1 BOTTLE (23155-876-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087605","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-876-05","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"500 TABLET in 1 BOTTLE (23155-876-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017201","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-172-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-172-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017205","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-172-05","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-172-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035110","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-351-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-351-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035150","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-351-50","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-351-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041410","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-414-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-414-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041450","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-414-50","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-414-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687065611","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687065621","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-656-21","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-656-21) / 1 TABLET in 1 BLISTER PACK (60687-656-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064031","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-640-31","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-640-31)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064090","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-640-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-640-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033200","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-332-00","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-332-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033203","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-332-03","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-332-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180051201","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-512-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-512-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180051202","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-512-02","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-512-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180051230","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-512-30","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-512-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645055054","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645060890","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-608-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-608-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041701","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-417-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-417-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041705","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-417-05","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-417-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282072801","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-728-01","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (76282-728-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282072805","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-728-05","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"500 TABLET in 1 BOTTLE (76282-728-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"82009006205","name":"LISINOPRIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-062-05","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-062-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040801","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0408-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0408-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040810","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0408-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0408-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00904679961","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6799-61","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6799-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087901","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-879-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"100 TABLET in 1 BOTTLE (23155-879-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087910","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-879-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"1000 TABLET in 1 BOTTLE (23155-879-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017801","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-178-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-178-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017810","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-178-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-178-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035410","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-354-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-354-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035411","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-354-11","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-354-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041710","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-417-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-417-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041711","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-417-11","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-417-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687033301","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-333-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-333-01) / 1 TABLET in 1 BLISTER PACK (60687-333-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687033311","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064331","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-643-31","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-643-31)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064390","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-643-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-643-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033500","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-335-00","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-335-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033508","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-335-08","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-335-08)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098101","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-981-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-981-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098103","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-981-03","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-981-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098130","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-981-30","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-981-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645053254","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645055354","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645061190","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-611-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-611-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042001","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-420-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-420-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042010","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-420-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-420-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042018","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-420-18","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"180 TABLET in 1 BOTTLE (76282-420-18)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042045","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-420-45","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"45 TABLET in 1 BOTTLE (76282-420-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042050","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-420-50","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"5000 TABLET in 1 BOTTLE (76282-420-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042090","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-420-90","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-420-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073101","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-731-01","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (76282-731-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073110","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-731-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"1000 TABLET in 1 BOTTLE (76282-731-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073118","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-731-18","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"180 TABLET in 1 BOTTLE (76282-731-18)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073145","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-731-45","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"45 TABLET in 1 BOTTLE (76282-731-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073150","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-731-50","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"5000 TABLET in 1 BOTTLE (76282-731-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073190","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-731-90","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"90 TABLET in 1 BOTTLE (76282-731-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"82009006510","name":"LISINOPRIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-065-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-065-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.02536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591088501","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0885-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0885-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155088001","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-880-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"100 TABLET in 1 BOTTLE (23155-880-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155088005","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-880-05","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"500 TABLET in 1 BOTTLE (23155-880-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017901","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-179-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-179-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017905","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-179-05","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-179-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035510","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-355-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-355-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035550","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-355-50","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-355-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041810","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-418-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-418-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041850","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-418-50","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"500 TABLET in 1 BOTTLE (43547-418-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064431","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-644-31","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-644-31)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064490","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-644-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-644-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033600","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-336-00","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-336-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098201","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-982-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-982-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098202","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-982-02","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-982-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180098230","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-982-30","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-982-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645055454","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645061290","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-612-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-612-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042101","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-421-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-421-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042105","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-421-05","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-421-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073201","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-732-01","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (76282-732-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073205","name":"LISINOPRIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-732-05","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"500 TABLET in 1 BOTTLE (76282-732-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00172376170","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040901","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0409-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0409-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040905","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0409-05","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0409-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00904720061","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7200-61","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7200-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155088101","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-881-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"100 TABLET in 1 BOTTLE (23155-881-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155088110","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-881-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"1000 TABLET in 1 BOTTLE (23155-881-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722018001","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-180-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-180-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722018010","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-180-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-180-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035610","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-356-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-356-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035611","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-356-11","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-356-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041910","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-419-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-419-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041911","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-419-11","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-419-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687067801","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-678-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-678-01) / 1 TABLET in 1 BLISTER PACK (60687-678-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687067811","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064531","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-645-31","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-645-31)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064590","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-645-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-645-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001048600","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-486-00","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-486-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001048608","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-486-08","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-486-08)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180097901","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-979-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-979-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180097903","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-979-03","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-979-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180097930","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-979-30","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-979-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645055554","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645059354","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645061390","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-613-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-613-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042201","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-422-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-422-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042210","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-422-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-422-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042218","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-422-18","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"180 TABLET in 1 BOTTLE (76282-422-18)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042245","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-422-45","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"45 TABLET in 1 BOTTLE (76282-422-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282042290","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-422-90","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-422-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073301","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-733-01","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (76282-733-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073310","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-733-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"1000 TABLET in 1 BOTTLE (76282-733-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073318","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-733-18","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"180 TABLET in 1 BOTTLE (76282-733-18)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073345","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-733-45","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"45 TABLET in 1 BOTTLE (76282-733-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282073390","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-733-90","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"90 TABLET in 1 BOTTLE (76282-733-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"82009006610","name":"LISINOPRIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-066-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-066-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.04625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040601","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0406-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0406-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591040610","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0406-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0406-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00904679761","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6797-61","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6797-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087701","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-877-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"100 TABLET in 1 BOTTLE (23155-877-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"23155087710","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-877-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.(780779901)","package_description":"1000 TABLET in 1 BOTTLE (23155-877-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017601","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-176-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-176-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"31722017610","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-176-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (31722-176-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035210","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-352-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-352-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547035211","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-352-11","proprietary_name":"LISINOPRIL","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-352-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041510","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-415-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE (43547-415-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"43547041511","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-415-11","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-415-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687066701","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-667-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-667-01) / 1 TABLET in 1 BLISTER PACK (60687-667-11)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"60687066711","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064131","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-641-31","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"300 TABLET in 1 BOTTLE (62135-641-31)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"62135064190","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-641-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-641-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033300","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-333-00","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-333-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68001033308","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-333-08","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-333-08)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180051301","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-513-01","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-513-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180051303","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-513-03","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-513-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68180051330","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-513-30","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-513-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645055154","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"68645060990","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-609-90","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-609-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041801","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-418-01","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-418-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041810","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-418-10","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-418-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041845","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-418-45","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"45 TABLET in 1 BOTTLE (76282-418-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282041890","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-418-90","proprietary_name":"lisinopril","nonproprietary_name":"lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-418-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282072901","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-729-01","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (76282-729-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282072910","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-729-10","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"1000 TABLET in 1 BOTTLE (76282-729-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282072945","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-729-45","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"45 TABLET in 1 BOTTLE (76282-729-45)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"76282072990","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-729-90","proprietary_name":"LISINOPRIL","nonproprietary_name":"LISINOPRIL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"90 TABLET in 1 BOTTLE (76282-729-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"82009006310","name":"LISINOPRIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-063-10","proprietary_name":"Lisinopril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-063-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril|Lisinopril","basis":"generic"},"part_b":null}, {"ndc":"00591086001","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0860-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0860-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00591086005","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0860-05","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0860-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042010","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-420-10","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-420-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042050","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-420-50","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-420-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180051801","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-518-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-518-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180051802","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-518-02","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-518-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180051830","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-518-30","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-518-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68645055654","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-556-54","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 10 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-556-54)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097096807","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-968-07","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-968-07)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097096812","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-968-12","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-968-12)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044601","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-446-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-446-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044605","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-446-05","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-446-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044610","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-446-10","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-446-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044690","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-446-90","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-446-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.02934,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00591086101","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0861-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0861-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00591086105","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0861-05","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0861-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042110","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-421-10","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-421-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042150","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-421-50","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-421-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180051901","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-519-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-519-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180051902","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-519-02","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-519-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180051930","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-519-30","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-519-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68645055754","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-557-54","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-557-54)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097096907","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-969-07","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-969-07)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097096912","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-969-12","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-969-12)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044701","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-447-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-447-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044705","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-447-05","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-447-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044710","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-447-10","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-447-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044790","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-447-90","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-447-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.03612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00591086201","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0862-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0862-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00591086205","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0862-05","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0862-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042210","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-422-10","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-422-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042250","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-422-50","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-422-50)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180052001","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-520-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-520-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180052002","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-520-02","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-520-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180052030","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-520-30","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 POUCH (68180-520-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68645055854","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-558-54","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-558-54)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097097107","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-971-07","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-971-07)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"69097097112","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-971-12","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-971-12)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044801","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-448-01","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-448-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044805","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-448-05","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-448-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044810","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-448-10","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-448-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"76282044890","name":"LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-448-90","proprietary_name":"Lisinopril and Hydrochlorothiazide","nonproprietary_name":"Lisinopril and Hydrochlorothiazide Tablets","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (76282-448-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.04084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lisinopril-Hydrochlorothiazide|Lisinopril/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00121102716","name":"LITHIUM 8 MEQ/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1027-16","proprietary_name":"Lithium","nonproprietary_name":"Lithium","dosage_form":"SOLUTION","route":"ORAL","strength":"8 meq/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"500 mL in 1 BOTTLE (0121-1027-16)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.45343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lithium Citrate|Lithium Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888017246","name":"LITHIUM 8 MEQ/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-172-46","proprietary_name":"Lithium","nonproprietary_name":"Lithium","dosage_form":"SOLUTION","route":"ORAL","strength":"8 meq/5mL","labeler":"Advagen Pharma Ltd","package_description":"500 mL in 1 BOTTLE (72888-172-46)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.45343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lithium Citrate|Lithium Citrate","basis":"generic"},"part_b":null}, {"ndc":"00054252625","name":"LITHIUM CARBONATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-2526-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"150 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0054-2526-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.09634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054852625","name":"LITHIUM CARBONATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8526-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"150 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (0054-8526-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.09634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"31722054401","name":"LITHIUM CARBONATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-544-01","proprietary_name":"lithium carbonate","nonproprietary_name":"lithium carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-544-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.09634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"62332001331","name":"LITHIUM CARBONATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-013-31","proprietary_name":"LITHIUM CARBONATE LITHIUM CARBONATE","nonproprietary_name":"LITHIUM CARBONATE","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-013-31)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.09634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68462022001","name":"LITHIUM CARBONATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-220-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-220-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.09634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054252725","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-2527-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0054-2527-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054252731","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-2527-31","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, GELATIN COATED in 1 BOTTLE (0054-2527-31)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054852725","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8527-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (0054-8527-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"31722054501","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-545-01","proprietary_name":"lithium carbonate","nonproprietary_name":"lithium carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-545-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"31722054510","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-545-10","proprietary_name":"lithium carbonate","nonproprietary_name":"lithium carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (31722-545-10)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687080601","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-806-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-806-01) / 1 CAPSULE in 1 BLISTER PACK (60687-806-11)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687080611","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"62332001431","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-014-31","proprietary_name":"LITHIUM CARBONATE LITHIUM CARBONATE","nonproprietary_name":"LITHIUM CARBONATE","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-014-31)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"62332001491","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-014-91","proprietary_name":"LITHIUM CARBONATE LITHIUM CARBONATE","nonproprietary_name":"LITHIUM CARBONATE","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (62332-014-91)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68462022101","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-221-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-221-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68462022110","name":"LITHIUM CARBONATE 300 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-221-10","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 CAPSULE in 1 BOTTLE (68462-221-10)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.10387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054452725","name":"LITHIUM CARBONATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4527-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-4527-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.19092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054452731","name":"LITHIUM CARBONATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4527-31","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (0054-4527-31)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.19092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054852825","name":"LITHIUM CARBONATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-8528-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 TABLET in 1 BLISTER PACK (0054-8528-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.19092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054253125","name":"LITHIUM CARBONATE 600 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-2531-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"600 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0054-2531-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.24258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"31722054601","name":"LITHIUM CARBONATE 600 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-546-01","proprietary_name":"lithium carbonate","nonproprietary_name":"lithium carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-546-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.24258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687096411","name":"LITHIUM CARBONATE 600 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687096421","name":"LITHIUM CARBONATE 600 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-964-21","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-964-21) / 1 CAPSULE in 1 BLISTER PACK (60687-964-11)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.24258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"62332001531","name":"LITHIUM CARBONATE 600 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-015-31","proprietary_name":"LITHIUM CARBONATE LITHIUM CARBONATE","nonproprietary_name":"LITHIUM CARBONATE","dosage_form":"CAPSULE","route":"ORAL","strength":"600 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-015-31)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.24258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68462022201","name":"LITHIUM CARBONATE 600 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-222-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"600 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-222-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.24258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054002125","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0021-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0054-0021-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054002129","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0021-29","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0054-0021-29)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"23155076301","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-763-01","proprietary_name":"Lithium carbonate","nonproprietary_name":"Lithium carbonate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (23155-763-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"64980020501","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-205-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-205-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"64980020505","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-205-05","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-205-05)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68084064001","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-640-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-640-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (68084-640-11)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68084064011","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68462022301","name":"LITHIUM CARBONATE ER 300 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-223-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-223-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00054002025","name":"LITHIUM CARBONATE ER 450 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0020-25","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0054-0020-25)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.25902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"64980027801","name":"LITHIUM CARBONATE ER 450 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-278-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-278-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.25902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68084065501","name":"LITHIUM CARBONATE ER 450 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-655-01","proprietary_name":"Lithium Carbonate","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-655-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (68084-655-11)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.25902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68084065511","name":"LITHIUM CARBONATE ER 450 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68462022401","name":"LITHIUM CARBONATE ER 450 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-224-01","proprietary_name":"Lithium Carbonate ER","nonproprietary_name":"Lithium Carbonate","dosage_form":"TABLET","route":"ORAL","strength":"450 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-224-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":0.25902,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithium Carbonate ER|Lithium Carbonate","basis":"generic"},"part_b":null}, {"ndc":"62559028001","name":"LITHOBID ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-280-01","proprietary_name":"LITHOBID","nonproprietary_name":"lithium carbonate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62559-280-01)","pharm_classes":["Mood Stabilizer [EPC]"]},"nadac":{"value":12.01942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00178050001","name":"LITHOSTAT 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0178-0500-01","proprietary_name":"Lithostat","nonproprietary_name":"acetohydroxamic acid","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Mission Pharmacal Company","package_description":"100 TABLET in 1 BOTTLE (0178-0500-01)","pharm_classes":["Urease Inhibitor [EPC]","Urease Inhibitors [MoA]"]},"nadac":{"value":6.66324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lithostat|Acetohydroxamic Acid","basis":"brand"},"part_b":null}, {"ndc":"66869010490","name":"LIVALO 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66869-104-90","proprietary_name":"Livalo","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.045 mg/1","labeler":"Kowa Pharmaceuticals America, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, DISPENSING (66869-104-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":10.21149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Livalo|Pitavastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"66869020490","name":"LIVALO 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66869-204-90","proprietary_name":"Livalo","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.09 mg/1","labeler":"Kowa Pharmaceuticals America, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, DISPENSING (66869-204-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":10.20605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Livalo|Pitavastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"66869040490","name":"LIVALO 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66869-404-90","proprietary_name":"Livalo","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4.18 mg/1","labeler":"Kowa Pharmaceuticals America, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, DISPENSING (66869-404-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":10.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Livalo|Pitavastatin Calcium","basis":"brand"},"part_b":null}, {"ndc":"00430042014","name":"LO LOESTRIN FE 1-10 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0430-0420-14","proprietary_name":"Lo Loestrin Fe","nonproprietary_name":"norethindrone acetate and ethinyl estradiol, ethinyl estradiol and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Allergan, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (0430-0420-14) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":6.76607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lo Loestrin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"59651002928","name":"LO-ZUMANDIMINE 3 MG-0.02 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lo-Zumandimine|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"59651002988","name":"LO-ZUMANDIMINE 3 MG-0.02 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-029-88","proprietary_name":"Lo-Zumandimine","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (59651-029-88) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lo-Zumandimine|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"82867000101","name":"LODOCO 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82867-001-01","proprietary_name":"LODOCO","nonproprietary_name":"Colchicine Tablets 0.5 mg","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"AGEPHA Pharma USA, LLC","package_description":"1 BLISTER PACK in 1 CARTON (82867-001-01) / 30 TABLET in 1 BLISTER PACK","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":16.99949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-29","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lodoco|Colchicine","basis":"brand"},"part_b":null}, {"ndc":"51285012570","name":"LOESTRIN FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51285-125-70","proprietary_name":"Loestrin Fe 28 Day","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Women's Health LLC","package_description":"5 POUCH in 1 CARTON (51285-125-70) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":8.23191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loestrin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"15370018060","name":"LOFENA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"15370-180-60","proprietary_name":"LOFENA","nonproprietary_name":"DICLOFENAC POTASSIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (15370-180-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":4.56677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofena|Diclofenac Potassium","basis":"brand"},"part_b":null}, {"ndc":"66993034537","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-345-37","proprietary_name":"Lofexidine hydrochloride","nonproprietary_name":"lofexidine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".2 mg/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE in 1 CARTON (66993-345-37) / 36 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"66993034576","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-345-76","proprietary_name":"Lofexidine hydrochloride","nonproprietary_name":"lofexidine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".2 mg/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE in 1 CARTON (66993-345-76) / 96 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954090910","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-909-10","proprietary_name":"Lofexidine","nonproprietary_name":"Lofexidine","dosage_form":"TABLET","route":"ORAL","strength":".18 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"36 TABLET in 1 BOTTLE (70954-909-10)"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954090920","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-909-20","proprietary_name":"Lofexidine","nonproprietary_name":"Lofexidine","dosage_form":"TABLET","route":"ORAL","strength":".18 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"96 TABLET in 1 BOTTLE (70954-909-20)"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"71921025036","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-250-36","proprietary_name":"Lofexidine","nonproprietary_name":"Lofexidine","dosage_form":"TABLET, COATED","route":"ORAL","strength":".18 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE in 1 CARTON (71921-250-36) / 36 TABLET, COATED in 1 BOTTLE"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"71921025096","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-250-96","proprietary_name":"Lofexidine","nonproprietary_name":"Lofexidine","dosage_form":"TABLET, COATED","route":"ORAL","strength":".18 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE in 1 CARTON (71921-250-96) / 96 TABLET, COATED in 1 BOTTLE"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205024642","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-246-42","proprietary_name":"lofexidine hydrochloride","nonproprietary_name":"lofexidine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-246-42) / 36 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205024643","name":"LOFEXIDINE 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-246-43","proprietary_name":"lofexidine hydrochloride","nonproprietary_name":"lofexidine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-246-43) / 96 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lofexidine HCl|Lofexidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68047012916","name":"LOHIST-DM SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-129-16","proprietary_name":"LoHist DM","nonproprietary_name":"Brompheniramine Maleate, Dextromethorphan Hydrobromide and Phenylephrine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"10 mg/5mL; 5 mg/5mL; 2 mg/5mL","labeler":"Larken Laboratories, Inc.","package_description":"473 mL in 1 BOTTLE (68047-129-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07408,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700012487","name":"LOJAIMIESS 0.1-0.02-0.01 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-124-87","proprietary_name":"LoJaimiess","nonproprietary_name":"levonorgestrel/ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"1 BLISTER PACK in 1 CARTON (70700-124-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.23385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lojaimiess|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"70700020787","name":"LOJAIMIESS 0.1-0.02-0.01 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lojaimiess|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"70700020793","name":"LOJAIMIESS 0.1-0.02-0.01 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-207-93","proprietary_name":"LOJAIMIESS","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol and Ethinyl Estradiol tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"2 POUCH in 1 CARTON (70700-207-93) / 1 BLISTER PACK in 1 POUCH (70700-207-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.23385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lojaimiess|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"00310111001","name":"LOKELMA 10 GRAM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":28.33002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lokelma|Sodium Zirconium Cyclosilicate","basis":"brand"},"part_b":null}, {"ndc":"00310111030","name":"LOKELMA 10 GRAM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-1110-30","proprietary_name":"LOKELMA","nonproprietary_name":"sodium zirconium cyclosilicate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 g/10g","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 PACKET in 1 BOX (0310-1110-30) / 10 g in 1 PACKET (0310-1110-01)"},"nadac":{"value":28.33002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lokelma|Sodium Zirconium Cyclosilicate","basis":"brand"},"part_b":null}, {"ndc":"00310111039","name":"LOKELMA 10 GRAM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-1110-39","proprietary_name":"LOKELMA","nonproprietary_name":"sodium zirconium cyclosilicate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 g/10g","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"11 PACKET in 1 BOX (0310-1110-39) / 10 g in 1 PACKET (0310-1110-01)"},"nadac":{"value":28.33002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lokelma|Sodium Zirconium Cyclosilicate","basis":"brand"},"part_b":null}, {"ndc":"00310110501","name":"LOKELMA 5 GRAM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":28.36158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lokelma|Sodium Zirconium Cyclosilicate","basis":"brand"},"part_b":null}, {"ndc":"00310110530","name":"LOKELMA 5 GRAM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-1105-30","proprietary_name":"LOKELMA","nonproprietary_name":"sodium zirconium cyclosilicate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"5 g/5g","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 PACKET in 1 BOX (0310-1105-30) / 5 g in 1 PACKET (0310-1105-01)"},"nadac":{"value":28.36158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lokelma|Sodium Zirconium Cyclosilicate","basis":"brand"},"part_b":null}, {"ndc":"00310110539","name":"LOKELMA 5 GRAM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-1105-39","proprietary_name":"LOKELMA","nonproprietary_name":"sodium zirconium cyclosilicate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"5 g/5g","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"11 PACKET in 1 BOX (0310-1105-39) / 5 g in 1 PACKET (0310-1105-01)"},"nadac":{"value":28.36158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lokelma|Sodium Zirconium Cyclosilicate","basis":"brand"},"part_b":null}, {"ndc":"10702000109","name":"LOMAIRA 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-001-09","proprietary_name":"LOMAIRA","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"KVK-TECH, INC.","package_description":"90 TABLET in 1 BOTTLE (10702-001-09)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.61814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"00025006131","name":"LOMOTIL 2.5-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0025-0061-31","proprietary_name":"Lomotil","nonproprietary_name":"diphenoxylate hydrochloride and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; .025 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"100 TABLET in 1 BOTTLE (0025-0061-31)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":2.99096,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13885,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lomotil|Diphenoxylate HCl/Atropine","basis":"brand"},"part_b":null}, {"ndc":"00904683620","name":"LOPERAMIDE 1 MG/7.5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6836-20","proprietary_name":"loperamide hydrochloride","nonproprietary_name":"loperamide HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/7.5mL","labeler":"Major Pharmaceuticals","package_description":"120 mL in 1 BOTTLE (0904-6836-20)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.02644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122054426","name":"LOPERAMIDE 1 MG/7.5 ML SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-544-26","proprietary_name":"good neighbor pharmacy loperamide hydrochloride","nonproprietary_name":"loperamide HCl","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/7.5mL","labeler":"Amerisource Bergen","package_description":"120 mL in 1 BOTTLE (46122-544-26)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.02644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093031101","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0311-01","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0311-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"00093031105","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0311-05","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-0311-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"00378210001","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2100-01","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2100-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"00378210005","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2100-05","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (0378-2100-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"00904747261","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7472-61","proprietary_name":"LOPERAMIDE HYDROCHLORIDE","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7472-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"42799060501","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-605-01","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 CAPSULE in 1 BOTTLE (42799-605-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"42799060502","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-605-02","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"500 CAPSULE in 1 BOTTLE (42799-605-02)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"50268048211","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"50268048215","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-482-15","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-482-15) / 1 CAPSULE in 1 BLISTER PACK (50268-482-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079069001","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"51079069020","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-690-20","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-690-20) / 1 CAPSULE in 1 BLISTER PACK (51079-690-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"59651069101","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-691-01","proprietary_name":"LOPERAMIDE HYDROCHLORIDE","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-691-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"59651069105","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-691-05","proprietary_name":"LOPERAMIDE HYDROCHLORIDE","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (59651-691-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"60687022901","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-229-01","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-229-01) / 1 CAPSULE in 1 BLISTER PACK (60687-229-11)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"60687022911","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"69452027120","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-271-20","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (69452-271-20)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"69452027130","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-271-30","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (69452-271-30)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72578013801","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-138-01","proprietary_name":"Loperamide hydrochloride","nonproprietary_name":"Loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-138-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72578013805","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-138-05","proprietary_name":"Loperamide hydrochloride","nonproprietary_name":"Loperamide hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (72578-138-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72603032801","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-328-01","proprietary_name":"LOPERAMIDE HYDROCHLORIDE","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-328-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72603032802","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-328-02","proprietary_name":"LOPERAMIDE HYDROCHLORIDE","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (72603-328-02)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72888013001","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-130-01","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"100 CAPSULE in 1 BOTTLE (72888-130-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"72888013005","name":"LOPERAMIDE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-130-05","proprietary_name":"Loperamide Hydrochloride","nonproprietary_name":"Loperamide Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Ltd.,","package_description":"500 CAPSULE in 1 BOTTLE (72888-130-05)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.0549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loperamide|Loperamide HCl","basis":"generic"},"part_b":null}, {"ndc":"69230032512","name":"LOPERAMIDE-SIMETH 2-125 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-325-12","proprietary_name":"Loperamide Hydrochloride and Simethicone","nonproprietary_name":"Loperamide Hydrochloride and Simethicone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 125 mg/1","labeler":"Camber Consumer Care Inc","package_description":"2 BLISTER PACK in 1 CARTON (69230-325-12) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]","Skin Barrier Activity [PE]"]},"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032524","name":"LOPERAMIDE-SIMETH 2-125 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-325-24","proprietary_name":"Loperamide Hydrochloride and Simethicone","nonproprietary_name":"Loperamide Hydrochloride and Simethicone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1; 125 mg/1","labeler":"Camber Consumer Care Inc","package_description":"4 BLISTER PACK in 1 CARTON (69230-325-24) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]","Skin Barrier Activity [PE]"]},"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032532","name":"LOPERAMIDE-SIMETH 2-125 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722055612","name":"LOPINAVIR-RITONAVR 200-50 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-556-12","proprietary_name":"Lopinavir and ritonavir","nonproprietary_name":"Lopinavir and ritonavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-556-12)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":4.46491,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lopinavir-Ritonavir|Lopinavir/Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"42385093412","name":"LOPINAVIR-RITONAVR 200-50 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-934-12","proprietary_name":"Lopinavir and Ritonavir","nonproprietary_name":"Lopinavir and Ritonavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 50 mg/1","labeler":"Laurus Labs Limited","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (42385-934-12)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":4.46491,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lopinavir-Ritonavir|Lopinavir/Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"30698046430","name":"LOPRESSOR 10 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-464-30","proprietary_name":"LOPRESSOR","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"VALIDUS PHARMACEUTICALS LLC","package_description":"1 BOTTLE in 1 CARTON (30698-464-30) / 300 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.19616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"30698045801","name":"LOPRESSOR 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"30698-458-01","proprietary_name":"Lopressor","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Validus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (30698-458-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.41634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136707","name":"LORATADINE 10 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1367-07","proprietary_name":"Loratadine ODT","nonproprietary_name":"Loratadine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Rugby Laboratories","package_description":"3 BLISTER PACK in 1 CARTON (0536-1367-07) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.52737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122053952","name":"LORATADINE 10 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-539-52","proprietary_name":"Loratadine ODT","nonproprietary_name":"Loratadine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Amerisource Bergen","package_description":"1 BLISTER PACK in 1 CARTON (46122-539-52) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.52737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888002909","name":"LORATADINE 10 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-029-09","proprietary_name":"LORATADINE","nonproprietary_name":"LORATADINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (72888-029-09) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.52737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888002911","name":"LORATADINE 10 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-029-11","proprietary_name":"LORATADINE","nonproprietary_name":"LORATADINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (72888-029-11) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.52737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904685272","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6852-72","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6852-72) / 300 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904685289","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6852-89","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6852-89) / 90 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904742646","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7426-46","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7426-46) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904742659","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7426-59","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7426-59) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904751161","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7511-61","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7511-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571082201","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-822-01","proprietary_name":"Loratadine","nonproprietary_name":"loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (16571-822-01)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571082203","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-822-03","proprietary_name":"Loratadine","nonproprietary_name":"loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharmaceuticals, Inc","package_description":"30 TABLET in 1 BOTTLE (16571-822-03)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571082230","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-822-30","proprietary_name":"Loratadine","nonproprietary_name":"loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharmaceuticals, Inc","package_description":"300 TABLET in 1 BOTTLE (16571-822-30)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802065065","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-650-65","proprietary_name":"Loratadine antihistamine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-650-65) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802065075","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-650-75","proprietary_name":"Loratadine antihistamine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-650-75) / 90 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802065078","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-650-78","proprietary_name":"Loratadine antihistamine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-650-78) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802065087","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-650-87","proprietary_name":"Loratadine antihistamine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-650-87) / 300 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079024601","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079024620","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-246-20","proprietary_name":"Loratadine","nonproprietary_name":"loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (51079-246-20) / 1 TABLET in 1 BLISTER PACK (51079-246-01)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043800","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-438-00","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-438-00) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043804","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-438-04","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-438-04) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043816","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043896","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-438-96","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"10 BLISTER PACK in 1 CARTON (68001-438-96) / 10 TABLET in 1 BLISTER PACK (68001-438-16)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043897","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-438-97","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-438-97) / 300 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084024801","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-248-01","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-248-01) / 1 TABLET in 1 BLISTER PACK (68084-248-11)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084024811","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599478506","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68599-4785-6","proprietary_name":"McKesson Loradatine","nonproprietary_name":"Loratainde","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"McKesson Medical Surgical","package_description":"50 PACKET in 1 BOX (68599-4785-6) / 1 TABLET in 1 PACKET"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032330","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-323-30","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-323-30) / 30 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032333","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-323-33","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-323-33) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032334","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-323-34","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-323-34) / 300 TABLET in 1 BOTTLE"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016201","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-162-01","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-162-01)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010016234","name":"LORATADINE 10 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-162-34","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"300 TABLET in 1 BOTTLE (70010-162-34)"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001044998","name":"LORATADINE 5 MG/5 ML SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-449-98","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine Oral","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-449-98) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672207308","name":"LORATADINE 5 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2073-8","proprietary_name":"Childrens Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-2073-8) / 120 mL in 1 BOTTLE"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838055840","name":"LORATADINE ALLERGY 5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-558-40","proprietary_name":"Loratadine","nonproprietary_name":"Loratadine","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Lannett Company, Inc.","package_description":"120 mL in 1 CARTON (54838-558-40)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802012246","name":"LORATADINE-D 12 HOUR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-122-46","proprietary_name":"loratadine D","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"10 BLISTER PACK in 1 CARTON (45802-122-46) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802012260","name":"LORATADINE-D 12 HOUR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-122-60","proprietary_name":"loratadine D","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"20 BLISTER PACK in 1 CARTON (45802-122-60) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802012265","name":"LORATADINE-D 12 HOUR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-122-65","proprietary_name":"loratadine D","nonproprietary_name":"loratadine, Pseudoephedrine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 120 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 BLISTER PACK in 1 CARTON (45802-122-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.78178,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904583315","name":"LORATADINE-D 24HR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5833-15","proprietary_name":"Loratadine and Pseudoephedrine Sulfate","nonproprietary_name":"Loratadine and Pseudoephedrine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (0904-5833-15)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904583348","name":"LORATADINE-D 24HR TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5833-48","proprietary_name":"Loratadine and Pseudoephedrine Sulfate","nonproprietary_name":"Loratadine and Pseudoephedrine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 240 mg/1","labeler":"Major Pharmaceuticals","package_description":"15 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (0904-5833-48)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.55347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342501","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3425-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0093-3425-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342505","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3425-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0093-3425-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342510","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3425-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0093-3425-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008301","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-083-01","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-083-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008305","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-083-05","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (13107-083-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687082001","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-820-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-820-01) / 1 TABLET in 1 BLISTER PACK (60687-820-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687082011","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135086101","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-861-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC","package_description":"100 TABLET in 1 BOTTLE (62135-861-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559019505","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-195-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (62559-195-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077201","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-772-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"100 TABLET in 1 BOTTLE (63304-772-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077205","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-772-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"500 TABLET in 1 BOTTLE (63304-772-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077210","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-772-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"1000 TABLET in 1 BOTTLE (63304-772-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062701","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-627-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-627-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062750","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-627-50","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-627-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090401","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-904-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-904-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090405","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-904-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-904-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090410","name":"LORAZEPAM 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-904-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-904-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342601","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3426-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0093-3426-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342605","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3426-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0093-3426-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342610","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3426-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0093-3426-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008401","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-084-01","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-084-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008405","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-084-05","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (13107-084-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008499","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-084-99","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurolife Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (13107-084-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687083101","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-831-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-831-01) / 1 TABLET in 1 BLISTER PACK (60687-831-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687083111","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559019610","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-196-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (62559-196-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077301","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-773-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"100 TABLET in 1 BOTTLE (63304-773-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077305","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-773-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"500 TABLET in 1 BOTTLE (63304-773-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077310","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-773-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"1000 TABLET in 1 BOTTLE (63304-773-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062801","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-628-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-628-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062850","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-628-50","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-628-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090501","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-905-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-905-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090505","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-905-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-905-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090510","name":"LORAZEPAM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-905-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-905-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.03671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342701","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3427-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0093-3427-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342705","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3427-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0093-3427-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093342710","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3427-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0093-3427-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008501","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-085-01","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-085-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107008505","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-085-05","proprietary_name":"LORAZEPAM","nonproprietary_name":"LORAZEPAM","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (13107-085-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687084201","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-842-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-842-01) / 1 TABLET in 1 BLISTER PACK (60687-842-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687084211","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559019701","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-197-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-197-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077401","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-774-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"100 TABLET in 1 BOTTLE (63304-774-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077405","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-774-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"500 TABLET in 1 BOTTLE (63304-774-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304077410","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-774-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES INC","package_description":"1000 TABLET in 1 BOTTLE (63304-774-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062901","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-629-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-629-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980062950","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-629-50","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-629-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090601","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-906-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-906-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090605","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-906-05","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-906-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315090610","name":"LORAZEPAM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-906-10","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-906-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.07314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121077001","name":"LORAZEPAM 2 MG/ML ORAL CONCENT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0770-01","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"LIQUID","route":"ORAL","strength":"2 mg/mL","labeler":"Pharmaceutical Associates, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0121-0770-01) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.68632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135054943","name":"LORAZEPAM 2 MG/ML ORAL CONCENT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-549-43","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"CONCENTRATE","route":"ORAL","strength":"2 mg/mL","labeler":"Chartwell RX, LLC","package_description":"30 mL in 1 BOTTLE (62135-549-43)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.68632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162068784","name":"LORAZEPAM 2 MG/ML ORAL CONCENT","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-687-84","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"CONCENTRATE","route":"ORAL","strength":"2 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 mL in 1 BOTTLE, DROPPER (65162-687-84)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.68632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00641604425","name":"LORAZEPAM 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6044-25","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6044-25) / 1 mL in 1 VIAL (0641-6044-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.17153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2060","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2060 (2 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6044-25) / 1 mL in 1 VIAL (0641-6044-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641604825","name":"LORAZEPAM 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6048-25","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6048-25) / 1 mL in 1 VIAL (0641-6048-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.17153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2060","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2060 (2 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6048-25) / 1 mL in 1 VIAL (0641-6048-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641620725","name":"LORAZEPAM 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6207-25","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6207-25) / 1 mL in 1 VIAL (0641-6207-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.17153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2060","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2060 (2 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6207-25) / 1 mL in 1 VIAL (0641-6207-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65219036802","name":"LORAZEPAM 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-368-02","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (65219-368-02) / 1 mL in 1 VIAL (65219-368-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.17153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2060","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2060 (2 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (65219-368-02) / 1 mL in 1 VIAL (65219-368-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572038025","name":"LORAZEPAM 2 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-380-25","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-380-25) / 1 mL in 1 VIAL (72572-380-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":2.17153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2060","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2060 (2 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-380-25) / 1 mL in 1 VIAL (72572-380-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054353244","name":"LORAZEPAM INTENSOL 2 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3532-44","proprietary_name":"Lorazepam","nonproprietary_name":"Lorazepam","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (0054-3532-44) / 30 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.68632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52427065830","name":"LOREEV XR 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-658-30","proprietary_name":"LOREEV XR","nonproprietary_name":"lorazepam","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52427-658-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":14.20977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loreev XR|Lorazepam","basis":"brand"},"part_b":null}, {"ndc":"52427066130","name":"LOREEV XR 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-661-30","proprietary_name":"LOREEV XR","nonproprietary_name":"lorazepam","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52427-661-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":14.24867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loreev XR|Lorazepam","basis":"brand"},"part_b":null}, {"ndc":"52427066330","name":"LOREEV XR 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-663-30","proprietary_name":"LOREEV XR","nonproprietary_name":"lorazepam","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52427-663-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":14.19082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loreev XR|Lorazepam","basis":"brand"},"part_b":null}, {"ndc":"52427066730","name":"LOREEV XR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-667-30","proprietary_name":"LOREEV XR","nonproprietary_name":"lorazepam","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52427-667-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":14.22681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loreev XR|Lorazepam","basis":"brand"},"part_b":null}, {"ndc":"70700011484","name":"LORYNA 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loryna|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"70700011485","name":"LORYNA 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-114-85","proprietary_name":"LORYNA","nonproprietary_name":"Drospirenone and Ethinyl Estradiol Tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-114-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loryna|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"00904704961","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7049-61","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7049-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010210","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-102-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (11788-102-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010230","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-102-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (11788-102-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010290","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-102-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET in 1 BOTTLE (11788-102-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070210","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-702-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-702-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070230","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-702-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-702-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070290","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-702-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-702-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004607","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-046-07","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-046-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004610","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-046-10","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-046-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004644","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-046-44","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-046-44)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036203","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-362-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-362-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036209","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-362-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-362-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036211","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-362-11","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-362-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"50268050611","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"50268050615","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-506-15","proprietary_name":"Losortan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-506-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-506-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033510","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-335-10","proprietary_name":"Losartan potassium Tablets, 100 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59746-335-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033530","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-335-30","proprietary_name":"Losartan potassium Tablets, 100 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-335-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033590","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-335-90","proprietary_name":"Losartan potassium Tablets, 100 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59746-335-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002930","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-029-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-029-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002990","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-029-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-029-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002991","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-029-91","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-029-91)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"64380093505","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-935-05","proprietary_name":"LOSARTAN POTASSIUM 100 mg","nonproprietary_name":"LOSARTAN POTASSIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (64380-935-05)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020330","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-203-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-203-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020390","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-203-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-203-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020399","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-203-99","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-203-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68084034801","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-348-01","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-348-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-348-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68084034811","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68180037803","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-378-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-378-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68180037809","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-378-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-378-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013706","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-137-06","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-137-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013710","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-137-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-137-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013716","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-137-16","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-137-16)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074303","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-743-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (70010-743-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074309","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-743-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (70010-743-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074310","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-743-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-743-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014330","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-143-30","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-143-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014390","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-143-90","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-143-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014399","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-143-99","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-143-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72603034201","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-342-01","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-342-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72603034202","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-342-02","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-342-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"82009004410","name":"LOSARTAN POTASSIUM 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-044-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-044-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"00904704761","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7047-61","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7047-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010010","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-100-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (11788-100-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010030","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-100-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (11788-100-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010090","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-100-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET in 1 BOTTLE (11788-100-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070005","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-700-05","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-700-05)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070010","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-700-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-700-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070090","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-700-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-700-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004410","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-044-10","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-044-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004444","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-044-44","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-044-44)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036009","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-360-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-360-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036011","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-360-11","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-360-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036050","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-360-50","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43547-360-50)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"50268050411","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"50268050415","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-504-15","proprietary_name":"Losortan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-504-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-504-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033310","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-333-10","proprietary_name":"Losartan potassium Tablets, 25 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59746-333-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033390","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-333-90","proprietary_name":"Losartan potassium Tablets, 25 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59746-333-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002730","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-027-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-027-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002790","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-027-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-027-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002791","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-027-91","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-027-91)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020190","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-201-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-201-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020199","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-201-99","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-201-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68084034601","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-346-01","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-346-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-346-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68084034611","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68180037603","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-376-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-376-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68180037609","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-376-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-376-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013506","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-135-06","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-135-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013510","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-135-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-135-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013516","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-135-16","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-135-16)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074103","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-741-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (70010-741-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074109","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-741-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (70010-741-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074110","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-741-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-741-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014190","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-141-90","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-141-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014199","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-141-99","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-141-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72603034001","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-340-01","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-340-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72603034002","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-340-02","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-340-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"82009004210","name":"LOSARTAN POTASSIUM 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-042-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-042-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.02183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"00904704861","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7048-61","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7048-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010110","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-101-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET in 1 BOTTLE (11788-101-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010130","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-101-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"30 TABLET in 1 BOTTLE (11788-101-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"11788010190","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-101-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET in 1 BOTTLE (11788-101-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"29300014519","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-145-19","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (29300-145-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070110","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-701-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-701-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"31722070190","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-701-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-701-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004507","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-045-07","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-045-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004510","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-045-10","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-045-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"33342004544","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-045-44","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-045-44)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036103","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-361-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-361-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036109","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-361-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-361-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"43547036111","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-361-11","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-361-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"50268050511","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"50268050515","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-505-15","proprietary_name":"Losortan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-505-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-505-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033410","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-334-10","proprietary_name":"Losartan potassium Tablets, 50 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59746-334-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033430","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-334-30","proprietary_name":"Losartan potassium Tablets, 50 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-334-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"59746033490","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-334-90","proprietary_name":"Losartan potassium Tablets, 50 mg","nonproprietary_name":"losartan potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59746-334-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002830","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-028-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-028-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002890","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-028-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-028-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"62332002891","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-028-91","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-028-91)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020230","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-202-30","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-202-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020290","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-202-90","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-202-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"65862020299","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-202-99","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-202-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68084034701","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-347-01","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-347-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-347-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68084034711","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68180037703","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-377-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-377-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68180037709","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-377-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-377-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013606","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-136-06","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-136-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013610","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-136-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-136-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68382013616","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-136-16","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-136-16)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"68645059954","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074203","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-742-03","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (70010-742-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074209","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-742-09","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (70010-742-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"70010074210","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-742-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-742-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014230","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-142-30","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-142-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014290","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-142-90","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-142-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72205014299","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-142-99","proprietary_name":"Losartan potassium","nonproprietary_name":"Losartan potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-142-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72603034101","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-341-01","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-341-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"72603034102","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-341-02","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-341-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"82009004310","name":"LOSARTAN POTASSIUM 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-043-10","proprietary_name":"Losartan Potassium","nonproprietary_name":"Losartan Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-043-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.03267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan Potassium|Losartan Potassium","basis":"generic"},"part_b":null}, {"ndc":"00093736910","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7369-10","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-7369-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736956","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7369-56","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7369-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736998","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7369-98","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-7369-98)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022401","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-224-01","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-224-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022402","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-224-02","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-224-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022403","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-224-03","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-224-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300019110","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-191-10","proprietary_name":"losartan potassium and hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-191-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300019119","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-191-19","proprietary_name":"losartan potassium and hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-191-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005107","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-051-07","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-051-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005110","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-051-10","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-051-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005144","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-051-44","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-051-44)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042503","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-425-03","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-425-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042509","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-425-09","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-425-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042511","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-425-11","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-425-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332004930","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-049-30","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-049-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332004990","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-049-90","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-049-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332004991","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-049-91","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-049-91)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862046930","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-469-30","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-469-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862046990","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-469-90","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-469-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862046999","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-469-99","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-469-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180021606","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-216-06","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-216-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180021609","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-216-09","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-216-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736810","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7368-10","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-7368-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736856","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7368-56","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7368-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736898","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7368-98","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-7368-98)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022501","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-225-01","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-225-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022502","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-225-02","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-225-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022504","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-225-04","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-225-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300019210","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-192-10","proprietary_name":"losartan potassium and hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-192-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300019219","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-192-19","proprietary_name":"losartan potassium and hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-192-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005207","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-052-07","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-052-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005210","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-052-10","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-052-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005244","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-052-44","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-052-44)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042403","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-424-03","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-424-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042409","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-424-09","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-424-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042411","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-424-11","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-424-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005030","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-050-30","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-050-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005090","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-050-90","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-050-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332005091","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-050-91","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-050-91)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862047030","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-470-30","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-470-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862047090","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-470-90","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-470-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862047099","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-470-99","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-470-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180021706","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-217-06","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-217-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180021709","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-217-09","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-217-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.07925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736710","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7367-10","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0093-7367-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736756","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7367-56","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7367-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093736798","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7367-98","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0093-7367-98)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022601","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-226-01","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-226-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022602","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-226-02","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-226-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"16714022604","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-226-04","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-226-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300019010","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-190-10","proprietary_name":"losartan potassium and hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-190-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"29300019019","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-190-19","proprietary_name":"losartan potassium and hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1; 50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-190-19)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005007","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-050-07","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-050-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005010","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-050-10","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-050-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342005044","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-050-44","proprietary_name":"Losartan potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-050-44)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042303","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-423-03","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-423-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042309","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-423-09","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-423-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547042311","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-423-11","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-423-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"59746033710","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-337-10","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"losartan potassium and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59746-337-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332004830","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-048-30","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-048-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332004890","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-048-90","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-048-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332004891","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-048-91","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (62332-048-91)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862046830","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-468-30","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-468-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862046890","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-468-90","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-468-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862046899","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-468-99","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-468-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180021506","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-215-06","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-215-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"68180021509","name":"LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-215-09","proprietary_name":"Losartan Potassium and Hydrochlorothiazide","nonproprietary_name":"Losartan Potassium and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-215-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.05542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Losartan-Hydrochlorothiazide|Losartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"24208044335","name":"LOTEMAX 0.5% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-443-35","proprietary_name":"Lotemax","nonproprietary_name":"loteprednol etabonate","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-443-35) / 3.5 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":99.7438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lotemax|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"24208050307","name":"LOTEMAX 0.5% OPHTHALMIC GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-503-07","proprietary_name":"LOTEMAX","nonproprietary_name":"loteprednol etabonate","dosage_form":"GEL","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-503-07) / 5 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":49.66158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":18.18798,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lotemax|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"24208050707","name":"LOTEMAX SM 0.38% OPHTH GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-507-07","proprietary_name":"Lotemax SM","nonproprietary_name":"loteprednol etabonate","dosage_form":"GEL","route":"OPHTHALMIC","strength":"3.8 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-507-07) / 5 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":49.48461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Lotemax Sm|Loteprednol Etabonate","basis":"brand"},"part_b":null}, {"ndc":"24208050801","name":"LOTEPREDNOL 0.5% OPHTHALMC GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-508-01","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"GEL","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-508-01) / 5 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":18.18798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70244003601","name":"LOTEPREDNOL 0.5% OPHTHALMC GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-036-01","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"GEL","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Sentiss Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70244-036-01) / 5 g in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":18.18798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72485063005","name":"LOTEPREDNOL 0.5% OPHTHALMC GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-630-05","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"GEL","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-630-05) / 5 g in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":18.18798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"82260050801","name":"LOTEPREDNOL 0.5% OPHTHALMC GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-508-01","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"GEL","route":"OPHTHALMIC","strength":"5 mg/g","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE in 1 CARTON (82260-508-01) / 5 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":18.18798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574408005","name":"LOTEPREDNOL ETABONATE 0.2% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4080-05","proprietary_name":"LOTEPREDNOL ETABONATE","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0574-4080-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.71714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219136603","name":"LOTEPREDNOL ETABONATE 0.2% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1366-3","proprietary_name":"loteprednol etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (60219-1366-3) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.71714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70244003501","name":"LOTEPREDNOL ETABONATE 0.2% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-035-01","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Sentiss Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70244-035-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.71714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485065305","name":"LOTEPREDNOL ETABONATE 0.2% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-653-05","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-653-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.71714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260036105","name":"LOTEPREDNOL ETABONATE 0.2% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-361-05","proprietary_name":"loteprednol etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-361-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.71714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574413505","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4135-05","proprietary_name":"LOTEPREDNOL ETABONATE","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0574-4135-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574413510","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4135-10","proprietary_name":"LOTEPREDNOL ETABONATE","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0574-4135-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":21.199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574413515","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4135-15","proprietary_name":"LOTEPREDNOL ETABONATE","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0574-4135-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":17.16787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219136201","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1362-1","proprietary_name":"LOTEPREDNOL ETABONATE","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (60219-1362-1) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62756023255","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-232-55","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (62756-232-55) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":21.199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62756023256","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-232-56","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (62756-232-56) / 15 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":17.16787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62756023290","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-232-90","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (62756-232-90) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70244003401","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70244-034-01","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sentiss Pharmaceuticals LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70244-034-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748030001","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-300-01","proprietary_name":"loteprednol etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-300-01) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748030002","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-300-02","proprietary_name":"loteprednol etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-300-02) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":21.199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485066505","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-665-05","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"Loteprednol Etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-665-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603032401","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-324-01","proprietary_name":"LOTEPREDNOL ETABONATE","nonproprietary_name":"LOTEPREDNOL ETABONATE","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-324-01) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260029905","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-299-05","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE in 1 CARTON (82260-299-05) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.47371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260029910","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-299-10","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE in 1 CARTON (82260-299-10) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":21.199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260029915","name":"LOTEPREDNOL ETABONATE 0.5% DRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-299-15","proprietary_name":"Loteprednol Etabonate","nonproprietary_name":"loteprednol etabonate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE in 1 CARTON (82260-299-15) / 15 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":17.16787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093092606","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0926-06","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-0926-06)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"00093092610","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0926-10","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-0926-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"61442014101","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-141-01","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (61442-141-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"61442014110","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-141-10","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (61442-141-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68001031400","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-314-00","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-314-00)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046701","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-467-01","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-467-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046703","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-467-03","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-467-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046707","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-467-07","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (68180-467-07)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046709","name":"LOVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-467-09","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (68180-467-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03653,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"00093057606","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0576-06","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-0576-06)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"00093057610","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0576-10","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-0576-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"61442014201","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-142-01","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (61442-142-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"61442014210","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-142-10","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (61442-142-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68001031500","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-315-00","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-315-00)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68001031508","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-315-08","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-315-08)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046801","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-468-01","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-468-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046803","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-468-03","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-468-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046805","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-468-05","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 BOTTLE (68180-468-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046807","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-468-07","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (68180-468-07)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68645056690","name":"LOVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-566-90","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-566-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"00093092806","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0928-06","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-0928-06)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"00093092810","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0928-10","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-0928-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"61442014301","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-143-01","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (61442-143-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"61442014310","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-143-10","proprietary_name":"Lovastatin","nonproprietary_name":"Lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (61442-143-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68001031600","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-316-00","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-316-00)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68001031608","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-316-08","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-316-08)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046901","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-469-01","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-469-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046903","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-469-03","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-469-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046905","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-469-05","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET in 1 BOTTLE (68180-469-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046907","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-469-07","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (68180-469-07)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"68645056790","name":"LOVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-567-90","proprietary_name":"Lovastatin","nonproprietary_name":"lovastatin","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"90 TABLET in 1 BOTTLE (68645-567-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lovastatin|Lovastatin","basis":"generic"},"part_b":null}, {"ndc":"00075062040","name":"LOVENOX 40 MG/0.4 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0075-0620-40","proprietary_name":"Lovenox","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0075-0620-40) / 1 SYRINGE in 1 CELLO PACK (0075-0620-01) / .4 mL in 1 SYRINGE","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lovenox|Enoxaparin Sodium","basis":"brand"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0075-0620-40) / 1 SYRINGE in 1 CELLO PACK (0075-0620-01) / .4 mL in 1 SYRINGE) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00075801410","name":"LOVENOX 40 MG/0.4 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0075-8014-10","proprietary_name":"Lovenox","nonproprietary_name":"enoxaparin sodium","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"40 mg/.4mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"10 CELLO PACK in 1 CARTON (0075-8014-10) / 1 SYRINGE in 1 CELLO PACK / .4 mL in 1 SYRINGE (0075-8014-01)","pharm_classes":["Heparin, Low-Molecular-Weight [CS]","Low Molecular Weight Heparin [EPC]"]},"nadac":{"value":6.775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":7.7791,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lovenox|Enoxaparin Sodium","basis":"brand"},"part_b":{"hcpcs":"J1650","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1650 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.4,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CELLO PACK in 1 CARTON (0075-8014-10) / 1 SYRINGE in 1 CELLO PACK / .4 mL in 1 SYRINGE (0075-8014-01)) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51862056401","name":"LOW-OGESTREL-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Low-Ogestrel|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"51862056406","name":"LOW-OGESTREL-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51862-564-06","proprietary_name":"Low-Ogestrel","nonproprietary_name":"Norgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mayne Pharma Inc.","package_description":"6 BLISTER PACK in 1 CARTON (51862-564-06) / 1 KIT in 1 BLISTER PACK (51862-564-01)"},"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Low-Ogestrel|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00527139501","name":"LOXAPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1395-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0527-1395-01)"},"nadac":{"value":0.46824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591037001","name":"LOXAPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0370-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-0370-01)"},"nadac":{"value":0.46824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"62135049360","name":"LOXAPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-493-60","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-493-60)"},"nadac":{"value":0.46824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"64850089101","name":"LOXAPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-891-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-891-01)"},"nadac":{"value":0.46824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00527139601","name":"LOXAPINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1396-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0527-1396-01)"},"nadac":{"value":0.69476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591037101","name":"LOXAPINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0371-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-0371-01)"},"nadac":{"value":0.69476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"64850089201","name":"LOXAPINE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-892-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-892-01)"},"nadac":{"value":0.69476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00527139401","name":"LOXAPINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1394-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0527-1394-01)"},"nadac":{"value":0.30917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591036901","name":"LOXAPINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0369-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-0369-01)"},"nadac":{"value":0.30917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"62135049260","name":"LOXAPINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-492-60","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-492-60)"},"nadac":{"value":0.30917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"64850089001","name":"LOXAPINE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-890-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-890-01)"},"nadac":{"value":0.30917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00527139701","name":"LOXAPINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1397-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0527-1397-01)"},"nadac":{"value":0.95202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591037201","name":"LOXAPINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0372-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-0372-01)"},"nadac":{"value":0.95202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"64850089301","name":"LOXAPINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-893-01","proprietary_name":"Loxapine","nonproprietary_name":"Loxapine","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64850-893-01)"},"nadac":{"value":0.95202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Loxapine|Loxapine Succinate","basis":"generic"},"part_b":null}, {"ndc":"00254302902","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-3029-02","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"Par Health USA, LLC","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (0254-3029-02)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"00480413806","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-4138-06","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (0480-4138-06)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"31722040460","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-404-60","proprietary_name":"Lubiprostone","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE","route":"ORAL","strength":".024 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (31722-404-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"43598016860","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-168-60","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (43598-168-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"60687082732","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-827-32","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-827-32) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (60687-827-33)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"60687082733","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"63304035260","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-352-60","proprietary_name":"Lubiprostone","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (63304-352-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"69339016317","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-163-17","proprietary_name":"LUBIPROSTONE","nonproprietary_name":"LUBIPROSTONE","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"24 ug/1","labeler":"Natco Pharma USA LLC","package_description":"40 BLISTER PACK in 1 CARTON (69339-163-17) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (69339-163-98)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"69339016398","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"70710164206","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1642-6","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE","route":"ORAL","strength":"24 ug/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 CAPSULE in 1 BOTTLE (70710-1642-6)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"72603028901","name":"LUBIPROSTONE 24 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-289-01","proprietary_name":"Lubiprostone","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE","route":"ORAL","strength":".024 mg/1","labeler":"Northstar Rx LLC","package_description":"60 CAPSULE in 1 BOTTLE (72603-289-01)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.6507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"00254302802","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-3028-02","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"Par Health USA, LLC","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (0254-3028-02)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"00480347906","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3479-06","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (0480-3479-06)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"31722040360","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-403-60","proprietary_name":"Lubiprostone","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE","route":"ORAL","strength":".008 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (31722-403-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"43598016360","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-163-60","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (43598-163-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"60687081632","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-816-32","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-816-32) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (60687-816-33)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"60687081633","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"63304035160","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-351-60","proprietary_name":"Lubiprostone","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (63304-351-60)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"69339016217","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-162-17","proprietary_name":"LUBIPROSTONE","nonproprietary_name":"LUBIPROSTONE","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"8 ug/1","labeler":"Natco Pharma USA LLC","package_description":"40 BLISTER PACK in 1 CARTON (69339-162-17) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (69339-162-98)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"69339016298","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"70710164106","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1641-6","proprietary_name":"Lubiprostone","nonproprietary_name":"Lubiprostone","dosage_form":"CAPSULE","route":"ORAL","strength":"8 ug/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 CAPSULE in 1 BOTTLE (70710-1641-6)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"72603028801","name":"LUBIPROSTONE 8 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-288-01","proprietary_name":"Lubiprostone","nonproprietary_name":"lubiprostone","dosage_form":"CAPSULE","route":"ORAL","strength":".008 mg/1","labeler":"Northstar Rx LLC","package_description":"60 CAPSULE in 1 BOTTLE (72603-288-01)","pharm_classes":["Chloride Channel Activator [EPC]","Chloride Channel Activators [MoA]"]},"nadac":{"value":0.56517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lubiprostone|Lubiprostone","basis":"generic"},"part_b":null}, {"ndc":"50268012615","name":"LUBRICANT 0.4-0.3% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50268-126-15","proprietary_name":"Lubricant Eye Drops Solution","nonproprietary_name":"polyethylene glycol 400 and Propylene Glycol","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"AvPAK","package_description":"1 BOTTLE in 1 CARTON (50268-126-15) / 15 mL in 1 BOTTLE"},"nadac":{"value":0.36253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536138792","name":"LUBRICANT 0.5% EYE DROP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1387-92","proprietary_name":"Rugby Lubricant Eye Drops","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Rugby Laboratories","package_description":"30 VIAL, SINGLE-USE in 1 BOX (0536-1387-92) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.22679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536138793","name":"LUBRICANT 0.5% EYE DROP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1387-93","proprietary_name":"Rugby Lubricant Eye Drops","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Rugby Laboratories","package_description":"50 VIAL, SINGLE-USE in 1 BOX (0536-1387-93) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.2548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000070501","name":"LUBRICANT 0.5% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0705-1","proprietary_name":"Leader Lubricant Eye Drops Soothing Relief","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"LEADER/Cardinal Health 110, Inc.","package_description":"1 BOTTLE, DROPPER in 1 BOX (70000-0705-1) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.32365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000070502","name":"LUBRICANT 0.5% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0705-2","proprietary_name":"Leader Lubricant Eye Drops Soothing Relief","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"LEADER/Cardinal Health 110, Inc.","package_description":"2 BOTTLE, DROPPER in 1 BOX (70000-0705-2) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.28017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000001201","name":"LUBRICANT 0.5% EYE DROPS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0012-1","proprietary_name":"Leader Lubricant Eye Drops","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Cardinal Health","package_description":"70 VIAL, SINGLE-USE in 1 BOX (70000-0012-1) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.16275,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000001202","name":"LUBRICANT 0.5% EYE DROPS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0012-2","proprietary_name":"Leader Lubricant Eye Drops","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL","labeler":"Cardinal Health","package_description":"30 VIAL, SINGLE-USE in 1 BOX (70000-0012-2) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.22679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000070601","name":"LUBRICANT 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.21406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000001701","name":"LUBRICANT EYE 0.4%-0.3% DROP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0017-1","proprietary_name":"Leader Lubricant Eye Drops 30ct","nonproprietary_name":"Polyethylene Glycol 400, Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".4 g/100mL; .3 g/100mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"30 VIAL, SINGLE-USE in 1 BOX (70000-0017-1) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.20368,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536121994","name":"LUBRICATING EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.36253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904754012","name":"LUBRIFRESH PM EYE 15-83% OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7540-12","proprietary_name":"LubriFresh PM","nonproprietary_name":"Light Mineral Oil, White Petrolatum","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"150 mg/g; 830 mg/g","labeler":"Major Pharmaceuticals","package_description":"1 TUBE in 1 BOX (0904-7540-12) / 3.5 g in 1 TUBE"},"nadac":{"value":1.68723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904648838","name":"LUBRIFRESH PM EYE OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.68723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"78670005036","name":"LUCEMYRA 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78670-050-36","proprietary_name":"Lucemyra","nonproprietary_name":"lofexidine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".2 mg/1","labeler":"USWM, LLC","package_description":"1 BOTTLE in 1 CARTON (78670-050-36) / 36 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":23.22082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lucemyra|Lofexidine HCl","basis":"brand"},"part_b":null}, {"ndc":"78670005096","name":"LUCEMYRA 0.18 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78670-050-96","proprietary_name":"Lucemyra","nonproprietary_name":"lofexidine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".2 mg/1","labeler":"USWM, LLC","package_description":"1 BOTTLE in 1 CARTON (78670-050-96) / 96 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":23.22082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.87932,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lucemyra|Lofexidine HCl","basis":"brand"},"part_b":null}, {"ndc":"70700031379","name":"LUIZZA 1 MG-20 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-313-79","proprietary_name":"LUIZZA 1/20","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"TABLET","route":"ORAL","strength":".02 mg/1; 1 mg/1","labeler":"Xiromed, LLC","package_description":"3 POUCH in 1 CARTON (70700-313-79) / 1 BLISTER PACK in 1 POUCH / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700031479","name":"LUIZZA 1.5 MG-30 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-314-79","proprietary_name":"LUIZZA 1.5/30","nonproprietary_name":"norethindrone acetate and ethinyl estradiol","dosage_form":"TABLET","route":"ORAL","strength":"30 ug/1; 1.5 mg/1","labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-314-79) / 1 BLISTER PACK in 1 POUCH (70700-314-78) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208053708","name":"LUMIFY 0.025% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-537-08","proprietary_name":"LUMIFY Redness Reliever Eye Drops","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-537-08) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":3.42973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208053725","name":"LUMIFY 0.025% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-537-25","proprietary_name":"LUMIFY Redness Reliever Eye Drops","nonproprietary_name":"BRIMONIDINE TARTRATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-537-25) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.99701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023320503","name":"LUMIGAN 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3205-03","proprietary_name":"LUMIGAN","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3205-03) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":103.06335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":42.51553,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lumigan|Bimatoprost","basis":"brand"},"part_b":null}, {"ndc":"00023320505","name":"LUMIGAN 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3205-05","proprietary_name":"LUMIGAN","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3205-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":102.99002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":42.752,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lumigan|Bimatoprost","basis":"brand"},"part_b":null}, {"ndc":"00023320508","name":"LUMIGAN 0.01% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3205-08","proprietary_name":"LUMIGAN","nonproprietary_name":"bimatoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3205-08) / 7.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":103.10858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":43.41341,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lumigan|Bimatoprost","basis":"brand"},"part_b":null}, {"ndc":"00074366303","name":"LUPRON DEPOT 11.25 MG 3MO KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-3663-03","proprietary_name":"Lupron Depot","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"1 KIT in 1 CARTON (0074-3663-03) * 1.5 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":5437.39667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lupron Depot|Leuprolide Acetate","basis":"brand"},"part_b":{"hcpcs":"J1950","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1950 (3.75 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (0074-3663-03) * 1.5 mL in 1 SYRINGE * 1 mL in 1 PACKET) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00074364103","name":"LUPRON DEPOT 3.75 MG KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-3641-03","proprietary_name":"Lupron Depot","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"1 KIT in 1 CARTON (0074-3641-03) * 1 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":1822.07714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lupron Depot|Leuprolide Acetate","basis":"brand"},"part_b":{"hcpcs":"J1950","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1950 (3.75 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (0074-3641-03) * 1 mL in 1 SYRINGE * 1 mL in 1 PACKET) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00074364203","name":"LUPRON DEPOT 7.5 MG 1 MONTH KT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0074-3642-03","proprietary_name":"Lupron Depot","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"1 KIT in 1 CARTON (0074-3642-03) * 1 mL in 1 SYRINGE (0074-9907-01) * 1 SWAB in 1 PACKET (0074-0009-01) * 1 mL in 1 SYRINGE * 1 SWAB in 1 PACKET"},"nadac":{"value":2174.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lupron Depot|Leuprolide Acetate","basis":"brand"},"part_b":{"hcpcs":"J9217","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9217 (7.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (0074-3642-03) * 1 mL in 1 SYRINGE (0074-9907-01) * 1 SWAB in 1 PACKET (0074-0009-01) * 1 mL in 1 SYRINGE * 1 SWAB in 1 PACKET) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00074364255","name":"LUPRON DEPOT 7.5 MG 1 MONTH KT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0074-3642-55","proprietary_name":"Lupron Depot","nonproprietary_name":"leuprolide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"1 KIT in 1 CELLO PACK (0074-3642-55) * 1 mL in 1 SYRINGE (0074-9907-01) * 1 SWAB in 1 PACKET (0074-0009-01) * 1 mL in 1 SYRINGE * 1 SWAB in 1 PACKET"},"nadac":{"value":2174.1678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lupron Depot|Leuprolide Acetate","basis":"brand"},"part_b":{"hcpcs":"J9217","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9217 (7.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CELLO PACK (0074-3642-55) * 1 mL in 1 SYRINGE (0074-9907-01) * 1 SWAB in 1 PACKET (0074-0009-01) * 1 mL in 1 SYRINGE * 1 SWAB in 1 PACKET) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904735904","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7359-04","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7359-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904742546","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7425-46","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7425-46)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668046730","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-467-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-467-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155089103","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-891-03","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-891-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722008430","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-084-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-084-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342042307","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-423-07","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-423-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598035530","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-355-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-355-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049830","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-498-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-498-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862095730","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-957-30","proprietary_name":"LURASIDONE HYDROCHLORIDE","nonproprietary_name":"LURASIDONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-957-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877064230","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-642-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-642-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68180067406","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-674-06","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-674-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382096806","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-968-06","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"120 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (68382-968-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205021130","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-211-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-211-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282052530","name":"LURASIDONE HCL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-525-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-525-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.48665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904735504","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7355-04","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7355-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904742146","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7421-46","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7421-46)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668046430","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-464-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-464-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155088703","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-887-03","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-887-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722008030","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-080-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-080-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342041907","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-419-07","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-419-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598035130","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-351-30","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-351-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"47335057883","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-578-83","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (47335-578-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687074711","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687074721","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-747-21","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-747-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-747-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049430","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-494-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-494-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862095330","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-953-30","proprietary_name":"LURASIDONE HYDROCHLORIDE","nonproprietary_name":"LURASIDONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-953-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877063830","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-638-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-638-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68180067006","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-670-06","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-670-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382096506","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-965-06","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (68382-965-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205020730","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-207-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-207-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603062101","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-621-01","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-621-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282052230","name":"LURASIDONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-522-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-522-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904735661","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7356-61","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7356-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904742246","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7422-46","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7422-46)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668046530","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-465-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-465-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155088803","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-888-03","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-888-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722008130","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-081-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-081-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342042007","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-420-07","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-420-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598035230","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-352-30","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-352-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"47335068483","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-684-83","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (47335-684-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687075811","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687075821","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-758-21","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-758-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-758-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049530","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-495-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-495-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862095430","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-954-30","proprietary_name":"LURASIDONE HYDROCHLORIDE","nonproprietary_name":"LURASIDONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-954-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877063930","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-639-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-639-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68180067106","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-671-06","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-671-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382096616","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-966-16","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (68382-966-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205020830","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-208-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-208-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603062201","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-622-01","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-622-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282052330","name":"LURASIDONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-523-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-523-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.20953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904735761","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7357-61","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7357-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904742346","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7423-46","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7423-46)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668050930","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-509-30","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-509-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155088903","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-889-03","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-889-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722008230","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-082-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-082-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342042107","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-421-07","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-421-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598035330","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-353-30","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-353-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"47335063983","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-639-83","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (47335-639-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687076911","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687076994","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-769-94","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-769-94) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-769-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049630","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-496-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-496-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862095530","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-955-30","proprietary_name":"LURASIDONE HYDROCHLORIDE","nonproprietary_name":"LURASIDONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-955-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877064030","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-640-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-640-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68180067206","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-672-06","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-672-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382085906","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-859-06","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"60 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (68382-859-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205020930","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-209-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-209-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603062301","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-623-01","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-623-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282053430","name":"LURASIDONE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-534-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-534-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.29118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904735861","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7358-61","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7358-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904742446","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7424-46","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0904-7424-46)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668046630","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-466-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-466-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155089003","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-890-03","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-890-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722008330","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-083-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-083-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342042207","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-422-07","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-422-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"43598035430","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-354-30","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-354-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"47335068583","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-685-83","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (47335-685-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687078011","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687078021","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-780-21","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-780-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-780-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049730","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-497-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-497-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862095630","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-956-30","proprietary_name":"LURASIDONE HYDROCHLORIDE","nonproprietary_name":"LURASIDONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-956-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877064130","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-641-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-641-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68180067306","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-673-06","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (68180-673-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382096706","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-967-06","proprietary_name":"Lurasidone hydrochloride","nonproprietary_name":"Lurasidone hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"80 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (68382-967-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205021030","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-210-30","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-210-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603062401","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-624-01","proprietary_name":"lurasidone hydrochloride","nonproprietary_name":"lurasidone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-624-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282052430","name":"LURASIDONE HCL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-524-30","proprietary_name":"Lurasidone Hydrochloride","nonproprietary_name":"Lurasidone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-524-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.3278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lurasidone HCl|Lurasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"71085008230","name":"LURBIRO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71085-082-30","proprietary_name":"LURBIRO","nonproprietary_name":"Flurbiprofen","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"IPG Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (71085-082-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":3.17335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Flurbiprofen|Flurbiprofen","basis":"generic"},"part_b":null}, {"ndc":"65757065242","name":"LYBALVI 10-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-652-42","proprietary_name":"LYBALVI","nonproprietary_name":"olanzapine and samidorphan L-malate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1; 10 mg/1","labeler":"Alkermes, Inc.","package_description":"1 BOTTLE in 1 CARTON (65757-652-42) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]","Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":55.09696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lybalvi|Olanzapine/Samidorphan Malate","basis":"brand"},"part_b":null}, {"ndc":"65757065342","name":"LYBALVI 15-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-653-42","proprietary_name":"LYBALVI","nonproprietary_name":"olanzapine and samidorphan L-malate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 10 mg/1","labeler":"Alkermes, Inc.","package_description":"1 BOTTLE in 1 CARTON (65757-653-42) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]","Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":55.11941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lybalvi|Olanzapine/Samidorphan Malate","basis":"brand"},"part_b":null}, {"ndc":"65757065442","name":"LYBALVI 20-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-654-42","proprietary_name":"LYBALVI","nonproprietary_name":"olanzapine and samidorphan L-malate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 10 mg/1","labeler":"Alkermes, Inc.","package_description":"1 BOTTLE in 1 CARTON (65757-654-42) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]","Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":54.9818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lybalvi|Olanzapine/Samidorphan Malate","basis":"brand"},"part_b":null}, {"ndc":"65757065142","name":"LYBALVI 5-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-651-42","proprietary_name":"LYBALVI","nonproprietary_name":"olanzapine and samidorphan L-malate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1; 10 mg/1","labeler":"Alkermes, Inc.","package_description":"1 BOTTLE in 1 CARTON (65757-651-42) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]","Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":55.21379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lybalvi|Olanzapine/Samidorphan Malate","basis":"brand"},"part_b":null}, {"ndc":"50102030001","name":"LYLEQ 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyleq|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"50102030011","name":"LYLEQ 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyleq|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"50102030013","name":"LYLEQ 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-300-13","proprietary_name":"Lyleq","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Afaxys Pharma, LLC","package_description":"3 PACKAGE in 1 CARTON (50102-300-13) / 1 BLISTER PACK in 1 PACKAGE (50102-300-11) / 28 TABLET in 1 BLISTER PACK (50102-300-01)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyleq|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"65162012604","name":"LYLLANA 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162012608","name":"LYLLANA 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-126-08","proprietary_name":"LYLLANA","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-126-08) / 1 d in 1 POUCH (65162-126-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162014804","name":"LYLLANA 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162014808","name":"LYLLANA 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-148-08","proprietary_name":"LYLLANA","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-148-08) / 1 d in 1 POUCH (65162-148-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162014904","name":"LYLLANA 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162014908","name":"LYLLANA 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-149-08","proprietary_name":"LYLLANA","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-149-08) / 1 d in 1 POUCH (65162-149-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162015004","name":"LYLLANA 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162015008","name":"LYLLANA 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-150-08","proprietary_name":"LYLLANA","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-150-08) / 1 d in 1 POUCH (65162-150-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162022804","name":"LYLLANA 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162022808","name":"LYLLANA 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-228-08","proprietary_name":"LYLLANA","nonproprietary_name":"Estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 POUCH in 1 CARTON (65162-228-08) / 1 d in 1 POUCH (65162-228-04)","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyllana|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50419047501","name":"LYNKUET 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.97051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50419047505","name":"LYNKUET 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-475-05","proprietary_name":"LYNKUET","nonproprietary_name":"elinzanetant","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"5 BLISTER PACK in 1 CARTON (50419-475-05) / 12 CAPSULE in 1 BLISTER PACK (50419-475-01)"},"nadac":{"value":9.97051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58151023932","name":"LYRICA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.69564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023977","name":"LYRICA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-239-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-239-77)"},"nadac":{"value":9.69564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023988","name":"LYRICA 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-239-88","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-239-88) / 1 CAPSULE in 1 BLISTER PACK (58151-239-32)"},"nadac":{"value":9.69564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151024032","name":"LYRICA 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.68758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151024077","name":"LYRICA 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-240-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-240-77)"},"nadac":{"value":9.68758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151024088","name":"LYRICA 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-240-88","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-240-88) / 1 CAPSULE in 1 BLISTER PACK (58151-240-32)"},"nadac":{"value":9.68758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151024177","name":"LYRICA 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-241-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-241-77)"},"nadac":{"value":9.68209,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151024377","name":"LYRICA 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-243-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-243-77)"},"nadac":{"value":9.68449,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023677","name":"LYRICA 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-236-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-236-77)"},"nadac":{"value":9.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"00071101868","name":"LYRICA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0071-1018-68","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Parke-Davis Div of Pfizer Inc","package_description":"90 CAPSULE in 1 BOTTLE (0071-1018-68)"},"nadac":{"value":9.67502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151024277","name":"LYRICA 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-242-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-242-77)"},"nadac":{"value":9.67502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023732","name":"LYRICA 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.68419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023777","name":"LYRICA 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-237-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-237-77)"},"nadac":{"value":9.68419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023788","name":"LYRICA 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-237-88","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-237-88) / 1 CAPSULE in 1 BLISTER PACK (58151-237-32)"},"nadac":{"value":9.68419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023832","name":"LYRICA 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.67102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023877","name":"LYRICA 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-238-77","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 CAPSULE in 1 BOTTLE (58151-238-77)"},"nadac":{"value":9.67102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"58151023888","name":"LYRICA 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-238-88","proprietary_name":"Lyrica","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-238-88) / 1 CAPSULE in 1 BLISTER PACK (58151-238-32)"},"nadac":{"value":9.67102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Lyrica|Pregabalin","basis":"brand"},"part_b":null}, {"ndc":"00002820705","name":"LYUMJEV 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8207-05","proprietary_name":"LYUMJEV KwikPen","nonproprietary_name":"Insulin lispro-aabc","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8207-05) / 3 mL in 1 SYRINGE (0002-8207-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.15486,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lyumjev Kwikpen U-100|Insulin Lispro-Aabc","basis":"brand"},"part_b":null}, {"ndc":"00002772801","name":"LYUMJEV 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-7728-01","proprietary_name":"LYUMJEV","nonproprietary_name":"Insulin lispro-aabc","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0002-7728-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":7.87326,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lyumjev|Insulin Lispro-Aabc","basis":"brand"},"part_b":{"hcpcs":"J1813","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1813 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0002-7728-01) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00002822827","name":"LYUMJEV 200 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8228-27","proprietary_name":"LYUMJEV KwikPen","nonproprietary_name":"Insulin lispro-aabc","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"2 SYRINGE in 1 CARTON (0002-8228-27) / 3 mL in 1 SYRINGE (0002-8228-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":20.28228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Lyumjev Kwikpen U-200|Insulin Lispro-Aabc","basis":"brand"},"part_b":null}, {"ndc":"00002823505","name":"LYUMJEV TEMPO PEN 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-8235-05","proprietary_name":"LYUMJEV Tempo Pen","nonproprietary_name":"Insulin lispro-aabc","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8235-05) / 3 mL in 1 SYRINGE (0002-8235-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [Chemical/Ingredient]"]},"nadac":{"value":10.13813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657052804","name":"M-DRYL 12.5 MG/5 ML SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-528-04","proprietary_name":"M-Dryl","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"120 mL in 1 BOTTLE (58657-528-04)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657052816","name":"M-DRYL 12.5 MG/5 ML SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-528-16","proprietary_name":"M-Dryl","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"12.5 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (58657-528-16)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657017001","name":"M-NATAL PLUS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-170-01","proprietary_name":"M-Natal Plus","nonproprietary_name":"Vitamin A, Vitamin C, Vitamin D, Vitamin E, Thiamine, Riboflavin, Niacin, Vitamin B6, Folic Acid, Vitamin B12, Calcium, Iron, Zinc, Copper","dosage_form":"TABLET","route":"ORAL","strength":"4000 [iU]/1; 120 mg/1; 400 [iU]/1; 22 [iU]/1; 1.84 mg/1; 3 mg/1; 20 mg/1; 10 mg/1; 1 mg/1; 12 ug/1; 200 mg/1; 27 mg/1; 25 mg/1; 2 mg/1","labeler":"METHOD PHARMACEUTICALS, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-170-01)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Calcium [CS]","Calcium [EPC]","Copper [CS]","Copper-containing Intrauterine Device [EPC]","Decreased Embryonic Implantation [PE]","Decreased Sperm Motility [PE]","Inhibit Ovum Fertilization [PE]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.11256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"M-Natal Plus|PNV,Calcium 72/Iron/Folic Acid","basis":"brand"},"part_b":null}, {"ndc":"58657052404","name":"M-PAP 160 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-524-04","proprietary_name":"M-PAP","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"120 mL in 1 BOTTLE (58657-524-04)"},"nadac":{"value":0.02406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657052416","name":"M-PAP 160 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-524-16","proprietary_name":"M-PAP","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (58657-524-16)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657052516","name":"M-PAP 160 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-525-16","proprietary_name":"M-PAP","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"160 mg/5mL","labeler":"Method Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (58657-525-16)"},"nadac":{"value":0.01067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904741844","name":"MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7418-44","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Major Magnesium Citrate Oral Solution - Lemon","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"Major Pharmaceuticals","package_description":"296 mL in 1 BOTTLE, PLASTIC (0904-7418-44)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000065901","name":"MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0659-1","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Leader Magnesium Citrate Oral Solution - Grape","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"CARDINAL HEALTH, INC. 063997360","package_description":"296 mL in 1 BOTTLE, PLASTIC (70000-0659-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000066001","name":"MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0660-1","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Leader Magnesium Citrate Oral Solution - Cherry","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"CARDINAL HEALTH, INC. 063997360","package_description":"296 mL in 1 BOTTLE, PLASTIC (70000-0660-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000066101","name":"MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0661-1","proprietary_name":"Magnesium Citrate","nonproprietary_name":"Leader Magnesium Citrate Oral Solution - Lemon","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"CARDINAL HEALTH, INC. 063997360","package_description":"296 mL in 1 BOTTLE, PLASTIC (70000-0661-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568005101","name":"MAGNESIUM CITRATE SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0051-1","proprietary_name":"Magnesium Citrate Saline Laxative","nonproprietary_name":"Magnesium Citrate","dosage_form":"LIQUID","route":"ORAL","strength":"1.745 g/29.6mL","labeler":"AARNA USA INC.","package_description":"296 mL in 1 BOTTLE (82568-0051-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00603020922","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-0209-22","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Endo USA","package_description":"120 TABLET in 1 BOTTLE (0603-0209-22)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24689013201","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-132-01","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"APNAR PHARMA LP","package_description":"120 TABLET in 1 BOTTLE (24689-132-01)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657012012","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-120-12","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (58657-120-12)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367029820","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-298-20","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (69367-298-20)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033002701","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-027-01","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Kesin Pharma","package_description":"10 BLISTER PACK in 1 CARTON (81033-027-01) / 100 TABLET in 1 BLISTER PACK (81033-027-41)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033002712","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-027-12","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Kesin Pharma","package_description":"120 TABLET in 1 BOTTLE (81033-027-12)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033002741","name":"MAGNESIUM OXIDE 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603021321","name":"MAGNESIUM OXIDE 420 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-0213-21","proprietary_name":"Magnesium Oxide","nonproprietary_name":"Magnesium Oxide","dosage_form":"TABLET","route":"ORAL","strength":"253 mg/1","labeler":"Endo USA","package_description":"100 TABLET in 1 BOTTLE (0603-0213-21)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672529404","name":"MALATHION 0.5% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-5294-4","proprietary_name":"Malathion","nonproprietary_name":"Malathion","dosage_form":"LOTION","route":"TOPICAL","strength":".0005 g/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-5294-4) / 59 mL in 1 BOTTLE","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":3.19135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Malathion|Malathion","basis":"generic"},"part_b":null}, {"ndc":"00904198760","name":"MAPAP 500 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-1987-60","proprietary_name":"MAPAP Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (0904-1987-60)"},"nadac":{"value":0.03484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904584709","name":"MAPAP 500 MG/15 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5847-09","proprietary_name":"Extra Strength Acetaminohpen Adult Rapid Burst Cherry","nonproprietary_name":"Acetaminophen","dosage_form":"LIQUID","route":"ORAL","strength":"500 mg/15mL","labeler":"Major Pharmaceuticals","package_description":"237 mL in 1 BOTTLE, PLASTIC (0904-5847-09)"},"nadac":{"value":0.0192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904578624","name":"MAPAP COLD FORMULA CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5786-24","proprietary_name":"Multi-Symptom Mapap Cold Formula","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 5 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-5786-24) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09367,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722057960","name":"MARAVIROC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-579-60","proprietary_name":"Maraviroc","nonproprietary_name":"Maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-579-60)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":9.14963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maraviroc|Maraviroc","basis":"generic"},"part_b":null}, {"ndc":"70710193006","name":"MARAVIROC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1930-6","proprietary_name":"Maraviroc","nonproprietary_name":"Maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1930-6)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":9.14963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maraviroc|Maraviroc","basis":"generic"},"part_b":null}, {"ndc":"72319002402","name":"MARAVIROC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72319-024-02","proprietary_name":"Maraviroc","nonproprietary_name":"Maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72319-024-02)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":9.14963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maraviroc|Maraviroc","basis":"generic"},"part_b":null}, {"ndc":"31722058060","name":"MARAVIROC 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-580-60","proprietary_name":"Maraviroc","nonproprietary_name":"Maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-580-60)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":6.33913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maraviroc|Maraviroc","basis":"generic"},"part_b":null}, {"ndc":"70710193106","name":"MARAVIROC 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1931-6","proprietary_name":"Maraviroc","nonproprietary_name":"Maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1931-6)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":6.33913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maraviroc|Maraviroc","basis":"generic"},"part_b":null}, {"ndc":"72319002502","name":"MARAVIROC 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-025-02","proprietary_name":"Maraviroc","nonproprietary_name":"Maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72319-025-02)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":6.33913,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maraviroc|Maraviroc","basis":"generic"},"part_b":null}, {"ndc":"68462038829","name":"MARLISSA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-388-29","proprietary_name":"MARLISSA","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-388-29) / 1 KIT in 1 BLISTER PACK (68462-388-84)"},"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Marlissa|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462038884","name":"MARLISSA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Marlissa|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"52544069119","name":"MATZIM LA 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-691-19","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-691-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.03058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069130","name":"MATZIM LA 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-691-30","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-691-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.03058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069219","name":"MATZIM LA 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-692-19","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-692-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.0087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069230","name":"MATZIM LA 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-692-30","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-692-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.0087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069319","name":"MATZIM LA 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-693-19","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-693-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.92826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069330","name":"MATZIM LA 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-693-30","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-693-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.92826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069419","name":"MATZIM LA 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-694-19","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-694-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.83372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069430","name":"MATZIM LA 360 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-694-30","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-694-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.83372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069519","name":"MATZIM LA 420 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-695-19","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"420 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-695-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":2.63186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"52544069530","name":"MATZIM LA 420 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52544-695-30","proprietary_name":"Matzim LA","nonproprietary_name":"Diltiazem Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"420 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (52544-695-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":2.63186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Matzim La|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"00074262504","name":"MAVYRET 100-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2625-04","proprietary_name":"Mavyret","nonproprietary_name":"Glecaprevir and Pibrentasvir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 100 mg/1","labeler":"AbbVie Inc.","package_description":"4 CARTON in 1 CARTON (0074-2625-04) / 7 BLISTER PACK in 1 CARTON / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HCV NS3/4A Protease Inhibitors [MoA]","Hepatitis C Virus NS3/4A Protease Inhibitor [EPC]","Hepatitis C Virus NS5A Inhibitor [EPC]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":152.98338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mavyret|Glecaprevir/Pibrentasvir","basis":"brand"},"part_b":null}, {"ndc":"00074262528","name":"MAVYRET 100-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2625-28","proprietary_name":"Mavyret","nonproprietary_name":"Glecaprevir and Pibrentasvir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 100 mg/1","labeler":"AbbVie Inc.","package_description":"4 CARTON in 1 CARTON (0074-2625-28) / 7 DOSE PACK in 1 CARTON / 3 TABLET, FILM COATED in 1 DOSE PACK","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HCV NS3/4A Protease Inhibitors [MoA]","Hepatitis C Virus NS3/4A Protease Inhibitor [EPC]","Hepatitis C Virus NS5A Inhibitor [EPC]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":152.98338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mavyret|Glecaprevir/Pibrentasvir","basis":"brand"},"part_b":null}, {"ndc":"00074262584","name":"MAVYRET 100-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2625-84","proprietary_name":"Mavyret","nonproprietary_name":"Glecaprevir and Pibrentasvir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 100 mg/1","labeler":"AbbVie Inc.","package_description":"84 TABLET, FILM COATED in 1 BOTTLE (0074-2625-84)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HCV NS3/4A Protease Inhibitors [MoA]","Hepatitis C Virus NS3/4A Protease Inhibitor [EPC]","Hepatitis C Virus NS5A Inhibitor [EPC]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","UGT1A1 Inhibitors [MoA]"]},"nadac":{"value":152.98338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mavyret|Glecaprevir/Pibrentasvir","basis":"brand"},"part_b":null}, {"ndc":"78206014201","name":"MAXALT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-142-01","proprietary_name":"MAXALT","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Organon LLC","package_description":"18 POUCH in 1 CARTON (78206-142-01) / 1 TABLET in 1 POUCH (78206-142-99)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":44.4765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maxalt|Rizatriptan Benzoate","basis":"brand"},"part_b":null}, {"ndc":"78206014299","name":"MAXALT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":44.4765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maxalt|Rizatriptan Benzoate","basis":"brand"},"part_b":null}, {"ndc":"78206014301","name":"MAXALT MLT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-143-01","proprietary_name":"MAXALT-MLT","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Organon LLC","package_description":"6 CONTAINER in 1 CARTON (78206-143-01) / 3 POUCH in 1 CONTAINER / 1 BLISTER PACK in 1 POUCH (78206-143-99) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":44.21394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maxalt Mlt|Rizatriptan Benzoate","basis":"brand"},"part_b":null}, {"ndc":"78206014399","name":"MAXALT MLT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":44.21394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Maxalt Mlt|Rizatriptan Benzoate","basis":"brand"},"part_b":null}, {"ndc":"00078092525","name":"MAXIDEX 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":13.1863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Maxidex|Dexamethasone","basis":"brand"},"part_b":null}, {"ndc":"82667060005","name":"MAXIDEX 0.1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82667-600-05","proprietary_name":"MAXIDEX","nonproprietary_name":"dexamethasone","dosage_form":"FOR SUSPENSION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (82667-600-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":13.1863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Maxidex|Dexamethasone","basis":"brand"},"part_b":null}, {"ndc":"58657045401","name":"ME-NAPHOS-MB-HYO 1 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-454-01","proprietary_name":"Me NaPhos MB Hyo 1","nonproprietary_name":"Urinary Antiseptic Antispasmodic","dosage_form":"TABLET","route":"ORAL","strength":"81.6 mg/1; 40.8 mg/1; 10.8 mg/1; .12 mg/1","labeler":"Method Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (58657-454-01)","pharm_classes":["Oxidation-Reduction Activity [MoA]","Oxidation-Reduction Agent [EPC]"]},"nadac":{"value":3.97609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536129701","name":"MECLIZINE 12.5 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1297-01","proprietary_name":"MECLIZINE","nonproprietary_name":"Meclizine HCl 12.5 mg","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"RUGBY LABORATORIES","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0536-1297-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536129710","name":"MECLIZINE 12.5 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1297-10","proprietary_name":"MECLIZINE","nonproprietary_name":"Meclizine HCl 12.5 mg","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"RUGBY LABORATORIES","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0536-1297-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904737561","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7375-61","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7375-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571066001","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-660-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-660-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571066050","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-660-50","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-660-50)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"24689013801","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-138-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-138-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806001210","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-012-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Epic Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (42806-012-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268052211","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268052215","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-522-15","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-522-15) / 1 TABLET in 1 BLISTER PACK (50268-522-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"52536012901","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746044101","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-441-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-441-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746044110","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-441-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 TABLET in 1 BOTTLE (53746-441-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237033301","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-333-01","proprietary_name":"Meclizine HCl","nonproprietary_name":"MECLIZINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-333-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651080701","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-807-01","proprietary_name":"MECLIZINE HYDROCHLORIDE","nonproprietary_name":"MECLIZINE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-807-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"59746012206","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-122-06","proprietary_name":"MECLIZINE HYDROCHLORIDE","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59746-122-06)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"59746012210","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-122-10","proprietary_name":"MECLIZINE HYDROCHLORIDE","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59746-122-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687077501","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-775-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-775-01) / 1 TABLET in 1 BLISTER PACK (60687-775-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687077511","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687077565","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-775-65","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-775-65) / 1 TABLET in 1 BLISTER PACK (60687-775-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135095290","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-952-90","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-952-90)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162044110","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-441-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-441-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162044111","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-441-11","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-441-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001052800","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-528-00","proprietary_name":"Meclizine HCl","nonproprietary_name":"MECLIZINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-528-00)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710116100","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1161-0","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1161-0)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710116101","name":"MECLIZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1161-1","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1161-1)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.04419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904737661","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7376-61","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7376-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571066101","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-661-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-661-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571066110","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-661-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-661-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"24689013901","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-139-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-139-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24689014601","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-146-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"APNAR PHARMA LP","package_description":"100 TABLET in 1 BOTTLE (24689-146-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806001410","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-014-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Epic Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (42806-014-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268052311","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268052315","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-523-15","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-523-15) / 1 TABLET in 1 BLISTER PACK (50268-523-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"52536013301","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746044201","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-442-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-442-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746044210","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-442-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 TABLET in 1 BOTTLE (53746-442-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651080801","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-808-01","proprietary_name":"MECLIZINE HYDROCHLORIDE","nonproprietary_name":"MECLIZINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-808-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651080899","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-808-99","proprietary_name":"MECLIZINE HYDROCHLORIDE","nonproprietary_name":"MECLIZINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-808-99)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687073001","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-730-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-730-01) / 1 TABLET in 1 BLISTER PACK (60687-730-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687073011","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687073065","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-730-65","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-730-65) / 1 TABLET in 1 BLISTER PACK (60687-730-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135095390","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-953-90","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-953-90)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162044210","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-442-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-442-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162044211","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-442-11","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-442-11)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710116200","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1162-0","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET in 1 BOTTLE (70710-1162-0)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710116201","name":"MECLIZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1162-1","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1162-1)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.07568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"00536129901","name":"MECLIZINE 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1299-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Rugby Laboratories","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0536-1299-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536129910","name":"MECLIZINE 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1299-10","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Rugby Laboratories","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE (0536-1299-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571082401","name":"MECLIZINE 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-824-01","proprietary_name":"Meclizine HCl","nonproprietary_name":"MECLIZINE HYDROCHLORIDE CHEWABLE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (16571-824-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571082410","name":"MECLIZINE 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-824-10","proprietary_name":"Meclizine HCl","nonproprietary_name":"MECLIZINE HYDROCHLORIDE CHEWABLE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE (16571-824-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001052900","name":"MECLIZINE 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-529-00","proprietary_name":"Meclizine HCl","nonproprietary_name":"MECLIZINE HYDROCHLORIDE CHEWABLE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (68001-529-00)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001052908","name":"MECLIZINE 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-529-08","proprietary_name":"Meclizine HCl","nonproprietary_name":"MECLIZINE HYDROCHLORIDE CHEWABLE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE (68001-529-08)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571066201","name":"MECLIZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-662-01","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-662-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":2.48424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155094301","name":"MECLIZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-943-01","proprietary_name":"MECLIZINE HYDROCHLORIDE","nonproprietary_name":"MECLIZINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-943-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":2.48424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135095460","name":"MECLIZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-954-60","proprietary_name":"Meclizine Hydrochloride","nonproprietary_name":"Meclizine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-954-60)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":2.48424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meclizine HCl|Meclizine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904682960","name":"MEDI-PADS 50%","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6829-60","proprietary_name":"Major Medi-Pads","nonproprietary_name":"WITCH HAZEL","dosage_form":"CLOTH","route":"TOPICAL","strength":"50 g/100g","labeler":"Major Pharmaceuticals","package_description":"100 PACKET in 1 PACKAGE (0904-6829-60) / 2.9 g in 1 PACKET"},"nadac":{"value":0.04352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000053101","name":"MEDICATED DANDRUFF 1% SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0531-1","proprietary_name":"Leader Medicated Dandruff Anti-Seborrheic Dermatitis, Anti-Dandruff","nonproprietary_name":"Selenium Sulfide","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"10 mg/mL","labeler":"Cardinal Health, 110 dba LEADER","package_description":"207 mL in 1 BOTTLE, PLASTIC (70000-0531-1)"},"nadac":{"value":0.01409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000073201","name":"MEDICATED WART REMOVER STRIP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0732-1","proprietary_name":"Medicated Wart Remover Strips","nonproprietary_name":"Salicylic Acid","dosage_form":"PLASTER","route":"TOPICAL","strength":"400 mg/g","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"18 PATCH in 1 BOX (70000-0732-1) / 1 g in 1 PATCH"},"nadac":{"value":0.10249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00009002001","name":"MEDROL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0020-01","proprietary_name":"Medrol","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"100 TABLET in 1 BOTTLE (0009-0020-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.57028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Medrol|Methylprednisolone","basis":"brand"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (0009-0020-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009005604","name":"MEDROL 4 MG DOSEPAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0056-04","proprietary_name":"Medrol","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 DOSE PACK in 1 CARTON (0009-0056-04) / 21 TABLET in 1 DOSE PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13607,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Medrol|Methylprednisolone","basis":"brand"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":21,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (21 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 DOSE PACK in 1 CARTON (0009-0056-04) / 21 TABLET in 1 DOSE PACK) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009005602","name":"MEDROL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0056-02","proprietary_name":"Medrol","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Pharmacia & Upjohn Company LLC","package_description":"100 TABLET in 1 BOTTLE (0009-0056-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.2454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Medrol|Methylprednisolone","basis":"brand"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (0009-0056-02)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00555077902","name":"MEDROXYPROGESTERONE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0779-02","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0779-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.1523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555077904","name":"MEDROXYPROGESTERONE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0779-04","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0555-0779-04)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.1523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005601","name":"MEDROXYPROGESTERONE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0056-1","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-0056-1)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.1523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005602","name":"MEDROXYPROGESTERONE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0056-2","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-0056-2)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.1523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687010511","name":"MEDROXYPROGESTERONE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687010521","name":"MEDROXYPROGESTERONE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-105-21","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-105-21) / 1 TABLET in 1 BLISTER PACK (60687-105-11)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.1523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00548540000","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5400-00","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0548-5400-00) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00548540025","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5400-25","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (0548-5400-25) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":22.84953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00548570100","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-5701-00","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 CARTON (0548-5701-00) / 1 mL in 1 SYRINGE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":27.36384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150032901","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-329-01","proprietary_name":"MEDROXYPROGESTERONE ACETATE","nonproprietary_name":"MEDROXYPROGESTERONE ACETATE","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Eugia US LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (55150-329-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150032925","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-329-25","proprietary_name":"MEDROXYPROGESTERONE ACETATE","nonproprietary_name":"MEDROXYPROGESTERONE ACETATE","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Eugia US LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (55150-329-25) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":22.84953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150033001","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-330-01","proprietary_name":"MEDROXYPROGESTERONE ACETATE","nonproprietary_name":"MEDROXYPROGESTERONE ACETATE","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Eugia US LLC","package_description":"1 SYRINGE in 1 CARTON (55150-330-01) / 1 mL in 1 SYRINGE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":27.36384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219146701","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1467-1","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 VIAL in 1 CARTON (60219-1467-1) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219146702","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1467-2","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"25 VIAL in 1 CARTON (60219-1467-2) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":22.84953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993037025","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-370-25","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Prasco Laboratories","package_description":"25 VIAL in 1 CARTON (66993-370-25) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":22.84953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993037083","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-370-83","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Prasco Laboratories","package_description":"1 VIAL in 1 CARTON (66993-370-83) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993037179","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-371-79","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Prasco Laboratories","package_description":"1 SYRINGE in 1 CARTON (66993-371-79) / 1 mL in 1 SYRINGE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":27.36384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70121146702","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1467-2","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL in 1 CARTON (70121-1467-2) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70121146705","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1467-5","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"25 VIAL in 1 CARTON (70121-1467-5) / 1 mL in 1 VIAL","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":22.84953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70121148001","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1480-1","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (70121-1480-1) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":27.36384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700031522","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700031525","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-315-25","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Xiromed LLC","package_description":"25 VIAL in 1 CARTON (70700-315-25) / 1 mL in 1 VIAL (70700-315-22)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":22.84953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700031527","name":"MEDROXYPROGESTERONE 150 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-315-27","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRAMUSCULAR","strength":"150 mg/mL","labeler":"Xiromed LLC","package_description":"1 VIAL in 1 CARTON (70700-315-27) / 1 mL in 1 VIAL (70700-315-22)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":18.85351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00555087202","name":"MEDROXYPROGESTERONE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0872-02","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0872-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.11556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555087204","name":"MEDROXYPROGESTERONE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0872-04","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0555-0872-04)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.11556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005501","name":"MEDROXYPROGESTERONE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0055-1","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-0055-1)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.11556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005502","name":"MEDROXYPROGESTERONE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0055-2","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-0055-2)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.11556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555087302","name":"MEDROXYPROGESTERONE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0873-02","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0873-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.14277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555087304","name":"MEDROXYPROGESTERONE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0873-04","proprietary_name":"Medroxyprogesterone Acetate","nonproprietary_name":"Medroxyprogesterone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0555-0873-04)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.14277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005801","name":"MEDROXYPROGESTERONE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0058-1","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-0058-1)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.14277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005802","name":"MEDROXYPROGESTERONE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0058-2","proprietary_name":"medroxyprogesterone acetate","nonproprietary_name":"medroxyprogesterone acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (59762-0058-2)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.14277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571025830","name":"MEFENAMIC ACID 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-258-30","proprietary_name":"Mefenamic acid","nonproprietary_name":"Mefenamic acid","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Micro Labs Limited","package_description":"30 CAPSULE in 1 BOTTLE (42571-258-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.94789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mefenamic Acid|Mefenamic Acid","basis":"generic"},"part_b":null}, {"ndc":"68180018506","name":"MEFENAMIC ACID 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-185-06","proprietary_name":"Mefenamic Acid","nonproprietary_name":"Mefenamic Acid","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-185-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.94789,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mefenamic Acid|Mefenamic Acid","basis":"generic"},"part_b":null}, {"ndc":"00555017178","name":"MEFLOQUINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0171-78","proprietary_name":"Mefloquine Hydrochloride","nonproprietary_name":"Mefloquine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"25 BLISTER PACK in 1 CARTON (0555-0171-78) / 1 TABLET in 1 BLISTER PACK (0555-0171-88)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":3.9742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mefloquine HCl|Mefloquine HCl","basis":"generic"},"part_b":null}, {"ndc":"00555017188","name":"MEFLOQUINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.9742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mefloquine HCl|Mefloquine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135097325","name":"MEFLOQUINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-973-25","proprietary_name":"Mefloquine Hydrochloride","nonproprietary_name":"Mefloquine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"25 TABLET in 1 BOTTLE (62135-973-25)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":3.9742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mefloquine HCl|Mefloquine HCl","basis":"generic"},"part_b":null}, {"ndc":"00555060602","name":"MEGESTROL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0606-02","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0606-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.19502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015801","name":"MEGESTROL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-158-01","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-158-01)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.19502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00555060702","name":"MEGESTROL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0607-02","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0607-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.24078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904723661","name":"MEGESTROL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7236-61","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7236-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.24078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015901","name":"MEGESTROL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-159-01","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-159-01)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.24078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015902","name":"MEGESTROL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-159-02","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Strides Pharma Science Limited","package_description":"250 TABLET in 1 BOTTLE (64380-159-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.24078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015903","name":"MEGESTROL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-159-03","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE (64380-159-03)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.24078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979004113","name":"MEGESTROL 625 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-041-13","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"150 mL in 1 BOTTLE (24979-041-13)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":1.44029,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380016001","name":"MEGESTROL ACET 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-160-01","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Strides Pharma Science Limited","package_description":"240 mL in 1 BOTTLE, PLASTIC (64380-160-01)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.13605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380016002","name":"MEGESTROL ACET 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-160-02","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Strides Pharma Science Limited","package_description":"480 mL in 1 BOTTLE, PLASTIC (64380-160-02)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.12905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954089610","name":"MEGESTROL ACET 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-896-10","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"240 mL in 1 BOTTLE (70954-896-10)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.13605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954089620","name":"MEGESTROL ACET 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-896-20","proprietary_name":"Megestrol Acetate","nonproprietary_name":"Megestrol Acetate","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"480 mL in 1 BOTTLE (70954-896-20)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.12905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700031784","name":"MELEYA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"70700031785","name":"MELEYA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-317-85","proprietary_name":"MELEYA","nonproprietary_name":"Norethindrone","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-317-85) / 1 BLISTER PACK in 1 POUCH (70700-317-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"68180018906","name":"MELOXICAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-189-06","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-189-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":11.24632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954007710","name":"MELOXICAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-077-10","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70954-077-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":11.24632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788004701","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-047-01","proprietary_name":"MELOXICAM","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-047-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788004705","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-047-05","proprietary_name":"MELOXICAM","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"500 TABLET in 1 BOTTLE (11788-047-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788004710","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-047-10","proprietary_name":"MELOXICAM","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-047-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571077701","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571077710","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571077750","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300012501","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-125-01","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-125-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300012510","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-125-10","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-125-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268052611","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268052615","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-526-15","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-526-15) / 1 TABLET in 1 BLISTER PACK (50268-526-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687019901","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-199-01","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-199-01) / 1 TABLET in 1 BLISTER PACK (60687-199-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687019911","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442012710","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-127-10","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (61442-127-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071618","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-716-18","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-716-18)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071690","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-716-90","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-716-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382005101","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-051-01","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-051-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382005105","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-051-05","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-051-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097015907","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-159-07","proprietary_name":"MELOXICAM","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-159-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097015912","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-159-12","proprietary_name":"MELOXICAM","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-159-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097015915","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-159-15","proprietary_name":"MELOXICAM","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-159-15)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282015301","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-153-01","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-153-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282015310","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-153-10","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-153-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009013005","name":"MELOXICAM 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-130-05","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-130-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180018806","name":"MELOXICAM 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-188-06","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-188-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":8.92251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954007610","name":"MELOXICAM 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-076-10","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70954-076-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":8.92251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788004601","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-046-01","proprietary_name":"MELOXICAM","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-046-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788004605","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-046-05","proprietary_name":"MELOXICAM","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"500 TABLET in 1 BOTTLE (11788-046-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788004610","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-046-10","proprietary_name":"MELOXICAM","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"1000 TABLET in 1 BOTTLE (11788-046-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571077601","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571077610","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571077650","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300012401","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-124-01","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (29300-124-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300012410","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-124-10","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE (29300-124-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268052511","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268052515","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-525-15","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-525-15) / 1 TABLET in 1 BLISTER PACK (50268-525-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61442012610","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-126-10","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (61442-126-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071518","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-715-18","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-715-18)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135071590","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-715-90","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-715-90)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862009701","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-097-01","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-097-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862009705","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-097-05","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-097-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382005001","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-050-01","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-050-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382005005","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-050-05","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-050-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097015807","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-158-07","proprietary_name":"MELOXICAM","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-158-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097015812","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-158-12","proprietary_name":"MELOXICAM","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-158-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097015815","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-158-15","proprietary_name":"MELOXICAM","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-158-15)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282015201","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-152-01","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-152-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282015210","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-152-10","proprietary_name":"Meloxicam","nonproprietary_name":"Meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-152-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009012905","name":"MELOXICAM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-129-05","proprietary_name":"meloxicam","nonproprietary_name":"meloxicam","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-129-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.01657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591390087","name":"MEMANTINE 5-10 MG TITRATION PK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0591-3900-87","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Actavis Pharma, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0591-3900-87) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.37236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591387544","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3875-44","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0591-3875-44) / 10 TABLET in 1 BLISTER PACK (0591-3875-45)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591387545","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591387560","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3875-60","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET in 1 BOTTLE (0591-3875-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832111360","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1113-60","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0832-1113-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904650606","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6506-06","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6506-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904650661","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6506-61","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6506-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241007105","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-071-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-071-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241007106","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-071-06","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-071-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300017205","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-172-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-172-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300017216","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-172-16","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-172-16)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722080860","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-808-60","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-808-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"33342029809","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-298-09","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-298-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"33342029815","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-298-15","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-298-15)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"47335032213","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-322-13","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (47335-322-13)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"47335032286","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-322-86","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-322-86)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268058811","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268058813","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-588-13","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-588-13) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-588-11)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746016960","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-169-60","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (53746-169-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111059705","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-597-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (55111-597-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111059760","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-597-60","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55111-597-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687018411","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687018457","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-184-57","proprietary_name":"Memantine","nonproprietary_name":"Memantine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-184-57) / 1 TABLET in 1 BLISTER PACK (60687-184-11)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"61442019305","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-193-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (61442-193-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135089660","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-896-60","proprietary_name":"memantine","nonproprietary_name":"memantine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-896-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162016906","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-169-06","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65162-169-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180023007","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-230-07","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68180-230-07)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578000405","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-004-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-004-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578000414","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-004-14","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"60 TABLET in 1 BOTTLE (72578-004-14)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603011901","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-119-01","proprietary_name":"Memantine","nonproprietary_name":"Memantine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET in 1 BOTTLE (72603-119-01)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603011902","name":"MEMANTINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-119-02","proprietary_name":"Memantine","nonproprietary_name":"Memantine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (72603-119-02)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"33342006628","name":"MEMANTINE HCL 2 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"33342-066-28","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"Macleods Pharmaceuticals Limited","package_description":"240 mL in 1 BOTTLE (33342-066-28)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.8106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505616205","name":"MEMANTINE HCL 2 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6162-5","proprietary_name":"MEMANTINE","nonproprietary_name":"memantine hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-6162-5) / 360 mL in 1 BOTTLE","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.36068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135094337","name":"MEMANTINE HCL 2 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-943-37","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"2 mg/mL","labeler":"Chartwell RX, LLC","package_description":"240 mL in 1 BOTTLE (62135-943-37)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.8106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591387044","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3870-44","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0591-3870-44) / 10 TABLET in 1 BLISTER PACK (0591-3870-45)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591387045","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591387060","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3870-60","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET in 1 BOTTLE (0591-3870-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00832111260","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1112-60","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0832-1112-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904650506","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6505-06","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6505-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904650561","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6505-61","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6505-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241007006","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-070-06","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-070-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300017105","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-171-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-171-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300017116","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-171-16","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-171-16)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722080760","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-807-60","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-807-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"33342029709","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-297-09","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-297-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"33342029715","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-297-15","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-297-15)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"47335032186","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-321-86","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-321-86)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268058711","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268058713","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-587-13","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-587-13) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-587-11)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"53746017360","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-173-60","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (53746-173-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111059660","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-596-60","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55111-596-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687017311","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687017357","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-173-57","proprietary_name":"Memantine","nonproprietary_name":"Memantine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-173-57) / 1 TABLET in 1 BLISTER PACK (60687-173-11)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"61442019205","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61442-192-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Carlsbad Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (61442-192-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135089560","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-895-60","proprietary_name":"memantine","nonproprietary_name":"memantine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-895-60)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162017306","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-173-06","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65162-173-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180022907","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-229-07","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68180-229-07)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578000305","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-003-05","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-003-05)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578000314","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-003-14","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"60 TABLET in 1 BOTTLE (72578-003-14)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603011801","name":"MEMANTINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-118-01","proprietary_name":"Memantine","nonproprietary_name":"Memantine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET in 1 BOTTLE (72603-118-01)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.07926,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571085303","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-853-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-853-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571085309","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-853-09","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-853-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651040530","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-405-30","proprietary_name":"MEMANTINE HYDROCHLORIDE","nonproprietary_name":"MEMANTINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-405-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651040590","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-405-90","proprietary_name":"MEMANTINE HYDROCHLORIDE","nonproprietary_name":"MEMANTINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-405-90)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162078303","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-783-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65162-783-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162078309","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-783-09","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65162-783-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180024706","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-247-06","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68180-247-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180024709","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-247-09","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68180-247-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382054706","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-547-06","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-547-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382054716","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-547-16","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-547-16)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"69680016230","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-162-30","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-162-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436005504","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-055-04","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-055-04)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436005506","name":"MEMANTINE HCL ER 14 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-055-06","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-055-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571085403","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-854-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-854-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651040630","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-406-30","proprietary_name":"MEMANTINE HYDROCHLORIDE","nonproprietary_name":"MEMANTINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-406-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162078403","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-784-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65162-784-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180024806","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-248-06","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68180-248-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382054806","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-548-06","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-548-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"69680016330","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-163-30","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-163-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436005604","name":"MEMANTINE HCL ER 21 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-056-04","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"21 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-056-04)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571085503","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-855-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-855-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571085509","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-855-09","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-855-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651040730","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-407-30","proprietary_name":"MEMANTINE HYDROCHLORIDE","nonproprietary_name":"MEMANTINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-407-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651040790","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-407-90","proprietary_name":"MEMANTINE HYDROCHLORIDE","nonproprietary_name":"MEMANTINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-407-90)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162078503","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-785-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65162-785-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162078509","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-785-09","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65162-785-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180024906","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-249-06","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68180-249-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180024909","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-249-09","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68180-249-09)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382054906","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-549-06","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-549-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382054916","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-549-16","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-549-16)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"69680016430","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-164-30","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-164-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436005704","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-057-04","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-057-04)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436005706","name":"MEMANTINE HCL ER 28 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-057-06","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-057-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.34223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904673461","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6734-61","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6734-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571085203","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-852-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-852-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651040430","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-404-30","proprietary_name":"MEMANTINE HYDROCHLORIDE","nonproprietary_name":"MEMANTINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-404-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162078203","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-782-03","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"Memantine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65162-782-03)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180024606","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-246-06","proprietary_name":"memantine hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68180-246-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382054606","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-546-06","proprietary_name":"Memantine hydrochloride","nonproprietary_name":"Memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-546-06)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"69680016130","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-161-30","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-161-30)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"70436005404","name":"MEMANTINE HCL ER 7 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-054-04","proprietary_name":"Memantine Hydrochloride","nonproprietary_name":"memantine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-054-04)","pharm_classes":["N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.31233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Memantine HCl ER|Memantine HCl","basis":"generic"},"part_b":null}, {"ndc":"33342031207","name":"MEMANTINE-DONEPEZIL ER 14-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-312-07","proprietary_name":"Memantine and Donepezil","nonproprietary_name":"Memantine and Donepezil","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1; 10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (33342-312-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":6.48822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238124803","name":"MEMANTINE-DONEPEZIL ER 14-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1248-3","proprietary_name":"Memantine and Donepezil Hydrochlorides Extended-release","nonproprietary_name":"Memantine and Donepezil","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1; 10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69238-1248-3)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":6.48822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680018330","name":"MEMANTINE-DONEPEZIL ER 14-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-183-30","proprietary_name":"memantine hydrochloride and donepezil hydrochloride","nonproprietary_name":"memantine hydrochloride and donepezil hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"14 mg/1; 10 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-183-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":6.48822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342031307","name":"MEMANTINE-DONEPEZIL ER 28-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-313-07","proprietary_name":"Memantine and Donepezil","nonproprietary_name":"Memantine and Donepezil","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1; 10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (33342-313-07)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":8.44457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238124703","name":"MEMANTINE-DONEPEZIL ER 28-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1247-3","proprietary_name":"Memantine and Donepezil Hydrochlorides Extended-release","nonproprietary_name":"Memantine and Donepezil","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1; 10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69238-1247-3)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":8.44457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680018530","name":"MEMANTINE-DONEPEZIL ER 28-10 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-185-30","proprietary_name":"memantine hydrochloride and donepezil hydrochloride","nonproprietary_name":"memantine hydrochloride and donepezil hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"28 mg/1; 10 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-185-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":8.44457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55566750102","name":"MENOPUR 75 UNIT VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55566-7501-2","proprietary_name":"Menopur","nonproprietary_name":"menotropins","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ferring Pharmaceuticals Inc.","package_description":"1 CARTON in 1 CARTON (55566-7501-2) / 1 KIT in 1 CARTON (55566-7501-1) * 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (55566-7502-0) * 1 INJECTION in 1 VIAL (55566-1600-0)"},"nadac":{"value":252.1192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50419045504","name":"MENOSTAR 14 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-455-04","proprietary_name":"Menostar","nonproprietary_name":"estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 ug/d","labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"4 PATCH in 1 CARTON (50419-455-04) / 7 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":38.74015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Menostar|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70000014501","name":"MENSTRUAL RELIEF CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0145-1","proprietary_name":"Menstrual Relief Maximum Strength Multi Symptom","nonproprietary_name":"Acetaminophen, Pamabrom, Pyrilamine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1; 15 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0145-1) / 20 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.09261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133215","name":"MENTHOL COLD-HOT 5% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1332-15","proprietary_name":"Rugby Menthol Hot Cold Patch","nonproprietary_name":"Menthol","dosage_form":"PATCH","route":"TOPICAL","strength":"5 g/100g","labeler":"RUGBY LABORATORIES","package_description":"5 PATCH in 1 CARTON (0536-1332-15) / 9 g in 1 PATCH"},"nadac":{"value":1.02295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054354563","name":"MEPERIDINE 50 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3545-63","proprietary_name":"Meperidine Hydrochloride","nonproprietary_name":"Meperidine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"50 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE (0054-3545-63)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.15672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332001931","name":"MEPROBAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-019-31","proprietary_name":"Meprobamate","nonproprietary_name":"Meprobamate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-019-31)"},"nadac":{"value":4.54257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meprobamate|Meprobamate","basis":"generic"},"part_b":null}, {"ndc":"69097097407","name":"MEPROBAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-974-07","proprietary_name":"Meprobamate","nonproprietary_name":"Meprobamate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-974-07)"},"nadac":{"value":4.54257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meprobamate|Meprobamate","basis":"generic"},"part_b":null}, {"ndc":"62332002031","name":"MEPROBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-020-31","proprietary_name":"Meprobamate","nonproprietary_name":"Meprobamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-020-31)"},"nadac":{"value":5.89239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meprobamate|Meprobamate","basis":"generic"},"part_b":null}, {"ndc":"69097097507","name":"MEPROBAMATE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-975-07","proprietary_name":"Meprobamate","nonproprietary_name":"Meprobamate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-975-07)"},"nadac":{"value":5.89239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meprobamate|Meprobamate","basis":"generic"},"part_b":null}, {"ndc":"00054458111","name":"MERCAPTOPURINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4581-11","proprietary_name":"Mercaptopurine","nonproprietary_name":"Mercaptopurine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 TABLET in 1 BOTTLE, PLASTIC (0054-4581-11)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":1.07143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mercaptopurine|Mercaptopurine","basis":"generic"},"part_b":null}, {"ndc":"00054458127","name":"MERCAPTOPURINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4581-27","proprietary_name":"Mercaptopurine","nonproprietary_name":"Mercaptopurine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"250 TABLET in 1 BOTTLE, PLASTIC (0054-4581-27)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":1.07143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mercaptopurine|Mercaptopurine","basis":"generic"},"part_b":null}, {"ndc":"71921015002","name":"MERCAPTOPURINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-150-02","proprietary_name":"Mercaptopurine","nonproprietary_name":"Mercaptopurine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"25 TABLET in 1 BOTTLE (71921-150-02)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":1.07143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mercaptopurine|Mercaptopurine","basis":"generic"},"part_b":null}, {"ndc":"71921015025","name":"MERCAPTOPURINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-150-25","proprietary_name":"Mercaptopurine","nonproprietary_name":"Mercaptopurine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"250 TABLET in 1 BOTTLE (71921-150-25)","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":1.07143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mercaptopurine|Mercaptopurine","basis":"generic"},"part_b":null}, {"ndc":"00024592700","name":"MERILOG 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5927-00","proprietary_name":"MERILOG","nonproprietary_name":"insulin aspart-szjj","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0024-5927-00) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.81956,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024592805","name":"MERILOG SOLOSTAR 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5928-05","proprietary_name":"MERILOG","nonproprietary_name":"insulin aspart-szjj","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"5 SYRINGE in 1 BOX (0024-5928-05) / 3 mL in 1 SYRINGE (0024-5928-00)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.7161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143943110","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9431-10","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"1 g/30mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0143-9431-10) / 30 mL in 1 VIAL (0143-9431-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0143-9431-10) / 30 mL in 1 VIAL (0143-9431-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409139122","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-1391-22","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/20mL","labeler":"Hospira, Inc.","package_description":"10 VIAL in 1 CARTON (0409-1391-22) / 20 mL in 1 VIAL (0409-1391-21)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0409-1391-22) / 20 mL in 1 VIAL (0409-1391-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00409341210","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3412-10","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/20mL","labeler":"Hospira, Inc.","package_description":"10 VIAL in 1 CARTON (0409-3412-10) / 20 mL in 1 VIAL (0409-3412-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0409-3412-10) / 20 mL in 1 VIAL (0409-3412-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781309895","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3098-95","proprietary_name":"MEROPENEM","nonproprietary_name":"MEROPENEM","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"1 g/30mL","labeler":"Sandoz Inc","package_description":"10 VIAL in 1 CARTON (0781-3098-95) / 30 mL in 1 VIAL (0781-3098-94)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0781-3098-95) / 30 mL in 1 VIAL (0781-3098-94)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567014610","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-146-10","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"10 VIAL in 1 CARTON (44567-146-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-146-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (44567-146-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-146-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567040110","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44567-401-10","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/1","labeler":"WG Critical Care, LLC","package_description":"10 VIAL in 1 CARTON (44567-401-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-401-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (44567-401-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-401-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55150020830","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-208-30","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/1","labeler":"Eugia US LLC","package_description":"10 VIAL in 1 CARTON (55150-208-30) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (55150-208-30) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323050830","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-508-30","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/20mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL in 1 CARTON (63323-508-30) / 20 mL in 1 VIAL (63323-508-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (63323-508-30) / 20 mL in 1 VIAL (63323-508-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323050831","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-508-31","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/20mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL in 1 CARTON (63323-508-31) / 20 mL in 1 VIAL (63323-508-21)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (63323-508-31) / 20 mL in 1 VIAL (63323-508-21)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70121145307","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1453-7","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/30mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"10 VIAL, GLASS in 1 CARTON (70121-1453-7) / 30 mL in 1 VIAL, GLASS (70121-1453-1)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (70121-1453-7) / 30 mL in 1 VIAL, GLASS (70121-1453-1)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70594007602","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70594-076-02","proprietary_name":"MEROPENEM","nonproprietary_name":"MEROPENEM","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"1 g/1","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"10 VIAL, GLASS in 1 CARTON (70594-076-02) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS (70594-076-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (70594-076-02) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS (70594-076-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72485041210","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-412-10","proprietary_name":"Meropenem","nonproprietary_name":"Meropenem","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"1 g/20mL","labeler":"ARMAS PHARMACEUTICALS INC","package_description":"10 VIAL in 1 CARTON (72485-412-10) / 20 mL in 1 VIAL","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (72485-412-10) / 20 mL in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572041610","name":"MEROPENEM IV 1 GM VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-416-10","proprietary_name":"MEROPENEM","nonproprietary_name":"MEROPENEM","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"1 g/30mL","labeler":"Civica, Inc","package_description":"10 VIAL in 1 CARTON (72572-416-10) / 30 mL in 1 VIAL (72572-416-01)","pharm_classes":["Carbapenems [CS]","Penem Antibacterial [EPC]"]},"nadac":{"value":4.68755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Meropenem|Meropenem","basis":"generic"},"part_b":{"hcpcs":"J2185","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2185 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (72572-416-10) / 30 mL in 1 VIAL (72572-416-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00472191501","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00472191530","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-1915-30","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 POUCH in 1 BOX (0472-1915-30) / 1 SUPPOSITORY in 1 POUCH (0472-1915-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571024603","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-246-03","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (16571-246-03) / 6 SUPPOSITORY in 1 BLISTER PACK (16571-246-16)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571024616","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714024501","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714024530","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-245-30","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Northstar Rx LLC.","package_description":"5 BLISTER PACK in 1 POUCH (16714-245-30) / 6 SUPPOSITORY in 1 BLISTER PACK (16714-245-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722000530","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-005-30","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"5 PACKAGE in 1 CARTON (31722-005-30) / 6 SUPPOSITORY in 1 PACKAGE (31722-005-32)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722000532","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980028203","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-282-03","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 PACKAGE in 1 CARTON (64980-282-03) / 6 SUPPOSITORY in 1 PACKAGE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69918056030","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-560-30","proprietary_name":"Mesalamine Rectal","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Amring Pharmaceuticals Inc.","package_description":"30 SUPPOSITORY in 1 BOX (69918-560-30)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710130206","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710130207","name":"MESALAMINE 1,000 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1302-7","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"1000 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"5 BLISTER PACK in 1 POUCH (70710-1302-7) / 6 SUPPOSITORY in 1 BLISTER PACK (70710-1302-6)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":1.28382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"21922004547","name":"MESALAMINE 4 GM/60 ML ENEMA","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-045-47","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUSPENSION","route":"RECTAL","strength":"4 g/60mL","labeler":"Encube Ethicals, Inc.","package_description":"7 BOTTLE, DISPENSING in 1 CARTON (21922-045-47) / 60 mL in 1 BOTTLE, DISPENSING (21922-045-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.09843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922004549","name":"MESALAMINE 4 GM/60 ML ENEMA","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-045-49","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUSPENSION","route":"RECTAL","strength":"4 g/60mL","labeler":"Encube Ethicals, Inc.","package_description":"28 BOTTLE, DISPENSING in 1 CARTON (21922-045-49) / 60 mL in 1 BOTTLE, DISPENSING (21922-045-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.17585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802009828","name":"MESALAMINE 4 GM/60 ML ENEMA","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-098-28","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"ENEMA","route":"RECTAL","strength":"4 g/60mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"28 BOTTLE in 1 CARTON (45802-098-28) / 60 mL in 1 BOTTLE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.17585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802009851","name":"MESALAMINE 4 GM/60 ML ENEMA","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-098-51","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"ENEMA","route":"RECTAL","strength":"4 g/60mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"7 BOTTLE in 1 CARTON (45802-098-51) / 60 mL in 1 BOTTLE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.09843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559042007","name":"MESALAMINE 4 GM/60 ML ENEMA","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-420-07","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"ENEMA","route":"RECTAL","strength":"4 g/60mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"7 BOTTLE in 1 BOX (62559-420-07) / 60 mL in 1 BOTTLE (62559-420-11)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.09843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954030120","name":"MESALAMINE 4 GM/60 ML ENEMA","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-301-20","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"SUSPENSION","route":"RECTAL","strength":"4 g/60mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"7 BOTTLE in 1 CARTON (70954-301-20) / 60 mL in 1 BOTTLE (70954-301-10)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.09843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802092341","name":"MESALAMINE 4 GM/60 ML KIT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-923-41","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"KIT","route":null,"strength":null,"labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 KIT in 1 CARTON (45802-923-41) * 60 mL in 1 BOTTLE (45802-098-46) * 1 SWAB in 1 PACKET"},"nadac":{"value":134.90444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802092949","name":"MESALAMINE 4 GM/60 ML KIT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-929-49","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"KIT","route":null,"strength":null,"labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"4 CARTON in 1 KIT (45802-929-49) / 1 KIT in 1 CARTON * 60 mL in 1 BOTTLE (45802-098-46) * 1 SWAB in 1 PACKET"},"nadac":{"value":134.90444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480775080","name":"MESALAMINE 800 MG DR TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7750-80","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"800 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (0480-7750-80)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":4.02045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687040825","name":"MESALAMINE 800 MG DR TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-408-25","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-408-25) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-408-95)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":4.02045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687040895","name":"MESALAMINE 800 MG DR TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.02045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"65162036018","name":"MESALAMINE 800 MG DR TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-360-18","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (65162-360-18)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":4.02045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"68382043528","name":"MESALAMINE 800 MG DR TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-435-28","proprietary_name":"mesalamine","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"180 TABLET, DELAYED RELEASE in 1 BOTTLE (68382-435-28)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":4.02045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00527301248","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-3012-48","proprietary_name":"MESALAMINE","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Lannett Company Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (0527-3012-48)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00591224522","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2245-22","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Actavis Pharma, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (0591-2245-22)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00904683204","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6832-04","proprietary_name":"mesalamine","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6832-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"31722004312","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-043-12","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (31722-043-12)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687039725","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-397-25","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-397-25) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-397-95)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687039795","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"62135071412","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-714-12","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (62135-714-12)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"62135071460","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-714-60","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (62135-714-60)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"63304017513","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-175-13","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (63304-175-13)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"68382071119","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-711-19","proprietary_name":"mesalamine","nonproprietary_name":"mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (68382-711-19)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"72603030401","name":"MESALAMINE DR 1.2 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-304-01","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"1.2 g/1","labeler":"NorthStar RxLLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-304-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.7809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00093590786","name":"MESALAMINE DR 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5907-86","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"180 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0093-5907-86)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":2.69898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687055632","name":"MESALAMINE DR 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-556-32","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-556-32) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (60687-556-33)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":2.69898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687055633","name":"MESALAMINE DR 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.69898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine Dr|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00093922489","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9224-89","proprietary_name":"mesalamine","nonproprietary_name":"mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"375 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-9224-89)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00378137578","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1375-78","proprietary_name":"Mesalamine","nonproprietary_name":"mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-1375-78)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00832605612","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6056-12","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0832-6056-12)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"50268057711","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"50268057715","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-577-15","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-577-15) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-577-11)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"59651039708","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-397-08","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"Aurobindo Pharma Limited","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-397-08)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687065032","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-650-32","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-650-32) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-650-33)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"60687065033","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"62332072435","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-724-35","proprietary_name":"MESALAMINE","nonproprietary_name":"MESALAMINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-724-35)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"67877071712","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-717-12","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"Ascend Laboratories, LLC","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (67877-717-12)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"68382045219","name":"MESALAMINE ER 0.375 GRAM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-452-19","proprietary_name":"Mesalamine","nonproprietary_name":"Mesalamine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":".375 g/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-452-19)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.47798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mesalamine ER|Mesalamine","basis":"generic"},"part_b":null}, {"ndc":"00115174501","name":"METAXALONE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1745-01","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-1745-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.59291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"69097099807","name":"METAXALONE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-998-07","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"CIPLA USA INC.","package_description":"100 TABLET in 1 BOTTLE (69097-998-07)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":2.59291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"00527143501","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1435-01","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-1435-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"00591234101","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2341-01","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-2341-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"00904683104","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6831-04","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6831-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"00904683106","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6831-06","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6831-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"50228032301","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-323-01","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-323-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"50228032305","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-323-05","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-323-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"50268053011","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"50268053015","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-530-15","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-530-15) / 1 TABLET in 1 BLISTER PACK (50268-530-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"55111065001","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-650-01","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Dr. Reddy’s Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-650-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"60687066311","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"60687066321","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-663-21","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-663-21) / 1 TABLET in 1 BLISTER PACK (60687-663-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"64980047201","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"65162055310","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-553-10","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-553-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"68001048500","name":"METAXALONE 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-485-00","proprietary_name":"Metaxalone","nonproprietary_name":"Metaxalone","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-485-00)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metaxalone|Metaxalone","basis":"generic"},"part_b":null}, {"ndc":"27241024190","name":"METFORMIN ER 1,000 MG GASTR-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-241-90","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-241-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42571033490","name":"METFORMIN ER 1,000 MG GASTR-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-334-90","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Micro Labs Limited","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42571-334-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228044690","name":"METFORMIN ER 1,000 MG GASTR-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-446-90","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Extended-Release Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-446-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68180033909","name":"METFORMIN ER 1,000 MG GASTR-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-339-09","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-339-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462052190","name":"METFORMIN ER 1,000 MG GASTR-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-521-90","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-521-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049709","name":"METFORMIN ER 1,000 MG GASTR-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-497-09","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-497-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3357,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378600191","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6001-91","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"metformin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6001-91)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00591272060","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"11788003860","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-038-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Extended-Release Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (11788-038-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241018960","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-189-60","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-189-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228050460","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-504-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Extended-Release Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-504-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50742063460","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-634-60","proprietary_name":"Metformin","nonproprietary_name":"metformin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-634-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651004360","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-043-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-043-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68180033707","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-337-07","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-337-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367041360","name":"METFORMIN ER 1,000 MG OSM-TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-413-60","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69367-413-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.31418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241024001","name":"METFORMIN ER 500 MG GASTRC-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-240-01","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-240-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.27102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42571033301","name":"METFORMIN ER 500 MG GASTRC-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-333-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42571-333-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.27102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228044501","name":"METFORMIN ER 500 MG GASTRC-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-445-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Extended-Release Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-445-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.27102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68180033801","name":"METFORMIN ER 500 MG GASTRC-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-338-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-338-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.27102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462052001","name":"METFORMIN ER 500 MG GASTRC-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-520-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-520-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.27102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049601","name":"METFORMIN ER 500 MG GASTRC-TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-496-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-496-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.27102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Gastric|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378600291","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6002-91","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"metformin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6002-91)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00591271960","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"11788003760","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-037-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Extended-Release Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (11788-037-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241018860","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-188-60","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-188-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228050360","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-503-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Extended-Release Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50228-503-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50742063360","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-633-60","proprietary_name":"Metformin","nonproprietary_name":"metformin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-633-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651004260","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-042-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-042-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68180033607","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-336-07","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-336-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367041260","name":"METFORMIN ER 500 MG OSMOTIC TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-412-60","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69367-412-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.1644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin ER Osmotic|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378718705","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7187-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7187-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904716461","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7164-61","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7164-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084301","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-843-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-843-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084305","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-843-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-843-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084310","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-843-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-843-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094901","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-949-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-949-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094905","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-949-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-949-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094911","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-949-11","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-949-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035910","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035950","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062001","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-620-01","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-620-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062010","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-620-10","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, FILM COATED in 1 PACKAGE (49483-620-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062050","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-620-50","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-620-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062081","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-620-81","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-620-81)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010701","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-107-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-107-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010705","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-107-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-107-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010710","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-107-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-107-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085601","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-856-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-856-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085605","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-856-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-856-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085699","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-856-99","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-856-99)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687016201","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-162-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-162-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-162-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687016211","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068405","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-684-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-684-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068418","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-684-18","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-684-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068490","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-684-90","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-684-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001001","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-010-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-010-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001005","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-010-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-010-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001099","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-010-99","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-010-99)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056301","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-563-01","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-563-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056305","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-563-05","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-563-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056310","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-563-10","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-563-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877093205","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-932-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-932-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877093210","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-932-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-932-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094048060","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-480-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (68094-480-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094048070","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-480-70","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Precision Dose, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (68094-480-70)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382076001","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-760-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-760-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382076005","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-760-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-760-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382076010","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-760-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-760-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645030059","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645054559","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645058459","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-584-59","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET in 1 BOTTLE (68645-584-59)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018201","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-182-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-182-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018205","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-182-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-182-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018210","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-182-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-182-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038301","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-383-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-383-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038305","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-383-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (69367-383-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038310","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-383-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69367-383-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006501","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-065-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-065-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006505","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-065-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-065-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006509","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-065-09","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (70010-065-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006599","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-065-99","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-065-99)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009004710","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-047-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Tablet","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-047-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009017510","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-175-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-175-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301001001","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0010-1","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (83301-0010-1)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301001002","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0010-2","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (83301-0010-2)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301001003","name":"METFORMIN HCL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0010-3","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (83301-0010-3)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378718505","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7185-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7185-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904716261","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7162-61","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7162-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084101","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-841-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-841-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084105","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-841-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-841-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084110","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-841-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-841-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094701","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-947-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-947-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094705","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-947-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-947-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094711","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-947-11","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-947-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035710","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035711","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035750","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062201","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-622-01","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-622-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062210","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-622-10","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-622-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062250","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-622-50","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-622-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062281","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-622-81","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-622-81)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010501","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-105-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-105-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010505","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-105-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-105-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010510","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-105-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-105-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085401","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-854-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-854-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085405","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-854-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-854-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085499","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-854-99","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (59651-854-99)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687015501","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-155-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-155-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-155-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687015511","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068005","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-680-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-680-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068018","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-680-18","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-680-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068090","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-680-90","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-680-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862000801","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-008-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-008-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862000805","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-008-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-008-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862000899","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-008-99","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-008-99)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056101","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-561-01","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-561-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056105","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-561-05","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-561-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056110","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-561-10","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-561-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877093001","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-930-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-930-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877093005","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-930-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-930-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877093010","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-930-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-930-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094068860","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-688-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (68094-688-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094068870","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-688-70","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (68094-688-70)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382075801","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-758-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-758-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382075805","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-758-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-758-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382075810","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-758-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-758-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645054459","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645058259","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-582-59","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET in 1 BOTTLE (68645-582-59)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018001","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-180-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-180-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018005","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-180-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-180-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018010","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-180-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-180-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038101","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-381-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-381-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038105","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-381-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (69367-381-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038110","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-381-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69367-381-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006301","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-063-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-063-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006305","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-063-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-063-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006309","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-063-09","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (70010-063-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006310","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-063-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-063-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009004610","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-046-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride Tablet","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-046-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009017410","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-174-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-174-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301000801","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0008-1","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (83301-0008-1)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301000802","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0008-2","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (83301-0008-2)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301000803","name":"METFORMIN HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0008-3","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (83301-0008-3)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.01451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"31722004247","name":"METFORMIN HCL 500 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-042-47","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"500 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-042-47) / 473 mL in 1 BOTTLE","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571036007","name":"METFORMIN HCL 500 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-360-07","proprietary_name":"Metformin Hydrochloride Oral Solution","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"500 mg/5mL","labeler":"MICRO LABS LIMITED","package_description":"473 mL in 1 BOTTLE (42571-360-07)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66689031816","name":"METFORMIN HCL 500 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-318-16","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"500 mg/5mL","labeler":"VistaPharm, LLC","package_description":"1 BOTTLE in 1 CARTON (66689-318-16) / 473 mL in 1 BOTTLE","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452038088","name":"METFORMIN HCL 500 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-380-88","proprietary_name":"Metformin Hydrochloride Oral Solution","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"500 mg/5mL","labeler":"Bionpharma Inc.,","package_description":"473 mL in 1 BOTTLE (69452-380-88)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.3829,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657072630","name":"METFORMIN HCL 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58657-726-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Method Pharmaceuticals, LLC.","package_description":"30 TABLET in 1 BOTTLE (58657-726-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":12.5266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-25","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068130","name":"METFORMIN HCL 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-681-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-681-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":12.5266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"72336006430","name":"METFORMIN HCL 625 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72336-064-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Lifsa Drugs, LLC","package_description":"30 TABLET in 1 BOTTLE (72336-064-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":12.5266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"58657072730","name":"METFORMIN HCL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58657-727-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Method Pharmaceuticals, LLC.","package_description":"30 TABLET in 1 BOTTLE (58657-727-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":14.605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-25","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068230","name":"METFORMIN HCL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-682-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-682-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":14.605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"72336009530","name":"METFORMIN HCL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72336-095-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Lifsa Drugs, LLC","package_description":"30 TABLET in 1 BOTTLE (72336-095-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":14.605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378718605","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7186-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7186-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904716361","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7163-61","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7163-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084201","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-842-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-842-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084205","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-842-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-842-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155084210","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-842-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-842-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094801","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-948-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42385-948-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094805","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-948-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (42385-948-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385094811","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-948-11","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (42385-948-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035810","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035850","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062101","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-621-01","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-621-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062110","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-621-10","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-621-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062150","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-621-50","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-621-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062181","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-621-81","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-621-81)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010601","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-106-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-106-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50228010605","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-106-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-106-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085501","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-855-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-855-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651085505","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-855-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-855-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687014301","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-143-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-143-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-143-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687014311","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068318","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-683-18","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-683-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135068330","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-683-30","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-683-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862000901","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-009-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-009-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862000905","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-009-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-009-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056201","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-562-01","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-562-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056205","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-562-05","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-562-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877056210","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-562-10","proprietary_name":"Metformin HCl","nonproprietary_name":"Metformin HCl","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (67877-562-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877093101","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-931-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-931-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094058060","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-580-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (68094-580-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094058070","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-580-70","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Precision Dose, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (68094-580-70)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382075901","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-759-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-759-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382075905","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-759-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-759-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382075910","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-759-10","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-759-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645054759","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645058359","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-583-59","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET in 1 BOTTLE (68645-583-59)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018101","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-181-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-181-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367018105","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-181-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"850 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-181-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038201","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-382-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69367-382-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038205","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-382-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (69367-382-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69367038210","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-382-10","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69367-382-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006401","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-064-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-064-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006405","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-064-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-064-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006409","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-064-09","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (70010-064-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010006499","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-064-99","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-064-99)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301000901","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0009-1","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (83301-0009-1)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301000902","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0009-2","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (83301-0009-2)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"83301000903","name":"METFORMIN HCL 850 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83301-0009-3","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"850 mg/1","labeler":"Mullan Pharmaceutical Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (83301-0009-3)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"29300038901","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-389-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-389-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"29300038905","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-389-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-389-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385097701","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-977-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42385-977-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385097705","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-977-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42385-977-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385097711","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-977-11","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (42385-977-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385097790","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-977-90","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Laurus Labs Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (42385-977-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42806063201","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-632-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-632-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42806063205","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-632-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-632-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062301","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-623-01","proprietary_name":"METFORMIN HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (49483-623-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062309","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-623-09","proprietary_name":"METFORMIN HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (49483-623-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062310","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-623-10","proprietary_name":"METFORMIN HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (49483-623-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062350","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-623-50","proprietary_name":"METFORMIN HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (49483-623-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268055011","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268055015","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-550-15","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-550-15) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-550-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877015901","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-159-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-159-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877015905","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-159-05","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-159-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877041301","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-413-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-413-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877041305","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-413-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-413-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877041390","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-413-90","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-413-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094090450","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-904-50","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68094-904-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094090460","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-904-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68094-904-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68645059559","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-595-59","proprietary_name":"Metformin","nonproprietary_name":"Metformin ER 500 mg","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68645-595-59)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69315041001","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-410-01","proprietary_name":"METFORMIN HYDROCHLORIDE ER","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69315-410-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"69315041005","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-410-05","proprietary_name":"METFORMIN HYDROCHLORIDE ER","nonproprietary_name":"metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (69315-410-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049101","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-491-01","proprietary_name":"Metformin","nonproprietary_name":"Metformin ER 500 mg","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-491-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049105","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-491-05","proprietary_name":"Metformin","nonproprietary_name":"Metformin ER 500 mg","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-491-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049109","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-491-09","proprietary_name":"Metformin","nonproprietary_name":"Metformin ER 500 mg","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-491-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049110","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-491-10","proprietary_name":"Metformin","nonproprietary_name":"Metformin ER 500 mg","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-491-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"76385012810","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-128-10","proprietary_name":"Metformin hydrochloride","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (76385-128-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009011710","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-117-10","proprietary_name":"Metformin ER 500 mg","nonproprietary_name":"Metformin ER 500 mg","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-117-10)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009018005","name":"METFORMIN HCL ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-180-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (82009-180-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.02838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"29300039901","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-399-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-399-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42385097801","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-978-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Laurus Labs Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42385-978-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"42806063301","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-633-01","proprietary_name":"METFORMIN HYDROCHLORIDE","nonproprietary_name":"METFORMIN HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-633-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062401","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-624-01","proprietary_name":"METFORMIN HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (49483-624-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"49483062450","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-624-50","proprietary_name":"METFORMIN HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (49483-624-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268055111","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268055115","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-551-15","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-551-15) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-551-11)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877041401","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-414-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-414-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877041405","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-414-05","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-414-05)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094080450","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-804-50","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68094-804-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"68094080460","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-804-60","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Precision Dose, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68094-804-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010049201","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-492-01","proprietary_name":"Metformin","nonproprietary_name":"Metformin ER 750 mg","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-492-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"72578003601","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-036-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72578-036-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"76385012901","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-129-01","proprietary_name":"Metformin hydrochloride ER","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (76385-129-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"76385012950","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-129-50","proprietary_name":"Metformin hydrochloride ER","nonproprietary_name":"Metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (76385-129-50)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009011801","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-118-01","proprietary_name":"Metformin ER 750 mg","nonproprietary_name":"Metformin ER 750 mg","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 TABLET in 1 BOTTLE (82009-118-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009018101","name":"METFORMIN HCL ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-181-01","proprietary_name":"Metformin Hydrochloride","nonproprietary_name":"Metformin Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (82009-181-01)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":0.05264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metformin HCl ER|Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00406412303","name":"METHADONE 10 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-4123-03","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"CONCENTRATE","route":"ORAL","strength":"10 mg/mL","labeler":"SpecGx LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0406-4123-03) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.54234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527192736","name":"METHADONE 10 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1927-36","proprietary_name":"Methadone Hydrocloride dye-free, sugar-free, unflavored","nonproprietary_name":"methadone hydrochloride","dosage_form":"CONCENTRATE","route":"ORAL","strength":"10 mg/mL","labeler":"Lannett Company, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0527-1927-36) / 30 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.54234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054071020","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0710-20","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0054-0710-20) / 100 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00054071025","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0710-25","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-0710-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406577101","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5771-01","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-5771-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406577123","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5771-23","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-5771-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406577162","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5771-62","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-5771-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904741761","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7417-61","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7417-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722094701","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-947-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (31722-947-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687091001","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-910-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-910-01) / 1 TABLET in 1 BLISTER PACK (60687-910-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687091011","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-910","inner_of":["60687-910-01"]},"part_b":null}, {"ndc":"64850060401","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-604-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64850-604-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"66689082010","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-820-10","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"VistaPharm, LLC","package_description":"100 TABLET in 1 BOTTLE (66689-820-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"66689083699","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-836-99","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"VistaPharm, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (66689-836-99)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877066001","name":"METHADONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-660-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-660-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.17691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00054070920","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0709-20","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0054-0709-20) / 100 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00054070925","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0709-25","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-0709-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406575501","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5755-01","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-5755-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406575523","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5755-23","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-5755-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406575562","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5755-62","proprietary_name":"METHADONE HYDROCHLORIDE","nonproprietary_name":"METHADONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-5755-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"31722094601","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-946-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"100 TABLET in 1 BOTTLE (31722-946-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"64850060301","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-603-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64850-603-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"67877065901","name":"METHADONE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-659-01","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-659-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methadone HCl*|Methadone HCl","basis":"generic"},"part_b":null}, {"ndc":"00054355344","name":"METHADONE INTENSOL 10 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3553-44","proprietary_name":"Methadone Hydrochloride","nonproprietary_name":"Methadone Hydrochloride","dosage_form":"CONCENTRATE","route":"ORAL","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (0054-3553-44) / 30 mL in 1 BOTTLE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.54234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054038925","name":"METHAMPHETAMINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0389-25","proprietary_name":"Methamphetamine Hydrochloride","nonproprietary_name":"Methamphetamine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0389-25)","pharm_classes":["Amphetamine Anorectic [EPC]","Amphetamines [CS]","Appetite Suppression [PE]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]"]},"nadac":{"value":5.0978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methamphetamine HCl|Methamphetamine HCl","basis":"generic"},"part_b":null}, {"ndc":"68308011501","name":"METHAMPHETAMINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-115-01","proprietary_name":"Methamphetamine Hydrochloride","nonproprietary_name":"METHAMPHETAMINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mayne Pharma Commercial LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (68308-115-01)","pharm_classes":["Amphetamine Anorectic [EPC]","Amphetamines [CS]","Appetite Suppression [PE]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]"]},"nadac":{"value":5.0978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methamphetamine HCl|Methamphetamine HCl","basis":"generic"},"part_b":null}, {"ndc":"75907009401","name":"METHAMPHETAMINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-094-01","proprietary_name":"Methamphetamine Hydrochloride","nonproprietary_name":"METHAMPHETAMINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75907-094-01)","pharm_classes":["Amphetamine Anorectic [EPC]","Amphetamines [CS]","Appetite Suppression [PE]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]"]},"nadac":{"value":5.0978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methamphetamine HCl|Methamphetamine HCl","basis":"generic"},"part_b":null}, {"ndc":"00574079001","name":"METHAZOLAMIDE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0790-01","proprietary_name":"methazolamide","nonproprietary_name":"methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Padagis US LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0574-0790-01)"},"nadac":{"value":0.62747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"24208002210","name":"METHAZOLAMIDE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-022-10","proprietary_name":"Methazolamide","nonproprietary_name":"methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Bausch & Lomb Incorporated","package_description":"100 TABLET in 1 BOTTLE (24208-022-10)"},"nadac":{"value":0.62747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"62559024001","name":"METHAZOLAMIDE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-240-01","proprietary_name":"Methazolamide","nonproprietary_name":"Methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-240-01)"},"nadac":{"value":0.62747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"68094090850","name":"METHAZOLAMIDE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-908-50","proprietary_name":"Methazolamide","nonproprietary_name":"Methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET in 1 BOTTLE (68094-908-50)"},"nadac":{"value":0.62747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"72603016601","name":"METHAZOLAMIDE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-166-01","proprietary_name":"Methazolamide","nonproprietary_name":"Methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-166-01)"},"nadac":{"value":0.62747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"24208002310","name":"METHAZOLAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-023-10","proprietary_name":"Methazolamide","nonproprietary_name":"methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Bausch & Lomb Incorporated","package_description":"100 TABLET in 1 BOTTLE (24208-023-10)"},"nadac":{"value":1.46836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"62559024101","name":"METHAZOLAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-241-01","proprietary_name":"Methazolamide","nonproprietary_name":"Methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-241-01)"},"nadac":{"value":1.46836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"68094080850","name":"METHAZOLAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-808-50","proprietary_name":"Methazolamide","nonproprietary_name":"Methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Precision Dose, Inc.","package_description":"100 TABLET in 1 BOTTLE (68094-808-50)"},"nadac":{"value":1.46836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"72603016701","name":"METHAZOLAMIDE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-167-01","proprietary_name":"Methazolamide","nonproprietary_name":"Methazolamide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-167-01)"},"nadac":{"value":1.46836,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methazolamide|Methazolamide","basis":"generic"},"part_b":null}, {"ndc":"42571033201","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-332-01","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-332-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"47781057701","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-577-01","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Alvogen Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-577-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"50268054911","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"50268054915","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-549-15","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 CARTON (50268-549-15) / 1 TABLET in 1 BLISTER PACK (50268-549-11)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"50742014201","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-142-01","proprietary_name":"METHENAMINE HIPPURATE","nonproprietary_name":"methenamine hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-142-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"59746079701","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-797-01","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59746-797-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"60687069411","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"60687069421","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-694-21","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-694-21) / 1 TABLET in 1 BLISTER PACK (60687-694-11)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"65862078201","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-782-01","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-782-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"70954095910","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-959-10","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-959-10)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"72578017501","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-175-01","proprietary_name":"Methenamine hippurate","nonproprietary_name":"Methenamine hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-175-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"72603081601","name":"METHENAMINE HIPP 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-816-01","proprietary_name":"Methenamine Hippurate","nonproprietary_name":"Methenamine Hippurate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-816-01)"},"nadac":{"value":0.31261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Hippurate|Methenamine Hippurate","basis":"generic"},"part_b":null}, {"ndc":"42799010601","name":"METHENAMINE MAND 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-106-01","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-106-01)"},"nadac":{"value":2.60435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"62135020112","name":"METHENAMINE MAND 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-201-12","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62135-201-12)"},"nadac":{"value":2.60435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"62135020160","name":"METHENAMINE MAND 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-201-60","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-201-60)"},"nadac":{"value":2.60435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"69367043701","name":"METHENAMINE MAND 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-437-01","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-437-01)"},"nadac":{"value":2.60435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"69367043760","name":"METHENAMINE MAND 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-437-60","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69367-437-60)"},"nadac":{"value":2.60435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"42799010501","name":"METHENAMINE MAND 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-105-01","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"100 TABLET in 1 BOTTLE (42799-105-01)"},"nadac":{"value":1.36088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"62135020012","name":"METHENAMINE MAND 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-200-12","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (62135-200-12)"},"nadac":{"value":1.36088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"62135020060","name":"METHENAMINE MAND 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-200-60","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-200-60)"},"nadac":{"value":1.36088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"69367043601","name":"METHENAMINE MAND 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-436-01","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69367-436-01)"},"nadac":{"value":1.36088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"69367043660","name":"METHENAMINE MAND 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-436-60","proprietary_name":"Methenamine Mandelate","nonproprietary_name":"Methenamine Mandelate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69367-436-60)"},"nadac":{"value":1.36088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methenamine Mandelate|Methenamine Mandelate","basis":"generic"},"part_b":null}, {"ndc":"00832607311","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6073-11","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-6073-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"11788001201","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-012-01","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-012-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"23155007101","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-071-01","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-071-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"33342033611","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-336-11","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-336-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"50268049611","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"50268049615","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-496-15","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-496-15) / 1 TABLET in 1 BLISTER PACK (50268-496-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"60687068001","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-680-01","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-680-01) / 1 TABLET in 1 BLISTER PACK (60687-680-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"60687068011","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"62135020618","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-206-18","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-206-18)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"62135020690","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-206-90","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-206-90)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"64380021301","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-213-01","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-213-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"64980026501","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-265-01","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-265-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"69452032920","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-329-20","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-329-20)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"72578021301","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-213-01","proprietary_name":"methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72578-213-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"72603031601","name":"METHIMAZOLE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-316-01","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET in 1 BOTTLE (72603-316-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"00832607211","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6072-11","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-6072-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"11788001101","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-011-01","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-011-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"23155007001","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-070-01","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-070-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"33342033511","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-335-11","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-335-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"50268049511","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"50268049515","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-495-15","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-495-15) / 1 TABLET in 1 BLISTER PACK (50268-495-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"60687066901","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-669-01","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-669-01) / 1 TABLET in 1 BLISTER PACK (60687-669-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"60687066911","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"62135020518","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-205-18","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-205-18)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"62135020590","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-205-90","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-205-90)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"64380021201","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-212-01","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-212-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"64380021202","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-212-02","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE (64380-212-02)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"64980026401","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-264-01","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-264-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"69452032820","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-328-20","proprietary_name":"Methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-328-20)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"72578021201","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-212-01","proprietary_name":"methimazole","nonproprietary_name":"methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (72578-212-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"72603031501","name":"METHIMAZOLE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-315-01","proprietary_name":"Methimazole","nonproprietary_name":"Methimazole","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET in 1 BOTTLE (72603-315-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.07021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methimazole|Methimazole","basis":"generic"},"part_b":null}, {"ndc":"73352051010","name":"METHOCARBAMOL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73352-510-10","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Trifluent Pharma LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (73352-510-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":8.348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"85477010110","name":"METHOCARBAMOL 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"85477-101-10","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Oncora Pharma, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (85477-101-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":8.348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"00904705761","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7057-61","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7057-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"31722053301","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-533-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-533-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"31722053305","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-533-05","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-533-05) / 500 TABLET in 1 BOTTLE","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"43547040510","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-405-10","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-405-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"43547040550","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-405-50","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-405-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"50268052011","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-520","inner_of":["50268-520-15"]},"part_b":null}, {"ndc":"50268052015","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-520-15","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-520-15) / 1 TABLET in 1 BLISTER PACK (50268-520-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"59651034001","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-340-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-340-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"59651034005","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-340-05","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-340-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"60687055901","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-559-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-559-01) / 1 TABLET in 1 BLISTER PACK (60687-559-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"60687055911","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-559","inner_of":["60687-559-01"]},"part_b":null}, {"ndc":"63561017301","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0173-1","proprietary_name":"Methocarbamol Tablets, USP, 500 mg","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Granulation Technology, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (63561-0173-1)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"63561017305","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0173-5","proprietary_name":"Methocarbamol Tablets, USP, 500 mg","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Granulation Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (63561-0173-5)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"69584061110","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-611-10","proprietary_name":"Methocarbamol","nonproprietary_name":"methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-611-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"69584061150","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-611-50","proprietary_name":"Methocarbamol","nonproprietary_name":"methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-611-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"69584061190","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-611-90","proprietary_name":"Methocarbamol","nonproprietary_name":"methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-611-90)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"70010075401","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-754-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol Tablets","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (70010-754-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"70010075405","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-754-05","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol Tablets","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (70010-754-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"76385012301","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-123-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76385-123-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"76385012350","name":"METHOCARBAMOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-123-50","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76385-123-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.03946,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"00904705861","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7058-61","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7058-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"31722053401","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-534-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-534-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"31722053405","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-534-05","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-534-05) / 500 TABLET in 1 BOTTLE","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"43547022610","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-226-10","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 TABLET in 1 BOTTLE (43547-226-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"43547022650","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-226-50","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 TABLET in 1 BOTTLE (43547-226-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"50268052111","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-521","inner_of":["50268-521-15"]},"part_b":null}, {"ndc":"50268052115","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-521-15","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-521-15) / 1 TABLET in 1 BLISTER PACK (50268-521-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"59651034101","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-341-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-341-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"59651034105","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-341-05","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-341-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"60687056801","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-568-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-568-01) / 1 TABLET in 1 BLISTER PACK (60687-568-11)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"60687056811","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-568","inner_of":["60687-568-01"]},"part_b":null}, {"ndc":"63561017401","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0174-1","proprietary_name":"Methocarbamol Tablets, USP, 750 mg","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Granulation Technology, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (63561-0174-1)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"63561017405","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0174-5","proprietary_name":"Methocarbamol Tablets, USP, 750 mg","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Granulation Technology, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (63561-0174-5)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"69584061210","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-612-10","proprietary_name":"Methocarbamol","nonproprietary_name":"methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-612-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"69584061250","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-612-50","proprietary_name":"Methocarbamol","nonproprietary_name":"methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-612-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"69584061290","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-612-90","proprietary_name":"Methocarbamol","nonproprietary_name":"methocarbamol","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69584-612-90)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"70010077001","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-770-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol Tablets","dosage_form":"TABLET, COATED","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (70010-770-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"70010077005","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-770-05","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol Tablets","dosage_form":"TABLET, COATED","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (70010-770-05)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"76385012401","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-124-01","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76385-124-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"76385012450","name":"METHOCARBAMOL 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-124-50","proprietary_name":"Methocarbamol","nonproprietary_name":"Methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76385-124-50)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.04311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methocarbamol*|Methocarbamol","basis":"generic"},"part_b":null}, {"ndc":"00054455025","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4550-25","proprietary_name":"Methotrexate Sodium","nonproprietary_name":"Methotrexate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4550-25)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0054-4550-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054855025","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00378001401","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0014-01","proprietary_name":"Methotrexate","nonproprietary_name":"methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0014-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0378-0014-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00555057202","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0572-02","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0572-02)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (0555-0572-02)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00555057235","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0572-35","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"36 TABLET in 1 BOTTLE (0555-0572-35)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":36,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (36 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":36,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (36 TABLET in 1 BOTTLE (0555-0572-35)) gives 36 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904714110","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7141-10","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7141-10) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (20 BLISTER PACK in 1 CARTON (0904-7141-10) / 1 TABLET in 1 BLISTER PACK) gives 20 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729048601","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-486-01","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-486-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (16729-486-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"47335023583","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-235-83","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (47335-235-83)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (47335-235-83)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"47335023596","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-235-96","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"36 TABLET in 1 BOTTLE (47335-235-96)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":36,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (36 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":36,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (36 TABLET in 1 BOTTLE (47335-235-96)) gives 36 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51079067001","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079067005","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-670-05","proprietary_name":"Methotrexate","nonproprietary_name":"methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"20 BLISTER PACK in 1 CARTON (51079-670-05) / 1 TABLET in 1 BLISTER PACK (51079-670-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (20 BLISTER PACK in 1 CARTON (51079-670-05) / 1 TABLET in 1 BLISTER PACK (51079-670-01)) gives 20 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651018201","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-182-01","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-182-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (59651-182-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135077235","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-772-35","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"36 TABLET in 1 BOTTLE (62135-772-35)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":36,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (36 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":36,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (36 TABLET in 1 BOTTLE (62135-772-35)) gives 36 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62332073031","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-730-31","proprietary_name":"METHOTREXATE","nonproprietary_name":"METHOTREXATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-730-31)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332073036","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-730-36","proprietary_name":"METHOTREXATE","nonproprietary_name":"METHOTREXATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"36 TABLET in 1 BOTTLE (62332-730-36)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850033001","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-330-01","proprietary_name":"Methotrexate Sodium","nonproprietary_name":"Methotrexate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64850-330-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382077501","name":"METHOTREXATE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-775-01","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-775-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.15774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00703367501","name":"METHOTREXATE 250 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0703-3675-01","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTERIAL; INTRAMUSCULAR; INTRATHECAL; INTRAVENOUS","strength":"25 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3675-01) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3675-01) / 10 mL in 1 VIAL, SINGLE-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16729027703","name":"METHOTREXATE 250 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-277-03","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION","route":"INTRA-ARTERIAL; INTRAMUSCULAR; INTRATHECAL; INTRAVENOUS","strength":"25 mg/mL","labeler":"Accord Healthcare, Inc.","package_description":"1 VIAL in 1 CARTON (16729-277-03) / 10 mL in 1 VIAL","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":0.702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (16729-277-03) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323012310","name":"METHOTREXATE 250 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-123-10","proprietary_name":"Methotrexate","nonproprietary_name":"METHOTREXATE SODIUM","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTERIAL; INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL in 1 CARTON (63323-123-10) / 10 mL in 1 VIAL","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":3.1832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (63323-123-10) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143951901","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.80329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143951910","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9519-10","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"SOLUTION","route":"INTRA-ARTERIAL; INTRAMUSCULAR; INTRATHECAL; INTRAVENOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0143-9519-10) / 2 mL in 1 VIAL","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":1.23696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0143-9519-10) / 2 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00703367101","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0703-3671-01","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION, SOLUTION","route":"INTRA-ARTERIAL; INTRAMUSCULAR; INTRATHECAL; INTRAVENOUS","strength":"25 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3671-01) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":1.80329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3671-01) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16729027730","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-277-30","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION","route":"INTRA-ARTERIAL; INTRAMUSCULAR; INTRATHECAL; INTRAVENOUS","strength":"25 mg/mL","labeler":"Accord Healthcare, Inc.","package_description":"1 VIAL in 1 CARTON (16729-277-30) / 2 mL in 1 VIAL","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":1.80329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (16729-277-30) / 2 mL in 1 VIAL) gives 2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"61703016105","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61703-161-05","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRATHECAL; INTRAVENOUS; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Hospira, Inc.","package_description":"5 VIAL, MULTI-DOSE in 1 CARTON (61703-161-05) / 2 mL in 1 VIAL, MULTI-DOSE (61703-161-02)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":3.1832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, MULTI-DOSE in 1 CARTON (61703-161-05) / 2 mL in 1 VIAL, MULTI-DOSE (61703-161-02)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"61703035010","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61703-350-10","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Hospira, Inc.","package_description":"5 VIAL, MULTI-DOSE in 1 CARTON (61703-350-10) / 2 mL in 1 VIAL, MULTI-DOSE (61703-350-09)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":3.1832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, MULTI-DOSE in 1 CARTON (61703-350-10) / 2 mL in 1 VIAL, MULTI-DOSE (61703-350-09)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"61703035038","name":"METHOTREXATE 50 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61703-350-38","proprietary_name":"Methotrexate","nonproprietary_name":"Methotrexate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Hospira, Inc.","package_description":"5 VIAL, MULTI-DOSE in 1 CARTON (61703-350-38) / 2 mL in 1 VIAL, MULTI-DOSE (61703-350-37)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":3.1832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J9260","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J9260 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 VIAL, MULTI-DOSE in 1 CARTON (61703-350-38) / 2 mL in 1 VIAL, MULTI-DOSE (61703-350-37)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51991019101","name":"METHSCOPOLAMINE BROM 2.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-191-01","proprietary_name":"Methscopolamine Bromide","nonproprietary_name":"methscopolamine bromide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (51991-191-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.60757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methscopolamine Bromide|Methscopolamine Bromide","basis":"generic"},"part_b":null}, {"ndc":"72319002904","name":"METHSCOPOLAMINE BROM 2.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-029-04","proprietary_name":"METHSCOPOLAMINE BROMIDE","nonproprietary_name":"methscopolamine bromide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (72319-029-04)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.60757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methscopolamine Bromide|Methscopolamine Bromide","basis":"generic"},"part_b":null}, {"ndc":"76385010001","name":"METHSCOPOLAMINE BROM 2.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-100-01","proprietary_name":"METHSCOPOLAMINE BROMIDE","nonproprietary_name":"methscopolamine bromide","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (76385-100-01)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.60757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methscopolamine Bromide|Methscopolamine Bromide","basis":"generic"},"part_b":null}, {"ndc":"51991019206","name":"METHSCOPOLAMINE BROM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-192-06","proprietary_name":"Methscopolamine Bromide","nonproprietary_name":"methscopolamine bromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-192-06)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.53165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methscopolamine Bromide|Methscopolamine Bromide","basis":"generic"},"part_b":null}, {"ndc":"72319003002","name":"METHSCOPOLAMINE BROM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-030-02","proprietary_name":"METHSCOPOLAMINE BROMIDE","nonproprietary_name":"methscopolamine bromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (72319-030-02)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.53165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methscopolamine Bromide|Methscopolamine Bromide","basis":"generic"},"part_b":null}, {"ndc":"76385010160","name":"METHSCOPOLAMINE BROM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-101-60","proprietary_name":"METHSCOPOLAMINE BROMIDE","nonproprietary_name":"methscopolamine bromide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE (76385-101-60)","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":1.53165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methscopolamine Bromide|Methscopolamine Bromide","basis":"generic"},"part_b":null}, {"ndc":"00054063905","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054063913","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093365522","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3655-22","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"12 TABLET in 1 BOTTLE (0093-3655-22)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"00093365528","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3655-28","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"28 TABLET in 1 BOTTLE (0093-3655-28)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"00904728210","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7282-10","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7282-10) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"16571073521","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-735-21","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"12 TABLET in 1 BOTTLE (16571-735-21)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"16571073528","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-735-28","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"28 TABLET in 1 BOTTLE (16571-735-28)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"60687081311","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-813","inner_of":["60687-813-94"]},"part_b":null}, {"ndc":"60687081394","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-813-94","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (60687-813-94) / 1 TABLET in 1 BLISTER PACK (60687-813-11)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69238160502","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1605-2","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"12 TABLET in 1 BOTTLE (69238-1605-2)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"69238160508","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1605-8","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"28 TABLET in 1 BOTTLE (69238-1605-8)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"70010078612","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-786-12","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"12 TABLET in 1 BOTTLE (70010-786-12)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"70010078628","name":"METHYLERGONOVINE 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-786-28","proprietary_name":"Methylergonovine Maleate","nonproprietary_name":"Methylergonovine Maleate","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"28 TABLET in 1 BOTTLE (70010-786-28)","pharm_classes":["Ergolines [CS]","Ergot Derivative [EPC]"]},"nadac":{"value":4.49722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylergonovine Maleate*|Methylergonovine Maleate","basis":"generic"},"part_b":null}, {"ndc":"59630075550","name":"METHYLIN 10 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59630-755-50","proprietary_name":"Methylin","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"SHIONOGI INC.","package_description":"500 mL in 1 BOTTLE (59630-755-50)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.23086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.1199,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Methylin|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"59630075050","name":"METHYLIN 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59630-750-50","proprietary_name":"Methylin","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"SHIONOGI INC.","package_description":"500 mL in 1 BOTTLE (59630-750-50)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.16161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.07817,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Methylin|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"31722092801","name":"METHYLPHENIDATE 10 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-928-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-928-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.95383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980022301","name":"METHYLPHENIDATE 10 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-223-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (64980-223-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.95383,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115180101","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1801-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0115-1801-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406114401","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1144-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-1144-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702010101","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-101-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 TABLET in 1 BOTTLE (10702-101-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729047901","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-479-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-479-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722017401","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-174-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceutical Inc","package_description":"100 TABLET in 1 BOTTLE (31722-174-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547048710","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-487-10","proprietary_name":"Methylphenidate hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 TABLET in 1 BOTTLE (43547-487-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664022988","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-229-88","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-229-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877061701","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-617-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-617-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084082311","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084082321","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-823-21","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-823-21) / 1 TABLET in 1 BLISTER PACK (68084-823-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834032501","name":"METHYLPHENIDATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-325-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-325-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27808005901","name":"METHYLPHENIDATE 10 MG/5 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-059-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 mL in 1 BOTTLE, PLASTIC (27808-059-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.1199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752013214","name":"METHYLPHENIDATE 10 MG/5 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-132-14","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"500 mL in 1 BOTTLE, PLASTIC (70752-132-14)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.1199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71930002552","name":"METHYLPHENIDATE 10 MG/5 ML SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-025-52","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Eywa Pharma Inc","package_description":"500 mL in 1 BOTTLE (71930-025-52)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.1199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378826016","name":"METHYLPHENIDATE 10 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.66369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00378826093","name":"METHYLPHENIDATE 10 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8260-93","proprietary_name":"Methylphenidate","nonproprietary_name":"Methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"1.1 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8260-93) / 1 PATCH in 1 POUCH (0378-8260-16) / 9 h in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.66369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574241001","name":"METHYLPHENIDATE 10 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":6.66369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574241065","name":"METHYLPHENIDATE 10 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2410-65","proprietary_name":"Methylphenidate Transdermal System","nonproprietary_name":"methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"27.5 mg/mg","labeler":"PADAGIS US LLC","package_description":"1 TRAY in 1 CARTON (0574-2410-65) / 30 POUCH in 1 TRAY / 1 PATCH in 1 POUCH / 27.5 mg in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.66369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00378826116","name":"METHYLPHENIDATE 15 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.63292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00378826193","name":"METHYLPHENIDATE 15 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8261-93","proprietary_name":"Methylphenidate","nonproprietary_name":"Methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"1.6 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8261-93) / 1 PATCH in 1 POUCH (0378-8261-16) / 9 h in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.63292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574241501","name":"METHYLPHENIDATE 15 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":6.63292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574241565","name":"METHYLPHENIDATE 15 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2415-65","proprietary_name":"Methylphenidate Transdermal System","nonproprietary_name":"methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"41.3 mg/mg","labeler":"PADAGIS US LLC","package_description":"1 TRAY in 1 CARTON (0574-2415-65) / 30 POUCH in 1 TRAY / 1 PATCH in 1 POUCH / 41.3 mg in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.63292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"31722092601","name":"METHYLPHENIDATE 2.5 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-926-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2.5 mg/1","labeler":"Camber Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-926-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.29914,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980022101","name":"METHYLPHENIDATE 2.5 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-221-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (64980-221-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.29914,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115180201","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1802-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0115-1802-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406114601","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1146-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-1146-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702010201","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-102-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 TABLET in 1 BOTTLE (10702-102-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729048001","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-480-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-480-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722017501","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-175-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceutical Inc","package_description":"100 TABLET in 1 BOTTLE (31722-175-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547048810","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-488-10","proprietary_name":"Methylphenidate hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 TABLET in 1 BOTTLE (43547-488-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268052911","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268052915","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664023088","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-230-88","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-230-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877061801","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-618-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-618-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834032601","name":"METHYLPHENIDATE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-326-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-326-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378826216","name":"METHYLPHENIDATE 20 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":6.60924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00378826293","name":"METHYLPHENIDATE 20 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8262-93","proprietary_name":"Methylphenidate","nonproprietary_name":"Methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"2.2 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8262-93) / 1 PATCH in 1 POUCH (0378-8262-16) / 9 h in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.60924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574242001","name":"METHYLPHENIDATE 20 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":6.60924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574242065","name":"METHYLPHENIDATE 20 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2420-65","proprietary_name":"Methylphenidate Transdermal System","nonproprietary_name":"methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"55 mg/mg","labeler":"PADAGIS US LLC","package_description":"1 TRAY in 1 CARTON (0574-2420-65) / 30 POUCH in 1 TRAY / 1 PATCH in 1 POUCH / 55 mg in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":6.60924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00378826316","name":"METHYLPHENIDATE 30 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.25282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00378826393","name":"METHYLPHENIDATE 30 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8263-93","proprietary_name":"Methylphenidate","nonproprietary_name":"Methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"3.3 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-8263-93) / 1 PATCH in 1 POUCH (0378-8263-16) / 9 h in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":7.25282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574243001","name":"METHYLPHENIDATE 30 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":7.25282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"00574243065","name":"METHYLPHENIDATE 30 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2430-65","proprietary_name":"Methylphenidate Transdermal System","nonproprietary_name":"methylphenidate","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"82.5 mg/mg","labeler":"PADAGIS US LLC","package_description":"1 TRAY in 1 CARTON (0574-2430-65) / 30 POUCH in 1 TRAY / 1 PATCH in 1 POUCH / 82.5 mg in 1 PATCH","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":7.25282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate|Methylphenidate","basis":"generic"},"part_b":null}, {"ndc":"31722092701","name":"METHYLPHENIDATE 5 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-927-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (31722-927-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.00923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980022201","name":"METHYLPHENIDATE 5 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-222-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (64980-222-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.00923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115180001","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1800-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0115-1800-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406114201","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1142-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-1142-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702010001","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-100-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 TABLET in 1 BOTTLE (10702-100-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729047801","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-478-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-478-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722017301","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-173-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceutical Inc","package_description":"100 TABLET in 1 BOTTLE (31722-173-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547048610","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-486-10","proprietary_name":"Methylphenidate hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US,LLC","package_description":"100 TABLET in 1 BOTTLE (43547-486-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57664022888","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-228-88","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-228-88)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877061601","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-616-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-616-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084080511","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084080521","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-805-21","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-805-21) / 1 TABLET in 1 BLISTER PACK (68084-805-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75834032401","name":"METHYLPHENIDATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-324-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-324-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27808005801","name":"METHYLPHENIDATE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-058-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 mL in 1 BOTTLE, PLASTIC (27808-058-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.07817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752013114","name":"METHYLPHENIDATE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-131-14","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"500 mL in 1 BOTTLE, PLASTIC (70752-131-14)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.07817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71930002452","name":"METHYLPHENIDATE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-024-52","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Eywa Pharma Inc","package_description":"500 mL in 1 BOTTLE (71930-024-52)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.07817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527457937","name":"METHYLPHENIDATE CD 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4579-37","proprietary_name":"methylphenidate hydrochloride CD","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4579-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.40098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl CD|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527458037","name":"METHYLPHENIDATE CD 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4580-37","proprietary_name":"methylphenidate hydrochloride CD","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4580-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.38759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl CD|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527458137","name":"METHYLPHENIDATE CD 30 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4581-37","proprietary_name":"methylphenidate hydrochloride CD","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4581-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.79463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl CD|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527458237","name":"METHYLPHENIDATE CD 40 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4582-37","proprietary_name":"methylphenidate hydrochloride CD","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4582-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.44136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl CD|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527458337","name":"METHYLPHENIDATE CD 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4583-37","proprietary_name":"methylphenidate hydrochloride CD","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4583-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.57263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl CD|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00527458437","name":"METHYLPHENIDATE CD 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4584-37","proprietary_name":"methylphenidate hydrochloride CD","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lannett Company, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4584-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.80174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl CD|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406144501","name":"METHYLPHENIDATE ER 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1445-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-1445-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"10702007501","name":"METHYLPHENIDATE ER 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-075-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"methylphenidate hydrochloride extended release","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-075-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010004201","name":"METHYLPHENIDATE ER 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-042-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70010-042-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.45832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070610","name":"METHYLPHENIDATE ER 18 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-706-10","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-706-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722095201","name":"METHYLPHENIDATE ER 18 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-952-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-952-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687053211","name":"METHYLPHENIDATE ER 18 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687053221","name":"METHYLPHENIDATE ER 18 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-532-21","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-532-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-532-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62037072501","name":"METHYLPHENIDATE ER 18 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-725-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62037-725-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62175031037","name":"METHYLPHENIDATE ER 18 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-310-37","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-310-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.5761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406147301","name":"METHYLPHENIDATE ER 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1473-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-1473-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.51315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"10702007601","name":"METHYLPHENIDATE ER 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-076-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE EXTENDED RELEASE","nonproprietary_name":"methylphenidate hydrochloride extended release","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-076-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.51315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010004301","name":"METHYLPHENIDATE ER 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-043-01","proprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","nonproprietary_name":"METHYLPHENIDATE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (70010-043-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.51315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406012701","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0127-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-0127-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070710","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-707-10","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-707-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722095301","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-953-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-953-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687054311","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687054321","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-543-21","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-543-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-543-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62037073401","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-734-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62037-734-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62175031137","name":"METHYLPHENIDATE ER 27 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-311-37","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-311-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406013601","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0136-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-0136-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070810","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-708-10","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-708-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722095401","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-954-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-954-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687055411","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687055421","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-554-21","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-554-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-554-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62037072601","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-726-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62037-726-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62175031237","name":"METHYLPHENIDATE ER 36 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-312-37","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-312-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.67155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071130","name":"METHYLPHENIDATE ER 45 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-711-30","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"45 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-711-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":17.50602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406015401","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0154-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-0154-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070910","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-709-10","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-709-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"31722095501","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-955-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-955-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687056511","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"60687056521","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-565-21","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-565-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-565-11)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62037072701","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-727-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62037-727-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"62175031337","name":"METHYLPHENIDATE ER 54 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-313-37","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-313-37)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.80506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811070030","name":"METHYLPHENIDATE ER 63 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-700-30","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"63 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-700-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":18.87437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071030","name":"METHYLPHENIDATE ER 72 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-710-30","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"72 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-710-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.50883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"57664071083","name":"METHYLPHENIDATE ER 72 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-710-83","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"72 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (57664-710-83)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.50883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"72603039901","name":"METHYLPHENIDATE ER 72 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-399-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"72 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (72603-399-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.50883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115173601","name":"METHYLPHENIDATE ER(CD) 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1736-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1736-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.40098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406181001","name":"METHYLPHENIDATE ER(CD) 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1810-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0406-1810-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.40098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115173701","name":"METHYLPHENIDATE ER(CD) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1737-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1737-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.38759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406182001","name":"METHYLPHENIDATE ER(CD) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1820-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0406-1820-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.38759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115173801","name":"METHYLPHENIDATE ER(CD) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1738-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1738-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.79463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406183001","name":"METHYLPHENIDATE ER(CD) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1830-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0406-1830-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.79463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115173901","name":"METHYLPHENIDATE ER(CD) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1739-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1739-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.44136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406184001","name":"METHYLPHENIDATE ER(CD) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1840-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0406-1840-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.44136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115174001","name":"METHYLPHENIDATE ER(CD) 50 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1740-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1740-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.57263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406185001","name":"METHYLPHENIDATE ER(CD) 50 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1850-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0406-1850-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.57263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00115174101","name":"METHYLPHENIDATE ER(CD) 60 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1741-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0115-1741-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.80174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00406186001","name":"METHYLPHENIDATE ER(CD) 60 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1860-01","proprietary_name":"Methylphenidate Hydrochloride Extended-Release","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0406-1860-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.80174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate HCl ER (Cd)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781238301","name":"METHYLPHENIDATE ER(LA) 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2383-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2383-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.39986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010001201","name":"METHYLPHENIDATE ER(LA) 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-012-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-012-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.39986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75907004901","name":"METHYLPHENIDATE ER(LA) 10 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-049-01","proprietary_name":"Methylphenidate Hydrochloride (LA)","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (75907-049-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.39986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093534601","name":"METHYLPHENIDATE ER(LA) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.69545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781236201","name":"METHYLPHENIDATE ER(LA) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2362-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2362-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.69545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781238401","name":"METHYLPHENIDATE ER(LA) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2384-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2384-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.69545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010001301","name":"METHYLPHENIDATE ER(LA) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-013-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-013-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.69545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75907005001","name":"METHYLPHENIDATE ER(LA) 20 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-050-01","proprietary_name":"Methylphenidate Hydrochloride (LA)","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (75907-050-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.69545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093534701","name":"METHYLPHENIDATE ER(LA) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.90366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781236301","name":"METHYLPHENIDATE ER(LA) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2363-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2363-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.90366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781238501","name":"METHYLPHENIDATE ER(LA) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2385-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2385-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.90366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010001401","name":"METHYLPHENIDATE ER(LA) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-014-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-014-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.90366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75907005101","name":"METHYLPHENIDATE ER(LA) 30 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-051-01","proprietary_name":"Methylphenidate Hydrochloride (LA)","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (75907-051-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.90366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093534801","name":"METHYLPHENIDATE ER(LA) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.85373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781236401","name":"METHYLPHENIDATE ER(LA) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2364-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2364-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.85373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"00781238601","name":"METHYLPHENIDATE ER(LA) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2386-01","proprietary_name":"Methylphenidate","nonproprietary_name":"methylphenidate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0781-2386-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.85373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"70010001501","name":"METHYLPHENIDATE ER(LA) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-015-01","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-015-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.85373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75907005201","name":"METHYLPHENIDATE ER(LA) 40 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-052-01","proprietary_name":"Methylphenidate Hydrochloride (LA)","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (75907-052-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.85373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010001603","name":"METHYLPHENIDATE ER(LA) 60 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-016-03","proprietary_name":"Methylphenidate Hydrochloride","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-016-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.51508,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylphenidate ER (La)|Methylphenidate HCl","basis":"generic"},"part_b":null}, {"ndc":"75907005330","name":"METHYLPHENIDATE ER(LA) 60 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-053-30","proprietary_name":"Methylphenidate Hydrochloride (LA)","nonproprietary_name":"Methylphenidate Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (75907-053-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.51508,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762005001","name":"METHYLPREDNISOLONE 16 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0050-1","proprietary_name":"Methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"50 TABLET in 1 BOTTLE (59762-0050-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.44606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 TABLET in 1 BOTTLE (59762-0050-1)) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135076250","name":"METHYLPREDNISOLONE 16 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-762-50","proprietary_name":"Methylprednisolone","nonproprietary_name":"Methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Chartwell RX, LLC","package_description":"50 TABLET in 1 BOTTLE (62135-762-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.44606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":200,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"68382091818","name":"METHYLPREDNISOLONE 16 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-918-18","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"50 TABLET in 1 BOTTLE (68382-918-18)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.44606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 TABLET in 1 BOTTLE (68382-918-18)) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59762005101","name":"METHYLPREDNISOLONE 32 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0051-1","proprietary_name":"Methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"25 TABLET in 1 BOTTLE (59762-0051-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.75486,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 TABLET in 1 BOTTLE (59762-0051-1)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135076326","name":"METHYLPREDNISOLONE 32 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-763-26","proprietary_name":"Methylprednisolone","nonproprietary_name":"Methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Chartwell RX, LLC","package_description":"25 TABLET in 1 BOTTLE (62135-763-26)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.75486,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 TABLET in 1 BOTTLE (62135-763-26)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68382091911","name":"METHYLPREDNISOLONE 32 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-919-11","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"32 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"25 TABLET in 1 BOTTLE (68382-919-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.75486,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 TABLET in 1 BOTTLE (68382-919-11)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00603459315","name":"METHYLPREDNISOLONE 4 MG DOSEPK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-4593-15","proprietary_name":"MethylPREDNISolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Par Health USA, LLC","package_description":"1 DOSE PACK in 1 CARTON (0603-4593-15) / 21 TABLET in 1 DOSE PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":null}, {"ndc":"42806040021","name":"METHYLPREDNISOLONE 4 MG DOSEPK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-400-21","proprietary_name":"METHYLPREDNISOLONE","nonproprietary_name":"METHYLPREDNISOLONE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Epic Pharma, LLC","package_description":"1 BLISTER PACK in 1 CARTON (42806-400-21) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":null}, {"ndc":"59762444002","name":"METHYLPREDNISOLONE 4 MG DOSEPK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-4440-2","proprietary_name":"Methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 DOSE PACK in 1 CARTON (59762-4440-2) / 21 TABLET in 1 DOSE PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":21,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (21 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 DOSE PACK in 1 CARTON (59762-4440-2) / 21 TABLET in 1 DOSE PACK) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001062401","name":"METHYLPREDNISOLONE 4 MG DOSEPK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-624-01","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (68001-624-01) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":21,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (21 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68001-624-01) / 21 TABLET in 1 BLISTER PACK) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68382091634","name":"METHYLPREDNISOLONE 4 MG DOSEPK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-916-34","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68382-916-34) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.13607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":21,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (21 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (68382-916-34) / 21 TABLET in 1 BLISTER PACK) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00603459321","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-4593-21","proprietary_name":"MethylPREDNISolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-4593-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":null}, {"ndc":"00904691461","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6914-61","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6914-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-6914-61) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59762444003","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-4440-3","proprietary_name":"Methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-4440-3)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (59762-4440-3)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135076001","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-760-01","proprietary_name":"Methylprednisolone","nonproprietary_name":"Methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"100 TABLET in 1 BOTTLE (62135-760-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (62135-760-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135076021","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-760-21","proprietary_name":"Methylprednisolone","nonproprietary_name":"Methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"21 TABLET in 1 BOTTLE (62135-760-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":21,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (21 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (21 TABLET in 1 BOTTLE (62135-760-21)) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084014901","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-149-01","proprietary_name":"Methylprednisolone","nonproprietary_name":"Methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-149-01) / 1 TABLET in 1 BLISTER PACK (68084-149-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-149-01) / 1 TABLET in 1 BLISTER PACK (68084-149-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084014911","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":null}, {"ndc":"68382091601","name":"METHYLPREDNISOLONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-916-01","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-916-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.12107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (68382-916-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60219157301","name":"METHYLPREDNISOLONE 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1573-1","proprietary_name":"Methylprednisolone acetate","nonproprietary_name":"Methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRASYNOVIAL; SOFT TISSUE","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (60219-1573-1) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.49,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (60219-1573-1) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121157301","name":"METHYLPREDNISOLONE 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1573-1","proprietary_name":"Methylprednisolone acetate","nonproprietary_name":"Methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRASYNOVIAL; SOFT TISSUE","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (70121-1573-1) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.49,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (70121-1573-1) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00781352270","name":"METHYLPREDNISOLONE 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":5.8078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"25021082010","name":"METHYLPREDNISOLONE 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"25021-820-10","proprietary_name":"methylprednisolone acetate","nonproprietary_name":"methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRASYNOVIAL; SOFT TISSUE","strength":"40 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 VIAL in 1 CARTON (25021-820-10) / 10 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.8078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (25021-820-10) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42023023901","name":"METHYLPREDNISOLONE 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":5.8078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"55150031301","name":"METHYLPREDNISOLONE 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-313-01","proprietary_name":"Methylprednisolone Acetate","nonproprietary_name":"Methylprednisolone Acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"40 mg/mL","labeler":"Eugia US LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (55150-313-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.8078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (55150-313-01) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121160901","name":"METHYLPREDNISOLONE 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70121-1609-1","proprietary_name":"Methylprednisolone acetate","nonproprietary_name":"Methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; INTRASYNOVIAL; SOFT TISSUE","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1609-1) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":5.8078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1609-1) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59762004901","name":"METHYLPREDNISOLONE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0049-1","proprietary_name":"Methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"25 TABLET in 1 BOTTLE (59762-0049-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.93297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 TABLET in 1 BOTTLE (59762-0049-1)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135076126","name":"METHYLPREDNISOLONE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-761-26","proprietary_name":"Methylprednisolone","nonproprietary_name":"Methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Chartwell RX, LLC","package_description":"25 TABLET in 1 BOTTLE (62135-761-26)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.93297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 TABLET in 1 BOTTLE (62135-761-26)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68382091711","name":"METHYLPREDNISOLONE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-917-11","proprietary_name":"methylprednisolone","nonproprietary_name":"methylprednisolone","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"25 TABLET in 1 BOTTLE (68382-917-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.93297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone|Methylprednisolone","basis":"generic"},"part_b":{"hcpcs":"J7509","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7509 (4 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":25,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 TABLET in 1 BOTTLE (68382-917-11)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60219157401","name":"METHYLPREDNISOLONE 80 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60219-1574-1","proprietary_name":"Methylprednisolone acetate","nonproprietary_name":"Methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"80 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (60219-1574-1) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.92429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (60219-1574-1) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121155201","name":"METHYLPREDNISOLONE 80 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70121-1552-1","proprietary_name":"Methylprednisolone acetate","nonproprietary_name":"Methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"80 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (70121-1552-1) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.92429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70121157401","name":"METHYLPREDNISOLONE 80 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70121-1574-1","proprietary_name":"Methylprednisolone acetate","nonproprietary_name":"Methylprednisolone acetate","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRALESIONAL; INTRAMUSCULAR; SOFT TISSUE","strength":"80 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (70121-1574-1) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":11.92429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1010","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1010 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (70121-1574-1) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143975425","name":"METHYLPREDNISOLONE SS 125 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9754-25","proprietary_name":"Methylprednisolone Sodium Succinate","nonproprietary_name":"Methylprednisolone Sodium Succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"125 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (0143-9754-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (0143-9754-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.26552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone Sodium Succ*|Methylprednisolone Sod Succ","basis":"generic"},"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":625,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (0143-9754-25) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (0143-9754-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"43598012925","name":"METHYLPREDNISOLONE SS 125 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-129-25","proprietary_name":"Methylprednisolone sodium succinate","nonproprietary_name":"Methylprednisolone sodium succinate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"125 mg/2mL","labeler":"Dr. Reddy's Laboratories Inc","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (43598-129-25) / 2 mL in 1 VIAL, SINGLE-DOSE (43598-129-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.26552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone Sodium Succ*|Methylprednisolone Sod Succ","basis":"generic"},"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":625,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (43598-129-25) / 2 mL in 1 VIAL, SINGLE-DOSE (43598-129-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323025803","name":"METHYLPREDNISOLONE SS 125 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-258-03","proprietary_name":"Methylprednisolone Sodium Succinate","nonproprietary_name":"METHYLPREDNISOLONE SODIUM SUCCINATE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"125 mg/2mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-258-03) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-258-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.26552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Methylprednisolone Sodium Succ*|Methylprednisolone Sod Succ","basis":"generic"},"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":625,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (63323-258-03) / 2 mL in 1 VIAL, SINGLE-DOSE (63323-258-01)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00093220301","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2203-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2203-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093220305","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2203-05","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-2203-05)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093220310","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2203-10","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-2203-10)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884068901","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884068905","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228023301","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-233-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-233-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228023305","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-233-05","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-233-05)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228023310","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-233-10","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50228-233-10)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079088801","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079088820","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-888-20","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-888-20) / 1 TABLET in 1 BLISTER PACK (51079-888-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687063101","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-631-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-631-01) / 1 TABLET in 1 BLISTER PACK (60687-631-11)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687063111","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559029601","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-296-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (62559-296-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980001101","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-011-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-011-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980001105","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-011-05","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ipca Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (83980-011-05)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980001110","name":"METOCLOPRAMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-011-10","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-011-10)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409341411","name":"METOCLOPRAMIDE 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-3414-11","proprietary_name":"Metoclopramide","nonproprietary_name":"metoclopramide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-3414-11) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-3414-21)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.52896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2765","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2765 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-3414-11) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-3414-21)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409525515","name":"METOCLOPRAMIDE 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-5255-15","proprietary_name":"Metoclopramide","nonproprietary_name":"metoclopramide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-5255-15) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-5255-10)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.52896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2765","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2765 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-5255-15) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-5255-10)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00703450204","name":"METOCLOPRAMIDE 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0703-4502-04","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"25 VIAL, SINGLE-USE in 1 TRAY (0703-4502-04) / 2 mL in 1 VIAL, SINGLE-USE (0703-4502-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.52896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2765","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2765 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 TRAY (0703-4502-04) / 2 mL in 1 VIAL, SINGLE-USE (0703-4502-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155024041","name":"METOCLOPRAMIDE 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23155-240-41","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (23155-240-41) / 2 mL in 1 VIAL (23155-240-31)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.52896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2765","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2765 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (23155-240-41) / 2 mL in 1 VIAL (23155-240-31)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"83634077902","name":"METOCLOPRAMIDE 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83634-779-02","proprietary_name":"Metoclopramide","nonproprietary_name":"metoclopramide hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Avenacy, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (83634-779-02) / 2 mL in 1 VIAL, SINGLE-DOSE (83634-779-41)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.52896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2765","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2765 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (83634-779-02) / 2 mL in 1 VIAL, SINGLE-DOSE (83634-779-41)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00093220401","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2204-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2204-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093220405","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2204-05","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-2204-05)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228023201","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-232-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-232-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228023205","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-232-05","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-232-05)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079088601","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079088620","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-886-20","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-886-20) / 1 TABLET in 1 BLISTER PACK (51079-886-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062001","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-620-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-620-01) / 1 TABLET in 1 BLISTER PACK (60687-620-11)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062011","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559029501","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-295-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (62559-295-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980001001","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-010-01","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-010-01)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83980001005","name":"METOCLOPRAMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-010-05","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ipca Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (83980-010-05)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.0358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135052647","name":"METOCLOPRAMIDE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-526-47","proprietary_name":"metoclopramide hydrochloride","nonproprietary_name":"metoclopramide hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-526-47)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.12569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559019016","name":"METOCLOPRAMIDE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-190-16","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (62559-190-16)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.12569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950034416","name":"METOCLOPRAMIDE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-344-16","proprietary_name":"Metoclopramide","nonproprietary_name":"Metoclopramide Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Genus Lifesciences Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (64950-344-16)","pharm_classes":["Dopamine D2 Antagonists [MoA]","Dopamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.12569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00185560001","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-5600-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-5600-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00378617401","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6174-01","proprietary_name":"Metolazone","nonproprietary_name":"metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-6174-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"50742035101","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-351-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ingenus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (50742-351-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657074201","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-742-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-742-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657094201","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-942-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-942-01) / 1 TABLET in 1 BLISTER PACK (58657-942-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657094210","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"62332053431","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-534-31","proprietary_name":"METOLAZONE","nonproprietary_name":"METOLAZONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-534-31)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"69292056601","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-566-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-566-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"72888005401","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-054-01","proprietary_name":"METOLAZONE","nonproprietary_name":"METOLAZONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-054-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"76385013801","name":"METOLAZONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-138-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (76385-138-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.38134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00185505001","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-5050-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-5050-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00378617201","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6172-01","proprietary_name":"Metolazone","nonproprietary_name":"metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-6172-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00904752061","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7520-61","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7520-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"50742034901","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-349-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ingenus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (50742-349-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"51079002301","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"51079002320","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-023-20","proprietary_name":"Metolazone","nonproprietary_name":"metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-023-20) / 1 TABLET in 1 BLISTER PACK (51079-023-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657074001","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-740-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-740-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657094001","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-940-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-940-01) / 1 TABLET in 1 BLISTER PACK (58657-940-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657094010","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"60687062401","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-624-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-624-01) / 1 TABLET in 1 BLISTER PACK (60687-624-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"60687062411","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"62332053231","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-532-31","proprietary_name":"METOLAZONE","nonproprietary_name":"METOLAZONE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-532-31)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"69292056201","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-562-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-562-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"72888005201","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-052-01","proprietary_name":"METOLAZONE","nonproprietary_name":"METOLAZONE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-052-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"76385013601","name":"METOLAZONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-136-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (76385-136-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00185005501","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0055-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (0185-0055-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00378617301","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6173-01","proprietary_name":"Metolazone","nonproprietary_name":"metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-6173-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00904752161","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7521-61","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7521-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"50742035001","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-350-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ingenus Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (50742-350-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"51079002401","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"51079002420","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-024-20","proprietary_name":"Metolazone","nonproprietary_name":"metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-024-20) / 1 TABLET in 1 BLISTER PACK (51079-024-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657074101","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-741-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (58657-741-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657094101","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-941-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-941-01) / 1 TABLET in 1 BLISTER PACK (58657-941-10)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"58657094110","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"60687063501","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-635-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-635-01) / 1 TABLET in 1 BLISTER PACK (60687-635-11)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"60687063511","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"62332053331","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-533-31","proprietary_name":"METOLAZONE","nonproprietary_name":"METOLAZONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-533-31)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"69292056401","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-564-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amici Pharma, Inc","package_description":"100 TABLET in 1 BOTTLE (69292-564-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"72888005301","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-053-01","proprietary_name":"METOLAZONE","nonproprietary_name":"METOLAZONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-053-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"76385013701","name":"METOLAZONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-137-01","proprietary_name":"Metolazone","nonproprietary_name":"Metolazone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE (76385-137-01)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":0.23919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metolazone|Metolazone","basis":"generic"},"part_b":null}, {"ndc":"00904632461","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6324-61","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6324-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030401","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-304-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-304-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030402","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-304-02","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-304-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030403","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-304-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-304-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059101","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-591-01","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-591-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059105","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-591-05","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-591-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059110","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-591-10","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-591-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072601","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-726-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-726-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072605","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-726-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-726-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072610","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-726-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-726-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963067711","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-677-11","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-677-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963067796","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-677-96","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-677-96)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054211","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054215","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-542-15","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-542-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-542-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061701","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-617-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-617-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061710","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-617-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-617-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046801","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-468-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-468-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046805","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-468-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-468-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687041301","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-413-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-413-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-413-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687041311","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687041365","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-413-65","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-413-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-413-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059201","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-592-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-592-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059205","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-592-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-592-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001047000","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-470-00","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-470-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050200","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-502-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-502-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050203","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-502-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-502-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068600","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-686-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-686-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068603","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-686-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-686-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056601","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-566-01","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-566-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056610","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-566-10","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-566-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68645047954","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097040807","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-408-07","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-408-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"69097040815","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-408-15","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-408-15)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078201","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-782-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-782-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078205","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-782-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-782-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078210","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-782-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-782-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516002710","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-027-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Oryza pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-027-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003201","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-032-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-032-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003210","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-032-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-032-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003250","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-032-50","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-032-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014401","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-144-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-144-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014402","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-144-02","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-144-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014403","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-144-03","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-144-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034501","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-345-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-345-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034510","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-345-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-345-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"82009011505","name":"METOPROLOL SUCC ER 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-115-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (82009-115-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030501","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-305-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-305-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059201","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-592-01","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-592-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059205","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-592-05","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-592-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072701","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-727-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-727-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072705","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-727-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-727-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072710","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-727-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-727-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963067811","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-678-11","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-678-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054311","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054315","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-543-15","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-543-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-543-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061801","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-618-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-618-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046901","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-469-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-469-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046905","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-469-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-469-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059301","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-593-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-593-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059305","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-593-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-593-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001047100","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-471-00","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-471-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050300","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-503-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-503-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068700","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-687-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-687-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056701","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-567-01","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-567-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056705","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-567-05","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-567-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"69097040907","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-409-07","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-409-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078301","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-783-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-783-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078305","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-783-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-783-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078310","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-783-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-783-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516002801","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-028-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Oryza pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-028-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003301","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-033-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-033-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014501","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-145-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-145-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014502","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-145-02","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-145-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034601","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-346-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-346-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034605","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-346-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-346-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"82009011605","name":"METOPROLOL SUCC ER 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-116-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (82009-116-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"00904632206","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6322-06","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6322-06) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"00904632261","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6322-61","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6322-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030201","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-302-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-302-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030202","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-302-02","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-302-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030203","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-302-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-302-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722058901","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-589-01","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-589-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722058905","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-589-05","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-589-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722058910","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-589-10","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-589-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072401","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-724-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-724-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072405","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-724-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-724-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072410","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-724-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-724-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963070911","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-709-11","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-709-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963070996","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-709-96","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-709-96)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054011","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054015","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-540-15","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-540-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-540-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061501","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-615-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-615-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061510","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-615-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-615-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046601","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-466-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-466-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046605","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-466-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-466-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687039001","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-390-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-390-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-390-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687039011","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687039065","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-390-65","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-390-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-390-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059001","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-590-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-590-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059005","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-590-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-590-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001035600","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-356-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-356-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001035603","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-356-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-356-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050000","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-500-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-500-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050003","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-500-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-500-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068400","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-684-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-684-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068403","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-684-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-684-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056401","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-564-01","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-564-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056410","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-564-10","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-564-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68645047754","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010078001","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-780-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-780-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078005","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-780-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-780-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078010","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-780-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-780-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003001","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-030-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-030-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003010","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-030-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-030-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003050","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-030-50","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-030-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014201","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-142-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-142-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014202","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-142-02","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-142-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014203","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-142-03","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-142-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034401","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-344-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-344-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034410","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-344-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-344-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"82009011305","name":"METOPROLOL SUCC ER 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-113-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (82009-113-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"00904632361","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6323-61","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6323-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030301","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-303-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-303-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030302","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-303-02","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-303-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"27808030303","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-303-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-303-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059001","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-590-01","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-590-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059005","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-590-05","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-590-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722059010","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-590-10","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"METOPROLOL SUCCINATE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-590-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072501","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-725-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-725-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072505","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-725-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-725-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"42806072510","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-725-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (42806-725-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963067611","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-676-11","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-676-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"45963067696","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45963-676-96","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (45963-676-96)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054111","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50268054115","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-541-15","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-541-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-541-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061601","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-616-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-616-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"50742061610","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-616-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-616-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046701","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-467-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-467-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"55111046705","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-467-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-467-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687040201","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-402-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-402-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-402-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687040211","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"60687040265","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-402-65","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-402-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-402-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059101","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-591-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-591-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877059105","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-591-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-591-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001046900","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-469-00","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-469-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050100","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-501-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-501-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001050103","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-501-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate ER Tablets","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-501-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068500","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-685-00","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-685-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68001068503","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-685-03","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-685-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056501","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-565-01","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-565-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68382056510","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-565-10","proprietary_name":"metoprolol succinate","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-565-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"68645047854","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097040707","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-407-07","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-407-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"69097040715","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-407-15","proprietary_name":"METOPROLOL SUCCINATE","nonproprietary_name":"metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (69097-407-15)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078101","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-781-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-781-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078105","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-781-05","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-781-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"70010078110","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-781-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70010-781-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516002610","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-026-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Oryza pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-026-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003101","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-031-01","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-031-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003110","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-031-10","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-031-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72516003150","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-031-50","proprietary_name":"Metoprolol Succinate","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Oryza Pharmaceuticals, Inc","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72516-031-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014301","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-143-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-143-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014302","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-143-02","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-143-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"72603014303","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-143-03","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-143-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034701","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-347-01","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-347-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"75907034710","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-347-10","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75907-347-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"82009011405","name":"METOPROLOL SUCC ER 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-114-05","proprietary_name":"Metoprolol succinate","nonproprietary_name":"Metoprolol succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (82009-114-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Succinate|Metoprolol Succinate","basis":"generic"},"part_b":null}, {"ndc":"00378004701","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0047-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0047-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378004710","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0047-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0047-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817025400","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-254-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"TRUPHARMA LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-254-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817025410","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-254-10","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"TRUPHARMA LLC","package_description":"100 TABLET in 1 BOTTLE (52817-254-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817036200","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-362-00","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"TruPharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (52817-362-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817036210","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-362-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-362-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57237010201","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-102-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-102-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57237010299","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-102-99","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-102-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332011431","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-114-31","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-114-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332011491","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-114-91","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-114-91)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62584026701","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-267-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (62584-267-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (62584-267-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62584026711","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"62584-267","inner_of":["62584-267-01"]},"part_b":null}, {"ndc":"65862006401","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-064-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-064-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862006439","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"65862-064","inner_of":[]},"part_b":null}, {"ndc":"65862006499","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-064-99","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-064-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68645019159","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-191-59","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68645-191-59)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000600","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-006-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-006-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000601","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-006-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-006-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888021200","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-212-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-212-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888021201","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-212-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-212-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76282079601","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-796-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-796-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76282079610","name":"METOPROLOL TARTRATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-796-10","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-796-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.02866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888019703","name":"METOPROLOL TARTRATE 12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-197-03","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (72888-197-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.87431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378001801","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0018-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0018-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378001805","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0018-05","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0018-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"51079025501","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-255","inner_of":["51079-255-20"]},"part_b":null}, {"ndc":"51079025520","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-255-20","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-255-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-255-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817025000","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-250-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"TRUPHARMA LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-250-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817025010","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-250-10","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"TRUPHARMA LLC","package_description":"100 TABLET in 1 BOTTLE (52817-250-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817036000","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-360-00","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"TruPharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (52817-360-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817036010","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-360-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-360-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57237010001","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-100-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-100-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57237010099","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-100-99","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-100-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332011231","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-112-31","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-112-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332011291","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-112-91","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-112-91)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62584026501","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-265-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (62584-265-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (62584-265-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62584026511","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"62584-265","inner_of":["62584-265-01"]},"part_b":null}, {"ndc":"65862006201","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-062-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-062-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862006299","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-062-99","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-062-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000400","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-004-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-004-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000401","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-004-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-004-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000405","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-004-05","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-004-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888020800","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-208-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-208-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888020801","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-208-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-208-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888020802","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-208-02","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"10000 TABLET in 1 POUCH (72888-208-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888020805","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-208-05","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-208-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76282079401","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-794-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-794-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76282079410","name":"METOPROLOL TARTRATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-794-10","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-794-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01587,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378459301","name":"METOPROLOL TARTRATE 37.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4593-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4593-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817035810","name":"METOPROLOL TARTRATE 37.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-358-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 PACKAGE (52817-358-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888010101","name":"METOPROLOL TARTRATE 37.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-101-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 PACKAGE (72888-101-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378003201","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0032-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0032-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378003210","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0032-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0032-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"51079080101","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"51079-801","inner_of":["51079-801-20"]},"part_b":null}, {"ndc":"51079080120","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-801-20","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-801-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-801-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817025200","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-252-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"TRUPHARMA LLC","package_description":"1000 TABLET in 1 BOTTLE (52817-252-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817025210","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-252-10","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"TRUPHARMA LLC","package_description":"100 TABLET in 1 BOTTLE (52817-252-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817036100","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-361-00","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"TruPharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (52817-361-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817036110","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-361-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52817-361-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57237010101","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-101-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-101-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"57237010199","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-101-99","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-101-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332011331","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-113-31","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-113-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62332011391","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-113-91","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (62332-113-91)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62584026601","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-266-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (62584-266-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (62584-266-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62584026611","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"62584-266","inner_of":["62584-266-01"]},"part_b":null}, {"ndc":"65862006301","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-063-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-063-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862006359","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"65862-063","inner_of":[]},"part_b":null}, {"ndc":"65862006399","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-063-99","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-063-99)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68645019059","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-190-59","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68645-190-59)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000500","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-005-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-005-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888000501","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-005-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-005-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888021000","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-210-00","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET in 1 BOTTLE (72888-210-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888021001","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-210-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-210-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888021002","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-210-02","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"5000 TABLET in 1 POUCH (72888-210-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76282079501","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-795-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-795-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"76282079510","name":"METOPROLOL TARTRATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-795-10","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-795-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.01949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378459401","name":"METOPROLOL TARTRATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4594-01","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"metoprolol tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4594-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52817035910","name":"METOPROLOL TARTRATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-359-10","proprietary_name":"Metoprolol Tartrate","nonproprietary_name":"Metoprolol Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, FILM COATED in 1 PACKAGE (52817-359-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72888002301","name":"METOPROLOL TARTRATE 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-023-01","proprietary_name":"METOPROLOL TARTRATE","nonproprietary_name":"METOPROLOL TARTRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 PACKAGE (72888-023-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol Tartrate*|Metoprolol Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00378043401","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0434-01","proprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","nonproprietary_name":"metoprolol tartrate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0434-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.4111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"27241030201","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-302-01","proprietary_name":"METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"metoprolol tartrate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-302-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.4111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332011631","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 100-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-116-31","proprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","nonproprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-116-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.4111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378044501","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 100-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0445-01","proprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","nonproprietary_name":"metoprolol tartrate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1; 50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0445-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.3598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378042401","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 50-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0424-01","proprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","nonproprietary_name":"metoprolol tartrate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0424-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.90917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"27241030101","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 50-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-301-01","proprietary_name":"METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"metoprolol tartrate and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-301-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.90917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332011531","name":"METOPROLOL-HYDROCHLOROTHIAZIDE 50-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-115-31","proprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","nonproprietary_name":"Metoprolol Tartrate and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-115-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.90917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Metoprolol-Hydrochlorothiazide|Metoprolol/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00168032346","name":"METRONIDAZOLE 0.75% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0323-46","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"CREAM","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Fougera Pharmaceuticals, LLC","package_description":"45 g in 1 TUBE (0168-0323-46)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.2571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063337","name":"METRONIDAZOLE 0.75% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0633-37","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"CREAM","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0633-37) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.2571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651077046","name":"METRONIDAZOLE 0.75% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-770-46","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"CREAM","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-770-46) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.2571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993096045","name":"METRONIDAZOLE 0.75% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-960-45","proprietary_name":"METRONIDAZOLE","nonproprietary_name":"METRONIDAZOLE","dosage_form":"CREAM","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Prasco Laboratories","package_description":"1 TUBE in 1 CARTON (66993-960-45) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.2571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308071145","name":"METRONIDAZOLE 0.75% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-711-45","proprietary_name":"METRONIDAZOLE","nonproprietary_name":"METRONIDAZOLE","dosage_form":"CREAM","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 TUBE in 1 CARTON (68308-711-45) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.2571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578012908","name":"METRONIDAZOLE 0.75% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-129-08","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"CREAM","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-129-08) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.2571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168038360","name":"METRONIDAZOLE 0.75% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0383-60","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"LOTION","route":"TOPICAL","strength":"7.5 mg/mL","labeler":"Fougera Pharmaceuticals, LLC","package_description":"59 mL in 1 BOTTLE, PLASTIC (0168-0383-60)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":1.81728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68308071259","name":"METRONIDAZOLE 0.75% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-712-59","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"LOTION","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 BOTTLE in 1 CARTON (68308-712-59) / 59.7 g in 1 BOTTLE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":1.81728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904715661","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7156-61","proprietary_name":"Metronidazole","nonproprietary_name":"METRONIDAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7156-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571066501","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-665-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-665-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571066550","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-665-50","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-665-50)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155065101","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-651-01","proprietary_name":"Metronidazole","nonproprietary_name":"METRONIDAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23155-651-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155065105","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-651-05","proprietary_name":"Metronidazole","nonproprietary_name":"METRONIDAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (23155-651-05)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300022601","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-226-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-226-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300022605","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-226-05","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-226-05)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300022652","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-226-52","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"250 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-226-52)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111033301","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-333-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-333-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111033302","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-333-02","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (50111-333-02)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111033306","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-333-06","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"250 TABLET in 1 BOTTLE (50111-333-06)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268053411","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268053415","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-534-15","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-534-15) / 1 TABLET in 1 BLISTER PACK (50268-534-11)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657093301","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-933-01","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-933-01) / 1 TABLET in 1 BLISTER PACK (58657-933-10)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657093305","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-933-05","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"50 BLISTER PACK in 1 CARTON (58657-933-05) / 1 TABLET in 1 BLISTER PACK (58657-933-10)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657093310","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687052601","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-526-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-526-01) / 1 TABLET in 1 BLISTER PACK (60687-526-11)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687052611","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135079590","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-795-90","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-795-90)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332001631","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-016-31","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-016-31)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332001671","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-016-71","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-016-71)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001036400","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-364-00","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68001-364-00)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292020750","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-207-50","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"AMICI PHARMA INC","package_description":"500 TABLET in 1 BOTTLE (69292-207-50)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000701","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-007-01","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-007-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000705","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-007-05","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-007-05)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000721","name":"METRONIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-007-21","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"250 TABLET in 1 BOTTLE (72578-007-21)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135083650","name":"METRONIDAZOLE 375 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-836-50","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"CAPSULE","route":"ORAL","strength":"375 mg/1","labeler":"Chartwell RX, LLC","package_description":"50 CAPSULE in 1 BOTTLE (62135-836-50)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":7.30796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332001850","name":"METRONIDAZOLE 375 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-018-50","proprietary_name":"Metronidazole","nonproprietary_name":"metronidazole","dosage_form":"CAPSULE","route":"ORAL","strength":"375 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"50 CAPSULE in 1 BOTTLE (62332-018-50)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":7.30796,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904712661","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7126-61","proprietary_name":"Metronidazole","nonproprietary_name":"METRONIDAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7126-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571066401","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-664-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-664-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571066450","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-664-50","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-664-50)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155065201","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-652-01","proprietary_name":"Metronidazole","nonproprietary_name":"METRONIDAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23155-652-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155065205","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-652-05","proprietary_name":"Metronidazole","nonproprietary_name":"METRONIDAZOLE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (23155-652-05)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300022701","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-227-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-227-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300022705","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-227-05","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-227-05)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"29300022746","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-227-46","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-227-46)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111033401","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-334-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-334-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50111033402","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-334-02","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (50111-334-02)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268053511","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268053515","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-535-15","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-535-15) / 1 TABLET in 1 BLISTER PACK (50268-535-11)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657093401","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-934-01","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"100 BLISTER PACK in 1 CARTON (58657-934-01) / 1 TABLET in 1 BLISTER PACK (58657-934-10)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657093405","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-934-05","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Method Pharmaceuticals LLC","package_description":"50 BLISTER PACK in 1 CARTON (58657-934-05) / 1 TABLET in 1 BLISTER PACK (58657-934-10)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657093410","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687055001","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-550-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-550-01) / 1 TABLET in 1 BLISTER PACK (60687-550-11)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687055011","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135079690","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-796-90","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-796-90)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332001731","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-017-31","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-017-31)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332001771","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-017-71","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-017-71)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001036500","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-365-00","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68001-365-00)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001036503","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-365-03","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (68001-365-03)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292020850","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-208-50","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"AMICI PHARMA INC","package_description":"500 TABLET in 1 BOTTLE (69292-208-50)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000801","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-008-01","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-008-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000805","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-008-05","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-008-05)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578000818","name":"METRONIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-008-18","proprietary_name":"metronidazole","nonproprietary_name":"metronidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"50 TABLET in 1 BOTTLE (72578-008-18)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.10426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672421509","name":"METRONIDAZOLE TOP 1% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4215-9","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (51672-4215-9) / 55 g in 1 BOTTLE, PUMP","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.53989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332063055","name":"METRONIDAZOLE TOP 1% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-630-55","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (62332-630-55) / 55 g in 1 BOTTLE, PUMP","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.53989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308066355","name":"METRONIDAZOLE TOP 1% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-663-55","proprietary_name":"Metronidazole","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (68308-663-55) / 55 g in 1 BOTTLE, PUMP","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.53989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063737","name":"METRONIDAZOLE TOPICAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0637-37","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0637-37) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.17928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007006","name":"METRONIDAZOLE TOPICAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-070-06","proprietary_name":"METRONIDAZOLE","nonproprietary_name":"Metronidazole Topical","dosage_form":"GEL","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-070-06) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.17928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672411606","name":"METRONIDAZOLE TOPICAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4116-6","proprietary_name":"Metronidazole","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4116-6) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.17928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578020904","name":"METRONIDAZOLE TOPICAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-209-04","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"7.5 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-209-04) / 45 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.17928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713057460","name":"METRONIDAZOLE TOPICAL 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0574-60","proprietary_name":"Metronidazole","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0574-60) / 60 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.62104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672421503","name":"METRONIDAZOLE TOPICAL 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4215-3","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-4215-3) / 60 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.62104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651081360","name":"METRONIDAZOLE TOPICAL 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-813-60","proprietary_name":"METRONIDAZOLE","nonproprietary_name":"METRONIDAZOLE","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-813-60) / 60 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.62104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332063060","name":"METRONIDAZOLE TOPICAL 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-630-60","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-630-60) / 60 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.62104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308066360","name":"METRONIDAZOLE TOPICAL 1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-663-60","proprietary_name":"Metronidazole","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Mayne Pharma Inc.","package_description":"1 TUBE in 1 CARTON (68308-663-60) / 60 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.62104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713057571","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0575-71","proprietary_name":"Metronidazole","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0713-0575-71) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714055701","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-557-01","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (16714-557-01) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922003923","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-039-23","proprietary_name":"Metronidazole Vaginal Gel, 0.75%","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (21922-039-23) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Metronidazole*|Metronidazole","basis":"generic"},"part_b":null}, {"ndc":"45802013970","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-139-70","proprietary_name":"metronidazole vaginal","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-139-70) / 70 g in 1 TUBE","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Metronidazole*|Metronidazole","basis":"generic"},"part_b":null}, {"ndc":"68462018449","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-184-49","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (68462-184-49) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"71656006770","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-067-70","proprietary_name":"metronidazole vaginal","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Saptalis Pharmaceuticals LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (71656-067-70) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Metronidazole*|Metronidazole","basis":"generic"},"part_b":null}, {"ndc":"73473030370","name":"METRONIDAZOLE VAGINAL 0.75% GL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-303-70","proprietary_name":"Metronidazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (73473-303-70) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.14055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093873901","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8739-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-8739-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527410737","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722003601","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-036-01","proprietary_name":"Mexiletine hydrochloride","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-036-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742023901","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-239-01","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (50742-239-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687077811","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687077821","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-778-21","proprietary_name":"Mexiletine hydrochloride","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-778-21) / 1 CAPSULE in 1 BLISTER PACK (60687-778-11)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62559082001","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-820-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-820-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62756095501","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-955-01","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62756-955-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980066601","name":"MEXILETINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-666-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-666-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.22248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093874001","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8740-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-8740-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527410837","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722003701","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-037-01","proprietary_name":"Mexiletine hydrochloride","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-037-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742024001","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-240-01","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (50742-240-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62559082101","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-821-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-821-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62756095601","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-956-01","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62756-956-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980066701","name":"MEXILETINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-667-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-667-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.25737,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093874101","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8741-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-8741-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527410937","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722003801","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-038-01","proprietary_name":"Mexiletine hydrochloride","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (31722-038-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742024101","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-241-01","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"Mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (50742-241-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135078590","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-785-90","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-785-90)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62559082201","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-822-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-822-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"62756095701","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-957-01","proprietary_name":"MEXILETINE HYDROCHLORIDE","nonproprietary_name":"mexiletine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62756-957-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980066801","name":"MEXILETINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-668-01","proprietary_name":"Mexiletine Hydrochloride","nonproprietary_name":"Mexiletine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (64980-668-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mexiletine HCl|Mexiletine HCl","basis":"generic"},"part_b":null}, {"ndc":"68180091171","name":"MIBELAS 24 FE CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mibelas 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"68180091173","name":"MIBELAS 24 FE CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-911-73","proprietary_name":"Mibelas 24 Fe","nonproprietary_name":"NORETHINDRONE ACETATE, ETHINYL ESTRADIOL AND FERROUS FUMARATE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-911-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mibelas 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"00597004337","name":"MICARDIS HCT 40-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0043-37","proprietary_name":"Micardis HCT","nonproprietary_name":"telmisartan and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0597-0043-37) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.48356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Micardis HCT|Telmisartan/Hydrochlorothiazid","basis":"brand"},"part_b":null}, {"ndc":"00597004437","name":"MICARDIS HCT 80-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0044-37","proprietary_name":"Micardis HCT","nonproprietary_name":"telmisartan and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0597-0044-37) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.472,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Micardis HCT|Telmisartan/Hydrochlorothiazid","basis":"brand"},"part_b":null}, {"ndc":"00597004237","name":"MICARDIS HCT 80-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0597-0042-37","proprietary_name":"Micardis HCT","nonproprietary_name":"telmisartan and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 25 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0597-0042-37) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":4.4768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Micardis HCT|Telmisartan/Hydrochlorothiazid","basis":"brand"},"part_b":null}, {"ndc":"00536137575","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1375-75","proprietary_name":"MICONAZOLE Nitrate 2% Cream ANTIFUNGAL","nonproprietary_name":"MICONAZOLE NITRATE","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Rugby","package_description":"1 TUBE in 1 BOX (0536-1375-75) / 28.3 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.12071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672200101","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2001-1","proprietary_name":"Miconazole Nitrate","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2001-1) / 15 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.20075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672200102","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2001-2","proprietary_name":"Miconazole Nitrate","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2001-2) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.12071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001048145","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-481-45","proprietary_name":"Antifungal Cream","nonproprietary_name":"antifungal","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-481-45) / 28.4 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.0822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001048147","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-481-47","proprietary_name":"Antifungal Cream","nonproprietary_name":"antifungal","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-481-47) / 42.5 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.07945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001048148","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-481-48","proprietary_name":"Antifungal Cream","nonproprietary_name":"antifungal","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-481-48) / 14.2 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.11958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000034001","name":"MICONAZOLE 2% TOPICAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0340-1","proprietary_name":"Miconazole Nitrate Cream USP, 2%","nonproprietary_name":"Miconazole Nitrate Cream USP, 2%","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Cardinal Health","package_description":"28.4 g in 1 TUBE (70000-0340-1)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.0822,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672203506","name":"MICONAZOLE 2% VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2035-6","proprietary_name":"Miconazole Nitrate","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (51672-2035-6) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472173803","name":"MICONAZOLE 3 200 MG VAG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-1738-03","proprietary_name":"Miconazole Nitrate","nonproprietary_name":"Miconazole Nitrate","dosage_form":"SUPPOSITORY","route":"VAGINAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"3 SUPPOSITORY in 1 CARTON (0472-1738-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":13.88647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Miconazole 3|Miconazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"00536142541","name":"MICONAZOLE 3 COMBO PACK","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1425-41","proprietary_name":"Rugby Miconazole 3","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Rugby Laboratories","package_description":"1 KIT in 1 CARTON (0536-1425-41) * 1 APPLICATOR in 1 POUCH (0113-7198-00) / 5 g in 1 APPLICATOR * 1 TUBE in 1 CARTON (0113-8123-00) / 9 g in 1 TUBE"},"nadac":{"value":0.41315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385060602","name":"MICONAZOLE 3 COMBO PACK","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-606-02","proprietary_name":"Good Neighbor Pharmacy Miconazole 3","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Amerisource Bergen","package_description":"1 KIT in 1 CARTON (24385-606-02) * 3 BLISTER PACK in 1 KIT / 1 SUPPOSITORY in 1 BLISTER PACK * 1 TUBE in 1 KIT / 9 g in 1 TUBE"},"nadac":{"value":7.427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000066901","name":"MICONAZOLE 3 COMBO PACK","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0669-1","proprietary_name":"Leader Miconazole 3","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 KIT in 1 CARTON (70000-0669-1) * 1 APPLICATOR in 1 POUCH (0113-7198-00) / 5 g in 1 APPLICATOR * 1 TUBE in 1 CARTON (0113-8123-00) / 9 g in 1 TUBE"},"nadac":{"value":0.41315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713059377","name":"MICONAZOLE 3-DAY COMBO PACK","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0593-77","proprietary_name":"MICONAZOLE 3 COMBINATION PACK (miconazole nitrate) kit","nonproprietary_name":"Miconazole nitrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (0713-0593-77) * 9 SUPPOSITORY in 1 BLISTER PACK * 9 g in 1 TUBE"},"nadac":{"value":7.427,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904773445","name":"MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7734-45","proprietary_name":"Miconazole 7","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"Major Pharmaceuticals","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0904-7734-45) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385059029","name":"MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-590-29","proprietary_name":"Good Neighbor Pharmacy Miconazole 7","nonproprietary_name":"Miconazole nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (24385-590-29) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269073041","name":"MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-730-41","proprietary_name":"Miconazole 7","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"H2-Pharma, LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (61269-730-41) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61269073063","name":"MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-730-63","proprietary_name":"Miconazole 7","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"H2-Pharma, LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (61269-730-63) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000000901","name":"MICONAZOLE-7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0009-1","proprietary_name":"Miconazole 7","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"Cardinal Health (Leader) 70000","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (70000-0009-1) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378822250","name":"MICONAZOLE-ZINC-PETRO 0.25-15%","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0378-8222-50","proprietary_name":"VUSION","nonproprietary_name":"miconazole nitrate, zinc oxide, white petrolatum","dosage_form":"OINTMENT","route":"TOPICAL","strength":"2.5 mg/g; 150 mg/g; 813.5 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8222-50) / 50 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":9.12072,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Vusion|Miconazole Nitrate/Zinc Ox/Pet","basis":"brand"},"part_b":null}, {"ndc":"75907008421","name":"MICROGESTIN 21 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-084-21","proprietary_name":"Microgestin 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr.Reddy's Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-084-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907008463","name":"MICROGESTIN 21 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-084-63","proprietary_name":"Microgestin 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr.Reddy's Laboratories Inc.","package_description":"6 BLISTER PACK in 1 CARTON (75907-084-63) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907008321","name":"MICROGESTIN 21 1.5-30 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-083-21","proprietary_name":"Microgestin 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-083-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907008363","name":"MICROGESTIN 21 1.5-30 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-083-63","proprietary_name":"Microgestin 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"6 BLISTER PACK in 1 CARTON (75907-083-63) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.33576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin|Norethindrone Ac/Eth Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907008228","name":"MICROGESTIN FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-082-28","proprietary_name":"Microgestin Fe 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-082-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"75907008262","name":"MICROGESTIN FE 1-20 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-082-62","proprietary_name":"Microgestin Fe 1/20","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy's Laboratories Inc.","package_description":"6 BLISTER PACK in 1 CARTON (75907-082-62) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"75907008128","name":"MICROGESTIN FE 1.5-30 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-081-28","proprietary_name":"Microgestin Fe 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc","package_description":"1 BLISTER PACK in 1 PACKET (75907-081-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"75907008162","name":"MICROGESTIN FE 1.5-30 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-081-62","proprietary_name":"Microgestin Fe 1.5/30","nonproprietary_name":"Norethindrone Acetate/Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc","package_description":"6 BLISTER PACK in 1 CARTON (75907-081-62) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.14187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Microgestin Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"00409230802","name":"MIDAZOLAM HCL 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2308-02","proprietary_name":"Midazolam","nonproprietary_name":"MIDAZOLAM HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-02) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-2308-22)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.56523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-02) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-2308-22)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409230850","name":"MIDAZOLAM HCL 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2308-50","proprietary_name":"MIDAZOLAM","nonproprietary_name":"MIDAZOLAM HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-50) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-2308-70)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.56523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-50) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-2308-70)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641606325","name":"MIDAZOLAM HCL 10 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6063-25","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6063-25) / 2 mL in 1 VIAL (0641-6063-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.50532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6063-25) / 2 mL in 1 VIAL (0641-6063-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641605725","name":"MIDAZOLAM HCL 2 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6057-25","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6057-25) / 2 mL in 1 VIAL (0641-6057-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.23341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6057-25) / 2 mL in 1 VIAL (0641-6057-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641620925","name":"MIDAZOLAM HCL 2 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6209-25","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6209-25) / 2 mL in 1 VIAL (0641-6209-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.23341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6209-25) / 2 mL in 1 VIAL (0641-6209-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641628125","name":"MIDAZOLAM HCL 2 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6281-25","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6281-25) / 2 mL in 1 VIAL (0641-6281-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.23341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6281-25) / 2 mL in 1 VIAL (0641-6281-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155060041","name":"MIDAZOLAM HCL 2 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-600-41","proprietary_name":"Midazolam hydrochloride","nonproprietary_name":"Midazolam hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (23155-600-41) / 2 mL in 1 VIAL, SINGLE-DOSE (23155-600-31)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.23341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (23155-600-41) / 2 mL in 1 VIAL, SINGLE-DOSE (23155-600-31)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323041112","name":"MIDAZOLAM HCL 2 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-411-12","proprietary_name":"Midazolam","nonproprietary_name":"MIDAZOLAM HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-411-12) / 2 mL in 1 VIAL (63323-411-15)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.23341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-411-12) / 2 mL in 1 VIAL (63323-411-15)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572043025","name":"MIDAZOLAM HCL 2 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-430-25","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"1 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-430-25) / 2 mL in 1 VIAL (72572-430-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.23341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-430-25) / 2 mL in 1 VIAL (72572-430-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054356699","name":"MIDAZOLAM HCL 2 MG/ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3566-99","proprietary_name":"Midazolam Hydrochloride","nonproprietary_name":"Midazolam Hydrochloride","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"118 mL in 1 BOTTLE, GLASS (0054-3566-99)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.61771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574015004","name":"MIDAZOLAM HCL 2 MG/ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0150-04","proprietary_name":"Midazolam Hydrochloride","nonproprietary_name":"Midazolam Hydrochloride","dosage_form":"SYRUP","route":"ORAL","strength":"2 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (0574-0150-04) / 118 mL in 1 BOTTLE, GLASS","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.61771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409230801","name":"MIDAZOLAM HCL 5 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2308-01","proprietary_name":"Midazolam","nonproprietary_name":"MIDAZOLAM HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2308-21)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.22585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2308-21)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409230849","name":"MIDAZOLAM HCL 5 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2308-49","proprietary_name":"MIDAZOLAM","nonproprietary_name":"MIDAZOLAM HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-49) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2308-69)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.22585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2308-49) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-2308-69)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409259605","name":"MIDAZOLAM HCL 50 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2596-05","proprietary_name":"Midazolam","nonproprietary_name":"MIDAZOLAM HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (0409-2596-05) / 10 mL in 1 VIAL, MULTI-DOSE (0409-2596-15)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.38167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 CARTON (0409-2596-05) / 10 mL in 1 VIAL, MULTI-DOSE (0409-2596-15)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641606010","name":"MIDAZOLAM HCL 50 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6060-10","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0641-6060-10) / 10 mL in 1 VIAL (0641-6060-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.38167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0641-6060-10) / 10 mL in 1 VIAL (0641-6060-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641619010","name":"MIDAZOLAM HCL 50 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6190-10","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0641-6190-10) / 10 mL in 1 VIAL (0641-6190-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.38167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0641-6190-10) / 10 mL in 1 VIAL (0641-6190-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641621110","name":"MIDAZOLAM HCL 50 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6211-10","proprietary_name":"Midazolam","nonproprietary_name":"Midazolam","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0641-6211-10) / 10 mL in 1 VIAL (0641-6211-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.38167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (0641-6211-10) / 10 mL in 1 VIAL (0641-6211-01)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155060142","name":"MIDAZOLAM HCL 50 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-601-42","proprietary_name":"Midazolam hydrochloride","nonproprietary_name":"Midazolam hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"5 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (23155-601-42) / 10 mL in 1 VIAL, MULTI-DOSE (23155-601-32)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.38167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2250","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2250 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 CARTON (23155-601-42) / 10 mL in 1 VIAL, MULTI-DOSE (23155-601-32)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00245021311","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0213-11","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0245-0213-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378190301","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1903-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-1903-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904681907","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6819-07","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6819-07) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155097101","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-971-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-971-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884087401","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-874-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-874-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268056311","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268056315","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-563-15","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 TABLET in 1 BOX (50268-563-15)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817032510","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-325-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-325-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651024801","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-248-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-248-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505132501","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1325-1","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-1325-1)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687040925","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-409-25","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-409-25) / 1 TABLET in 1 BLISTER PACK (60687-409-95)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687040995","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332034031","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-340-31","proprietary_name":"MIDODRINE HYDROCHLORIDE","nonproprietary_name":"MIDODRINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-340-31)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980043501","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-435-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-435-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382073901","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-739-01","proprietary_name":"Midodrine hydrochloride","nonproprietary_name":"Midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-739-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700015901","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-159-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Xiromed, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70700-159-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756005011","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-050-11","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-050-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603060701","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-607-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-607-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090801","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090803","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-908-03","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"3 BLISTER PACK in 1 CARTON (72603-908-03) / 10 TABLET in 1 BLISTER PACK (72603-908-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090805","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-908-05","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"5 BLISTER PACK in 1 CARTON (72603-908-05) / 10 TABLET in 1 BLISTER PACK (72603-908-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011401","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-114-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-114-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"82293000510","name":"MIDODRINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-005-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"100 TABLET in 1 BOTTLE (82293-005-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.15125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00245021111","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0211-11","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0245-0211-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378190101","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1901-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-1901-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904681706","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6817-06","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6817-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904681761","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6817-61","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6817-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155096901","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-969-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-969-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884081401","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-814-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-814-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268056111","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268056115","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-561-15","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"AvPAK","package_description":"50 TABLET in 1 BOX (50268-561-15)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817032310","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-323-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-323-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651024601","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-246-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-246-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505132001","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1320-1","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-1320-1)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687038701","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-387-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-387-01) / 1 TABLET in 1 BLISTER PACK (60687-387-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687038711","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332033831","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-338-31","proprietary_name":"MIDODRINE HYDROCHLORIDE","nonproprietary_name":"MIDODRINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-338-31)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980043301","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-433-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-433-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382073701","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-737-01","proprietary_name":"Midodrine hydrochloride","nonproprietary_name":"Midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-737-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700015701","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-157-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Xiromed, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70700-157-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756001011","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-010-11","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-010-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603060501","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-605-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-605-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090601","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090605","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-906-05","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"5 BLISTER PACK in 1 CARTON (72603-906-05) / 10 TABLET in 1 BLISTER PACK (72603-906-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090610","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-906-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-906-10) / 10 TABLET in 1 BLISTER PACK (72603-906-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011201","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-112-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-112-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"82293000310","name":"MIDODRINE HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-003-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"100 TABLET in 1 BOTTLE (82293-003-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00245021201","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0212-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0245-0212-01) / 1 TABLET in 1 BLISTER PACK (0245-0212-89)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00245021211","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0212-11","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0245-0212-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00245021289","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378190201","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1902-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-1902-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904681806","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6818-06","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6818-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904681861","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6818-61","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6818-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155097001","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-970-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-970-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884084901","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-849-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-849-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268056211","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268056215","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-562-15","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 TABLET in 1 BOX (50268-562-15)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079045301","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079045320","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-453-20","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-453-20) / 1 TABLET in 1 BLISTER PACK (51079-453-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"52817032410","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-324-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET in 1 BOTTLE (52817-324-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651024701","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-247-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-247-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505132101","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1321-1","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-1321-1)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687039801","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-398-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-398-01) / 1 TABLET in 1 BLISTER PACK (60687-398-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687039811","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332033931","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-339-31","proprietary_name":"MIDODRINE HYDROCHLORIDE","nonproprietary_name":"MIDODRINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-339-31)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980043401","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-434-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-434-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382073801","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-738-01","proprietary_name":"Midodrine hydrochloride","nonproprietary_name":"Midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-738-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700015801","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-158-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"midodrine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Xiromed, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70700-158-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756004911","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-049-11","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-049-11)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603060601","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-606-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-606-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090701","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090705","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-907-05","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"5 BLISTER PACK in 1 CARTON (72603-907-05) / 10 TABLET in 1 BLISTER PACK (72603-907-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603090710","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-907-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"10 BLISTER PACK in 1 CARTON (72603-907-10) / 10 TABLET in 1 BLISTER PACK (72603-907-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888011301","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-113-01","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-113-01)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"82293000410","name":"MIDODRINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-004-10","proprietary_name":"Midodrine Hydrochloride","nonproprietary_name":"Midodrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"100 TABLET in 1 BOTTLE (82293-004-10)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Midodrine HCl|Midodrine HCl","basis":"generic"},"part_b":null}, {"ndc":"24208037705","name":"MIEBO 100% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-377-05","proprietary_name":"MIEBO","nonproprietary_name":"Perfluorohexyloctane","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mg","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-377-05) / 3 mg in 1 BOTTLE","pharm_classes":["Semifluorinated Alkane [EPC]","Semifluorinated Alkane [EXT]"]},"nadac":{"value":263.56664,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Miebo|Perfluorohexyloctane/PF","basis":"brand"},"part_b":null}, {"ndc":"24385036571","name":"MIGRAINE 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-365-71","proprietary_name":"good neighbor pharmacy migraine relief","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-365-71) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000024701","name":"MIGRAINE 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0247-1","proprietary_name":"Leader Migraine Relief","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0247-1) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000024702","name":"MIGRAINE 250-250-65 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0247-2","proprietary_name":"Leader Migraine Relief","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0247-2) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000061101","name":"MIGRAINE 250-250-65 MG GELTAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0611-1","proprietary_name":"leader migraine relief","nonproprietary_name":"acetaminophen, aspirin, caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0611-1) / 80 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385036578","name":"MIGRAINE FORMULA CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-365-78","proprietary_name":"good neighbor pharmacy migraine relief","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 250 mg/1; 65 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-365-78) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862077628","name":"MILI 0.25-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-776-28","proprietary_name":"Mili","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-776-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mili|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862077685","name":"MILI 0.25-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-776-85","proprietary_name":"Mili","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-776-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mili|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00536131983","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1319-83","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"1200 mg/15mL","labeler":"RUGBY LABORATORIES","package_description":"355 mL in 1 BOTTLE (0536-1319-83)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536247085","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-2470-85","proprietary_name":"MILK OF MAGNESIA MINT","nonproprietary_name":"magnesium hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"1200 mg/15mL","labeler":"Rugby Laboratories","package_description":"473 mL in 1 BOTTLE (0536-2470-85)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904078816","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-0788-16","proprietary_name":"MILK OF MAGNESIA ORIGINAL","nonproprietary_name":"magnesium hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"1200 mg/15mL","labeler":"MAJOR Pharmaceuticals Inc.","package_description":"473 mL in 1 BOTTLE (0904-0788-16)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122043540","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-435-40","proprietary_name":"MILK OF MAGNESIA CHERRY","nonproprietary_name":"magnesium hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"1200 mg/15mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-435-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122043640","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-436-40","proprietary_name":"MILK OF MAGNESIA MINT","nonproprietary_name":"magnesium hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"1200 mg/15mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-436-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122043740","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-437-40","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"LIQUID","route":"ORAL","strength":"1200 mg/15mL","labeler":"AMERISOURCEBERGEN DRUG CORPORATION","package_description":"355 mL in 1 BOTTLE (46122-437-40)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000006101","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0061-1","proprietary_name":"MILK OF MAGNESIA","nonproprietary_name":"magnesium hydroxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"1200 mg/15mL","labeler":"CARDINAL HEALTH","package_description":"355 mL in 1 BOTTLE (70000-0061-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000006501","name":"MILK OF MAGNESIA SUSPENSION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0065-1","proprietary_name":"MILK OF MAGNESIA MINT","nonproprietary_name":"magnesium hydroxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"1200 mg/15mL","labeler":"CARDINAL HEALTH","package_description":"355 mL in 1 BOTTLE (70000-0065-1)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722084960","name":"MILNACIPRAN HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-849-60","proprietary_name":"MILNACIPRAN HYDROCHLORIDE","nonproprietary_name":"MILNACIPRAN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-849-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.81889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991003706","name":"MILNACIPRAN HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-037-06","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"Milnacipran Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-037-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.81889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462076660","name":"MILNACIPRAN HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-766-60","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-766-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.81889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722084660","name":"MILNACIPRAN HCL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-846-60","proprietary_name":"MILNACIPRAN HYDROCHLORIDE","nonproprietary_name":"MILNACIPRAN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-846-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.78243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991003406","name":"MILNACIPRAN HCL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-034-06","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"Milnacipran Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-034-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.78243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462076360","name":"MILNACIPRAN HCL 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-763-60","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-763-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.78243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722084760","name":"MILNACIPRAN HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-847-60","proprietary_name":"MILNACIPRAN HYDROCHLORIDE","nonproprietary_name":"MILNACIPRAN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-847-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.52611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991087606","name":"MILNACIPRAN HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-876-06","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"Milnacipran Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-876-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.52611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462076460","name":"MILNACIPRAN HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-764-60","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-764-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.52611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722084860","name":"MILNACIPRAN HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-848-60","proprietary_name":"MILNACIPRAN HYDROCHLORIDE","nonproprietary_name":"MILNACIPRAN HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-848-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.80179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991003606","name":"MILNACIPRAN HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-036-06","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"Milnacipran Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-036-06)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.80179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462076560","name":"MILNACIPRAN HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-765-60","proprietary_name":"Milnacipran Hydrochloride","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-765-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.80179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573047030","name":"MILOPHENE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-470-30","proprietary_name":"MiloPhene","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (35573-470-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"35573047075","name":"MILOPHENE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-470-75","proprietary_name":"MiloPhene","nonproprietary_name":"Clomiphene Citrate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"10 TABLET in 1 BOTTLE (35573-470-75)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":4.20523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Clomiphene Citrate|Clomiphene Citrate","basis":"generic"},"part_b":null}, {"ndc":"00093545528","name":"MIMVEY 1-0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5455-28","proprietary_name":"Mimvey","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0093-5455-28) / 28 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mimvey|Estradiol/Norethindrone Acet","basis":"brand"},"part_b":null}, {"ndc":"00093545542","name":"MIMVEY 1-0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5455-42","proprietary_name":"Mimvey","nonproprietary_name":"Estradiol and Norethindrone Acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1; .5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (0093-5455-42) / 28 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.56967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mimvey|Estradiol/Norethindrone Acet","basis":"brand"},"part_b":null}, {"ndc":"46122039516","name":"MINERAL OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-395-16","proprietary_name":"Mineral Oil","nonproprietary_name":"Mineral Oil","dosage_form":"OIL","route":"ORAL; TOPICAL","strength":"100 mg/100mL","labeler":"AmerisourceBergen (Good Neighbor Pharmacy) 46122","package_description":"473 mL in 1 BOTTLE, PLASTIC (46122-395-16)"},"nadac":{"value":0.00991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000066301","name":"MINERAL OIL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0663-1","proprietary_name":"Mineral Oil","nonproprietary_name":"Mineral Oil","dosage_form":"LIQUID","route":"ORAL","strength":"999 mg/mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"473 mL in 1 BOTTLE, PLASTIC (70000-0663-1)"},"nadac":{"value":0.00991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68968662501","name":"MINIVELLE 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.58761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968662508","name":"MINIVELLE 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-6625-8","proprietary_name":"Minivelle","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 PACKET (68968-6625-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.58761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968663701","name":"MINIVELLE 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.58428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968663708","name":"MINIVELLE 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-6637-8","proprietary_name":"Minivelle","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 PACKET (68968-6637-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.58428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968665001","name":"MINIVELLE 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.58736,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968665008","name":"MINIVELLE 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-6650-8","proprietary_name":"Minivelle","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 PACKET (68968-6650-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.58736,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968667501","name":"MINIVELLE 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.57477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968667508","name":"MINIVELLE 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-6675-8","proprietary_name":"Minivelle","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 PACKET (68968-6675-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.57477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968661001","name":"MINIVELLE 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.57565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68968661008","name":"MINIVELLE 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-6610-8","proprietary_name":"Minivelle","nonproprietary_name":"estradiol","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"8 POUCH in 1 PACKET (68968-6610-8) / 1 d in 1 POUCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":11.57565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minivelle|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00591569550","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5695-50","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"50 CAPSULE in 1 BOTTLE, PLASTIC (0591-5695-50)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00904688806","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6888-06","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharamceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6888-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048405","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-484-05","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-484-05)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048450","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-484-50","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"50 CAPSULE in 1 BOTTLE (13668-484-50)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687033611","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687033665","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-336-65","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-336-65) / 1 CAPSULE in 1 BLISTER PACK (60687-336-11)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862021105","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-211-05","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-211-05)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862021150","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-211-50","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 CAPSULE in 1 BOTTLE (65862-211-50)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"68382031818","name":"MINOCYCLINE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-318-18","proprietary_name":"Minocycline hydrochloride","nonproprietary_name":"Minocycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"50 CAPSULE in 1 BOTTLE (68382-318-18)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00591569401","name":"MINOCYCLINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00591569460","name":"MINOCYCLINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048201","name":"MINOCYCLINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-482-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-482-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.18012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862020901","name":"MINOCYCLINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-209-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-209-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.18012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"68382031601","name":"MINOCYCLINE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-316-01","proprietary_name":"Minocycline hydrochloride","nonproprietary_name":"Minocycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-316-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.18012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048301","name":"MINOCYCLINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-483-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (13668-483-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.39676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862021001","name":"MINOCYCLINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-210-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-210-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.39676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"68382031701","name":"MINOCYCLINE 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-317-01","proprietary_name":"Minocycline hydrochloride","nonproprietary_name":"Minocycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-317-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.39676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"67877057630","name":"MINOCYCLINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67877-576-30","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-576-30)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":3.03047,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl ER|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048750","name":"MINOCYCLINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-487-50","proprietary_name":"MINOCYCLINE HYDROCHLORIDE","nonproprietary_name":"MINOCYCLINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"50 TABLET in 1 BOTTLE (13668-487-50)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.70414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"59651033950","name":"MINOCYCLINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-339-50","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"50 TABLET, FILM COATED in 1 CONTAINER (59651-339-50)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.70414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135088960","name":"MINOCYCLINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-889-60","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-889-60)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.70414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"64380015601","name":"MINOCYCLINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-156-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Strides Pharma Science Limited","package_description":"50 TABLET in 1 BOTTLE (64380-156-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.70414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048501","name":"MINOCYCLINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-485-01","proprietary_name":"MINOCYCLINE HYDROCHLORIDE","nonproprietary_name":"MINOCYCLINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-485-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"59651033701","name":"MINOCYCLINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-337-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 CONTAINER (59651-337-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135088790","name":"MINOCYCLINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-887-90","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-887-90)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"64380015401","name":"MINOCYCLINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-154-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-154-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.34351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"13668048601","name":"MINOCYCLINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"13668-486-01","proprietary_name":"MINOCYCLINE HYDROCHLORIDE","nonproprietary_name":"MINOCYCLINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-486-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.30184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"59651033801","name":"MINOCYCLINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-338-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 CONTAINER (59651-338-01)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.30184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135088860","name":"MINOCYCLINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-888-60","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-888-60)","pharm_classes":["Decreased Prothrombin Activity [PE]","Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.30184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"64380015501","name":"MINOCYCLINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64380-155-01","proprietary_name":"Minocycline Hydrochloride","nonproprietary_name":"Minocycline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-155-01)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.30184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minocycline HCl|Minocycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00591564301","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5643-01","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5643-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"00591564305","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5643-05","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-5643-05)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"49884025701","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-257-01","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-257-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"49884025705","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-257-05","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE (49884-257-05)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"53489038701","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-387-01","proprietary_name":"MINOXIDIL","nonproprietary_name":"minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (53489-387-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"68084020501","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-205-01","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-205-01) / 1 TABLET in 1 BLISTER PACK (68084-205-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"68084020511","name":"MINOXIDIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"00591564201","name":"MINOXIDIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5642-01","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5642-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.09821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"00591564205","name":"MINOXIDIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5642-05","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-5642-05)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.09821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"49884025601","name":"MINOXIDIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-256-01","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-256-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.09821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"53489038601","name":"MINOXIDIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-386-01","proprietary_name":"MINOXIDIL","nonproprietary_name":"minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (53489-386-01)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.09821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"68084020401","name":"MINOXIDIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-204-01","proprietary_name":"Minoxidil","nonproprietary_name":"Minoxidil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-204-01) / 1 TABLET in 1 BLISTER PACK (68084-204-11)","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.09821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"68084020411","name":"MINOXIDIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Minoxidil|Minoxidil","basis":"generic"},"part_b":null}, {"ndc":"51672215104","name":"MINOXIDIL 5% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2151-4","proprietary_name":"Minoxidil Topical Solution, 5%","nonproprietary_name":"Minoxidil Solution","dosage_form":"SOLUTION","route":"TOPICAL","strength":"50 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-2151-4) / 60 mL in 1 BOTTLE","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.30095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000065301","name":"MINOXIDIL 5% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0653-1","proprietary_name":"Leader Minoxidil","nonproprietary_name":"minoxidil","dosage_form":"SOLUTION","route":"TOPICAL","strength":"5 g/100mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"3 BOTTLE, DROPPER in 1 CARTON (70000-0653-1) / 60 mL in 1 BOTTLE, DROPPER","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.30095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672212804","name":"MINOXIDIL FOR MEN 5% FOAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2128-4","proprietary_name":"Minoxidil 5% (For Men)","nonproprietary_name":"Minoxidil","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 PACKAGE (51672-2128-4) / 60 g in 1 CAN","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.27469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672212904","name":"MINOXIDIL FOR WOMEN 5% FOAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2129-4","proprietary_name":"Minoxidil For Women","nonproprietary_name":"Minoxidil","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CAN in 1 PACKAGE (51672-2129-4) / 60 g in 1 CAN","pharm_classes":["Arteriolar Vasodilation [PE]","Arteriolar Vasodilator [EPC]"]},"nadac":{"value":0.27469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904572514","name":"MINTOX MAXIMUM STRENGTH SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5725-14","proprietary_name":"MINTOX MAXIMUM STRENGTH","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, dimethicone","dosage_form":"SUSPENSION","route":"ORAL","strength":"400 mg/5mL; 400 mg/5mL; 40 mg/5mL","labeler":"MAJOR Pharmaceuticals Inc.","package_description":"355 mL in 1 BOTTLE (0904-5725-14)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904670060","name":"MINTOX PLUS TABLET CHEWABLE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6700-60","proprietary_name":"Mintox Plus Tabs","nonproprietary_name":"Aluminum hydroxide, Magnesium hydroxide, Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"200 mg/1; 200 mg/1; 25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0904-6700-60)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.03936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748032211","name":"MINZOYA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748032214","name":"MINZOYA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-322-14","proprietary_name":"MINZOYA","nonproprietary_name":"levonorgestrel and ethinyl estradiol and ferrous bisglycinate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (70748-322-14) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":3.44543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180015106","name":"MIRABEGRON ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-151-06","proprietary_name":"MIRABEGRON","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-151-06)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"68180015109","name":"MIRABEGRON ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-151-09","proprietary_name":"MIRABEGRON","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-151-09)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"69238286001","name":"MIRABEGRON ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2860-1","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69238-2860-1)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"69238286002","name":"MIRABEGRON ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2860-2","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69238-2860-2)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"70710115903","name":"MIRABEGRON ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1159-3","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1159-3)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"70710115909","name":"MIRABEGRON ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1159-9","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1159-9)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"68180015206","name":"MIRABEGRON ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-152-06","proprietary_name":"MIRABEGRON","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-152-06)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"68180015209","name":"MIRABEGRON ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-152-09","proprietary_name":"MIRABEGRON","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-152-09)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"69238286101","name":"MIRABEGRON ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2861-1","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69238-2861-1)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"69238286102","name":"MIRABEGRON ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2861-2","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69238-2861-2)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"70710116003","name":"MIRABEGRON ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1160-3","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1160-3)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"70710116009","name":"MIRABEGRON ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1160-9","proprietary_name":"Mirabegron","nonproprietary_name":"Mirabegron","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1160-9)","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirabegron ER|Mirabegron","basis":"generic"},"part_b":null}, {"ndc":"57237001106","name":"MIRTAZAPINE 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-011-06","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-011-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.31386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862002106","name":"MIRTAZAPINE 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-021-06","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"5 BLISTER PACK in 1 CARTON (65862-021-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.31386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010369","name":"MIRTAZAPINE 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010384","name":"MIRTAZAPINE 15 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-103-84","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"5 BLISTER PACK in 1 CARTON (72578-103-84) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (72578-103-69)"},"nadac":{"value":0.31386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378351501","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3515-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3515-01)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00378351510","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3515-10","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3515-10)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00378351593","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3515-93","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3515-93)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00904651961","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6519-61","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6519-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107003105","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-031-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-031-05)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107003130","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-031-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-031-30)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107003134","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-031-34","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-031-34)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722040810","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-408-10","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-408-10)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722040830","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-408-30","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-408-30)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"51079008601","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"51079008620","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-086-20","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-086-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-086-01)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237000805","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-008-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-008-05)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237000830","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-008-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-008-30)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57664049918","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-499-18","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (57664-499-18)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57664049983","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-499-83","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (57664-499-83)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60505024701","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0247-1","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0247-1)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60505024708","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0247-8","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0247-8)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"63739009810","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63739-098-10","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"McKesson Corporation dba SKY Packaging","package_description":"10 BLISTER PACK in 1 BOX (63739-098-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"65862003130","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-031-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-031-30)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060704","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-607-04","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Prasco Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (66993-607-04)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060730","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-607-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (66993-607-30)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"68084011901","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-119-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-119-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-119-11)"},"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"68084011911","name":"MIRTAZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237001206","name":"MIRTAZAPINE 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-012-06","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-012-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.42285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862002206","name":"MIRTAZAPINE 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-022-06","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"5 BLISTER PACK in 1 CARTON (65862-022-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.42285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010469","name":"MIRTAZAPINE 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.42285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010484","name":"MIRTAZAPINE 30 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-104-84","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"30 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"5 BLISTER PACK in 1 CARTON (72578-104-84) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (72578-104-69)"},"nadac":{"value":0.42285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378353001","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3530-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3530-01)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00378353005","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3530-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3530-05)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00378353093","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3530-93","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3530-93)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107000305","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-003-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-003-05)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107000330","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-003-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-003-30)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107000334","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-003-34","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-003-34)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722040905","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-409-05","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-409-05)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722040930","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-409-30","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-409-30)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"51079008701","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"51079008720","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-087-20","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-087-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-087-01)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237000905","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-009-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-009-05)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237000930","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-009-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-009-30)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57664050083","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-500-83","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (57664-500-83)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60505024801","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0248-1","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0248-1)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60505024808","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0248-8","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0248-8)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"65862000330","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-003-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-003-30)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060804","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-608-04","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Prasco Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (66993-608-04)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060830","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-608-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (66993-608-30)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"68084012001","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-120-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-120-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-120-11)"},"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"68084012011","name":"MIRTAZAPINE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237001306","name":"MIRTAZAPINE 45 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-013-06","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"45 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-013-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.40814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862002306","name":"MIRTAZAPINE 45 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-023-06","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"45 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"5 BLISTER PACK in 1 CARTON (65862-023-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK"},"nadac":{"value":0.40814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010569","name":"MIRTAZAPINE 45 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.40814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578010584","name":"MIRTAZAPINE 45 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-105-84","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"45 mg/1","labeler":"Viona Pharmaceuticals Inc.","package_description":"5 BLISTER PACK in 1 CARTON (72578-105-84) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (72578-105-69)"},"nadac":{"value":0.40814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378354501","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3545-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3545-01)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00378354505","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3545-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3545-05)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00378354593","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3545-93","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3545-93)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107003205","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-032-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-032-05)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107003234","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-032-34","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-032-34)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722041005","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-410-05","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-410-05)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722041030","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-410-30","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-410-30)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"51079008801","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"51079008820","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-088-20","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-088-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-088-01)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237001005","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-010-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-010-05)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237001030","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-010-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-010-30)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57664050183","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-501-83","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (57664-501-83)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60505024901","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0249-1","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0249-1)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60505024908","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0249-8","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0249-8)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"65862003230","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-032-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-032-30)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060904","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-609-04","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Prasco Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (66993-609-04)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060930","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-609-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (66993-609-30)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"68084012101","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-121-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-121-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-121-11)"},"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"68084012111","name":"MIRTAZAPINE 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107000105","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-001-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-001-05)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"13107000130","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-001-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-001-30)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"31722040730","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-407-30","proprietary_name":"mirtazapine","nonproprietary_name":"mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-407-30)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237000705","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-007-05","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-007-05)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57237000730","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-007-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-007-30)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"57664051083","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-510-83","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET in 1 BOTTLE (57664-510-83)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60687058411","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"60687058421","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-584-21","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-584-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-584-11)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060604","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-606-04","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Prasco Laboratories","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (66993-606-04)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"66993060630","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-606-30","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (66993-606-30)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"70954083010","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-830-10","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70954-830-10)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"72603055801","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-558-01","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-558-01)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"72603055802","name":"MIRTAZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-558-02","proprietary_name":"Mirtazapine","nonproprietary_name":"Mirtazapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-558-02)"},"nadac":{"value":0.34857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mirtazapine|Mirtazapine","basis":"generic"},"part_b":null}, {"ndc":"00299598035","name":"MIRVASO 0.33% GEL PUMP","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0299-5980-35","proprietary_name":"Mirvaso","nonproprietary_name":"brimonidine tartrate","dosage_form":"GEL","route":"TOPICAL","strength":"5 mg/g","labeler":"Galderma Laboratories, L.P.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0299-5980-35) / 30 g in 1 BOTTLE, PUMP","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":21.46607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":13.92613,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Mirvaso|Brimonidine Tartrate","basis":"brand"},"part_b":null}, {"ndc":"59762500701","name":"MISOPROSTOL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5007-1","proprietary_name":"misoprostol","nonproprietary_name":"MISOPROSTOL","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (59762-5007-1)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.4645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"59762500702","name":"MISOPROSTOL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5007-2","proprietary_name":"misoprostol","nonproprietary_name":"MISOPROSTOL","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"120 TABLET in 1 BOTTLE (59762-5007-2)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.4645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"60687073501","name":"MISOPROSTOL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-735-01","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-735-01) / 1 TABLET in 1 BLISTER PACK (60687-735-11)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.4645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"60687073511","name":"MISOPROSTOL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.4645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"70954044310","name":"MISOPROSTOL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-443-10","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (70954-443-10)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.4645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"70954044320","name":"MISOPROSTOL 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-443-20","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"120 TABLET in 1 BOTTLE (70954-443-20)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.4645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"43393002404","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43393-024-04","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"GenBioPro, Inc.","package_description":"4 TABLET in 1 BOTTLE (43393-024-04)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"43393020004","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"43393020048","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43393-200-48","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"GenBioPro, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (43393-200-48) / 4 TABLET in 1 BLISTER PACK (43393-200-04)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"43393020060","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43393-200-60","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"GenBioPro, Inc.","package_description":"60 TABLET in 1 BOTTLE (43393-200-60)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"50268055560","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-555-60","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"AvPAK","package_description":"60 TABLET in 1 BOTTLE (50268-555-60)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"59762500801","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5008-1","proprietary_name":"misoprostol","nonproprietary_name":"MISOPROSTOL","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (59762-5008-1)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"59762500802","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5008-2","proprietary_name":"misoprostol","nonproprietary_name":"MISOPROSTOL","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-5008-2)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"60687074601","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-746-01","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-746-01) / 1 TABLET in 1 BLISTER PACK (60687-746-11)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"60687074611","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"70954044410","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-444-10","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (70954-444-10)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"70954044420","name":"MISOPROSTOL 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-444-20","proprietary_name":"Misoprostol","nonproprietary_name":"Misoprostol","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-444-20)","pharm_classes":["Prostaglandin E1 Analog [EPC]","Prostaglandins E, Synthetic [CS]"]},"nadac":{"value":0.71894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Misoprostol|Misoprostol","basis":"generic"},"part_b":null}, {"ndc":"59467031801","name":"MITIGARE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59467-318-01","proprietary_name":"MITIGARE","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Hikma Specialty USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59467-318-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":6.02925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mitigare|Colchicine","basis":"brand"},"part_b":null}, {"ndc":"59467031810","name":"MITIGARE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59467-318-10","proprietary_name":"MITIGARE","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Hikma Specialty USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (59467-318-10)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":6.02925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mitigare|Colchicine","basis":"brand"},"part_b":null}, {"ndc":"59467031830","name":"MITIGARE 0.6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59467-318-30","proprietary_name":"MITIGARE","nonproprietary_name":"Colchicine","dosage_form":"CAPSULE","route":"ORAL","strength":".6 mg/1","labeler":"Hikma Specialty USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (59467-318-30)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":6.02925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.75282,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mitigare|Colchicine","basis":"brand"},"part_b":null}, {"ndc":"00904679104","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6791-04","proprietary_name":"Modafinil","nonproprietary_name":"modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6791-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"23155060403","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-604-03","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (23155-604-03)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"23155060409","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-604-09","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (23155-604-09)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"50268057011","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"50268057012","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-570-12","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-570-12) / 1 TABLET in 1 BLISTER PACK (50268-570-11)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"55253080130","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55253-801-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"CIMA LABS INC.","package_description":"30 TABLET in 1 BOTTLE (55253-801-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"57237015430","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-154-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-154-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"57237015490","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-154-90","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-154-90)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"60505252601","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2526-1","proprietary_name":"Modafinil","nonproprietary_name":"modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-2526-1)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"60505252603","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2526-3","proprietary_name":"Modafinil","nonproprietary_name":"modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-2526-3)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"62332038530","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-385-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-385-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"62332038590","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-385-90","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-385-90)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"65862060101","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-601-01","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-601-01)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"65862060130","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-601-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-601-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"68084062111","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"68084062121","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-621-21","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-621-21) / 1 TABLET in 1 BLISTER PACK (68084-621-11)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"69452034213","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-342-13","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (69452-342-13)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"72578000506","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-005-06","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-005-06)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"72578000516","name":"MODAFINIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-005-16","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (72578-005-16)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"00904679204","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6792-04","proprietary_name":"Modafinil","nonproprietary_name":"modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6792-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"23155060503","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-605-03","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (23155-605-03)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"23155060509","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-605-09","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (23155-605-09)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"23155086203","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-862-03","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (23155-862-03)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"23155086209","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-862-09","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (23155-862-09)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"50268057111","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"50268057112","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-571-12","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-571-12) / 1 TABLET in 1 BLISTER PACK (50268-571-11)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"55253080290","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55253-802-90","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"CIMA LABS INC.","package_description":"90 TABLET in 1 BOTTLE (55253-802-90)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"57237015530","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-155-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-155-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"57237015590","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-155-90","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-155-90)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"60505252701","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2527-1","proprietary_name":"Modafinil","nonproprietary_name":"modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-2527-1)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"60505252703","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2527-3","proprietary_name":"Modafinil","nonproprietary_name":"modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-2527-3)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"62332038630","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-386-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-386-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"62332038690","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-386-90","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-386-90)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"65862060201","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-602-01","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-602-01)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"65862060230","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-602-30","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-602-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"68084072111","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"68084072121","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-721-21","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-721-21) / 1 TABLET in 1 BLISTER PACK (68084-721-11)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"69452034313","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-343-13","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (69452-343-13)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"69452034319","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-343-19","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (69452-343-19)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"72578000601","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-006-01","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-006-01)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"72578000606","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-006-06","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET in 1 BOTTLE (72578-006-06)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"72578000616","name":"MODAFINIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-006-16","proprietary_name":"Modafinil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET in 1 BOTTLE (72578-006-16)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Modafinil|Modafinil","basis":"generic"},"part_b":null}, {"ndc":"00093515001","name":"MOEXIPRIL HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5150-01","proprietary_name":"Moexipril Hydrochloride","nonproprietary_name":"Moexipril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5150-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":1.00027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moexipril HCl|Moexipril HCl","basis":"generic"},"part_b":null}, {"ndc":"62135096990","name":"MOEXIPRIL HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-969-90","proprietary_name":"Moexipril Hydrochloride","nonproprietary_name":"Moexipril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-969-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":1.00027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moexipril HCl|Moexipril HCl","basis":"generic"},"part_b":null}, {"ndc":"68462020801","name":"MOEXIPRIL HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-208-01","proprietary_name":"Moexipril Hydrochloride","nonproprietary_name":"Moexipril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-208-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":1.00027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moexipril HCl|Moexipril HCl","basis":"generic"},"part_b":null}, {"ndc":"00093001701","name":"MOEXIPRIL HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0017-01","proprietary_name":"Moexipril Hydrochloride","nonproprietary_name":"Moexipril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0017-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.89715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moexipril HCl|Moexipril HCl","basis":"generic"},"part_b":null}, {"ndc":"62135096790","name":"MOEXIPRIL HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-967-90","proprietary_name":"Moexipril Hydrochloride","nonproprietary_name":"Moexipril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-967-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.89715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moexipril HCl|Moexipril HCl","basis":"generic"},"part_b":null}, {"ndc":"68462020901","name":"MOEXIPRIL HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-209-01","proprietary_name":"Moexipril Hydrochloride","nonproprietary_name":"Moexipril Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-209-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.89715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moexipril HCl|Moexipril HCl","basis":"generic"},"part_b":null}, {"ndc":"00713063415","name":"MOMETASONE FUROATE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0634-15","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0634-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.42021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063437","name":"MOMETASONE FUROATE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0634-37","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0634-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.28693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802025735","name":"MOMETASONE FUROATE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-257-35","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-257-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.42021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802025742","name":"MOMETASONE FUROATE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-257-42","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-257-42) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.28693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063515","name":"MOMETASONE FUROATE 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0635-15","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0635-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713063537","name":"MOMETASONE FUROATE 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0635-37","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0635-37) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668052701","name":"MOMETASONE FUROATE 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-527-01","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"15 OINTMENT in 1 BOX (13668-527-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668052704","name":"MOMETASONE FUROATE 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-527-04","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"45 OINTMENT in 1 BOX (13668-527-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802011937","name":"MOMETASONE FUROATE 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-119-37","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-119-37) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.29224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802011942","name":"MOMETASONE FUROATE 0.1% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-119-42","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-119-42) / 45 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.20768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007201","name":"MOMETASONE FUROATE 0.1% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-072-01","proprietary_name":"MOMETASONE FUROATE","nonproprietary_name":"MOMETASONE FUROATE","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 BOTTLE (21922-072-01) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"21922007221","name":"MOMETASONE FUROATE 0.1% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-072-21","proprietary_name":"MOMETASONE FUROATE","nonproprietary_name":"MOMETASONE FUROATE","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE in 1 CARTON (21922-072-21) / 30 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.48751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802011846","name":"MOMETASONE FUROATE 0.1% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-118-46","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-118-46) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.47768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802011859","name":"MOMETASONE FUROATE 0.1% SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-118-59","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone Furoate","dosage_form":"SOLUTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-118-59) / 30 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.48751,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651040217","name":"MOMETASONE FUROATE 50 MCG SPRY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-402-17","proprietary_name":"MOMETASONE FUROATE MONOHYDRATE","nonproprietary_name":"MOMETASONE FUROATE MONOHYDRATE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE, SPRAY in 1 CARTON (59651-402-17) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.58728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"60505083001","name":"MOMETASONE FUROATE 50 MCG SPRY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0830-1","proprietary_name":"MOMETASONE FUROATE","nonproprietary_name":"MOMETASONE FUROATE","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, PUMP in 1 CARTON (60505-0830-1) / 120 SPRAY, METERED in 1 BOTTLE, PUMP","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.58728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65162089129","name":"MOMETASONE FUROATE 50 MCG SPRY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-891-29","proprietary_name":"Mometasone Furoate","nonproprietary_name":"Mometasone","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (65162-891-29) / 120 SPRAY, METERED in 1 BOTTLE, PUMP","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.58728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714036001","name":"MONO-LINYAH 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-360-01","proprietary_name":"Mono-Linyah","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-360-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mono-Linyah|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714036004","name":"MONO-LINYAH 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-360-04","proprietary_name":"Mono-Linyah","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-360-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Mono-Linyah|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00904680806","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6808-06","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6808-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904680861","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6808-61","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6808-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668008105","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-081-05","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-081-05)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668008130","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-081-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-081-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668008190","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-081-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-081-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"16571010009","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-100-09","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-100-09)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"16571010010","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-100-10","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-100-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022010","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-220-10","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-220-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022013","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-220-13","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-220-13)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022019","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-220-19","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-220-19)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072610","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-726-10","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-726-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072630","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-726-30","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-726-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072690","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-726-90","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-726-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342010207","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-102-07","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-102-07)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342010210","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-102-10","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-102-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342010215","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-102-15","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-102-15)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268055611","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268055615","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-556-15","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-556-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-556-11)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111072510","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-725-10","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"1000 TABLET, COATED in 1 BOTTLE (55111-725-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111072530","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-725-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (55111-725-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111072590","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-725-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"90 TABLET, COATED in 1 BOTTLE (55111-725-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862057490","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-574-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-574-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001036103","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-361-03","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-361-03)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001036104","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-361-04","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET in 1 BOTTLE (68001-361-04)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"68001036105","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-361-05","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"90 TABLET in 1 BOTTLE (68001-361-05)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084087501","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-875-01","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-875-01) / 1 TABLET, COATED in 1 BLISTER PACK (68084-875-11)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084087511","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"68645056054","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"69367028705","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-287-05","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-287-05)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"69367028709","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-287-09","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (69367-287-09)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009000910","name":"MONTELUKAST SOD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-009-10","proprietary_name":"Montelukast","nonproprietary_name":"Montelukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-009-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668053111","name":"MONTELUKAST SOD 4 MG GRANULES","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.81256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668053194","name":"MONTELUKAST SOD 4 MG GRANULES","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-531-94","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"GRANULE","route":"ORAL","strength":"4 mg/500mg","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 PACKET in 1 CARTON (13668-531-94) / 500 mg in 1 PACKET (13668-531-11)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.81256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"27241001531","name":"MONTELUKAST SOD 4 MG GRANULES","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-015-31","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"GRANULE","route":"ORAL","strength":"4 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 GRANULE in 1 CARTON (27241-015-31)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.81256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111076303","name":"MONTELUKAST SOD 4 MG GRANULES","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.81256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111076307","name":"MONTELUKAST SOD 4 MG GRANULES","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.81256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"59651032930","name":"MONTELUKAST SOD 4 MG GRANULES","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-329-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"GRANULE","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 PACKET in 1 CARTON (59651-329-30) / 1 GRANULE in 1 PACKET (59651-329-05)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.81256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668007905","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-079-05","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, CHEWABLE in 1 BOTTLE (13668-079-05)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668007930","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-079-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (13668-079-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668007990","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-079-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (13668-079-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022110","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-221-10","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (29300-221-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022113","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-221-13","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (29300-221-13)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022119","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-221-19","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (29300-221-19)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072730","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-727-30","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (31722-727-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072790","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-727-90","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (31722-727-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342011007","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-110-07","proprietary_name":"Montelukast sodium","nonproprietary_name":"Montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (33342-110-07)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342011010","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-110-10","proprietary_name":"Montelukast sodium","nonproprietary_name":"Montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (33342-110-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268057311","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268057315","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-573-15","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-573-15) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (50268-573-11)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237021230","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-212-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (57237-212-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237021290","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-212-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (57237-212-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"62135078130","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-781-30","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (62135-781-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"62175020443","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-204-43","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Lannett Company, Inc.","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE (62175-204-43)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862056790","name":"MONTELUKAST SOD 4 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-567-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (65862-567-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668008005","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-080-05","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, CHEWABLE in 1 BOTTLE (13668-080-05)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668008030","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-080-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (13668-080-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668008090","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-080-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (13668-080-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022210","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-222-10","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (29300-222-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022213","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-222-13","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (29300-222-13)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"29300022219","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-222-19","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (29300-222-19)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072830","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-728-30","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (31722-728-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722072890","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-728-90","proprietary_name":"montelukast sodium","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (31722-728-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342011107","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-111-07","proprietary_name":"Montelukast sodium","nonproprietary_name":"Montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (33342-111-07)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342011110","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-111-10","proprietary_name":"Montelukast sodium","nonproprietary_name":"Montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (33342-111-10)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268057411","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268057415","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-574-15","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-574-15) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (50268-574-11)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237021330","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-213-30","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (57237-213-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237021390","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-213-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (57237-213-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"62135078230","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-782-30","proprietary_name":"MONTELUKAST SODIUM","nonproprietary_name":"MONTELUKAST SODIUM","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (62135-782-30)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"62175020532","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-205-32","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (62175-205-32)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"62175020543","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-205-43","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE (62175-205-43)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862056890","name":"MONTELUKAST SOD 5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-568-90","proprietary_name":"Montelukast Sodium","nonproprietary_name":"Montelukast Sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (65862-568-90)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Montelukast Sodium|Montelukast Sodium","basis":"generic"},"part_b":null}, {"ndc":"00054023749","name":"MORPHINE SULF 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0237-49","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0054-0237-49)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.09151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054023763","name":"MORPHINE SULF 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0237-63","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE (0054-0237-63)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826012905","name":"MORPHINE SULF 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-129-05","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Winder Laboratories LLC","package_description":"100 mL in 1 BOTTLE, PLASTIC (75826-129-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.09151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826012917","name":"MORPHINE SULF 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-129-17","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Winder Laboratories LLC","package_description":"500 mL in 1 BOTTLE, PLASTIC (75826-129-17)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054051741","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0517-41","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"15 mL in 1 BOTTLE (0054-0517-41)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.45992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054051744","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0517-44","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 mL in 1 BOTTLE (0054-0517-44)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.39203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054051750","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0517-50","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 mL in 1 BOTTLE (0054-0517-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00406800312","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8003-12","proprietary_name":"Morphine Sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"SpecGx LLC","package_description":"6 CARTON in 1 CASE (0406-8003-12) / 1 BOTTLE, PLASTIC in 1 CARTON / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00406800315","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8003-15","proprietary_name":"Morphine Sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"SpecGx LLC","package_description":"6 CARTON in 1 CASE (0406-8003-15) / 1 BOTTLE, PLASTIC in 1 CARTON / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.45992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00406800330","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8003-30","proprietary_name":"Morphine Sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"SpecGx LLC","package_description":"6 CARTON in 1 CASE (0406-8003-30) / 1 BOTTLE, PLASTIC in 1 CARTON / 30 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.39203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27808008201","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-082-01","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1 BOTTLE, UNIT-DOSE in 1 CARTON (27808-082-01) / 30 mL in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.39203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27808008202","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-082-02","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"1 BOTTLE, UNIT-DOSE in 1 CARTON (27808-082-02) / 120 mL in 1 BOTTLE, UNIT-DOSE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826013101","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-131-01","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"Winder Laboratories LLC","package_description":"30 mL in 1 BOTTLE, PLASTIC (75826-131-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.39203,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826013104","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-131-04","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"Winder Laboratories LLC","package_description":"120 mL in 1 BOTTLE, PLASTIC (75826-131-04)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826013115","name":"MORPHINE SULF 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-131-15","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"Winder Laboratories LLC","package_description":"15 mL in 1 BOTTLE, PLASTIC (75826-131-15)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.45992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054023849","name":"MORPHINE SULF 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0238-49","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 mL in 1 BOTTLE (0054-0238-49)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"75826013005","name":"MORPHINE SULF 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-130-05","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Winder Laboratories LLC","package_description":"100 mL in 1 BOTTLE, PLASTIC (75826-130-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00406839001","name":"MORPHINE SULF ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8390-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-8390-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.85389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406839023","name":"MORPHINE SULF ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8390-23","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8390-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.85389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406839062","name":"MORPHINE SULF ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8390-62","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8390-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.85389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904656061","name":"MORPHINE SULF ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6560-61","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6560-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.85389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42858080401","name":"MORPHINE SULF ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-804-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-804-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.85389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"63304045201","name":"MORPHINE SULF ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-452-01","proprietary_name":"Morphine sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-452-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.85389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406831501","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8315-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-8315-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406831523","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8315-23","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8315-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406831562","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8315-62","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8315-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904655761","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6557-61","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6557-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42858080101","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-801-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-801-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"63304045001","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-450-01","proprietary_name":"Morphine sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-450-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084015701","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-157-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-157-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-157-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084015711","name":"MORPHINE SULF ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406832001","name":"MORPHINE SULF ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8320-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-8320-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.12665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42858080501","name":"MORPHINE SULF ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-805-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-805-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.12665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"63304045301","name":"MORPHINE SULF ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-453-01","proprietary_name":"Morphine sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-453-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.12665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406833001","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8330-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-8330-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406833023","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8330-23","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8330-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406833062","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8330-62","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8330-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904655861","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6558-61","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6558-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42858080201","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-802-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-802-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"63304045101","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-451-01","proprietary_name":"Morphine sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-451-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084015801","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-158-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-158-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-158-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68084015811","name":"MORPHINE SULF ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406838001","name":"MORPHINE SULF ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8380-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0406-8380-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.65658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406838023","name":"MORPHINE SULF ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8380-23","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8380-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.65658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00406838062","name":"MORPHINE SULF ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8380-62","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (0406-8380-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.65658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00904655961","name":"MORPHINE SULF ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6559-61","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6559-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.65658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"42858080301","name":"MORPHINE SULF ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-803-01","proprietary_name":"Morphine Sulfate Extended Release","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-803-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.65658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"63304075801","name":"MORPHINE SULF ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-758-01","proprietary_name":"Morphine sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (63304-758-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.65658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00641612725","name":"MORPHINE SULFATE 10 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6127-25","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 PACKAGE (0641-6127-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6127-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.34224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2270","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2270 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 PACKAGE (0641-6127-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6127-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641612525","name":"MORPHINE SULFATE 4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6125-25","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"4 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 PACKAGE (0641-6125-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6125-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.31744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2270","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2270 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (0.4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 PACKAGE (0641-6125-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6125-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00832022500","name":"MORPHINE SULFATE ER 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0832-0225-00","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0832-0225-00)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.60553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00832022600","name":"MORPHINE SULFATE ER 20 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0832-0226-00","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0832-0226-00)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":3.08084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Morphine Sulfate ER|Morphine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00054023524","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0235-24","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-0235-24) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054023525","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0235-25","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0235-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406511801","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5118-01","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-5118-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406511823","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406511862","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5118-62","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"10 BLISTER PACK in 1 CARTON (0406-5118-62) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832027311","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0273-11","proprietary_name":"Morphine Sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0273-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687061701","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-617-01","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-617-01) / 1 TABLET in 1 BLISTER PACK (60687-617-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687061711","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877067001","name":"MORPHINE SULFATE IR 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-670-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-670-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.22552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054023624","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0236-24","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0054-0236-24) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054023625","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0236-25","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0236-25)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406511901","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5119-01","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-5119-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406511923","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406511962","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-5119-62","proprietary_name":"Morphine Sulfate","nonproprietary_name":"Morphine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"10 BLISTER PACK in 1 CARTON (0406-5119-62) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832027411","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0274-11","proprietary_name":"Morphine Sulfate","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0274-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877067101","name":"MORPHINE SULFATE IR 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-671-01","proprietary_name":"MORPHINE SULFATE","nonproprietary_name":"MORPHINE SULFATE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (67877-671-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.3414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092054601","name":"MOTEGRITY 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-546-01","proprietary_name":"MOTEGRITY","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (54092-546-01)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":17.73123,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Motegrity|Prucalopride Succinate","basis":"brand"},"part_b":null}, {"ndc":"54092054701","name":"MOTEGRITY 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-547-01","proprietary_name":"MOTEGRITY","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (54092-547-01)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":17.75118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Motegrity|Prucalopride Succinate","basis":"brand"},"part_b":null}, {"ndc":"46122053653","name":"MOTION SICKNESS 50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-536-53","proprietary_name":"Motion Sickness Relief","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amerisource Bergen","package_description":"2 BLISTER PACK in 1 CARTON (46122-536-53) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000074901","name":"MOTION SICKNESS 50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0749-1","proprietary_name":"Motion Sickness Relief","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0749-1) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122053551","name":"MOTION SICKNESS RLF 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-535-51","proprietary_name":"Motion Sickness Relief","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amerisource Bergen","package_description":"1 BLISTER PACK in 1 CARTON (46122-535-51) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000009701","name":"MOTION SICKNESS RLF 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0097-1","proprietary_name":"Motion Sickness Relief","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"4 BLISTER PACK in 1 CARTON (70000-0097-1) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.12808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483033301","name":"MOTION-TIME 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-333-01","proprietary_name":"Motion-Time Chewable","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/251","labeler":"Time-Cap Labs, Inc","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (49483-333-01)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483033310","name":"MOTION-TIME 25 MG TABLET CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-333-10","proprietary_name":"Motion-Time Chewable","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/251","labeler":"Time-Cap Labs, Inc","package_description":"1000 TABLET, CHEWABLE in 1 BOTTLE (49483-333-10)","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54766020010","name":"MOTOFEN 1-0.025 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"54766-200-10","proprietary_name":"Motofen","nonproprietary_name":"difenoxin and atropine sulfate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; .025 mg/1","labeler":"Sebela Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (54766-200-10)","pharm_classes":["Anticholinergic [EPC]","Antidiarrheal [EPC]","Cholinergic Antagonists [MoA]","Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":6.91338,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Motofen|Difenoxin HCl/Atropine Sulfate","basis":"brand"},"part_b":null}, {"ndc":"73289006302","name":"MOTPOLY XR 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73289-0063-2","proprietary_name":"MOTPOLY XR","nonproprietary_name":"lacosamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Aucta Pharmaceuticals, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (73289-0063-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":21.43011,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Motpoly XR|Lacosamide","basis":"brand"},"part_b":null}, {"ndc":"73289006402","name":"MOTPOLY XR 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73289-0064-2","proprietary_name":"MOTPOLY XR","nonproprietary_name":"lacosamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aucta Pharmaceuticals, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (73289-0064-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":21.50185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Motpoly XR|Lacosamide","basis":"brand"},"part_b":null}, {"ndc":"73289006502","name":"MOTPOLY XR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73289-0065-2","proprietary_name":"MOTPOLY XR","nonproprietary_name":"lacosamide","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Aucta Pharmaceuticals, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (73289-0065-2)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":21.5109,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Motpoly XR|Lacosamide","basis":"brand"},"part_b":null}, {"ndc":"00002147180","name":"MOUNJARO 10 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1471-80","proprietary_name":"Mounjaro","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"10 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1471-80) / .5 mL in 1 SYRINGE (0002-1471-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":538.68356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Mounjaro|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002146080","name":"MOUNJARO 12.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1460-80","proprietary_name":"Mounjaro","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"12.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1460-80) / .5 mL in 1 SYRINGE (0002-1460-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":538.52518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Mounjaro|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002145780","name":"MOUNJARO 15 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1457-80","proprietary_name":"Mounjaro","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"15 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1457-80) / .5 mL in 1 SYRINGE (0002-1457-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":538.51759,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Mounjaro|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002150680","name":"MOUNJARO 2.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1506-80","proprietary_name":"Mounjaro","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1506-80) / .5 mL in 1 SYRINGE (0002-1506-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":538.68839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Mounjaro|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002149580","name":"MOUNJARO 5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1495-80","proprietary_name":"Mounjaro","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1495-80) / .5 mL in 1 SYRINGE (0002-1495-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":538.63384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Mounjaro|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002148480","name":"MOUNJARO 7.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1484-80","proprietary_name":"Mounjaro","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1484-80) / .5 mL in 1 SYRINGE (0002-1484-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":538.68042,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Mounjaro|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"82625880101","name":"MOVANTIK 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82625-8801-1","proprietary_name":"MOVANTIK","nonproprietary_name":"naloxegol oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Averitas Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82625-8801-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":14.59872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Movantik|Naloxegol Oxalate","basis":"brand"},"part_b":null}, {"ndc":"82625880201","name":"MOVANTIK 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82625-8802-1","proprietary_name":"MOVANTIK","nonproprietary_name":"naloxegol oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Averitas Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82625-8802-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":14.61317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Movantik|Naloxegol Oxalate","basis":"brand"},"part_b":null}, {"ndc":"82625880203","name":"MOVANTIK 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82625-8802-3","proprietary_name":"MOVANTIK","nonproprietary_name":"naloxegol oxalate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Averitas Pharma, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (82625-8802-3) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":14.61317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Movantik|Naloxegol Oxalate","basis":"brand"},"part_b":null}, {"ndc":"00781713593","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7135-93","proprietary_name":"Moxifloxacin Ophthalmic Solution","nonproprietary_name":"moxifloxacin hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0781-7135-93) / 3 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00832141003","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1410-03","proprietary_name":"Moxifloxacin Hydrochloride","nonproprietary_name":"Moxifloxacin Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0832-1410-03) / 3 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714064301","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-643-01","proprietary_name":"MOXIFLOXACIN","nonproprietary_name":"MOXIFLOXACIN","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (16714-643-01) / 3 mL in 1 BOTTLE","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505058204","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0582-4","proprietary_name":"Moxifloxacin","nonproprietary_name":"moxifloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0582-4) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332050503","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-505-03","proprietary_name":"Moxifloxacin ophthalmic solution","nonproprietary_name":"Moxifloxacin ophthalmic solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-505-03) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862084003","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-840-03","proprietary_name":"MOXIFLOXACIN","nonproprietary_name":"MOXIFLOXACIN","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (65862-840-03) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180042201","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-422-01","proprietary_name":"Moxifloxacin","nonproprietary_name":"Moxifloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-422-01) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069008101","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-081-01","proprietary_name":"Moxifloxacin Hydrochloride","nonproprietary_name":"Moxifloxacin Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-081-01) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756063825","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-638-25","proprietary_name":"Moxifloxacin ophthalmic solution","nonproprietary_name":"Moxifloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-638-25) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72266015801","name":"MOXIFLOXACIN 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-158-01","proprietary_name":"Moxifloxacin Ophthalmic Solution","nonproprietary_name":"Moxifloxacin Ophthalmic","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 BOTTLE in 1 CARTON (72266-158-01) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093738756","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904740704","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7407-04","proprietary_name":"MOXIFLOXACIN HYDROCHLORIDE","nonproprietary_name":"moxifloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7407-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904740706","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7407-06","proprietary_name":"MOXIFLOXACIN HYDROCHLORIDE","nonproprietary_name":"moxifloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7407-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268057611","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268057613","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-576-13","proprietary_name":"Moxifloxacin Hydrochloride","nonproprietary_name":"Moxifloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-576-13) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-576-11)","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237015630","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-156-30","proprietary_name":"Moxifloxacin Hydrochloride","nonproprietary_name":"Moxifloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-156-30)","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862060330","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-603-30","proprietary_name":"MOXIFLOXACIN HYDROCHLORIDE","nonproprietary_name":"moxifloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-603-30)","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084072211","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084072265","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-722-65","proprietary_name":"Moxifloxacin Hydrochloride","nonproprietary_name":"Moxifloxacin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-722-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-722-11)","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205000130","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-001-30","proprietary_name":"Moxifloxacin Hydrochloride Tablets, 400 mg","nonproprietary_name":"Moxifloxacin Hydrochloride Tablets, 400 mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-001-30)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Moxifloxacin HCl|Moxifloxacin HCl","basis":"generic"},"part_b":null}, {"ndc":"73473090330","name":"MOXIFLOXACIN HCL 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-903-30","proprietary_name":"Moxifloxacin","nonproprietary_name":"moxifloxacin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Solaris Pharma Corporation","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (73473-903-30)","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":1.33723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858051501","name":"MS CONTIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-515-01","proprietary_name":"MS Contin","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-515-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":4.65312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.30984,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858063101","name":"MS CONTIN ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-631-01","proprietary_name":"MS Contin","nonproprietary_name":"morphine sulfate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (42858-631-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.94776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.44128,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237035912","name":"MUCOLYTE 100 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-359-12","proprietary_name":"Mucolyte","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118 mL in 1 BOTTLE (57237-359-12)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237035916","name":"MUCOLYTE 100 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-359-16","proprietary_name":"Mucolyte","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (57237-359-16)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237036012","name":"MUCOLYTE-DM 100-10 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-360-12","proprietary_name":"Mucolyte DM","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL; 10 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"118 mL in 1 BOTTLE (57237-360-12)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49483027206","name":"MUCOSA 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-272-06","proprietary_name":"MUCOSA","nonproprietary_name":"GUAIFENESIN","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"TIME CAP LABORATORIES,INC","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (49483-272-06)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483028006","name":"MUCOSA DM 400-20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-280-06","proprietary_name":"MUCOSA DM","nonproprietary_name":"GUAIFENESIN DEXTROMETHORPHAN","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 20 mg/1","labeler":"TIME CAP LABORATORIES, INC.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (49483-280-06)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113891162","name":"MUCUS D ER 1,200-120 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8911-62","proprietary_name":"Mucus D","nonproprietary_name":"guaifenesin, pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 120 mg/1","labeler":"L. Perrigo Company","package_description":"4 BLISTER PACK in 1 CARTON (0113-8911-62) / 6 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.42347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113830768","name":"MUCUS D ER 600-60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8307-68","proprietary_name":"mucus D","nonproprietary_name":"guaifenesin and pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"L. Perrigo Company","package_description":"2 BLISTER PACK in 1 CARTON (0113-8307-68) / 18 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122041660","name":"MUCUS ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385060271","name":"MUCUS RELIEF 400 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-602-71","proprietary_name":"Good Neighbor Pharmacy Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (24385-602-71) / 50 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.06559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000071901","name":"MUCUS RELIEF D ER 1,200-120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0719-1","proprietary_name":"Leader Mucus Relief D","nonproprietary_name":"guaifenesin, pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 120 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"4 BLISTER PACK in 1 CARTON (70000-0719-1) / 6 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.42347,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536144921","name":"MUCUS RELIEF D ER 600-60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1449-21","proprietary_name":"Rugby Mucus Relief D","nonproprietary_name":"guaifenesin and pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Rugby Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (0536-1449-21) / 18 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536144936","name":"MUCUS RELIEF D ER 600-60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1449-36","proprietary_name":"Rugby Mucus Relief D","nonproprietary_name":"guaifenesin and pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Rugby Laboratories","package_description":"2 BLISTER PACK in 1 CARTON (0536-1449-36) / 18 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058001","name":"MUCUS RELIEF D ER 600-60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000058002","name":"MUCUS RELIEF D ER 600-60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072001","name":"MUCUS RELIEF D ER 600-60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0720-1","proprietary_name":"Leader Mucus Relief D","nonproprietary_name":"guaifenesin and pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BLISTER PACK in 1 CARTON (70000-0720-1) / 18 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072002","name":"MUCUS RELIEF D ER 600-60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0720-2","proprietary_name":"Leader Mucus Relief D","nonproprietary_name":"guaifenesin and pseudoephedrine hydrochloride","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 60 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0720-2) / 18 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.38412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000027801","name":"MUCUS RELIEF DM COUGH TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0278-1","proprietary_name":"Mucus Relief DM Cough Maximum Strength","nonproprietary_name":"Dextromethorphan HBr and Guaifenesin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0278-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536124971","name":"MUCUS RELIEF ER 1,200 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1249-71","proprietary_name":"Mucus Relief ER","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Rugby Laboratories","package_description":"2 BLISTER PACK in 1 CARTON (0536-1249-71) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536145188","name":"MUCUS RELIEF ER 1,200 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1451-88","proprietary_name":"Rugby Mucus Relief ER","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Rugby Laboratories","package_description":"2 BLISTER PACK in 1 CARTON (0536-1451-88) / 7 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072101","name":"MUCUS RELIEF ER 1,200 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0721-1","proprietary_name":"Leader Mucus Relief","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0721-1) / 7 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000073001","name":"MUCUS RELIEF ER 1,200 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0730-1","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (70000-0730-1) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904671839","name":"MUCUS RELIEF ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6718-39","proprietary_name":"Mucus Relief ER","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6718-39) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904698640","name":"MUCUS RELIEF ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6986-40","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (0904-6986-40)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63739006702","name":"MUCUS RELIEF ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63739-067-02","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"McKesson Corporation dba SKY Packaging","package_description":"30 BLISTER PACK in 1 BOX (63739-067-02) / 10 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000075801","name":"MUCUS RELIEF ER 600 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0758-1","proprietary_name":"Leader Mucus Relief","nonproprietary_name":"guaifenesin","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BLISTER PACK in 1 CARTON (70000-0758-1) / 20 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000014101","name":"MUCUS RELIEF PE TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0141-1","proprietary_name":"Mucus Relief PE Sinus Congestion","nonproprietary_name":"Guaifenesin, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1; 10 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0141-1) / 50 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536116134","name":"MUCUS RLF DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1161-34","proprietary_name":"Mucus Relief DM Extended Release Caplets","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 30 mg/1","labeler":"Rugby Laboratories","package_description":"20 BLISTER PACK in 1 CARTON (0536-1161-34) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536116137","name":"MUCUS RLF DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1161-37","proprietary_name":"Mucus Relief DM Extended Release Caplets","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1; 30 mg/1","labeler":"Rugby Laboratories","package_description":"40 BLISTER PACK in 1 CARTON (0536-1161-37) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536116144","name":"MUCUS RLF DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536144634","name":"MUCUS RLF DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1446-34","proprietary_name":"Rugby Mucus Relief DM ER","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1; 600 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1446-34) / 20 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072201","name":"MUCUS RLF DM ER 600-30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0722-1","proprietary_name":"Leader Mucus Relief DM","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1; 600 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0722-1) / 20 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.35604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000070701","name":"MUCUS RLF DM MAX 400-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0707-1","proprietary_name":"Mucus Relief DM","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"177 mL in 1 BOTTLE, PLASTIC (70000-0707-1)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536144788","name":"MUCUS RLF DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1447-88","proprietary_name":"RUGBY MUCUS RELIEF DM ER","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1; 60 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1447-88) / 14 TABLET, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000046401","name":"MUCUS RLF DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0464-1","proprietary_name":"Mucus Relief DM Extended Release Caplets","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1; 1200 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"28 BLISTER PACK in 1 CARTON (70000-0464-1) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000046402","name":"MUCUS RLF DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0464-2","proprietary_name":"Mucus Relief DM Extended Release Caplets","nonproprietary_name":"Guaifenesin, Dextromethorphan HBr","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1; 1200 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"14 BLISTER PACK in 1 CARTON (70000-0464-2) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536143097","name":"MUCUS-CHEST CONG 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1430-97","proprietary_name":"Rugby Mucus and Chest Congestion 541","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1430-97) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024414260","name":"MULTAQ 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-4142-60","proprietary_name":"Multaq","nonproprietary_name":"Dronedarone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Sanofi-Aventis U.S. LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0024-4142-60)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":13.18651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Multaq|Dronedarone HCl","basis":"brand"},"part_b":null}, {"ndc":"58657016301","name":"MULTIVIT-FLUOR 0.25 MG TAB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-163-01","proprietary_name":"Multivitamin with Fluoride","nonproprietary_name":".ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2500 [iU]/1; 60 mg/1; 400 [iU]/1; 15 [iU]/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1; .25 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (58657-163-01)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.10233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657016390","name":"MULTIVIT-FLUOR 0.25 MG TAB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-163-90","proprietary_name":"Multivitamin with Fluoride","nonproprietary_name":".ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2500 [iU]/1; 60 mg/1; 400 [iU]/1; 15 [iU]/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1; .25 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (58657-163-90)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.10233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657032550","name":"MULTIVIT-FLUOR 0.25 MG/ML DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-325-50","proprietary_name":"Multi-Vitamin with Fluoride","nonproprietary_name":"VITAMIN A, ASCORBIC ACID, CHOLECALCIFEROL, ALPHA-TOCOPHEROL ACETATE, THIAMINE HYDROCHLORIDE, RIBOFLAVIN 5-PHOSPHATE SODIUM, CYANOCOBALAMIN, NIACINAMIDE, PYRIDOXINE HYDROCHLORIDE and SODIUM FLUORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"1500 [iU]/mL; 35 mg/mL; 400 [iU]/mL; 5 [iU]/mL; .5 mg/mL; .6 mg/mL; 2 ug/mL; 8 mg/mL; .4 mg/mL; .25 mg/mL","labeler":"Method Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 BOX (58657-325-50) / 50 mL in 1 BOTTLE, DROPPER","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Photoabsorption [MoA]","Photoenhancer [EPC]","Photosensitizing Activity [PE]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.17794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61269016150","name":"MULTIVIT-FLUOR 0.25 MG/ML DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.17794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657016401","name":"MULTIVIT-FLUOR 0.5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-164-01","proprietary_name":"Multivitamin with Fluoride","nonproprietary_name":".ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2500 [iU]/1; 60 mg/1; 400 [iU]/1; 15 [iU]/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1; .5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (58657-164-01)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.10654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657016490","name":"MULTIVIT-FLUOR 0.5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-164-90","proprietary_name":"Multivitamin with Fluoride","nonproprietary_name":".ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2500 [iU]/1; 60 mg/1; 400 [iU]/1; 15 [iU]/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1; .5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (58657-164-90)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.10654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61269015601","name":"MULTIVIT-FLUOR 0.5 MG TAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657032650","name":"MULTIVIT-FLUOR 0.5 MG/ML DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-326-50","proprietary_name":"Multi-Vitamin with Fluoride","nonproprietary_name":"VITAMIN A, ASCORBIC ACID, CHOLECALCIFEROL, ALPHA-TOCOPHEROL ACETATE, THIAMINE HYDROCHLORIDE, RIBOFLAVIN 5-PHOSPHATE SODIUM, CYANOCOBALAMIN, NIACINAMIDE, PYRIDOXINE HYDROCHLORIDE and SODIUM FLUORIDE","dosage_form":"LIQUID","route":"ORAL","strength":".6 mg/mL; 1500 [iU]/mL; 35 mg/mL; 400 [iU]/mL; 5 [iU]/mL; .5 mg/mL; 2 ug/mL; 8 mg/mL; .4 mg/mL; .5 mg/mL","labeler":"Method Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 BOX (58657-326-50) / 50 mL in 1 BOTTLE, DROPPER","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Photoabsorption [MoA]","Photoenhancer [EPC]","Photosensitizing Activity [PE]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.17505,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657032750","name":"MULTIVIT-FLUOR-IRON 0.25 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-327-50","proprietary_name":"Multi-Vitamin Drops with Fluoride and Iron","nonproprietary_name":"VITAMIN A, ASCORBIC ACID, CHOLECALCIFEROL, ALPHA-TOCOPHEROL ACETATE, THIAMINE HYDROCHLORIDE, RIBOFLAVIN 5-PHOSPHATE SODIUM, NIACINAMIDE, PYRIDOXINE HYDROCHLORIDE, Ferrous sulfate and SODIUM FLUORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"1500 [iU]/mL; 35 mg/mL; 400 [iU]/mL; 5 [iU]/mL; .5 mg/mL; .6 mg/mL; 8 mg/mL; .4 mg/mL; 10 mg/mL; .25 mg/mL","labeler":"Method Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 BOX (58657-327-50) / 50 mL in 1 BOTTLE, DROPPER","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Photoabsorption [MoA]","Photoenhancer [EPC]","Photosensitizing Activity [PE]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.19376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657016501","name":"MULTIVIT-FLUORIDE 1 MG TAB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-165-01","proprietary_name":"Multivitamin with Fluoride","nonproprietary_name":".ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2500 [iU]/1; 60 mg/1; 400 [iU]/1; 15 [iU]/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1; 1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (58657-165-01)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.09875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657016590","name":"MULTIVIT-FLUORIDE 1 MG TAB CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-165-90","proprietary_name":"Multivitamin with Fluoride","nonproprietary_name":".ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"2500 [iU]/1; 60 mg/1; 400 [iU]/1; 15 [iU]/1; 1.05 mg/1; 1.2 mg/1; 13.5 mg/1; 1.05 mg/1; 300 ug/1; 4.5 ug/1; 1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"90 TABLET, CHEWABLE in 1 BOTTLE (58657-165-90)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.09875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714005501","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-055-01","proprietary_name":"Mupirocin","nonproprietary_name":"mupirocin calcium","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-055-01) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.82599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714005502","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-055-02","proprietary_name":"Mupirocin","nonproprietary_name":"mupirocin calcium","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-055-02) / 30 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.88299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002904","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-029-04","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-029-04) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.82599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002905","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-029-05","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-029-05) / 30 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.88299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672137001","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1370-1","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin Calcium","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1370-1) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.82599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672137002","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1370-2","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin Calcium","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1370-2) / 30 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.88299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332062415","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-624-15","proprietary_name":"MUPIROCIN","nonproprietary_name":"MUPIROCIN","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-624-15) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.82599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332062430","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-624-30","proprietary_name":"MUPIROCIN","nonproprietary_name":"MUPIROCIN","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-624-30) / 30 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.88299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462056417","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-564-17","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"15 g in 1 TUBE (68462-564-17)","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.82599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462056435","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-564-35","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 g in 1 TUBE (68462-564-35)","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.88299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238202903","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2029-3","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-2029-3) / 30 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.88299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238202905","name":"MUPIROCIN 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2029-5","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"CREAM","route":"TOPICAL","strength":"2 g/100g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-2029-5) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.82599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093101042","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1010-42","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-1010-42) / 22 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.14555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007304","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-073-04","proprietary_name":"MUPIROCIN","nonproprietary_name":"MUPIROCIN","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-073-04) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.29847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922007325","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-073-25","proprietary_name":"MUPIROCIN","nonproprietary_name":"MUPIROCIN","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-073-25) / 22 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.14555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802011214","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-112-14","proprietary_name":"mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-112-14) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.29847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802011222","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-112-22","proprietary_name":"mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-112-22) / 22 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.14555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131200","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1312-0","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1312-0) / 22 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.14555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672131201","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1312-1","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1312-1) / 15 g in 1 TUBE","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.29847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462018022","name":"MUPIROCIN 2% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-180-22","proprietary_name":"Mupirocin","nonproprietary_name":"Mupirocin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"22 g in 1 TUBE (68462-180-22)","pharm_classes":["RNA Synthetase Inhibitor Antibacterial [EPC]","RNA Synthetase Inhibitors [MoA]"]},"nadac":{"value":0.14555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208027615","name":"MURO-128 2% EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-276-15","proprietary_name":"Muro 128","nonproprietary_name":"sodium chloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-276-15) / 15 mL in 1 BOTTLE","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":1.0618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208027715","name":"MURO-128 5% EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-277-15","proprietary_name":"Muro 128","nonproprietary_name":"sodium chloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"50 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-277-15) / 15 mL in 1 BOTTLE","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":1.11626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.32865,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208038555","name":"MURO-128 5% EYE OINTMENT","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24208-385-55","proprietary_name":"Muro 128","nonproprietary_name":"sodium chloride","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"50 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-385-55) / 3.5 g in 1 TUBE","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":4.79111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":2.99016,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536134957","name":"MUSCLE RUB 15%-10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1349-57","proprietary_name":"Muscle Rub","nonproprietary_name":"menthol and methyl salicylate","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g; 150 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1349-57) / 85 g in 1 TUBE"},"nadac":{"value":0.03651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000020801","name":"MUSCLE RUB ULTRA STR CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0208-1","proprietary_name":"Leader Ultra Strength Muscle Rub Topical Analgesic","nonproprietary_name":"Camphor (Synthetic), Menthol, Unspecified Form, and Methyl Salicylate","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g; 100 mg/g; 300 mg/g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"1 TUBE in 1 CARTON (70000-0208-1) / 113 g in 1 TUBE"},"nadac":{"value":0.03595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000020802","name":"MUSCLE RUB ULTRA STR CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0208-2","proprietary_name":"Leader Ultra Strength Muscle Rub Topical Analgesic","nonproprietary_name":"Camphor (Synthetic), Menthol, Unspecified Form, and Methyl Salicylate","dosage_form":"CREAM","route":"TOPICAL","strength":"40 mg/g; 100 mg/g; 300 mg/g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"1 TUBE in 1 CARTON (70000-0208-2) / 56.7 g in 1 TUBE"},"nadac":{"value":0.05525,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62756072060","name":"MY CHOICE 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-720-60","proprietary_name":"My Choice TM","nonproprietary_name":"levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"1 BLISTER PACK in 1 CARTON (62756-720-60) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine Device [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180085211","name":"MY WAY 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-852-11","proprietary_name":"My Way","nonproprietary_name":"levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-852-11) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527516082","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-5160-82","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"Lannett Company, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0527-5160-82) / 225 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7529","bill_units_per_package":{"value":7000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7529 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (7000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"23155084851","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-848-51","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"MYCOPHENOLATE MOFETIL","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (23155-848-51) / 225 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7529","bill_units_per_package":{"value":7000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7529 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (7000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"59651064626","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-646-26","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"mycophenolate mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-646-26) / 225 mL in 1 BOTTLE","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7529","bill_units_per_package":{"value":7000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7529 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (7000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"66689030708","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-307-08","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"VistaPharm, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (66689-307-08) / 250 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877023022","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-230-22","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67877-230-22) / 225 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7529","bill_units_per_package":{"value":7000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7529 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (7000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":175,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"69238159502","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1595-2","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69238-1595-2) / 225 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603075101","name":"MYCOPHENOLATE 200 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-751-01","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"mycophenolate mofetil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"200 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (72603-751-01) / 225 mL in 1 BOTTLE","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.98162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7529","bill_units_per_package":{"value":7000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7529 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (7000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00054016325","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054016329","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093733401","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7334-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-7334-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (5000 per item) x PKG QTY (500000), but FDA's strength 250 mg/1 x 100 EA per NDC / 5 MG = 5000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0093-7334-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":100,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00093733405","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7334-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-7334-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (25000 per item) x PKG QTY (12500000), but FDA's strength 250 mg/1 x 500 EA per NDC / 5 MG = 25000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 CAPSULE in 1 BOTTLE (0093-7334-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":500,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781206701","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2067-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2067-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (5000 per item) x PKG QTY (500000), but FDA's strength 250 mg/1 x 100 EA per NDC / 5 MG = 5000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0781-2067-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":100,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781206705","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2067-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"500 CAPSULE in 1 BOTTLE (0781-2067-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (25000 per item) x PKG QTY (12500000), but FDA's strength 250 mg/1 x 500 EA per NDC / 5 MG = 25000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 CAPSULE in 1 BOTTLE (0781-2067-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":500,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781206789","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2067-89","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sandoz Inc","package_description":"12 CAPSULE in 1 CARTON (0781-2067-89)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904746661","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7466-61","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7466-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729009401","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-094-01","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16729-094-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729009416","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-094-16","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 CAPSULE in 1 BOTTLE (16729-094-16)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083001","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-830-01","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (23155-830-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE, PLASTIC (23155-830-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"23155083005","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-830-05","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (23155-830-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 CAPSULE in 1 BOTTLE, PLASTIC (23155-830-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722087801","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-878-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-878-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722087805","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-878-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-878-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268055711","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268055715","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-557-15","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-557-15) / 1 CAPSULE in 1 BLISTER PACK (50268-557-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":2500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 BLISTER PACK in 1 BOX (50268-557-15) / 1 CAPSULE in 1 BLISTER PACK (50268-557-11)) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651062401","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-624-01","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-624-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (59651-624-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651062405","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-624-05","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (59651-624-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 CAPSULE in 1 BOTTLE (59651-624-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687088501","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-885-01","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-885-01) / 1 CAPSULE in 1 BLISTER PACK (60687-885-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (60687-885-01) / 1 CAPSULE in 1 BLISTER PACK (60687-885-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687088511","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072606","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-726-06","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (64380-726-06)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE, PLASTIC (64380-726-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380072607","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-726-07","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (64380-726-07)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (25000 per item) x PKG QTY (12500000), but FDA's strength 250 mg/1 x 500 EA per NDC / 5 MG = 25000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 CAPSULE in 1 BOTTLE, PLASTIC (64380-726-07)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":500,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877026601","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-266-01","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-266-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (67877-266-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877026605","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-266-05","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-266-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":25000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 CAPSULE in 1 BOTTLE (67877-266-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888019201","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-192-01","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"MYCOPHENOLATE MOFETIL","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (72888-192-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888019205","name":"MYCOPHENOLATE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-192-05","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"MYCOPHENOLATE MOFETIL","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (72888-192-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.13821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054016625","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0166-25","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-0166-25)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054016629","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0166-29","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (0054-0166-29)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781517501","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5175-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-5175-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (10000 per item) x PKG QTY (1000000), but FDA's strength 500 mg/1 x 100 EA per NDC / 5 MG = 10000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (0781-5175-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":100,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781517505","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5175-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Sandoz Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0781-5175-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":50000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (50000 per item) x PKG QTY (25000000), but FDA's strength 500 mg/1 x 500 EA per NDC / 5 MG = 50000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET, FILM COATED in 1 BOTTLE (0781-5175-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":500,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904707861","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7078-61","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7078-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-7078-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729001901","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-019-01","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Accord Healthcare Inc.","package_description":"100 TABLET in 1 BOTTLE (16729-019-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16729001916","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-019-16","proprietary_name":"mycophenolate mofetil","nonproprietary_name":"mycophenolate mofetil","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET in 1 BOTTLE (16729-019-16)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155083601","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-836-01","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (23155-836-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (23155-836-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"23155083605","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-836-05","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (23155-836-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":50000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (23155-836-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722087901","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-879-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-879-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722087905","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-879-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-879-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268055811","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268055815","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-558-15","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-558-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-558-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 BLISTER PACK in 1 BOX (50268-558-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-558-11)) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651063801","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-638-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-638-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (59651-638-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651063805","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-638-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59651-638-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687043801","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-438-01","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-438-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-438-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (10000 per item) x PKG QTY (1000000), but FDA's strength 500 mg/1 x 100 EA per NDC / 5 MG = 10000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-438-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-438-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":100,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687043811","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072506","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-725-06","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-725-06)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-725-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380072507","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-725-07","proprietary_name":"Mycophenolate mofetil","nonproprietary_name":"Mycophenolate mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-725-07)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":50000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (50000 per item) x PKG QTY (25000000), but FDA's strength 500 mg/1 x 500 EA per NDC / 5 MG = 50000 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-725-07)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":500,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877022501","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-225-01","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-225-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (67877-225-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877022505","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-225-05","proprietary_name":"Mycophenolate Mofetil","nonproprietary_name":"Mycophenolate Mofetil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-225-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7524","bill_units_per_package":{"value":50000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7524 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET, FILM COATED in 1 BOTTLE (67877-225-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888018501","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-185-01","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"MYCOPHENOLATE MOFETIL","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-185-01)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888018505","name":"MYCOPHENOLATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-185-05","proprietary_name":"MYCOPHENOLATE MOFETIL","nonproprietary_name":"MYCOPHENOLATE MOFETIL","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-185-05)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.26327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904678504","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6785-04","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6785-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0904-6785-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904678561","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6785-61","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6785-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-6785-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729026129","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-261-29","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Accord Healthcare Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (16729-261-29)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (16729-261-29)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651062108","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-621-08","proprietary_name":"MYCOPHENOLIC ACID","nonproprietary_name":"MYCOPHENOLIC ACID","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-621-08)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-621-08)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505296507","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2965-7","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Apotex Corp","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (60505-2965-7)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (60505-2965-7)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877042612","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-426-12","proprietary_name":"MYCOPHENOLIC ACID","nonproprietary_name":"MYCOPHENOLIC ACID","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-426-12)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-426-12)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877092812","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-928-12","proprietary_name":"MYCOPHENOLIC ACID","nonproprietary_name":"MYCOPHENOLIC ACID","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-928-12)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-928-12)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084090711","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084090721","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-907-21","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-907-21) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (68084-907-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-907-21) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (68084-907-11)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377003911","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-039-11","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Biocon Pharma Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-039-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-039-11)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377012611","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-126-11","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Biocon Pharma Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-126-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-126-11)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72819015508","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-155-08","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"mycophenilic acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Archis Pharma LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (72819-155-08)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (72819-155-08)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888019912","name":"MYCOPHENOLIC ACID DR 180 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-199-12","proprietary_name":"mycophenolic acid","nonproprietary_name":"mycophenolic acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Advagen Pharma Limited","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-199-12)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904678604","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6786-04","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6786-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0904-6786-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904678661","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6786-61","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6786-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-6786-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729018929","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-189-29","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Accord Healthcare Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (16729-189-29)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651062208","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-622-08","proprietary_name":"MYCOPHENOLIC ACID","nonproprietary_name":"MYCOPHENOLIC ACID","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-622-08)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-622-08)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505296607","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2966-7","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Apotex Corp","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (60505-2966-7)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (60505-2966-7)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877042712","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-427-12","proprietary_name":"MYCOPHENOLIC ACID","nonproprietary_name":"MYCOPHENOLIC ACID","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-427-12)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-427-12)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877092912","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-929-12","proprietary_name":"MYCOPHENOLIC ACID","nonproprietary_name":"MYCOPHENOLIC ACID","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-929-12)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-929-12)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084091825","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-918-25","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-918-25) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (68084-918-95)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-918-25) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (68084-918-95)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084091895","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377004011","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-040-11","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Biocon Pharma Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-040-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-040-11)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377012711","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-127-11","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"Mycophenolic Acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Biocon Pharma Inc.","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-127-11)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-127-11)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72819015608","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-156-08","proprietary_name":"Mycophenolic Acid","nonproprietary_name":"mycophenilic acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Archis Pharma LLC","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (72819-156-08)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (72819-156-08)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72888020012","name":"MYCOPHENOLIC ACID DR 360 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-200-12","proprietary_name":"mycophenolic acid","nonproprietary_name":"mycophenolic acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Advagen Pharma Limited","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-200-12)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092046801","name":"MYDAYIS ER 12.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-468-01","proprietary_name":"MYDAYIS","nonproprietary_name":"DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.125 mg/1; 3.125 mg/1; 3.125 mg/1; 3.125 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-468-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.75933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.43593,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092047101","name":"MYDAYIS ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-471-01","proprietary_name":"MYDAYIS","nonproprietary_name":"DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1; 6.25 mg/1; 6.25 mg/1; 6.25 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-471-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.78837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.92393,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092047401","name":"MYDAYIS ER 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-474-01","proprietary_name":"MYDAYIS","nonproprietary_name":"DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"9.375 mg/1; 9.375 mg/1; 9.375 mg/1; 9.375 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-474-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.75294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.65441,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092047701","name":"MYDAYIS ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-477-01","proprietary_name":"MYDAYIS","nonproprietary_name":"DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, and AMPHETAMINE SULFATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 12.5 mg/1; 12.5 mg/1; 12.5 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (54092-477-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.78273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.10719,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72974041501","name":"MYFEMBREE 40 MG-1 MG-0.5 MG TB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72974-415-01","proprietary_name":"Myfembree","nonproprietary_name":"relugolix, estradiol hemihydrate, and norethindrone acetate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 1 mg/1; .5 mg/1","labeler":"Sumitomo Pharma America, Inc","package_description":"28 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72974-415-01)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased GnRH Secretion [PE]","Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":45.25137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Myfembree|Relugolix/Estradiol/Norethindr","basis":"brand"},"part_b":null}, {"ndc":"00078038566","name":"MYFORTIC 180 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0385-66","proprietary_name":"Myfortic","nonproprietary_name":"mycophenolic acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (0078-0385-66)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":7.43311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.09959,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (0078-0385-66)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00078038666","name":"MYFORTIC 360 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0386-66","proprietary_name":"Myfortic","nonproprietary_name":"mycophenolic acid","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"120 TABLET, DELAYED RELEASE in 1 BOTTLE (0078-0386-66)","pharm_classes":["Antimetabolite Immunosuppressant [EPC]"]},"nadac":{"value":14.9342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22157,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7518","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7518 (180 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 TABLET, DELAYED RELEASE in 1 BOTTLE (0078-0386-66)) gives 120 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00469260130","name":"MYRBETRIQ ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-2601-30","proprietary_name":"Myrbetriq","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-2601-30) / 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":14.67843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00469260190","name":"MYRBETRIQ ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-2601-90","proprietary_name":"Myrbetriq","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-2601-90) / 90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":14.67843,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.17671,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00469260230","name":"MYRBETRIQ ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-2602-30","proprietary_name":"Myrbetriq","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-2602-30) / 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":14.69886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00469260290","name":"MYRBETRIQ ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-2602-90","proprietary_name":"Myrbetriq","nonproprietary_name":"mirabegron","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-2602-90) / 90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":14.69886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.38658,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00469502099","name":"MYRBETRIQ ER 8 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-5020-99","proprietary_name":"Myrbetriq","nonproprietary_name":"mirabegron","dosage_form":"GRANULE, FOR SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/mL","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-5020-99) / 100 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta3-Agonists [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","beta3-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.20702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591367001","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3670-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-3670-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"00591367005","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3670-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-3670-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"50228046501","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-465-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-465-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"50228046505","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-465-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-465-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"60687063011","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"60687063021","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-630-21","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-630-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-630-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"62135014560","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-145-60","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-145-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69097096507","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-965-07","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69097-965-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69097096512","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-965-12","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69097-965-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69367024101","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-241-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69367-241-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69367024105","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-241-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (69367-241-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"70954078410","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-784-10","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70954-784-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"76282025701","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-257-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-257-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"76282025705","name":"NABUMETONE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-257-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-257-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12816,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"00591367101","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3671-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-3671-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"00591367105","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3671-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-3671-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"50228046601","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-466-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (50228-466-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"50228046605","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-466-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (50228-466-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"62135014660","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-146-60","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-146-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69097096607","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-966-07","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69097-966-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69097096612","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-966-12","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69097-966-12)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69367024201","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-242-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69367-242-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"69367024205","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-242-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (69367-242-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"70954078510","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-785-10","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70954-785-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"76282025801","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-258-01","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (76282-258-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"76282025805","name":"NABUMETONE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-258-05","proprietary_name":"Nabumetone","nonproprietary_name":"Nabumetone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"750 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-258-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nabumetone|Nabumetone","basis":"generic"},"part_b":null}, {"ndc":"59651058901","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-589-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-589-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"60687088711","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"60687088721","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-887-21","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-887-21) / 1 TABLET in 1 BLISTER PACK (60687-887-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"62332040231","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-402-31","proprietary_name":"NADOLOL","nonproprietary_name":"NADOLOL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-402-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68001063000","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-630-00","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-630-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68001069000","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-690-00","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-690-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68382073201","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-732-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-732-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"69238112309","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1123-9","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 TABLET in 1 BOTTLE (69238-1123-9)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"76282034701","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-347-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-347-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"76385013301","name":"NADOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-133-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-133-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"23155073101","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"59651025101","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-251-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-251-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"60687089811","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"60687089821","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-898-21","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-898-21) / 1 TABLET in 1 BLISTER PACK (60687-898-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"62332040331","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-403-31","proprietary_name":"NADOLOL","nonproprietary_name":"NADOLOL","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-403-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68001063100","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-631-00","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-631-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68001069100","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-691-00","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-691-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68382073301","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-733-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-733-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"69238112409","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1124-9","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 TABLET in 1 BOTTLE (69238-1124-9)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"76282034801","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-348-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-348-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"76385013401","name":"NADOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-134-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-134-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"23155073201","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"59651025201","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-252-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-252-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"62332040431","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-404-31","proprietary_name":"NADOLOL","nonproprietary_name":"NADOLOL","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-404-31)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68001063200","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-632-00","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-632-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68001069200","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-692-00","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-692-00)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"68382073401","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-734-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-734-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"69238112509","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1125-9","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 TABLET in 1 BOTTLE (69238-1125-9)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"76282034901","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-349-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-349-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"76385013501","name":"NADOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-135-01","proprietary_name":"Nadolol","nonproprietary_name":"Nadolol","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE (76385-135-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.27372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nadolol|Nadolol","basis":"generic"},"part_b":null}, {"ndc":"51672136203","name":"NAFTIFINE HCL 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1362-3","proprietary_name":"Naftifine Hydrochloride","nonproprietary_name":"Naftifine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1362-3) / 60 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":4.19287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672136803","name":"NAFTIFINE HCL 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1368-3","proprietary_name":"Naftifine Hydrochloride","nonproprietary_name":"Naftifine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1368-3) / 60 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":2.18907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672136806","name":"NAFTIFINE HCL 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1368-6","proprietary_name":"Naftifine Hydrochloride","nonproprietary_name":"Naftifine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1368-6) / 45 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":1.80609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700016117","name":"NAFTIFINE HCL 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.18907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"70700016118","name":"NAFTIFINE HCL 2% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.80609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672137603","name":"NAFTIFINE HCL 2% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51672-1376-3","proprietary_name":"Naftifine Hydrochloride","nonproprietary_name":"Naftifine Hydrochloride","dosage_form":"GEL","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1376-3) / 60 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":8.5652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"51672137606","name":"NAFTIFINE HCL 2% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1376-6","proprietary_name":"Naftifine Hydrochloride","nonproprietary_name":"Naftifine Hydrochloride","dosage_form":"GEL","route":"TOPICAL","strength":"20 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1376-6) / 45 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":8.9536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Naftifine HCl|Naftifine HCl","basis":"generic"},"part_b":null}, {"ndc":"00409146301","name":"NALBUPHINE 10 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-1463-01","proprietary_name":"Nalbuphine Hydrochloride","nonproprietary_name":"NALBUPHINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"10 AMPULE in 1 TRAY (0409-1463-01) / 1 mL in 1 AMPULE (0409-1463-71)","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.3216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Nalbuphine HCl|Nalbuphine HCl","basis":"generic"},"part_b":{"hcpcs":"J2300","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2300 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 AMPULE in 1 TRAY (0409-1463-01) / 1 mL in 1 AMPULE (0409-1463-71)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409146349","name":"NALBUPHINE 10 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-1463-49","proprietary_name":"Nalbuphine Hydrochloride","nonproprietary_name":"NALBUPHINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"10 AMPULE in 1 TRAY (0409-1463-49) / 1 mL in 1 AMPULE (0409-1463-69)","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.3216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Nalbuphine HCl|Nalbuphine HCl","basis":"generic"},"part_b":{"hcpcs":"J2300","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2300 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 AMPULE in 1 TRAY (0409-1463-49) / 1 mL in 1 AMPULE (0409-1463-69)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069067110","name":"NALBUPHINE 10 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70069-671-10","proprietary_name":"Nalbuphine hydrochloride","nonproprietary_name":"Nalbuphine hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 AMPULE in 1 CARTON (70069-671-10) / 1 mL in 1 AMPULE (70069-671-01)","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.3216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Nalbuphine HCl|Nalbuphine HCl","basis":"generic"},"part_b":{"hcpcs":"J2300","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2300 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 AMPULE in 1 CARTON (70069-671-10) / 1 mL in 1 AMPULE (70069-671-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409121501","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-1215-01","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"NALOXONE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Hospira, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0409-1215-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-1215-21)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0409-1215-01) / 1 mL in 1 VIAL, SINGLE-DOSE (0409-1215-21)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"36000030810","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-308-10","proprietary_name":"naloxone hydrochloride","nonproprietary_name":"naloxone hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (36000-308-10) / 1 mL in 1 VIAL, SINGLE-DOSE (36000-308-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (36000-308-10) / 1 mL in 1 VIAL, SINGLE-DOSE (36000-308-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457029202","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-292-02","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"naloxone hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Mylan Institutional LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (67457-292-02) / 1 mL in 1 VIAL, SINGLE-DOSE (67457-292-00)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (67457-292-02) / 1 mL in 1 VIAL, SINGLE-DOSE (67457-292-00)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70069007110","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-071-10","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"10 VIAL in 1 CARTON (70069-071-10) / 1 mL in 1 VIAL (70069-071-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70069-071-10) / 1 mL in 1 VIAL (70069-071-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756065810","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-658-10","proprietary_name":"naloxone hydrochloride","nonproprietary_name":"naloxone hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (70756-658-10) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (70756-658-10) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70756085010","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-850-10","proprietary_name":"naloxone hydrochloride","nonproprietary_name":"naloxone hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (70756-850-10) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (70756-850-10) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603059010","name":"NALOXONE 0.4 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-590-10","proprietary_name":"naloxone hydrochloride","nonproprietary_name":"naloxone hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"NorthStar RxLLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72603-590-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72603-590-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72603-590-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72603-590-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641620501","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic","route_from":"fda_product","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","product_ndc":"0641-6205","inner_of":["0641-6205-10"]},"part_b":null}, {"ndc":"00641620510","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6205-10","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 SYRINGE in 1 CARTON (0641-6205-10) / 2 mL in 1 SYRINGE (0641-6205-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":4000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (0641-6205-10) / 2 mL in 1 SYRINGE (0641-6205-01)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42023022401","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42023-224-01","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Par Health USA, LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (42023-224-01) / 2 mL in 1 SYRINGE, GLASS","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (42023-224-01) / 2 mL in 1 SYRINGE, GLASS) gives 2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43066014201","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic","route_from":"fda_product","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","product_ndc":"43066-142","inner_of":["43066-142-10"]},"part_b":null}, {"ndc":"43066014210","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43066-142-10","proprietary_name":"naloxone hydrochloride","nonproprietary_name":"naloxone hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"10 CARTON in 1 CARTON (43066-142-10) / 1 SYRINGE, GLASS in 1 CARTON (43066-142-01) / 2 mL in 1 SYRINGE, GLASS","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 CARTON in 1 CARTON (43066-142-10) / 1 SYRINGE, GLASS in 1 CARTON (43066-142-01) / 2 mL in 1 SYRINGE, GLASS) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598075010","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-750-10","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"10 SYRINGE in 1 BOX (43598-750-10) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 BOX (43598-750-10) / 2 mL in 1 SYRINGE) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598075011","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-750-11","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"1 SYRINGE in 1 BOX (43598-750-11) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"55150034501","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-345-01","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Eugia US LLC","package_description":"1 SYRINGE in 1 BOX (55150-345-01) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"55150034510","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-345-10","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Eugia US LLC","package_description":"10 SYRINGE in 1 BOX (55150-345-10) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 BOX (55150-345-10) / 2 mL in 1 SYRINGE) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457099202","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-992-02","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mg/mL","labeler":"Mylan Institutional LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (67457-992-02) / 2 mL in 1 SYRINGE, GLASS","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (67457-992-02) / 2 mL in 1 SYRINGE, GLASS) gives 2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76045011201","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":6.27129,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76329146901","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76329-1469-1","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"PARENTERAL","strength":"1 mg/mL","labeler":"International Medication Systems, Limited","package_description":"10 SYRINGE in 1 BOX (76329-1469-1) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76329336901","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76329-3369-1","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"PARENTERAL","strength":"1 mg/mL","labeler":"International Medication Systems, Limited","package_description":"10 SYRINGE in 1 BOX (76329-3369-1) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76329346901","name":"NALOXONE 2 MG/2 ML SYRINGE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76329-3469-1","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"INJECTION","route":"PARENTERAL","strength":"1 mg/mL","labeler":"International Medication Systems, Limited","package_description":"10 SYRINGE in 1 BOX (76329-3469-1) / 2 mL in 1 SYRINGE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":12.74097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409121941","name":"NALOXONE 4 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"36000031001","name":"NALOXONE 4 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic","route_from":"fda_product","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","product_ndc":"36000-310","inner_of":["36000-310-02"]},"part_b":null}, {"ndc":"36000031002","name":"NALOXONE 4 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-310-02","proprietary_name":"NALOXONE HYDROCHLORIDE","nonproprietary_name":"NALOXONE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":".4 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (36000-310-02) / 10 mL in 1 VIAL, MULTI-DOSE (36000-310-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Naloxone HCl*|Naloxone HCl","basis":"generic"},"part_b":{"hcpcs":"J2312","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2312 (0.01 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (36000-310-02) / 10 mL in 1 VIAL, MULTI-DOSE (36000-310-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150032801","name":"NALOXONE 4 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67457029900","name":"NALOXONE 4 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069007201","name":"NALOXONE 4 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.82425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00480347868","name":"NALOXONE HCL 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3478-68","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"4 mg/.1mL","labeler":"Teva Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (0480-3478-68) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK (0480-3478-19) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802057884","name":"NALOXONE HCL 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-578-84","proprietary_name":"NALOXONE HYDROCHLORIDE","nonproprietary_name":"naloxone hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"2 VIAL, SINGLE-DOSE in 1 CARTON (45802-578-84) / .1 mL in 1 VIAL, SINGLE-DOSE (45802-578-00)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219210407","name":"NALOXONE HCL 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2104-7","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"2 VIAL in 1 CARTON (60219-2104-7) / .1 mL in 1 VIAL (60219-2104-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001064545","name":"NALOXONE HCL 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-645-45","proprietary_name":"NALOXONE HYDROCHLORIDE","nonproprietary_name":"naloxone hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"BluePoint Laboratories","package_description":"2 VIAL, SINGLE-DOSE in 1 CARTON (68001-645-45) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238210407","name":"NALOXONE HCL 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2104-7","proprietary_name":"Naloxone Hydrochloride","nonproprietary_name":"Naloxone Hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"2 VIAL, SINGLE-DOSE in 1 CARTON (69238-2104-7) / .1 mL in 1 VIAL, SINGLE-DOSE (69238-2104-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406117001","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1170-01","proprietary_name":"NALTREXONE HYDROCHLORIDE","nonproprietary_name":"naltrexone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0406-1170-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"00406117003","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-1170-03","proprietary_name":"NALTREXONE HYDROCHLORIDE","nonproprietary_name":"naltrexone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0406-1170-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904703604","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7036-04","proprietary_name":"NALTREXONE HYDROCHLORIDE","nonproprietary_name":"NALTREXONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7036-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"16729008101","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-081-01","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16729-081-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"16729008110","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-081-10","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-081-10)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155088601","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-886-01","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc d/b/a Avet Pharmaceuticals Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (23155-886-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"23155088603","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-886-03","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc d/b/a Avet Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-886-03)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"47335032683","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-326-83","proprietary_name":"NALTREXONE HYDROCHLORIDE","nonproprietary_name":"NALTREXONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (47335-326-83)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"47335032688","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-326-88","proprietary_name":"NALTREXONE HYDROCHLORIDE","nonproprietary_name":"NALTREXONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (47335-326-88)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135024230","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-242-30","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-242-30)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135024260","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-242-60","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-242-60)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135024290","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-242-90","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-242-90)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"64850030001","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-300-01","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64850-300-01)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"64850030030","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-300-30","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64850-300-30)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084029111","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084029121","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-291-21","proprietary_name":"NALTREXONE HYDROCHLORIDE","nonproprietary_name":"naltrexone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-291-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-291-11)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68094085359","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68094085361","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-853-61","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Precision Dose Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68094-853-61) / 10 TABLET, FILM COATED in 1 BLISTER PACK (68094-853-59)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68094085366","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-853-66","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Precision Dose Inc.","package_description":"2 BLISTER PACK in 1 CARTON (68094-853-66) / 10 TABLET, FILM COATED in 1 BLISTER PACK (68094-853-59)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68094090930","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-909-30","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Precision Dose Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68094-909-30)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"68094090950","name":"NALTREXONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-909-50","proprietary_name":"Naltrexone Hydrochloride","nonproprietary_name":"Naltrexone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Precision Dose Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68094-909-50)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":1.13746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naltrexone HCl|Naltrexone HCl","basis":"generic"},"part_b":null}, {"ndc":"00456121430","name":"NAMZARIC 14 MG-10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1214-30","proprietary_name":"Namzaric","nonproprietary_name":"memantine hydrochloride and donepezil hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"14 mg/1; 10 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0456-1214-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":19.84763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.48822,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Namzaric|Memantine HCl/Donepezil HCl","basis":"brand"},"part_b":null}, {"ndc":"00456122130","name":"NAMZARIC 21 MG-10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1221-30","proprietary_name":"Namzaric","nonproprietary_name":"memantine hydrochloride and donepezil hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"21 mg/1; 10 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0456-1221-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":19.95748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Namzaric|Memantine HCl/Donepezil HCl","basis":"brand"},"part_b":null}, {"ndc":"00456122830","name":"NAMZARIC 28 MG-10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1228-30","proprietary_name":"Namzaric","nonproprietary_name":"memantine hydrochloride and donepezil hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"28 mg/1; 10 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0456-1228-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":19.80435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.44457,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Namzaric|Memantine HCl/Donepezil HCl","basis":"brand"},"part_b":null}, {"ndc":"00456120730","name":"NAMZARIC 7 MG-10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1207-30","proprietary_name":"Namzaric","nonproprietary_name":"memantine hydrochloride and donepezil hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"7 mg/1; 10 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0456-1207-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]","N-methyl-D-aspartate Receptor Antagonist [EPC]","NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":19.82669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Namzaric|Memantine HCl/Donepezil HCl","basis":"brand"},"part_b":null}, {"ndc":"00065008515","name":"NAPHCON-A EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0085-15","proprietary_name":"Naphcon A","nonproprietary_name":"naphazoline hydrochloride and pheniramine maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE in 1 CARTON (0065-0085-15) / 15 mL in 1 BOTTLE"},"nadac":{"value":0.55744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054363063","name":"NAPROXEN 125 MG/5 ML SUSPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3630-63","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE, PLASTIC (0054-3630-63)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722068205","name":"NAPROXEN 125 MG/5 ML SUSPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-682-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 mL in 1 BOTTLE (31722-682-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192061916","name":"NAPROXEN 125 MG/5 ML SUSPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-619-16","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (42192-619-16)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238173002","name":"NAPROXEN 125 MG/5 ML SUSPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1730-2","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"473 mL in 1 BOTTLE (69238-1730-2)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.12157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954015110","name":"NAPROXEN 125 MG/5 ML SUSPEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-151-10","proprietary_name":"Naproxen Oral Suspension","nonproprietary_name":"Naproxen oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 mL in 1 BOTTLE (70954-151-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.20183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49483061901","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-619-01","proprietary_name":"NAPROXEN","nonproprietary_name":"NAPROXEN","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"TIME CAP LABORATORIES","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (49483-619-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483061950","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-619-50","proprietary_name":"NAPROXEN","nonproprietary_name":"NAPROXEN","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"TIME CAP LABORATORIES","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (49483-619-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228043401","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-434-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-434-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228043405","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-434-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-434-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268059411","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268059415","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-594-15","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-594-15) / 1 TABLET in 1 BLISTER PACK (50268-594-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162018810","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-188-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-188-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162018850","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-188-50","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-188-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462018801","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-188-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-188-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462018805","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-188-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-188-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013701","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-137-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-137-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013705","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-137-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-137-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282034001","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-340-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-340-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282034005","name":"NAPROXEN 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-340-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-340-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.04356,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483061701","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-617-01","proprietary_name":"NAPROXEN","nonproprietary_name":"NAPROXEN","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"TIME CAP LABORATORIES","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (49483-617-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483061750","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-617-50","proprietary_name":"NAPROXEN","nonproprietary_name":"NAPROXEN","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"TIME CAP LABORATORIES","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (49483-617-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228043501","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-435-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-435-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228043505","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-435-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-435-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268059511","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268059515","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-595-15","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-595-15) / 1 TABLET in 1 BLISTER PACK (50268-595-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162018910","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-189-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-189-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162018950","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-189-50","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-189-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462018901","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-189-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-189-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462018905","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-189-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-189-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013801","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-138-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-138-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013805","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-138-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-138-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282034101","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-341-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-341-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282034105","name":"NAPROXEN 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-341-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-341-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483061801","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-618-01","proprietary_name":"NAPROXEN","nonproprietary_name":"NAPROXEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (49483-618-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483061850","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-618-50","proprietary_name":"NAPROXEN","nonproprietary_name":"NAPROXEN","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"TIME CAP LABORATORIES","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (49483-618-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228043601","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-436-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-436-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228043605","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-436-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-436-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687049101","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-491-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-491-01) / 1 TABLET in 1 BLISTER PACK (60687-491-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687049111","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162019010","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-190-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-190-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162019011","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-190-11","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-190-11)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162019050","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-190-50","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-190-50)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862052201","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-522-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-522-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862052205","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-522-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-522-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462019001","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-190-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-190-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462019005","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-190-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-190-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462019030","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-190-30","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-190-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013901","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-139-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-139-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013905","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-139-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-139-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013910","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-139-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-139-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282034201","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-342-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-342-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282034205","name":"NAPROXEN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-342-05","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (76282-342-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.05654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42494045310","name":"NAPROXEN DR 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-453-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"375 mg/1","labeler":"Cameron Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42494-453-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.23429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651098601","name":"NAPROXEN DR 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-986-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"375 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-986-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.23429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954092510","name":"NAPROXEN DR 375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-925-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"375 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (70954-925-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":2.23429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42494045410","name":"NAPROXEN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-454-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Cameron Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42494-454-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52817038110","name":"NAPROXEN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-381-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (52817-381-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954092810","name":"NAPROXEN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-928-10","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (70954-928-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"90096016101","name":"NAPROXEN DR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"90096-161-01","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Zameer Pharmaceuticals LLC","package_description":"100 TABLET, DELAYED RELEASE in 1 BOTTLE (90096-161-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":1.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979025368","name":"NAPROXEN SOD CR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-253-68","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"75 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (24979-253-68)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.58512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium Cr|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"47781015475","name":"NAPROXEN SOD CR 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-154-75","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Alvogen Inc.","package_description":"75 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47781-154-75)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.58512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium Cr|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"00480095258","name":"NAPROXEN SOD ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-0952-58","proprietary_name":"Naproxen sodium","nonproprietary_name":"naproxen sodium","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"75 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0480-0952-58)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":9.58512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium ER|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"46122053460","name":"NAPROXEN SODIUM 220 MG CAPSULE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802049075","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-490-75","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-490-75) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122056278","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-562-78","proprietary_name":"Naproxen","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-562-78) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483060901","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-609-01","proprietary_name":"NAPROXEN SODIUM","nonproprietary_name":"NAPROXEN SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49483-609-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483060905","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-609-05","proprietary_name":"NAPROXEN SODIUM","nonproprietary_name":"NAPROXEN SODIUM","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (49483-609-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032901","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-329-01","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-329-01) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032902","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-329-02","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-329-02) / 200 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032905","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-329-05","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Camber Consumer Care Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69230-329-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032910","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-329-10","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69230-329-10)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032924","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-329-24","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-329-24) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032950","name":"NAPROXEN SODIUM 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-329-50","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"220 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-329-50) / 50 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598049401","name":"NAPROXEN SODIUM 275 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-494-01","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"275 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-494-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"50228043201","name":"NAPROXEN SODIUM 275 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-432-01","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET","route":"ORAL","strength":"275 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-432-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"50228043205","name":"NAPROXEN SODIUM 275 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-432-05","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET","route":"ORAL","strength":"275 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-432-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862051501","name":"NAPROXEN SODIUM 275 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-515-01","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"275 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-515-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462017801","name":"NAPROXEN SODIUM 275 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-178-01","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET","route":"ORAL","strength":"275 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-178-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.19786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"43598049501","name":"NAPROXEN SODIUM 550 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-495-01","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"550 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-495-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.2253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"43598049505","name":"NAPROXEN SODIUM 550 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-495-05","proprietary_name":"Naproxen sodium","nonproprietary_name":"Naproxen sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"550 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-495-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.2253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"50228043301","name":"NAPROXEN SODIUM 550 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-433-01","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET","route":"ORAL","strength":"550 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50228-433-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.2253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"50228043305","name":"NAPROXEN SODIUM 550 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-433-05","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET","route":"ORAL","strength":"550 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (50228-433-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.2253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862051601","name":"NAPROXEN SODIUM 550 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-516-01","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"550 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-516-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.2253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462017901","name":"NAPROXEN SODIUM 550 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-179-01","proprietary_name":"Naproxen Sodium","nonproprietary_name":"Naproxen Sodium","dosage_form":"TABLET","route":"ORAL","strength":"550 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-179-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.2253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen Sodium|Naproxen Sodium","basis":"generic"},"part_b":null}, {"ndc":"27241020260","name":"NAPROXEN-ESOMEPRAZ DR 375-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"27241-202-60","proprietary_name":"Naproxen and esomeprazole magnesium","nonproprietary_name":"Naproxen and esomeprazole magnesium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"375 mg/1; 20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (27241-202-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.89903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag","basis":"generic"},"part_b":null}, {"ndc":"50228043760","name":"NAPROXEN-ESOMEPRAZ DR 375-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50228-437-60","proprietary_name":"Naproxen and esomeprazole magnesium","nonproprietary_name":"Naproxen and esomeprazole magnesium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"375 mg/1; 20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (50228-437-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.89903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag","basis":"generic"},"part_b":null}, {"ndc":"55111028960","name":"NAPROXEN-ESOMEPRAZ DR 375-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55111-289-60","proprietary_name":"Naproxen and esomeprazole magnesium","nonproprietary_name":"Naproxen and esomeprazole magnesium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"375 mg/1; 20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (55111-289-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.89903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag","basis":"generic"},"part_b":null}, {"ndc":"27241020360","name":"NAPROXEN-ESOMEPRAZ DR 500-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-203-60","proprietary_name":"Naproxen and esomeprazole magnesium","nonproprietary_name":"Naproxen and esomeprazole magnesium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1; 20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (27241-203-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.95826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag","basis":"generic"},"part_b":null}, {"ndc":"50228043860","name":"NAPROXEN-ESOMEPRAZ DR 500-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-438-60","proprietary_name":"Naproxen and esomeprazole magnesium","nonproprietary_name":"Naproxen and esomeprazole magnesium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1; 20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (50228-438-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.95826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag","basis":"generic"},"part_b":null}, {"ndc":"55111070160","name":"NAPROXEN-ESOMEPRAZ DR 500-20 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-701-60","proprietary_name":"Naproxen and esomeprazole magnesium","nonproprietary_name":"Naproxen and esomeprazole magnesium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1; 20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (55111-701-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":1.95826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naproxen-Esomeprazole Mag|Naproxen/Esomeprazole Mag","basis":"generic"},"part_b":null}, {"ndc":"00054027803","name":"NARATRIPTAN HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0278-03","proprietary_name":"Naratriptan","nonproprietary_name":"Naratriptan","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"9 TABLET in 1 BOTTLE (0054-0278-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.77638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naratriptan HCl|Naratriptan HCl","basis":"generic"},"part_b":null}, {"ndc":"23155005419","name":"NARATRIPTAN HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-054-19","proprietary_name":"naratriptan","nonproprietary_name":"naratriptan","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"9 TABLET in 1 BLISTER PACK (23155-054-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.77638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naratriptan HCl|Naratriptan HCl","basis":"generic"},"part_b":null}, {"ndc":"00054027903","name":"NARATRIPTAN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0279-03","proprietary_name":"Naratriptan","nonproprietary_name":"Naratriptan","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"9 TABLET in 1 BOTTLE (0054-0279-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.08353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naratriptan HCl|Naratriptan HCl","basis":"generic"},"part_b":null}, {"ndc":"23155005519","name":"NARATRIPTAN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-055-19","proprietary_name":"naratriptan","nonproprietary_name":"naratriptan","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"9 TABLET in 1 BLISTER PACK (23155-055-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.08353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naratriptan HCl|Naratriptan HCl","basis":"generic"},"part_b":null}, {"ndc":"69452034160","name":"NARATRIPTAN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.08353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naratriptan HCl|Naratriptan HCl","basis":"generic"},"part_b":null}, {"ndc":"69452034172","name":"NARATRIPTAN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-341-72","proprietary_name":"Naratriptan","nonproprietary_name":"Naratriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-341-72) / 9 TABLET, FILM COATED in 1 BLISTER PACK (69452-341-60)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.08353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Naratriptan HCl|Naratriptan HCl","basis":"generic"},"part_b":null}, {"ndc":"69547062702","name":"NARCAN 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69547-627-02","proprietary_name":"NARCAN","nonproprietary_name":"naloxone hydrochloride nasal","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"Emergent Devices Inc.","package_description":"2 VIAL, SINGLE-DOSE in 1 CARTON (69547-627-02) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":16.449,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Narcan|Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"69547062705","name":"NARCAN 4 MG NASAL SPRAY","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69547-627-05","proprietary_name":"NARCAN","nonproprietary_name":"naloxone hydrochloride nasal","dosage_form":"SPRAY","route":"NASAL","strength":"4 mg/.1mL","labeler":"Emergent Devices Inc.","package_description":"1 CASE in 1 CARTON (69547-627-05) / 2 VIAL, SINGLE-DOSE in 1 CASE / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":16.449,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":17.17734,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Narcan|Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"00536145769","name":"NASAL ALLERGY 55 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1457-69","proprietary_name":"Nasal Allergy","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0536-1457-69) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904742730","name":"NASAL DECONGESTANT 0.05% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7427-30","proprietary_name":"Major Nasal Decongestant","nonproprietary_name":"Oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".5 mg/mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PUMP in 1 CARTON (0904-7427-30) / 30 mL in 1 BOTTLE, PUMP","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904743535","name":"NASAL DECONGESTANT 0.05% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7435-35","proprietary_name":"Major Nasal Decongestant","nonproprietary_name":"Oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".5 mg/mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, SPRAY in 1 CARTON (0904-7435-35) / 15 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.12144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000066501","name":"NASAL DECONGESTANT 0.05% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0665-1","proprietary_name":"Leader Nasal Decongestant","nonproprietary_name":"Oxymetazoline Hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".5 mg/mL","labeler":"Cardinal Health 110,Inc","package_description":"1 BOTTLE in 1 CARTON (70000-0665-1) / 30 mL in 1 BOTTLE","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.09967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000067601","name":"NASAL DECONGESTANT 0.05% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0676-1","proprietary_name":"Leader Nasal Decongestant","nonproprietary_name":"Oxymetazoline Hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".5 mg/mL","labeler":"Cardinal Health 110,Inc","package_description":"1 BOTTLE in 1 CARTON (70000-0676-1) / 15 mL in 1 BOTTLE","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.12144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536360735","name":"NASAL DECONGESTANT 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3607-35","proprietary_name":"Nasal Decongestant","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rugby Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (0536-3607-35) / 24 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122042862","name":"NASAL DECONGESTANT 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-428-62","proprietary_name":"Nasal Decongestant Maximum Strength, Non-Drowsy","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Amerisource Bergen","package_description":"1 BLISTER PACK in 1 CARTON (46122-428-62) / 24 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000000201","name":"NASAL DECONGESTANT 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0002-1","proprietary_name":"Leader Nasal Decongestant","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"24 BLISTER PACK in 1 CARTON (70000-0002-1) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000000202","name":"NASAL DECONGESTANT 30 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0002-2","proprietary_name":"Leader Nasal Decongestant","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"8 BLISTER PACK in 1 CARTON (70000-0002-2) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11527014055","name":"NASAL SPRAY 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-140-55","proprietary_name":"12 Hour Original Nasal Decongestant","nonproprietary_name":"Nasal Spray","dosage_form":"LIQUID","route":"NASAL","strength":"50 mg/100mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (11527-140-55) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802041059","name":"NASAL SPRAY 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-410-59","proprietary_name":"oxymetazoline hcl","nonproprietary_name":"oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, SPRAY in 1 CARTON (45802-410-59) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122016510","name":"NASAL SPRAY ORIGINAL 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-165-10","proprietary_name":"good neighbor pharmacy nasal","nonproprietary_name":"oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, SPRAY in 1 CARTON (46122-165-10) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113172002","name":"NASONEX 24HR ALLERGY 50 MCG NASAL SPRAY","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1720-02","proprietary_name":"Nasonex","nonproprietary_name":"mometasone furoate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 PACKAGE (0113-1720-02) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.19339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.71412,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113172011","name":"NASONEX 24HR ALLERGY 50 MCG NASAL SPRAY","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-1720-11","proprietary_name":"Nasonex","nonproprietary_name":"mometasone furoate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"L. Perrigo Company","package_description":"1 BOTTLE, SPRAY in 1 PACKAGE (0113-1720-11) / 60 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.27243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50419040901","name":"NATAZIA 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.46366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Natazia|Estradiol Valerate/Dienogest","basis":"brand"},"part_b":null}, {"ndc":"50419040903","name":"NATAZIA 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-409-03","proprietary_name":"Natazia","nonproprietary_name":"estradiol valerate and estradiol valerate/dienogest","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 PACKAGE (50419-409-03) / 1 KIT in 1 BLISTER PACK (50419-409-01)"},"nadac":{"value":8.46366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Natazia|Estradiol Valerate/Dienogest","basis":"brand"},"part_b":null}, {"ndc":"00591335501","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"16571075909","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-759-09","proprietary_name":"NATEGLINIDE","nonproprietary_name":"NATEGLINIDE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-759-09)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"60687068411","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"60687068421","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-684-21","proprietary_name":"Nateglinide","nonproprietary_name":"nateglinide","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-684-21) / 1 TABLET in 1 BLISTER PACK (60687-684-11)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"64380016802","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-168-02","proprietary_name":"Nateglinide","nonproprietary_name":"nateglinide","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (64380-168-02)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"68382072216","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-722-16","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-722-16)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"72241000304","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-003-04","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET, COATED","route":"ORAL","strength":"120 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-003-04)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"72241000305","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-003-05","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET, COATED","route":"ORAL","strength":"120 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (72241-003-05)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"75834020601","name":"NATEGLINIDE 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"16571075809","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-758-09","proprietary_name":"NATEGLINIDE","nonproprietary_name":"NATEGLINIDE","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (16571-758-09)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"55111032890","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-328-90","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-328-90)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"60687067311","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"60687067321","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-673-21","proprietary_name":"Nateglinide","nonproprietary_name":"nateglinide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-673-21) / 1 TABLET in 1 BLISTER PACK (60687-673-11)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"64380016702","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-167-02","proprietary_name":"Nateglinide","nonproprietary_name":"nateglinide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (64380-167-02)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"68382072116","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-721-16","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-721-16)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"72241000204","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-002-04","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET, COATED","route":"ORAL","strength":"60 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-002-04)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"72241000205","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-002-05","proprietary_name":"Nateglinide","nonproprietary_name":"Nateglinide","dosage_form":"TABLET, COATED","route":"ORAL","strength":"60 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (72241-002-05)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"75834020501","name":"NATEGLINIDE 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1794,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nateglinide|Nateglinide","basis":"generic"},"part_b":null}, {"ndc":"42667551101","name":"NATESTO NASAL 5.5 MG/0.122 GM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["2","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42667-5511-1","proprietary_name":"Natesto nasal gel","nonproprietary_name":"testosterone","dosage_form":"GEL, METERED","route":"NASAL","strength":"5.5 mg/.122g","labeler":"Acerus Pharmaceuticals Corporation","package_description":"1 APPLICATOR in 1 BOX (42667-5511-1) / 11 g in 1 APPLICATOR","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":41.27698,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52246092904","name":"NATROBA 0.9% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52246-929-04","proprietary_name":"Natroba","nonproprietary_name":"spinosad","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"9 mg/mL","labeler":"ParaPRO LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (52246-929-04) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Pediculicide [EPC]"]},"nadac":{"value":2.20204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":2.0169,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Natroba|Spinosad","basis":"brand"},"part_b":null}, {"ndc":"84635092904","name":"NATROBA 0.9% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84635-929-04","proprietary_name":"Natroba","nonproprietary_name":"spinosad","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"9 mg/mL","labeler":"Cipher Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (84635-929-04) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Pediculicide [EPC]"]},"nadac":{"value":2.20204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":2.0169,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Natroba|Spinosad","basis":"brand"},"part_b":null}, {"ndc":"70000005201","name":"NAUSEA RELIEF LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0052-1","proprietary_name":"Anti Nausea","nonproprietary_name":"dextrose(glucose),Levulose(fructose),Phosphoric acid","dosage_form":"LIQUID","route":"ORAL","strength":"1.87 g/5mL; 1.87 g/5mL; 21.5 mg/5mL","labeler":"Cardinal Health","package_description":"1 BOTTLE in 1 CARTON (70000-0052-1) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50474050015","name":"NAYZILAM 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-500-15","proprietary_name":"Nayzilam","nonproprietary_name":"midazolam","dosage_form":"SPRAY","route":"NASAL","strength":"5 mg/.1mL","labeler":"UCB, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (50474-500-15) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK (50474-500-14) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":327.04771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nayzilam|Midazolam","basis":"brand"},"part_b":null}, {"ndc":"00904749904","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7499-04","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7499-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035530","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035590","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689016101","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-161-01","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apnar Pharma LP","package_description":"30 TABLET in 1 BOTTLE (24689-161-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689016102","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-161-02","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apnar Pharma LP","package_description":"90 TABLET in 1 BOTTLE (24689-161-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037713","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-377-13","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE (29300-377-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037719","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-377-19","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE (29300-377-19)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058730","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-587-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-587-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058790","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-587-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-587-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342045907","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-459-07","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-459-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342045910","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-459-10","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-459-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052603","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-526-03","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-526-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052609","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-526-09","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-526-09)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651013930","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-139-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-139-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651013990","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-139-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (59651-139-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687065211","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687065221","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-652-21","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-652-21) / 1 TABLET in 1 BLISTER PACK (60687-652-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027705","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-277-05","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (62559-277-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027730","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-277-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-277-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027790","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-277-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-277-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039130","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-391-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-391-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039190","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-391-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-391-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015230","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-152-30","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-152-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015290","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-152-90","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72205-152-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003404","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-034-04","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72241-034-04)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003422","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-034-22","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-034-22)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087201","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-872-01","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-872-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087202","name":"NEBIVOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-872-02","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-872-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.14144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904749704","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7497-04","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7497-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035330","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689015901","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-159-01","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Apnar Pharma LP","package_description":"30 TABLET in 1 BOTTLE (24689-159-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689015902","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-159-02","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Apnar Pharma LP","package_description":"90 TABLET in 1 BOTTLE (24689-159-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037513","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-375-13","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE (29300-375-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058530","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-585-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-585-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342045707","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-457-07","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-457-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052403","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-524-03","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-524-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651013730","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-137-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-137-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027530","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-275-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-275-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027583","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-275-83","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"2300 TABLET in 1 BOTTLE (62559-275-83)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039330","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-393-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-393-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015030","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-150-30","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-150-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003222","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-032-22","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-032-22)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087001","name":"NEBIVOLOL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-870-01","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-870-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904750004","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7500-04","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7500-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035630","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035690","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689016201","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-162-01","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Apnar Pharma LP","package_description":"30 TABLET in 1 BOTTLE (24689-162-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689016202","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-162-02","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Apnar Pharma LP","package_description":"90 TABLET in 1 BOTTLE (24689-162-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037813","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-378-13","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE (29300-378-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037819","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-378-19","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE (29300-378-19)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058830","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-588-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-588-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058890","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-588-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-588-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342046007","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-460-07","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-460-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342046010","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-460-10","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-460-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052703","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-527-03","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-527-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052709","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-527-09","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-527-09)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651014030","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-140-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-140-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651014090","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-140-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (59651-140-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027805","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-278-05","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (62559-278-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027830","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-278-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-278-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027890","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-278-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-278-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039030","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-390-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-390-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039090","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-390-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-390-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015330","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-153-30","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-153-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015390","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-153-90","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72205-153-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003504","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-035-04","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72241-035-04)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003522","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-035-22","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-035-22)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087301","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-873-01","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-873-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087302","name":"NEBIVOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-873-02","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-873-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904749804","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7498-04","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7498-04) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035430","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"13668035490","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689016001","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-160-01","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apnar Pharma LP","package_description":"30 TABLET in 1 BOTTLE (24689-160-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"24689016002","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-160-02","proprietary_name":"nebivolol","nonproprietary_name":"nebivolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apnar Pharma LP","package_description":"90 TABLET in 1 BOTTLE (24689-160-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037613","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-376-13","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET in 1 BOTTLE (29300-376-13)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300037619","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-376-19","proprietary_name":"Nebivolol Hydrochloride","nonproprietary_name":"Nebivolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE (29300-376-19)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058630","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-586-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-586-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"31722058690","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-586-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-586-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342045807","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-458-07","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-458-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342045810","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-458-10","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-458-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052503","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-525-03","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-525-03)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"43547052509","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-525-09","proprietary_name":"NEBIVOLOL","nonproprietary_name":"nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-525-09)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651013830","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-138-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-138-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651013890","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-138-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (59651-138-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687064111","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687064121","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-641-21","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-641-21) / 1 TABLET in 1 BLISTER PACK (60687-641-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027630","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-276-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-276-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027671","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-276-71","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1100 TABLET in 1 BOTTLE (62559-276-71)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"62559027690","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-276-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (62559-276-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039230","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-392-30","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-392-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"67877039290","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-392-90","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-392-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015130","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-151-30","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-151-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72205015190","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-151-90","proprietary_name":"NEBIVOLOL","nonproprietary_name":"NEBIVOLOL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72205-151-90)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003304","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-033-04","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72241-033-04)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003322","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-033-22","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-033-22)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087101","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-871-01","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (72603-871-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"72603087102","name":"NEBIVOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-871-02","proprietary_name":"Nebivolol","nonproprietary_name":"Nebivolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (72603-871-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.11337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nebivolol HCl|Nebivolol HCl","basis":"generic"},"part_b":null}, {"ndc":"75907008528","name":"NECON 0.5-35-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-085-28","proprietary_name":"Necon","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-085-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.48747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Necon|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907008532","name":"NECON 0.5-35-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-085-32","proprietary_name":"Necon","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Dr. Reddy's Laboratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (75907-085-32) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.48747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Necon|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093102406","name":"NEFAZODONE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1024-06","proprietary_name":"Nefazodone Hydrochloride","nonproprietary_name":"Nefazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-1024-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.1657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nefazodone HCl|Nefazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093102506","name":"NEFAZODONE HCL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-1025-06","proprietary_name":"Nefazodone Hydrochloride","nonproprietary_name":"Nefazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET in 1 BOTTLE (0093-1025-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.33063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nefazodone HCl|Nefazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"82580001002","name":"NEFFY 1 MG/0.1 ML NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82580-010-02","proprietary_name":"neffy","nonproprietary_name":"epinephrine","dosage_form":"SPRAY","route":"NASAL","strength":"1 mg/100uL","labeler":"ARS Pharmaceuticals Operations, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (82580-010-02) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK / 100 uL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":360.13761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neffy|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"82580002002","name":"NEFFY 2 MG/0.1 ML NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82580-020-02","proprietary_name":"neffy","nonproprietary_name":"epinephrine","dosage_form":"SPRAY","route":"NASAL","strength":"2 mg/100uL","labeler":"ARS Pharmaceuticals Operations, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (82580-020-02) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK / 100 uL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Adrenergic beta-Agonists [MoA]","Catecholamine [EPC]","Catecholamines [CS]","alpha-Adrenergic Agonist [EPC]","beta-Adrenergic Agonist [EPC]"]},"nadac":{"value":359.49229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neffy|Epinephrine","basis":"brand"},"part_b":null}, {"ndc":"24208078555","name":"NEO-BACIT-POLY-HC EYE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-785-55","proprietary_name":"Neomycin and Polymyxin B Sulfates, Bacitracin Zinc and Hydrocortisone","nonproprietary_name":"Neomycin sulfate and Polymyxin B Sulfate, Bacitracin Zinc and Hydrocortisone","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3.5 mg/g; 10000 [USP'U]/g; 400 [USP'U]/g; 10 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-785-55) / 3.5 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":5.51819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16571075453","name":"NEOMYC-BACIT-POLYMIX EYE OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":4.70243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208078055","name":"NEOMYC-BACIT-POLYMIX EYE OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-780-55","proprietary_name":"Neomycin and Polymyxin B Sulfates and Bacitracin Zinc","nonproprietary_name":"Neomycin sulfate, Polymyxin B Sulfate and Bacitracin Zinc","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3.5 mg/g; 10000 [USP'U]/g; 400 [USP'U]/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-780-55) / 3.5 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":4.70243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208079535","name":"NEOMYC-POLYM-DEXAMET EYE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-795-35","proprietary_name":"Neomycin and Polymyxin B Sulfates and Dexamethasone","nonproprietary_name":"Neomycin Sulfate, Polymyxin B Sulfate, and Dexamethasone","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3.5 mg/g; 10000 [USP'U]/g; 1 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE in 1 CARTON (24208-795-35) / 3.5 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":2.55131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"61314063136","name":"NEOMYC-POLYM-DEXAMET EYE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-631-36","proprietary_name":"Neomycin and Polymyxin B Sulfates and Dexamethasone","nonproprietary_name":"Neomycin and Polymyxin B Sulfates and Dexamethasone","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3.5 mg/g; 10000 [iU]/g; 1 mg/g","labeler":"Sandoz Inc","package_description":"3.5 g in 1 TUBE (61314-631-36)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":2.55131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24208083060","name":"NEOMYC-POLYM-DEXAMETH EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-830-60","proprietary_name":"Neomycin Polymyxin B Sulfates and Dexamethasone","nonproprietary_name":"Neomycin sulfate, Polymyxin B Sulfate and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-830-60) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":1.78233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314063006","name":"NEOMYC-POLYM-DEXAMETH EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-630-06","proprietary_name":"Neomycin and Polymyxin B Sulfates and Dexamethasone","nonproprietary_name":"neomycin sulfate, polymyxin b sulfate and dexamethasone","dosage_form":"SUSPENSION","route":"OPHTHALMIC","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 1 mg/mL","labeler":"Sandoz Inc.","package_description":"5 mL in 1 BOTTLE, PLASTIC (61314-630-06)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":1.78233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69918051505","name":"NEOMYC-POLYM-DEXAMETH EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-515-05","proprietary_name":"neomycin sulfate, polymyxin b sulfate and dexamethasone","nonproprietary_name":"neomycin sulfate, polymyxin b sulfate and dexamethasone","dosage_form":"SUSPENSION","route":"OPHTHALMIC","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 1 mg/mL","labeler":"Nordic Pharma, Inc.","package_description":"5 mL in 1 BOTTLE, PLASTIC (69918-515-05)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":1.78233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208079062","name":"NEOMYC-POLYM-GRAMICID EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-790-62","proprietary_name":"NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN","nonproprietary_name":"neomycin sulfate, polymyxin b sulfate and gramicidin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.75 mg/mL; 10000 [USP'U]/mL; .025 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-790-62) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":4.58557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093117701","name":"NEOMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1177-01","proprietary_name":"Neomycin Sulfate","nonproprietary_name":"Neomycin Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1177-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83308,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neomycin Sulfate|Neomycin Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62135044390","name":"NEOMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-443-90","proprietary_name":"Neomycin Sulfate","nonproprietary_name":"Neomycin Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-443-90)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83308,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neomycin Sulfate|Neomycin Sulfate","basis":"generic"},"part_b":null}, {"ndc":"73473090105","name":"NEOMYCIN 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-901-05","proprietary_name":"Neomycin Sulfate","nonproprietary_name":"Neomycin Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Solaris Pharma Corporation","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (73473-901-05)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83308,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neomycin Sulfate|Neomycin Sulfate","basis":"generic"},"part_b":null}, {"ndc":"61314064175","name":"NEOMYCIN-POLY-HC EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-641-75","proprietary_name":"Neomycin and Polymyxin B Sulfates and Hydrocortisone","nonproprietary_name":"neomycin sulfate, polymyxin b sulfate and hydrocortisone","dosage_form":"SUSPENSION","route":"OPHTHALMIC","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 10 mg/mL","labeler":"Sandoz Inc","package_description":"7.5 mL in 1 BOTTLE, PLASTIC (61314-641-75)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":17.63867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208063110","name":"NEOMYCIN-POLYMYXIN-HC EAR SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-631-10","proprietary_name":"Neomycin and Polymyxin B Sulfates and Hydrocortisone","nonproprietary_name":"Neomycin Sulfate, Polymyxin B Sulfate, Hydrocortisone","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 10 mg/mL","labeler":"Bausch & Lomb Incoporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-631-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":5.08952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219208301","name":"NEOMYCIN-POLYMYXIN-HC EAR SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2083-1","proprietary_name":"NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE","nonproprietary_name":"neomycin sulfate, polymyxin b sulfate, hydrocortisone","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (60219-2083-1) / 10 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":5.08952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208063562","name":"NEOMYCIN-POLYMYXIN-HC EAR SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-635-62","proprietary_name":"Neomycin and Polymyxin B Sulfates and Hydrocortisone","nonproprietary_name":"Neomycin sulfate, Polymyxin B Sulfate and Hydrocortisone","dosage_form":"SUSPENSION/ DROPS","route":"AURICULAR (OTIC)","strength":"10 mg/mL; 3.5 mg/mL; 10000 [USP'U]/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-635-62) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":3.83312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314064511","name":"NEOMYCIN-POLYMYXIN-HC EAR SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-645-11","proprietary_name":"Neomycin and Polymyxin B Sulfates and Hydrocortisone","nonproprietary_name":"neomycin sulfate, polymyxin b sulfate and hydrocortisone","dosage_form":"SUSPENSION","route":"AURICULAR (OTIC)","strength":"3.5 mg/mL; 10000 [USP'U]/mL; 10 mg/mL","labeler":"Sandoz Inc.","package_description":"10 mL in 1 BOTTLE, PLASTIC (61314-645-11)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":3.83312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980044801","name":"NEOMYCIN-POLYMYXIN-HC EAR SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-448-01","proprietary_name":"Neomycin and Polymyxin B Sulfates and Hydrocortisone Otic Suspension","nonproprietary_name":"neomycin and polymyxin B sulfates and hydrocortisone otic","dosage_form":"SUSPENSION","route":"AURICULAR (OTIC)","strength":"10 mg/mL; 3.5 mg/mL; 10000 [USP'U]/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-448-01) / 10 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":3.83312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078024815","name":"NEORAL 100 MG GELATIN CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0248-15","proprietary_name":"Neoral","nonproprietary_name":"cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 BLISTER PACK in 1 CARTON (0078-0248-15) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0078-0248-61)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":11.7731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neoral|Cyclosporine, Modified","basis":"brand"},"part_b":{"hcpcs":"J7502","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7502 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0078-0248-15) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0078-0248-61)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00078024861","name":"NEORAL 100 MG GELATIN CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":11.7731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.23348,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neoral|Cyclosporine, Modified","basis":"brand"},"part_b":null}, {"ndc":"00078024615","name":"NEORAL 25 MG GELATIN CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0246-15","proprietary_name":"Neoral","nonproprietary_name":"cyclosporine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"30 BLISTER PACK in 1 CARTON (0078-0246-15) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0078-0246-61)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.94566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neoral|Cyclosporine, Modified","basis":"brand"},"part_b":{"hcpcs":"J7515","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7515 (25 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 CARTON (0078-0246-15) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (0078-0246-61)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00078024661","name":"NEORAL 25 MG GELATIN CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":2.94566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31377,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neoral|Cyclosporine, Modified","basis":"brand"},"part_b":null}, {"ndc":"59528031701","name":"NEPHPLEX RX TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.36199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55513092401","name":"NEUPOGEN 300 MCG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":650.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Neupogen|Filgrastim","basis":"brand"},"part_b":null}, {"ndc":"55513092491","name":"NEUPOGEN 300 MCG/0.5 ML SYR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-924-91","proprietary_name":"NEUPOGEN","nonproprietary_name":"Filgrastim","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 ug/.5mL","labeler":"Amgen, Inc","package_description":"1 SYRINGE in 1 BOX (55513-924-91) / .5 mL in 1 SYRINGE","pharm_classes":["Granulocyte Colony-Stimulating Factor [CS]","Increased Myeloid Cell Production [PE]","Leukocyte Growth Factor [EPC]"]},"nadac":{"value":650.052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Neupogen|Filgrastim","basis":"brand"},"part_b":{"hcpcs":"J1442","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1442 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 BOX (55513-924-91) / .5 mL in 1 SYRINGE) gives 0.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55513053010","name":"NEUPOGEN 300 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-530-10","proprietary_name":"NEUPOGEN","nonproprietary_name":"Filgrastim","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 ug/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-530-10) / 1 mL in 1 VIAL (55513-530-01)","pharm_classes":["Granulocyte Colony-Stimulating Factor [CS]","Increased Myeloid Cell Production [PE]","Leukocyte Growth Factor [EPC]"]},"nadac":{"value":304.0908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Neupogen|Filgrastim","basis":"brand"},"part_b":{"hcpcs":"J1442","bill_units_per_package":{"value":3000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1442 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 PACKAGE (55513-530-10) / 1 mL in 1 VIAL (55513-530-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55513053020","name":"NEUPOGEN 300 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-530-20","proprietary_name":"NEUPOGEN","nonproprietary_name":"Filgrastim","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 ug/mL","labeler":"Amgen, Inc","package_description":"10 VIAL in 1 PACKAGE (55513-530-20) / 1 mL in 1 VIAL (55513-530-01)","pharm_classes":["Granulocyte Colony-Stimulating Factor [CS]","Increased Myeloid Cell Production [PE]","Leukocyte Growth Factor [EPC]"]},"nadac":{"value":304.0908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Neupogen|Filgrastim","basis":"brand"},"part_b":{"hcpcs":"J1442","bill_units_per_package":{"value":3000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1442 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 PACKAGE (55513-530-20) / 1 mL in 1 VIAL (55513-530-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"50474080103","name":"NEUPRO 1 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-801-03","proprietary_name":"Neupro","nonproprietary_name":"rotigotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/24h","labeler":"UCB, Inc.","package_description":"30 POUCH in 1 CARTON (50474-801-03) / 1 PATCH in 1 POUCH / 24 h in 1 PATCH","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":28.28679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474080203","name":"NEUPRO 2 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-802-03","proprietary_name":"Neupro","nonproprietary_name":"rotigotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"2 mg/24h","labeler":"UCB, Inc.","package_description":"30 POUCH in 1 CARTON (50474-802-03) / 1 PATCH in 1 POUCH / 24 h in 1 PATCH","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":28.26022,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474080303","name":"NEUPRO 3 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-803-03","proprietary_name":"Neupro","nonproprietary_name":"rotigotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"3 mg/24h","labeler":"UCB, Inc.","package_description":"30 POUCH in 1 CARTON (50474-803-03) / 1 PATCH in 1 POUCH / 24 h in 1 PATCH","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":28.25044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474080403","name":"NEUPRO 4 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-804-03","proprietary_name":"Neupro","nonproprietary_name":"rotigotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4 mg/24h","labeler":"UCB, Inc.","package_description":"30 POUCH in 1 CARTON (50474-804-03) / 1 PATCH in 1 POUCH / 24 h in 1 PATCH","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":28.31614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474080503","name":"NEUPRO 6 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-805-03","proprietary_name":"Neupro","nonproprietary_name":"rotigotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"6 mg/24h","labeler":"UCB, Inc.","package_description":"30 POUCH in 1 CARTON (50474-805-03) / 1 PATCH in 1 POUCH / 24 h in 1 PATCH","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":28.17877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50474080603","name":"NEUPRO 8 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50474-806-03","proprietary_name":"Neupro","nonproprietary_name":"rotigotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"8 mg/24h","labeler":"UCB, Inc.","package_description":"30 POUCH in 1 CARTON (50474-806-03) / 1 PATCH in 1 POUCH / 24 h in 1 PATCH","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":28.24156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00071080324","name":"NEURONTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":2.95761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"58151028101","name":"NEURONTIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58151-281-01","proprietary_name":"Neurontin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE in 1 BOTTLE (58151-281-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.95761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02184,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"00071080524","name":"NEURONTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0071-0805-24","proprietary_name":"Neurontin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Parke-Davis Div of Pfizer Inc","package_description":"100 CAPSULE in 1 BOTTLE (0071-0805-24)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.37105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"58151028201","name":"NEURONTIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-282-01","proprietary_name":"Neurontin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE in 1 BOTTLE (58151-282-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.37105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"00071080624","name":"NEURONTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":8.86718,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"58151028301","name":"NEURONTIN 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58151-283-01","proprietary_name":"Neurontin","nonproprietary_name":"gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 CAPSULE in 1 BOTTLE (58151-283-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":8.86718,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"58151028401","name":"NEURONTIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-284-01","proprietary_name":"Neurontin","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (58151-284-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":14.11861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06398,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"58151028501","name":"NEURONTIN 800 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-285-01","proprietary_name":"Neurontin","nonproprietary_name":"gabapentin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (58151-285-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":16.88137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08829,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Neurontin|Gabapentin","basis":"brand"},"part_b":null}, {"ndc":"00078077803","name":"NEVANAC 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":104.7075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Nevanac|Nepafenac","basis":"brand"},"part_b":null}, {"ndc":"82667050003","name":"NEVANAC 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82667-500-03","proprietary_name":"NEVANAC","nonproprietary_name":"nepafenac","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (82667-500-03) / 3 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":104.7075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Nevanac|Nepafenac","basis":"brand"},"part_b":null}, {"ndc":"00378405091","name":"NEVIRAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4050-91","proprietary_name":"Nevirapine","nonproprietary_name":"nevirapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (0378-4050-91)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.14722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nevirapine|Nevirapine","basis":"generic"},"part_b":null}, {"ndc":"31722050560","name":"NEVIRAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-505-60","proprietary_name":"Nevirapine","nonproprietary_name":"Nevirapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (31722-505-60)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.14722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nevirapine|Nevirapine","basis":"generic"},"part_b":null}, {"ndc":"33342000409","name":"NEVIRAPINE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-004-09","proprietary_name":"Nevirapine","nonproprietary_name":"Nevirapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-004-09)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.14722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nevirapine|Nevirapine","basis":"generic"},"part_b":null}, {"ndc":"00378489093","name":"NEVIRAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4890-93","proprietary_name":"Nevirapine","nonproprietary_name":"nevirapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-4890-93)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.5719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nevirapine ER|Nevirapine","basis":"generic"},"part_b":null}, {"ndc":"33342023807","name":"NEVIRAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-238-07","proprietary_name":"NEVIRAPINE","nonproprietary_name":"NEVIRAPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-238-07)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":1.5719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nevirapine ER|Nevirapine","basis":"generic"},"part_b":null}, {"ndc":"16714080901","name":"NEW DAY 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-809-01","proprietary_name":"New Day","nonproprietary_name":"levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-809-01) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186401001","name":"NEXIUM DR 10 MG PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-4010-01","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (0186-4010-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.14112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.96363,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186402501","name":"NEXIUM DR 2.5 MG PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-4025-01","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (0186-4025-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.16605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.49156,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186502031","name":"NEXIUM DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-5020-31","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0186-5020-31)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.77673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186502054","name":"NEXIUM DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-5020-54","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0186-5020-54)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.77673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14458,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186402001","name":"NEXIUM DR 20 MG PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-4020-01","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (0186-4020-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.1365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.00136,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186504031","name":"NEXIUM DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-5040-31","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0186-5040-31)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.78027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186504054","name":"NEXIUM DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-5040-54","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0186-5040-54)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.78027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12181,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186404001","name":"NEXIUM DR 40 MG PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-4040-01","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (0186-4040-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.12893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.17167,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186405001","name":"NEXIUM DR 5 MG PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-4050-01","proprietary_name":"NEXIUM","nonproprietary_name":"Esomeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (0186-4050-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":9.15935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.00536,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72426011803","name":"NEXLETOL 180 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72426-118-03","proprietary_name":"Nexletol","nonproprietary_name":"Bempedoic Acid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1","labeler":"Esperion Therapeutics, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72426-118-03)","pharm_classes":["Adenosine Triphosphate-Citrate Lyase Inhibitor [EPC]","Adenosine Triphosphate-Citrate Lyase Inhibitors [MoA]"]},"nadac":{"value":13.81038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nexletol|Bempedoic Acid","basis":"brand"},"part_b":null}, {"ndc":"72426081803","name":"NEXLIZET 180-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72426-818-03","proprietary_name":"Nexlizet","nonproprietary_name":"Bempedoic Acid and Ezetimibe","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"180 mg/1; 10 mg/1","labeler":"Esperion Therapeutics, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72426-818-03)","pharm_classes":["Adenosine Triphosphate-Citrate Lyase Inhibitor [EPC]","Adenosine Triphosphate-Citrate Lyase Inhibitors [MoA]","Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":13.7964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nexlizet|Bempedoic Acid/Ezetimibe","basis":"brand"},"part_b":null}, {"ndc":"51862025801","name":"NEXTSTELLIS 3-14.2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51862-258-01","proprietary_name":"Nextstellis","nonproprietary_name":"drospirenone and estetrol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Mayne Pharma","package_description":"1 BLISTER PACK in 1 CARTON (51862-258-01) / 1 KIT in 1 BLISTER PACK * 24 TABLET, FILM COATED in 1 BLISTER PACK (51862-259-24) * 4 TABLET, FILM COATED in 1 BLISTER PACK (51862-261-04)"},"nadac":{"value":7.66753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nextstellis|Drospirenone/Estetrol","basis":"brand"},"part_b":null}, {"ndc":"00093739486","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"00093739498","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"33342018910","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-189-10","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-189-10)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"47335061381","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-613-81","proprietary_name":"NIACIN","nonproprietary_name":"NIACIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-613-81)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"59651002018","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-020-18","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-020-18)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"59651002090","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-020-90","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-020-90)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"62135049890","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-498-90","proprietary_name":"NIACIN","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-498-90)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"62175032246","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-322-46","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-322-46)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"65162032309","name":"NIACIN ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-323-09","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-323-09)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.32626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"00093739286","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"33342018710","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-187-10","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-187-10)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"47335053981","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-539-81","proprietary_name":"NIACIN","nonproprietary_name":"NIACIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-539-81)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"50268058411","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"50268058413","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-584-13","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-584-13) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-584-11)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"59651001818","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-018-18","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-018-18)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"59651001890","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-018-90","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-018-90)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"62135049790","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-497-90","proprietary_name":"NIACIN","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-497-90)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"62175032046","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-320-46","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-320-46)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"65162032109","name":"NIACIN ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-321-09","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-321-09)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.19288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"00093739386","name":"NIACIN ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"00093739398","name":"NIACIN ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"47335061481","name":"NIACIN ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-614-81","proprietary_name":"NIACIN","nonproprietary_name":"NIACIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-614-81)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.28483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"59651001918","name":"NIACIN ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-019-18","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-019-18)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.28483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"59651001990","name":"NIACIN ER 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-019-90","proprietary_name":"Niacin","nonproprietary_name":"Niacin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-019-90)","pharm_classes":["Nicotinic Acid [EPC]","Nicotinic Acids [CS]"]},"nadac":{"value":0.28483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niacin ER|Niacin","basis":"generic"},"part_b":null}, {"ndc":"42806050109","name":"NICARDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-501-09","proprietary_name":"Nicardipine Hydrochloride","nonproprietary_name":"Nicardipine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 CAPSULE in 1 BOTTLE (42806-501-09)","pharm_classes":["Calcium Channel Antagonists [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.12012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nicardipine HCl*|Nicardipine HCl","basis":"generic"},"part_b":null}, {"ndc":"62559020590","name":"NICARDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-205-90","proprietary_name":"Nicardipine Hydrochloride","nonproprietary_name":"Nicardipine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62559-205-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.12012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nicardipine HCl*|Nicardipine HCl","basis":"generic"},"part_b":null}, {"ndc":"68462012090","name":"NICARDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-120-90","proprietary_name":"Nicardipine Hydrochloride","nonproprietary_name":"Nicardipine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 CAPSULE in 1 BOTTLE (68462-120-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.12012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nicardipine HCl*|Nicardipine HCl","basis":"generic"},"part_b":null}, {"ndc":"69238269101","name":"NICARDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2691-1","proprietary_name":"Nicardipine hydrochloride","nonproprietary_name":"Nicardipine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-2691-1)","pharm_classes":["Calcium Channel Antagonists [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.12012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nicardipine HCl*|Nicardipine HCl","basis":"generic"},"part_b":null}, {"ndc":"69292062090","name":"NICARDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-620-90","proprietary_name":"NICARDIPINE HYDROCHLORIDE","nonproprietary_name":"nicardipine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Amici Pharma Inc","package_description":"90 CAPSULE in 1 BOTTLE (69292-620-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.12012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nicardipine HCl*|Nicardipine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452043619","name":"NICARDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-436-19","proprietary_name":"Nicardipine Hydrochloride","nonproprietary_name":"Nicardipine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Bionpharma Inc.","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (69452-436-19)","pharm_classes":["Calcium Channel Antagonists [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.12012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nicardipine HCl*|Nicardipine HCl","basis":"generic"},"part_b":null}, {"ndc":"00536110788","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1107-88","proprietary_name":"Nicotine transdermal system step 2","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Rugby Laboratories","package_description":"14 PATCH in 1 CARTON (0536-1107-88) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589553","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5895-53","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Rugby Laboratories","package_description":"7 POUCH in 1 CARTON (0536-5895-53) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589571","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5895-71","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Rugby Laboratories","package_description":"28 POUCH in 1 CARTON (0536-5895-71) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589588","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5895-88","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Rugby Laboratories","package_description":"14 POUCH in 1 CARTON (0536-5895-88) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044770","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-447-70","proprietary_name":"Nicotine transdermal system step 2","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"7 PATCH in 1 CARTON (43598-447-70) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044771","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044774","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-447-74","proprietary_name":"Nicotine transdermal system step 2","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"14 PATCH in 1 CARTON (43598-447-74) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122035274","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-352-74","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"AmerisourceBergen Drug Corporation","package_description":"14 POUCH in 1 CARTON (46122-352-74) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742066907","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-669-07","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"7 POUCH in 1 CARTON (50742-669-07) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742066914","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-669-14","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"14 POUCH in 1 CARTON (50742-669-14) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742066928","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-669-28","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"28 POUCH in 1 CARTON (50742-669-28) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043388","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-433-88","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"BluePoint Laboratories","package_description":"7 POUCH in 1 CARTON (68001-433-88) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043390","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-433-90","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"BluePoint Laboratories","package_description":"14 POUCH in 1 CARTON (68001-433-90) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069888","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-698-88","proprietary_name":"Nicotine Transdermal System Patch Step 2","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"BluePoint Laboratories","package_description":"7 PATCH in 1 CARTON (68001-698-88) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069890","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-698-90","proprietary_name":"Nicotine Transdermal System Patch Step 2","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"BluePoint Laboratories","package_description":"14 PATCH in 1 CARTON (68001-698-90) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051101","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0511-1","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Cardinal Health","package_description":"7 POUCH in 1 CARTON (70000-0511-1) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051102","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0511-2","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Cardinal Health","package_description":"14 POUCH in 1 CARTON (70000-0511-2) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000076101","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0761-1","proprietary_name":"Nicotine Transdermal System step 2","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"7 PATCH in 1 CARTON (70000-0761-1) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000076102","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0761-2","proprietary_name":"Nicotine Transdermal System step 2","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"14 PATCH in 1 CARTON (70000-0761-2) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677126501","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1265-1","proprietary_name":"Nicotine transdermal system step 2","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"14 PATCH in 1 CARTON (70677-1265-1) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282078240","name":"NICOTINE 14 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-782-40","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"14 mg/24h","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"14 POUCH in 1 CARTON (76282-782-40) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.85466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136206","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1362-06","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"50 BLISTER PACK in 1 CARTON (0536-1362-06) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-1362-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136223","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1362-23","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"110 BLISTER PACK in 1 CARTON (0536-1362-23) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-1362-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136225","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536136234","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1362-34","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"20 BLISTER PACK in 1 CARTON (0536-1362-34) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-1362-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536302906","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3029-06","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"50 BLISTER PACK in 1 CARTON (0536-3029-06) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3029-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536302923","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3029-23","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"110 BLISTER PACK in 1 CARTON (0536-3029-23) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3029-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536302925","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536302934","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3029-34","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"20 BLISTER PACK in 1 CARTON (0536-3029-34) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3029-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536311201","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3112-01","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"100 BLISTER PACK in 1 CARTON (0536-3112-01) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3112-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536311225","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536311237","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3112-37","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"40 BLISTER PACK in 1 CARTON (0536-3112-37) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3112-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536338601","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3386-01","proprietary_name":"Rugby Nicotine Polacrilex Gum, Coated Fruit Flavor","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"10 BLISTER PACK in 1 CARTON (0536-3386-01) / 10 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536340401","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3404-01","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"Rugby Laboratories","package_description":"100 BLISTER PACK in 1 CARTON (0536-3404-01) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3404-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802082725","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-827-25","proprietary_name":"nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"110 BLISTER PACK in 1 CARTON (45802-827-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032201","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-322-01","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (57237-322-01) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032211","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-322-11","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"110 BLISTER PACK in 1 CARTON (57237-322-11) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032250","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-322-50","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 BLISTER PACK in 1 CARTON (57237-322-50) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63739037010","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63739037163","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63739-371-63","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"2 mg/1","labeler":"McKesson Corporation dba SKY Packaging","package_description":"110 BLISTER PACK in 1 CARTON (63739-371-63) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034501","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0345-1","proprietary_name":"Nicotine Polacrilex Original","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"50 BLISTER PACK in 1 CARTON (70000-0345-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034601","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0346-1","proprietary_name":"Nicotine Polacrilex Coated Fruit","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"20 BLISTER PACK in 1 CARTON (70000-0346-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034701","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0347-1","proprietary_name":"Nicotine Polacrilex Coated Mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"10 BLISTER PACK in 1 CARTON (70000-0347-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034801","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0348-1","proprietary_name":"Nicotine Polacrilex Coated Ice Mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"20 BLISTER PACK in 1 CARTON (70000-0348-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034802","name":"NICOTINE 2 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0348-2","proprietary_name":"Nicotine Polacrilex Coated Ice Mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"100 BLISTER PACK in 1 CARTON (70000-0348-2) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.23281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133709","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1337-09","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (0536-1337-09) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133735","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1337-35","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 BOX (0536-1337-35) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598048624","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-486-24","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-486-24) / 24 LOZENGE in 1 BOTTLE","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598048672","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-486-72","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"3 BOTTLE in 1 CARTON (43598-486-72) / 24 LOZENGE in 1 BOTTLE","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802034403","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802034405","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-344-05","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 CONTAINER in 1 CARTON (45802-344-05) / 24 LOZENGE in 1 CONTAINER","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000056201","name":"NICOTINE 2 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0562-1","proprietary_name":"Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"3 BOTTLE, PLASTIC in 1 BOX (70000-0562-1) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536123927","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1239-27","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 BOX (0536-1239-27) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536123981","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1239-81","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (0536-1239-81) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802008901","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802008902","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-089-02","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 CONTAINER in 1 CARTON (45802-089-02) / 27 LOZENGE in 1 CONTAINER (45802-089-01)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032072","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-320-72","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (57237-320-72) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032081","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-320-81","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (57237-320-81) / 27 LOZENGE in 1 BOTTLE, PLASTIC (57237-320-27)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000056001","name":"NICOTINE 2 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0560-1","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"2 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"3 BOTTLE, PLASTIC in 1 BOX (70000-0560-1) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.3742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536110888","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1108-88","proprietary_name":"Nicotine transdermal system step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Rugby Laboratories","package_description":"14 PATCH in 1 CARTON (0536-1108-88) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589653","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5896-53","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Rugby Laboratories","package_description":"7 POUCH in 1 CARTON (0536-5896-53) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589671","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5896-71","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Rugby Laboratories","package_description":"28 POUCH in 1 CARTON (0536-5896-71) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589688","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5896-88","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Rugby Laboratories","package_description":"14 POUCH in 1 CARTON (0536-5896-88) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044828","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-448-28","proprietary_name":"Nicotine transdermal system step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"28 PATCH in 1 CARTON (43598-448-28) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044870","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-448-70","proprietary_name":"Nicotine transdermal system step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"7 PATCH in 1 CARTON (43598-448-70) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044871","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044874","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-448-74","proprietary_name":"Nicotine transdermal system step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"14 PATCH in 1 CARTON (43598-448-74) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122035374","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-353-74","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"AmerisourceBergen Drug Corporation","package_description":"14 POUCH in 1 CARTON (46122-353-74) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742067007","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-670-07","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"7 POUCH in 1 CARTON (50742-670-07) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742067014","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-670-14","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"14 POUCH in 1 CARTON (50742-670-14) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742067028","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-670-28","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"28 POUCH in 1 CARTON (50742-670-28) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043488","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-434-88","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"BluePoint Laboratories","package_description":"7 POUCH in 1 CARTON (68001-434-88) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043490","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-434-90","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"BluePoint Laboratories","package_description":"14 POUCH in 1 CARTON (68001-434-90) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043491","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-434-91","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"BluePoint Laboratories","package_description":"28 POUCH in 1 CARTON (68001-434-91) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069988","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-699-88","proprietary_name":"Nicotine Transdermal System Patch Step 1","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"BluePoint Laboratories","package_description":"7 PATCH in 1 CARTON (68001-699-88) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069990","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-699-90","proprietary_name":"Nicotine Transdermal System Patch Step 1","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"BluePoint Laboratories","package_description":"14 PATCH in 1 CARTON (68001-699-90) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069991","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-699-91","proprietary_name":"Nicotine Transdermal System Patch Step 1","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"BluePoint Laboratories","package_description":"28 PATCH in 1 CARTON (68001-699-91) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051201","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0512-1","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Cardinal Health","package_description":"7 POUCH in 1 CARTON (70000-0512-1) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051202","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0512-2","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Cardinal Health","package_description":"14 POUCH in 1 CARTON (70000-0512-2) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000076201","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0762-1","proprietary_name":"Nicotine Transdermal System step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"7 PATCH in 1 CARTON (70000-0762-1) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000076202","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0762-2","proprietary_name":"Nicotine Transdermal System step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"14 PATCH in 1 CARTON (70000-0762-2) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677126601","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1266-1","proprietary_name":"Nicotine transdermal system step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"14 PATCH in 1 CARTON (70677-1266-1) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677126602","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1266-2","proprietary_name":"Nicotine transdermal system step 1","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"28 PATCH in 1 CARTON (70677-1266-2) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282078340","name":"NICOTINE 21 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-783-40","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"21 mg/24h","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"14 POUCH in 1 CARTON (76282-783-40) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.87251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536137206","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1372-06","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"50 BLISTER PACK in 1 CARTON (0536-1372-06) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-1372-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536137223","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1372-23","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"110 BLISTER PACK in 1 CARTON (0536-1372-23) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-1372-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536137225","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536137234","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1372-34","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"20 BLISTER PACK in 1 CARTON (0536-1372-34) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-1372-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536303006","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3030-06","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"50 BLISTER PACK in 1 CARTON (0536-3030-06) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3030-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536303023","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3030-23","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"110 BLISTER PACK in 1 CARTON (0536-3030-23) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3030-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536303025","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536311301","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3113-01","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"100 BLISTER PACK in 1 CARTON (0536-3113-01) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3113-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536311337","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3113-37","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"40 BLISTER PACK in 1 CARTON (0536-3113-37) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3113-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536338701","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3387-01","proprietary_name":"Rugby Nicotine Polacrilex Gum, Coated Fruit Flavor","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"10 BLISTER PACK in 1 CARTON (0536-3387-01) / 10 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536340501","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-3405-01","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"Rugby Laboratories","package_description":"100 BLISTER PACK in 1 CARTON (0536-3405-01) / 1 GUM, CHEWING in 1 BLISTER PACK (0536-3405-25)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802065125","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-651-25","proprietary_name":"NICOTINE","nonproprietary_name":"nicotine polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"110 BLISTER PACK in 1 CARTON (45802-651-25) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032301","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-323-01","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (57237-323-01) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032311","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-323-11","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"110 BLISTER PACK in 1 CARTON (57237-323-11) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032350","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-323-50","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"50 BLISTER PACK in 1 CARTON (57237-323-50) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63739036810","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63739036910","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63739-369-10","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"ORAL","strength":"4 mg/1","labeler":"McKesson Corporation dba SKY Packaging","package_description":"100 BLISTER PACK in 1 CARTON (63739-369-10) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034101","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0341-1","proprietary_name":"Nicotine Polacrilex Original","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"50 BLISTER PACK in 1 CARTON (70000-0341-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034201","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0342-1","proprietary_name":"Nicotine Polacrilex Coated Fruit","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"20 BLISTER PACK in 1 CARTON (70000-0342-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034301","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0343-1","proprietary_name":"Nicotine Polacrilex Coated Mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"10 BLISTER PACK in 1 CARTON (70000-0343-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034401","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0344-1","proprietary_name":"Nicotine Polacrilex Coated Ice Mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"20 BLISTER PACK in 1 CARTON (70000-0344-1) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000034402","name":"NICOTINE 4 MG CHEWING GUM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0344-2","proprietary_name":"Nicotine Polacrilex Coated Ice Mint","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"GUM, CHEWING","route":"BUCCAL","strength":"4 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"100 BLISTER PACK in 1 CARTON (70000-0344-2) / 1 GUM, CHEWING in 1 BLISTER PACK","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.28661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133809","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1338-09","proprietary_name":"Maxi Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (0536-1338-09) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536133835","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1338-35","proprietary_name":"Maxi Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"24 LOZENGE in 1 BOTTLE, PLASTIC (0536-1338-35)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598048724","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-487-24","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-487-24) / 24 LOZENGE in 1 BOTTLE","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598048772","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-487-72","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"3 BOTTLE in 1 CARTON (43598-487-72) / 24 LOZENGE in 1 BOTTLE","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802087303","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802087305","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-873-05","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 CONTAINER in 1 CARTON (45802-873-05) / 24 LOZENGE in 1 CONTAINER (45802-873-03)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000056101","name":"NICOTINE 4 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0561-1","proprietary_name":"Maxi Nicotine","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"3 BOTTLE, PLASTIC in 1 BOX (70000-0561-1) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.34431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536124127","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1241-27","proprietary_name":"Mini Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 BOX (0536-1241-27) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536124181","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1241-81","proprietary_name":"Mini Nicotine","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (0536-1241-81) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802095701","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802095702","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-957-02","proprietary_name":"Nicotine Polacrilex","nonproprietary_name":"Nicotine Polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 CONTAINER in 1 CARTON (45802-957-02) / 27 LOZENGE in 1 CONTAINER (45802-957-01)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032172","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-321-72","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (57237-321-72) / 24 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237032181","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-321-81","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BOTTLE, PLASTIC in 1 BOX (57237-321-81) / 27 LOZENGE in 1 BOTTLE, PLASTIC (57237-321-27)","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000055901","name":"NICOTINE 4 MG MINI LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0559-1","proprietary_name":"Nicotine Mini","nonproprietary_name":"nicotine polacrilex","dosage_form":"LOZENGE","route":"ORAL","strength":"4 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"3 BOTTLE, PLASTIC in 1 BOX (70000-0559-1) / 27 LOZENGE in 1 BOTTLE, PLASTIC","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":0.38851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536110688","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1106-88","proprietary_name":"Nicotine transdermal system step 3","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Rugby Laboratories","package_description":"14 PATCH in 1 CARTON (0536-1106-88) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589453","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5894-53","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Rugby Laboratories","package_description":"7 POUCH in 1 CARTON (0536-5894-53) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536589488","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-5894-88","proprietary_name":"Nicotine","nonproprietary_name":"Nicotine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Rugby Laboratories","package_description":"14 POUCH in 1 CARTON (0536-5894-88) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044670","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-446-70","proprietary_name":"Nicotine transdermal system step 3","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"7 PATCH in 1 CARTON (43598-446-70) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044671","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044674","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-446-74","proprietary_name":"Nicotine transdermal system step 3","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"14 PATCH in 1 CARTON (43598-446-74) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122035474","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-354-74","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"AmerisourceBergen Drug Corporation","package_description":"14 POUCH in 1 CARTON (46122-354-74) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742066807","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-668-07","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"7 POUCH in 1 CARTON (50742-668-07) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742066814","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-668-14","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"14 POUCH in 1 CARTON (50742-668-14) / 24 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043288","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-432-88","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"BluePoint Laboratories","package_description":"7 POUCH in 1 CARTON (68001-432-88) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001043290","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-432-90","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"BluePoint Laboratories","package_description":"14 POUCH in 1 CARTON (68001-432-90) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069788","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-697-88","proprietary_name":"Nicotine Transdermal System Patch Step 3","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"BluePoint Laboratories","package_description":"7 PATCH in 1 CARTON (68001-697-88) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001069790","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-697-90","proprietary_name":"Nicotine Transdermal System Patch Step 3","nonproprietary_name":"Nicotine Transdermal System Patch","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"BluePoint Laboratories","package_description":"14 PATCH in 1 CARTON (68001-697-90) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051001","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0510-1","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Cardinal Health","package_description":"7 POUCH in 1 CARTON (70000-0510-1) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051002","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0510-2","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine Transdermal System","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Cardinal Health","package_description":"14 POUCH in 1 CARTON (70000-0510-2) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70677126401","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-1264-1","proprietary_name":"Nicotine transdermal system step 3","nonproprietary_name":"Nicotine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"Strategic Sourcing Services LLC","package_description":"14 PATCH in 1 CARTON (70677-1264-1) / 24 h in 1 PATCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282078140","name":"NICOTINE 7 MG/24HR PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-781-40","proprietary_name":"Nicotine Transdermal System","nonproprietary_name":"Nicotine","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7 mg/24h","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"14 POUCH in 1 CARTON (76282-781-40) / 1 h in 1 POUCH","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":1.81971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598044556","name":"NICOTINE TRANSDERMAL SYSTEM","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-445-56","proprietary_name":"Nicotine transdermal system","nonproprietary_name":"Nicotine","dosage_form":"KIT","route":"TRANSDERMAL","strength":null,"labeler":"Dr. Reddys Laboratories Inc.","package_description":"56 PATCH in 1 CARTON (43598-445-56) / 1 KIT in 1 PATCH"},"nadac":{"value":1.37689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00009540101","name":"NICOTROL NS 10 MG/ML SPRAY","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-5401-01","proprietary_name":"Nicotrol","nonproprietary_name":"nicotine","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"10 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"4 BOTTLE, SPRAY in 1 BOX (0009-5401-01) / 10 mL in 1 BOTTLE, SPRAY","pharm_classes":["Cholinergic Nicotinic Agonist [EPC]","Nicotine [CS]"]},"nadac":{"value":12.956,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904722961","name":"NIFEDIPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7229-61","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7229-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.25672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"23155019401","name":"NIFEDIPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-194-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-194-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.25672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62135073990","name":"NIFEDIPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-739-90","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-739-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.25672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"69315021101","name":"NIFEDIPINE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"23155019501","name":"NIFEDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-195-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-195-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.68559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62135074090","name":"NIFEDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-740-90","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-740-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.68559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"69315021201","name":"NIFEDIPINE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"00904720806","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7208-06","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7208-06) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"00904720861","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7208-61","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7208-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"24979001101","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-011-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (24979-011-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"24979001112","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-011-12","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"300 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (24979-011-12)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50268059711","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50268059715","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-597-15","proprietary_name":"Nifedipine ER","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-597-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-597-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742026001","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-260-01","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50742-260-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742026003","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-260-03","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"300 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50742-260-03)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742062001","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-620-01","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-620-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"59651029501","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-295-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-295-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.11663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62135052190","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-521-90","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-521-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026037","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-260-37","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-260-37)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026046","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-260-46","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-260-46)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026055","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-260-55","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, Inc.","package_description":"300 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-260-55)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"67877075701","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-757-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-757-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"67877075758","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-757-58","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"300 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-757-58)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084059701","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-597-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-597-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-597-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084059711","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084059765","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-597-65","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-597-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-597-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68645051254","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68645060354","name":"NIFEDIPINE ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"00904708106","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7081-06","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7081-06) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"00904708161","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7081-61","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7081-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"24979001001","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-010-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-010-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"24979001012","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-010-12","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"300 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-010-12)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50268059811","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50268059815","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-598-15","proprietary_name":"Nifedipine ER","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-598-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-598-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742026101","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-261-01","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50742-261-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742026103","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-261-03","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"300 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50742-261-03)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742062101","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-621-01","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-621-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"59651029601","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-296-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-296-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62135052290","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-522-90","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-522-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026137","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-261-37","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-261-37)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026146","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-261-46","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-261-46)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026155","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-261-55","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lannett Company, Inc.","package_description":"300 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-261-55)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"67877075801","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-758-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-758-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"67877075858","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-758-58","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"300 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-758-58)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084059801","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-598-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-598-01) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-598-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084059811","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084059865","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-598-65","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-598-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-598-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68645051354","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68645060454","name":"NIFEDIPINE ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"00904708204","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7082-04","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7082-04) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"00904708206","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7082-06","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7082-06) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"24979000901","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-009-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-009-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"24979000912","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-009-12","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"300 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-009-12)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50268059911","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50268059915","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-599-15","proprietary_name":"Nifedipine ER","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-599-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-599-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742026201","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-262-01","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50742-262-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"50742062201","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-622-01","proprietary_name":"Nifedipine","nonproprietary_name":"nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-622-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.25884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"59651029701","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-297-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-297-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.25884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62135052390","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-523-90","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-523-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026232","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-262-32","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-262-32)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026237","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-262-37","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-262-37)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"62175026246","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-262-46","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-262-46)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"67877075601","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-756-01","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-756-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084060311","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084060321","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-603-21","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-603-21) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-603-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"68084060365","name":"NIFEDIPINE ER 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-603-65","proprietary_name":"Nifedipine","nonproprietary_name":"Nifedipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"90 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-603-65) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (68084-603-11)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":0.26915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nifedipine ER|Nifedipine","basis":"generic"},"part_b":null}, {"ndc":"46122013634","name":"NIGHT TIME COLD-FLU LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-136-34","proprietary_name":"good neighbor pharmacy night time","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Amerisource Bergen","package_description":"237 mL in 1 BOTTLE (46122-136-34)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122019834","name":"NIGHT TIME COLD-FLU LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-198-34","proprietary_name":"good neighbor pharmacy night time cold and flu","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Amerisource Bergen","package_description":"237 mL in 1 BOTTLE (46122-198-34)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01503,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122019840","name":"NIGHT TIME COLD-FLU LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-198-40","proprietary_name":"good neighbor pharmacy night time cold and flu","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/30mL; 30 mg/30mL; 12.5 mg/30mL","labeler":"Amerisource Bergen","package_description":"355 mL in 1 BOTTLE (46122-198-40)","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46122024562","name":"NIGHT TIME COLD-FLU SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-245-62","proprietary_name":"Good Neighbor Pharmacy Night Time","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Doxylamine succinate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 15 mg/1; 6.25 mg/1","labeler":"Amerisource Bergen","package_description":"12 BLISTER PACK in 1 CARTON (46122-245-62) / 2 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904699644","name":"NIGHTTIME COLD-FLU RLF SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6996-44","proprietary_name":"Night Time Cold and Flu Relief","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, DOXYLAMINE SUCCINATE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 15 mg/1; 6.25 mg/1","labeler":"Major Pharmaceuticals","package_description":"16 BLISTER PACK in 1 CARTON (0904-6996-44) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000051601","name":"NIGHTTIME COLD-FLU RLF SFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0516-1","proprietary_name":"NightTime Cold and Flu Multi Symptom","nonproprietary_name":"ACETAMINOPHEN DEXTROMETHORPHAN HYDROBROMIDE DOXYLAMINE SUCCINATE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 15 mg/1; 6.25 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"16 BLISTER PACK in 1 CARTON (70000-0516-1) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122075737","name":"NIGHTTIME LUBRICANT EYE OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-757-37","proprietary_name":"Nighttime Relief Lubricant","nonproprietary_name":"Light Mineral Oil, White Petrolatum","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"425 mg/g; 573 mg/g","labeler":"Amerisource Bergen Drug Corp.","package_description":"1 TUBE in 1 BOX (46122-757-37) / 3.5 g in 1 TUBE"},"nadac":{"value":1.48809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000072401","name":"NIGHTTIME LUBRICANT EYE OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0724-1","proprietary_name":"Leader Nighttime Relief Lubricant Eye","nonproprietary_name":"Light Mineral Oil, White Petrolatum","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"425 mg/g; 573 mg/g","labeler":"LEADER/Cardinal Health 110, Inc.","package_description":"1 TUBE in 1 BOX (70000-0724-1) / 3.5 g in 1 TUBE"},"nadac":{"value":1.48809,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180088671","name":"NIKKI 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nikki|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"68180088673","name":"NIKKI 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-886-73","proprietary_name":"Nikki","nonproprietary_name":"drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-886-73) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nikki|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"23155051200","name":"NIMODIPINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-512-00","proprietary_name":"nimodipine","nonproprietary_name":"nimodipine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 BLISTER PACK in 1 CARTON (23155-512-00) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.36945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nimodipine|Nimodipine","basis":"generic"},"part_b":null}, {"ndc":"23155051230","name":"NIMODIPINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-512-30","proprietary_name":"nimodipine","nonproprietary_name":"nimodipine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (23155-512-30) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.36945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nimodipine|Nimodipine","basis":"generic"},"part_b":null}, {"ndc":"69452020907","name":"NIMODIPINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.36945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nimodipine|Nimodipine","basis":"generic"},"part_b":null}, {"ndc":"69452020913","name":"NIMODIPINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-209-13","proprietary_name":"Nimodipine","nonproprietary_name":"Nimodipine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"BIONPHARMA INC.","package_description":"3 BLISTER PACK in 1 CARTON (69452-209-13) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.36945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nimodipine|Nimodipine","basis":"generic"},"part_b":null}, {"ndc":"69452020920","name":"NIMODIPINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-209-20","proprietary_name":"Nimodipine","nonproprietary_name":"Nimodipine","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"30 mg/1","labeler":"BIONPHARMA INC.","package_description":"10 BLISTER PACK in 1 CARTON (69452-209-20) / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":1.36945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nimodipine|Nimodipine","basis":"generic"},"part_b":null}, {"ndc":"23359003216","name":"NINJACOF LIQUID","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23359-032-16","proprietary_name":"Ninjacof","nonproprietary_name":"chlophedianol hcl and pyrilamine maleate","dosage_form":"SOLUTION","route":"ORAL","strength":"12.5 mg/5mL; 12.5 mg/5mL","labeler":"Centurion Labs, LLC","package_description":"473 mL in 1 BOTTLE (23359-032-16)"},"nadac":{"value":0.0792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781249560","name":"NINTEDANIB ESYLATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2495-60","proprietary_name":"nintedanib","nonproprietary_name":"nintedanib","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Sandoz Inc","package_description":"60 CAPSULE in 1 BOTTLE (0781-2495-60)","pharm_classes":["Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":13.45627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799097301","name":"NINTEDANIB ESYLATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-973-01","proprietary_name":"Nintedanib","nonproprietary_name":"nintedanib","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"60 CAPSULE in 1 BOTTLE (42799-973-01)","pharm_classes":["Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":13.45627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598014760","name":"NINTEDANIB ESYLATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-147-60","proprietary_name":"Nintedanib","nonproprietary_name":"Nintedanib","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 CAPSULE in 1 BOTTLE (43598-147-60)","pharm_classes":["Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":13.45627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505481906","name":"NINTEDANIB ESYLATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4819-6","proprietary_name":"Nintedanib","nonproprietary_name":"Nintedanib","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-4819-6) / 60 CAPSULE in 1 BOTTLE","pharm_classes":["Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":13.45627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097063903","name":"NINTEDANIB ESYLATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-639-03","proprietary_name":"Nintedanib","nonproprietary_name":"Nintedanib","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Cipla USA Inc.","package_description":"60 CAPSULE in 1 BOTTLE (69097-639-03)","pharm_classes":["Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":13.45627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282078760","name":"NINTEDANIB ESYLATE 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-787-60","proprietary_name":"Nintedanib Capsules, 100 mg and 150 mg","nonproprietary_name":"Nintedanib","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"60 CAPSULE in 1 BOTTLE (76282-787-60)","pharm_classes":["Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":13.45627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993047302","name":"NISOLDIPINE ER 17 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66993-473-02","proprietary_name":"Nisoldipine","nonproprietary_name":"Nisoldipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"17 mg/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE in 1 CARTON (66993-473-02) / 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Calcium Channel Antagonists [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":4.659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nisoldipine|Nisoldipine","basis":"generic"},"part_b":null}, {"ndc":"66993047502","name":"NISOLDIPINE ER 34 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66993-475-02","proprietary_name":"Nisoldipine","nonproprietary_name":"Nisoldipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"34 mg/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE in 1 CARTON (66993-475-02) / 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Calcium Channel Antagonists [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":5.23722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nisoldipine|Nisoldipine","basis":"generic"},"part_b":null}, {"ndc":"66993047202","name":"NISOLDIPINE ER 8.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66993-472-02","proprietary_name":"Nisoldipine","nonproprietary_name":"Nisoldipine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8.5 mg/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE in 1 CARTON (66993-472-02) / 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Calcium Channel Antagonists [MoA]","Decreased Blood Pressure [PE]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":3.55988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nisoldipine|Nisoldipine","basis":"generic"},"part_b":null}, {"ndc":"31722010032","name":"NITAZOXANIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-100-32","proprietary_name":"Nitazoxanide","nonproprietary_name":"Nitazoxanide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-100-32) / 6 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Antiprotozoal [EPC]"]},"nadac":{"value":82.19697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nitazoxanide|Nitazoxanide","basis":"generic"},"part_b":null}, {"ndc":"64980052660","name":"NITAZOXANIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-526-60","proprietary_name":"Nitazoxanide","nonproprietary_name":"Nitazoxanide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"6 TABLET, FILM COATED in 1 BOTTLE (64980-526-60)","pharm_classes":["Antiprotozoal [EPC]"]},"nadac":{"value":82.19697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nitazoxanide|Nitazoxanide","basis":"generic"},"part_b":null}, {"ndc":"70954093410","name":"NITAZOXANIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-934-10","proprietary_name":"Nitazoxanide","nonproprietary_name":"Nitazoxanide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"6 TABLET in 1 BOTTLE (70954-934-10)","pharm_classes":["Antiprotozoal [EPC]"]},"nadac":{"value":82.19697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nitazoxanide|Nitazoxanide","basis":"generic"},"part_b":null}, {"ndc":"00281032608","name":"NITRO-BID 2% OINTMENT","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0281-0326-08","proprietary_name":"NITRO-BID","nonproprietary_name":"Nitroglycerin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Savage Laboratories a division of Fougera Pharmaceuticals, LLC","package_description":"48 PACKET in 1 BOX (0281-0326-08) / 1 g in 1 PACKET","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":2.42188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nitro-Bid|Nitroglycerin","basis":"brand"},"part_b":null}, {"ndc":"00281032630","name":"NITRO-BID 2% OINTMENT","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0281-0326-30","proprietary_name":"NITRO-BID","nonproprietary_name":"Nitroglycerin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Savage Laboratories a division of Fougera Pharmaceuticals, LLC","package_description":"30 g in 1 TUBE (0281-0326-30)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":1.23629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nitro-Bid|Nitroglycerin","basis":"brand"},"part_b":null}, {"ndc":"00281032660","name":"NITRO-BID 2% OINTMENT","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0281-0326-60","proprietary_name":"NITRO-BID","nonproprietary_name":"Nitroglycerin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 mg/g","labeler":"Savage Laboratories a division of Fougera Pharmaceuticals, LLC","package_description":"60 g in 1 TUBE (0281-0326-60)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":1.22466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nitro-Bid|Nitroglycerin","basis":"brand"},"part_b":null}, {"ndc":"50742051501","name":"NITRO-DUR 0.3 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":50.49727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nitro-Dur|Nitroglycerin","basis":"brand"},"part_b":null}, {"ndc":"50742051530","name":"NITRO-DUR 0.3 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50742-515-30","proprietary_name":"NITRO-DUR","nonproprietary_name":"nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"60 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 POUCH in 1 BOX, UNIT-DOSE (50742-515-30) / 1 PATCH in 1 POUCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":50.49727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nitro-Dur|Nitroglycerin","basis":"brand"},"part_b":null}, {"ndc":"00472199208","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571074024","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651020623","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-206-23","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-206-23) / 230 mL in 1 BOTTLE","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980059324","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-593-24","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-593-24) / 230 mL in 1 BOTTLE","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238251209","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2512-9","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (69238-2512-9) / 230 mL in 1 BOTTLE, GLASS","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069082901","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-829-01","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (70069-829-01) / 230 mL in 1 BOTTLE, GLASS","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70377011831","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-118-31","proprietary_name":"NITROFURANTOIN","nonproprietary_name":"NITROFURANTOIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Biocon Pharma Inc","package_description":"1 BOTTLE, GLASS in 1 CARTON (70377-118-31) / 230 mL in 1 BOTTLE, GLASS","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954049610","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-496-10","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"230 mL in 1 BOTTLE (70954-496-10)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603017601","name":"NITROFURANTOIN 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-176-01","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE in 1 CARTON (72603-176-01) / 230 mL in 1 BOTTLE","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.68598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115164501","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1645-01","proprietary_name":"Nitrofurantoin Macrocrystals","nonproprietary_name":"Nitrofurantoin Macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1645-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268062411","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268062415","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-624-15","proprietary_name":"Nitrofurantoin Macrocrystals","nonproprietary_name":"Nitrofurantoin Macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-624-15) / 1 CAPSULE in 1 BLISTER PACK (50268-624-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651079501","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-795-01","proprietary_name":"nitrofurantoin (macrocrystals)","nonproprietary_name":"nitrofurantoin (macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-795-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085001","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-850-01","proprietary_name":"Nitrofurantoin Macrocrystals","nonproprietary_name":"Nitrofurantoin Macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-850-01) / 1 CAPSULE in 1 BLISTER PACK (60687-850-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085011","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332039131","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-391-31","proprietary_name":"NITROFURANTOIN","nonproprietary_name":"NITROFURANTOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-391-31)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001060500","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-605-00","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-605-00)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756041211","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-412-11","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-412-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603018401","name":"NITROFURANTOIN MCR 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-184-01","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-184-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.23267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332038931","name":"NITROFURANTOIN MCR 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-389-31","proprietary_name":"NITROFURANTOIN","nonproprietary_name":"NITROFURANTOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-389-31)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.53931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001060300","name":"NITROFURANTOIN MCR 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-603-00","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-603-00)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.53931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756041011","name":"NITROFURANTOIN MCR 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-410-11","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-410-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.53931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603018201","name":"NITROFURANTOIN MCR 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-182-01","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-182-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":1.53931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115164301","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1643-01","proprietary_name":"Nitrofurantoin Macrocrystals","nonproprietary_name":"Nitrofurantoin Macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (0115-1643-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904702661","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7026-61","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7026-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268062311","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268062315","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-623-15","proprietary_name":"Nitrofurantoin Macrocrystals","nonproprietary_name":"Nitrofurantoin Macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-623-15) / 1 CAPSULE in 1 BLISTER PACK (50268-623-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651075301","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-753-01","proprietary_name":"nitrofurantoin (macrocrystals)","nonproprietary_name":"nitrofurantoin (macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-753-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687083901","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-839-01","proprietary_name":"Nitrofurantoin Macrocrystals","nonproprietary_name":"Nitrofurantoin Macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-839-01) / 1 CAPSULE in 1 BLISTER PACK (60687-839-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687083911","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332039031","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-390-31","proprietary_name":"NITROFURANTOIN","nonproprietary_name":"NITROFURANTOIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-390-31)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001060400","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-604-00","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-604-00)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382055901","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-559-01","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-559-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756041111","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-411-11","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-411-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603018301","name":"NITROFURANTOIN MCR 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-183-01","proprietary_name":"nitrofurantoin macrocrystals","nonproprietary_name":"nitrofurantoin macrocrystals","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-183-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.16496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185012201","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0122-01","proprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0185-0122-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00185012210","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0122-10","proprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"Sandoz Inc","package_description":"1000 CAPSULE in 1 BOTTLE (0185-0122-10)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591365801","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904757161","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7571-61","proprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7571-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811071910","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-719-10","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 75 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (13811-719-10)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571039301","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-393-01","proprietary_name":"Nitrofurantoin","nonproprietary_name":"Nitrofurantoin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-393-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781030301","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-303-01","proprietary_name":"Nitrofurantoin Monohydrate/ Macrocrystalline","nonproprietary_name":"Nitrofurantoin Monohydrate/Macrocrystalline","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 75 mg/1","labeler":"Alvogen Inc.","package_description":"100 CAPSULE in 1 BOTTLE (47781-303-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746076201","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-762-01","proprietary_name":"NITROFURANTOIN (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59746-762-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746076206","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-762-06","proprietary_name":"NITROFURANTOIN (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59746-762-06)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862092901","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-929-01","proprietary_name":"NITROFURANTOIN","nonproprietary_name":"Nitrofurantoin (Monohydrate/Macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1; 75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-929-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001060600","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-606-00","proprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-606-00)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756040411","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-404-11","proprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-404-11)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603019601","name":"NITROFURANTOIN MONO-MCR 100 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-196-01","proprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","nonproprietary_name":"Nitrofurantoin (monohydrate/macrocrystals)","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1; 25 mg/1","labeler":"NorthStar RxLLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-196-01)","pharm_classes":["Nitrofuran Antibacterial [EPC]","Nitrofurans [CS]"]},"nadac":{"value":0.29577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378910216","name":"NITROGLYCERIN 0.1 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.49331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378910293","name":"NITROGLYCERIN 0.1 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9102-93","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".1 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9102-93) / 1 PATCH in 1 POUCH (0378-9102-16) / 14 h in 1 PATCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.49331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598089630","name":"NITROGLYCERIN 0.1 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-896-30","proprietary_name":"Nitroglycerin Transdermal Infusion System","nonproprietary_name":"Nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"30 POUCH in 1 BOX, UNIT-DOSE (43598-896-30) / 1 PATCH in 1 POUCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.49331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378910416","name":"NITROGLYCERIN 0.2 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.59034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378910493","name":"NITROGLYCERIN 0.2 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9104-93","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".2 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9104-93) / 1 PATCH in 1 POUCH (0378-9104-16) / 14 h in 1 PATCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.59034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598089511","name":"NITROGLYCERIN 0.2 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.59034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598089530","name":"NITROGLYCERIN 0.2 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-895-30","proprietary_name":"Nitroglycerin Transdermal Infusion System","nonproprietary_name":"Nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"30 POUCH in 1 BOX, UNIT-DOSE (43598-895-30) / 1 PATCH in 1 POUCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.59034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547098510","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-985-10","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1 BOTTLE in 1 CARTON (43547-985-10) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598043501","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-435-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE (43598-435-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651065700","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-657-00","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-657-00) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762492101","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-4921-1","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (59762-4921-1) / 100 TABLET in 1 BOTTLE, GLASS","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462063801","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-638-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE in 1 CARTON (68462-638-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017301","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-173-01","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Natco Pharma USA LLC","package_description":"1 TABLET in 1 CARTON (69339-173-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756001311","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-013-11","proprietary_name":"nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-013-11) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888013801","name":"NITROGLYCERIN 0.3 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-138-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".3 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-138-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.06315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547098604","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-986-04","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"4 BOTTLE in 1 CARTON (43547-986-04) / 25 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547098610","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-986-10","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1 BOTTLE in 1 CARTON (43547-986-10) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598043601","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-436-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE (43598-436-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598043611","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-436-11","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"4 BOTTLE in 1 CARTON (43598-436-11) / 25 TABLET in 1 BOTTLE (43598-436-35)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598043635","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651065800","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-658-00","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-658-00) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651065804","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-658-04","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"4 BOTTLE in 1 CARTON (59651-658-04) / 25 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651065825","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762330401","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3304-1","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (59762-3304-1) / 100 TABLET in 1 BOTTLE, GLASS","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762330403","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3304-3","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 BOTTLE, GLASS in 1 CARTON (59762-3304-3) / 25 TABLET in 1 BOTTLE, GLASS","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462063901","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-639-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE in 1 CARTON (68462-639-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462063925","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462063945","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-639-45","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"4 BOTTLE in 1 CARTON (68462-639-45) / 25 TABLET in 1 BOTTLE (68462-639-25)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017401","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-174-01","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Natco Pharma USA LLC","package_description":"1 BOTTLE in 1 CARTON (69339-174-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017402","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017441","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-174-41","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Natco Pharma USA LLC","package_description":"4 BOTTLE in 1 CARTON (69339-174-41) / 25 TABLET in 1 BOTTLE (69339-174-02)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756001402","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-014-02","proprietary_name":"nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Lifestar Pharma LLC","package_description":"4 BOTTLE in 1 CARTON (70756-014-02) / 25 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756001405","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756001411","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-014-11","proprietary_name":"nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-014-11) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603026601","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603026604","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-266-04","proprietary_name":"nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"NorthStar RxLLC","package_description":"4 BOTTLE in 1 CARTON (72603-266-04) / 25 TABLET in 1 BOTTLE (72603-266-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888013901","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-139-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-139-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888013933","name":"NITROGLYCERIN 0.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-139-33","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".4 mg/1","labeler":"Advagen Pharma Ltd","package_description":"4 BOTTLE in 1 CARTON (72888-139-33) / 25 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.12724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378911216","name":"NITROGLYCERIN 0.4 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378911293","name":"NITROGLYCERIN 0.4 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9112-93","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".4 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9112-93) / 1 PATCH in 1 POUCH (0378-9112-16) / 14 h in 1 PATCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.72064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598089411","name":"NITROGLYCERIN 0.4 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.72064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598089430","name":"NITROGLYCERIN 0.4 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-894-30","proprietary_name":"Nitroglycerin Transdermal Infusion System","nonproprietary_name":"Nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"30 POUCH in 1 BOX, UNIT-DOSE (43598-894-30) / 1 PATCH in 1 POUCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.72064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713056431","name":"NITROGLYCERIN 0.4% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0564-31","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"nitroglycerin","dosage_form":"OINTMENT","route":"RECTAL","strength":"4 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0564-31) / 30 g in 1 TUBE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":8.3149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922004805","name":"NITROGLYCERIN 0.4% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-048-05","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"Nitroglycerin","dosage_form":"OINTMENT","route":"RECTAL","strength":"4 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-048-05) / 30 g in 1 TUBE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":8.3149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802093294","name":"NITROGLYCERIN 0.4% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-932-94","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"nitroglycerin","dosage_form":"OINTMENT","route":"RECTAL","strength":"4 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-932-94) / 30 g in 1 TUBE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":8.3149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817083530","name":"NITROGLYCERIN 0.4% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-835-30","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"Nitroglycerin","dosage_form":"OINTMENT","route":"RECTAL","strength":"4 mg/g","labeler":"Trupharma, LLC","package_description":"1 TUBE in 1 CARTON (52817-835-30) / 30 g in 1 TUBE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":8.3149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"73473050030","name":"NITROGLYCERIN 0.4% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-500-30","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"OINTMENT","route":"RECTAL","strength":"4 mg/g","labeler":"Solaris Pharma Corporation","package_description":"30 g in 1 TUBE (73473-500-30)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":8.3149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43547098710","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-987-10","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1 BOTTLE in 1 CARTON (43547-987-10) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598043701","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-437-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"100 TABLET in 1 BOTTLE (43598-437-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651065900","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-659-00","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-659-00) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762048901","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0489-1","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (59762-0489-1) / 100 TABLET in 1 BOTTLE, GLASS","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462064001","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-640-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BOTTLE in 1 CARTON (68462-640-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017501","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-175-01","proprietary_name":"NITROGLYCERIN","nonproprietary_name":"NITROGLYCERIN","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Natco Pharma USA LLC","package_description":"1 TABLET in 1 CARTON (69339-175-01)","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756001611","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-016-11","proprietary_name":"nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE in 1 CARTON (70756-016-11) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888014001","name":"NITROGLYCERIN 0.6 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-140-01","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"TABLET","route":"SUBLINGUAL","strength":".6 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-140-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.08428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378911616","name":"NITROGLYCERIN 0.6 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378911693","name":"NITROGLYCERIN 0.6 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9116-93","proprietary_name":"Nitroglycerin","nonproprietary_name":"nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":".6 mg/h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9116-93) / 1 PATCH in 1 POUCH (0378-9116-16) / 14 h in 1 PATCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.96273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598089330","name":"NITROGLYCERIN 0.6 MG/HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-893-30","proprietary_name":"Nitroglycerin Transdermal Infusion System","nonproprietary_name":"Nitroglycerin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"120 mg/1","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"30 POUCH in 1 BOX, UNIT-DOSE (43598-893-30) / 1 PATCH in 1 POUCH","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":0.96273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"28595012012","name":"NITROGLYCERIN 400 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":14.91392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"28595012049","name":"NITROGLYCERIN 400 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"28595-120-49","proprietary_name":"NITROGLYCERIN LINGUAL","nonproprietary_name":"Nitroglycerin","dosage_form":"SPRAY","route":"ORAL","strength":"400 ug/1","labeler":"Allegis Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (28595-120-49) / 60 SPRAY in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":23.52335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802021001","name":"NITROGLYCERIN 400 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-210-01","proprietary_name":"nitroglycerin lingual","nonproprietary_name":"Nitroglycerin","dosage_form":"SPRAY","route":"ORAL","strength":"400 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-210-01) / 60 SPRAY in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":23.52335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802021002","name":"NITROGLYCERIN 400 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-210-02","proprietary_name":"nitroglycerin lingual","nonproprietary_name":"Nitroglycerin","dosage_form":"SPRAY","route":"ORAL","strength":"400 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-210-02) / 200 SPRAY in 1 BOTTLE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":14.91392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993024141","name":"NITROGLYCERIN 400 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-241-41","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"SPRAY","route":"ORAL","strength":"400 ug/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (66993-241-41) / 200 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":14.91392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993024150","name":"NITROGLYCERIN 400 MCG SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-241-50","proprietary_name":"Nitroglycerin","nonproprietary_name":"Nitroglycerin","dosage_form":"SPRAY","route":"ORAL","strength":"400 ug/1","labeler":"Prasco Laboratories","package_description":"1 BOTTLE, SPRAY in 1 CARTON (66993-241-50) / 60 SPRAY in 1 BOTTLE, SPRAY","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":23.52335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75834031401","name":"NIVA THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-314-01","proprietary_name":"Niva Thyroid","nonproprietary_name":"thyroid, porcine","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-314-01)"},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niva Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"75834031001","name":"NIVA THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-310-01","proprietary_name":"Niva Thyroid","nonproprietary_name":"thyroid, porcine","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-310-01)"},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niva Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"75834031101","name":"NIVA THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-311-01","proprietary_name":"Niva Thyroid","nonproprietary_name":"thyroid, porcine","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-311-01)"},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niva Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"75834031201","name":"NIVA THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-312-01","proprietary_name":"Niva Thyroid","nonproprietary_name":"thyroid, porcine","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-312-01)"},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niva Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"75834031301","name":"NIVA THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-313-01","proprietary_name":"Niva Thyroid","nonproprietary_name":"thyroid, porcine","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (75834-313-01)"},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Niva Thyroid|Thyroid,Pork","basis":"brand"},"part_b":null}, {"ndc":"00591313760","name":"NIZATIDINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3137-60","proprietary_name":"Nizatidine","nonproprietary_name":"Nizatidine","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (0591-3137-60)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.80421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nizatidine|Nizatidine","basis":"generic"},"part_b":null}, {"ndc":"42806029960","name":"NIZATIDINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-299-60","proprietary_name":"Nizatidine","nonproprietary_name":"Nizatidine","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"60 CAPSULE in 1 BOTTLE (42806-299-60)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.80421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nizatidine|Nizatidine","basis":"generic"},"part_b":null}, {"ndc":"00591313830","name":"NIZATIDINE 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0591-3138-30","proprietary_name":"Nizatidine","nonproprietary_name":"Nizatidine","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (0591-3138-30)","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.79878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nizatidine|Nizatidine","basis":"generic"},"part_b":null}, {"ndc":"24385035210","name":"NO DRIP 0.05% NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-352-10","proprietary_name":"Good Neighbor Pharmacy Nasal","nonproprietary_name":"Oxymetazoline HCl","dosage_form":"SPRAY, METERED","route":"NASAL","strength":".05 g/100mL","labeler":"Amerisource Bergen","package_description":"1 BOTTLE, SPRAY in 1 CARTON (24385-352-10) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68047018616","name":"NOHIST-DM LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-186-16","proprietary_name":"NoHist DM","nonproprietary_name":"Chlorpheniramine Maleate, Dextromethorphan Hydrobromide and Phenylephrine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"4 mg/5mL; 10 mg/5mL; 15 mg/5mL","labeler":"Larken Laboratories, Inc.","package_description":"473 mL in 1 BOTTLE (68047-186-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.06691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00480347516","name":"NORA-BE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3475-16","proprietary_name":"Nora BE","nonproprietary_name":"Norethindrone","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"6 PACKAGE in 1 CARTON (0480-3475-16) / 28 TABLET in 1 PACKAGE","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nora-Be|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"00480347519","name":"NORA-BE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nora-Be|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"00169770521","name":"NORDITROPIN FLEXPRO 10 MG/1.5","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-7705-21","proprietary_name":"Norditropin","nonproprietary_name":"somatropin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"10 mg/1.5mL","labeler":"Novo Nordisk","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (0169-7705-21) / 1.5 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Human Growth Hormone [CS]","Recombinant Human Growth Hormone [EPC]"]},"nadac":{"value":1136.45556,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Norditropin Flexpro|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"00169770821","name":"NORDITROPIN FLEXPRO 15 MG/1.5","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-7708-21","proprietary_name":"Norditropin","nonproprietary_name":"somatropin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"15 mg/1.5mL","labeler":"Novo Nordisk","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (0169-7708-21) / 1.5 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Human Growth Hormone [CS]","Recombinant Human Growth Hormone [EPC]"]},"nadac":{"value":1704.64417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Norditropin Flexpro|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"00169770421","name":"NORDITROPIN FLEXPRO 5 MG/1.5","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-7704-21","proprietary_name":"Norditropin","nonproprietary_name":"somatropin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"5 mg/1.5mL","labeler":"Novo Nordisk","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (0169-7704-21) / 1.5 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Human Growth Hormone [CS]","Recombinant Human Growth Hormone [EPC]"]},"nadac":{"value":570.77429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Norditropin Flexpro|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"70710119001","name":"NORELGESTROM-EE 150-35 MCG/DAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":33.28945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119003","name":"NORELGESTROM-EE 150-35 MCG/DAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1190-3","proprietary_name":"norelgestromin and ethinyl estradiol","nonproprietary_name":"norelgestromin and ethinyl estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"150 ug/mg; 35 ug/mg","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"3 POUCH in 1 CARTON (70710-1190-3) / 1 POUCH in 1 POUCH (70710-1190-1) / 7 mg in 1 POUCH","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":33.28945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084929","name":"NORETH-EE-FE 1-0.02(24)-75 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-849-29","proprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 CARTON in 1 BOX (68462-849-29) / 1 BLISTER PACK in 1 CARTON (68462-849-84) / 1 KIT in 1 BLISTER PACK * 24 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68462-821-40) * 4 CAPSULE, LIQUID FILLED in 1 BLISTER PACK (68462-822-40)"},"nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084984","name":"NORETH-EE-FE 1-0.02(24)-75 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700010184","name":"NORETH-EE-FE 1-0.02(24)-75 CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700010185","name":"NORETH-EE-FE 1-0.02(24)-75 CHW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-101-85","proprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol Tablets and Ferrous Fumarate Tablets","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Xiromed, LLC","package_description":"3 BLISTER PACK in 1 CARTON (70700-101-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.3041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065729","name":"NORETHIN-ETH ESTRAD 1 MG-5 MCG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-657-29","proprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; 5 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-657-29) / 1 BLISTER PACK in 1 POUCH / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065784","name":"NORETHIN-ETH ESTRAD 1 MG-5 MCG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065790","name":"NORETHIN-ETH ESTRAD 1 MG-5 MCG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-657-90","proprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; 5 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-657-90)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.57994,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065629","name":"NORETHIND-ETH ESTRAD 0.5-2.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-656-29","proprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1; 2.5 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-656-29) / 1 BLISTER PACK in 1 POUCH / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.9127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462065684","name":"NORETHIND-ETH ESTRAD 0.5-2.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.9127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462013279","name":"NORETHIND-ETH ESTRAD 1-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462013281","name":"NORETHIND-ETH ESTRAD 1-0.02 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-132-81","proprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; .02 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-132-81) / 1 BLISTER PACK in 1 POUCH (68462-132-79) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.18122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180087671","name":"NORETHINDRONE 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"68180087673","name":"NORETHINDRONE 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-876-73","proprietary_name":"NORETHINDRONE","nonproprietary_name":"NORETHINDRONE","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-876-73) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"68462030529","name":"NORETHINDRONE 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-305-29","proprietary_name":"Norethindrone","nonproprietary_name":"Norethindrone","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 POUCH in 1 CARTON (68462-305-29) / 28 TABLET in 1 POUCH (68462-305-84)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"68462030584","name":"NORETHINDRONE 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"00555021110","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0211-10","proprietary_name":"Norethindrone Acetate","nonproprietary_name":"Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"50 TABLET in 1 BOTTLE (0555-0211-10)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742026750","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-267-50","proprietary_name":"Norethindrone acetate","nonproprietary_name":"norethindrone acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"50 TABLET in 1 BOTTLE (50742-267-50)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687092111","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687092121","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-921-21","proprietary_name":"Norethindrone Acetate","nonproprietary_name":"Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-921-21) / 1 TABLET in 1 BLISTER PACK (60687-921-11)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162047505","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-475-05","proprietary_name":"Norethindrone Acetate","nonproprietary_name":"Norethindrone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"50 TABLET in 1 BOTTLE (65162-475-05)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162047509","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-475-09","proprietary_name":"Norethindrone Acetate","nonproprietary_name":"Norethindrone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-475-09)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462030450","name":"NORETHINDRONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-304-50","proprietary_name":"Norethindrone Acetate","nonproprietary_name":"Norethindrone Acetate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"50 TABLET in 1 BOTTLE (68462-304-50)","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.28984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180083871","name":"NORG-EE 0.18-0.215-0.25/0.035","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68180083873","name":"NORG-EE 0.18-0.215-0.25/0.035","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-838-73","proprietary_name":"Norgestimate and ethinyl estradiol","nonproprietary_name":"Norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 CARTON in 1 CARTON (68180-838-73) / 1 KIT in 1 CARTON"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68462056529","name":"NORG-EE 0.18-0.215-0.25/0.035","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-565-29","proprietary_name":"Norgestimate and Ethinyl Estradiol","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-565-29) / 1 KIT in 1 BLISTER PACK (68462-565-84)"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68462056584","name":"NORG-EE 0.18-0.215-0.25/0.035","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68180084071","name":"NORG-ETHIN ESTRA 0.25-0.035 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68180084073","name":"NORG-ETHIN ESTRA 0.25-0.035 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-840-73","proprietary_name":"Norgestimate and Ethinyl Estradiol","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-840-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68462030929","name":"NORG-ETHIN ESTRA 0.25-0.035 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-309-29","proprietary_name":"Norgestimate and Ethinyl Estradiol","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-309-29) / 1 KIT in 1 BLISTER PACK (68462-309-84)"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"68462030984","name":"NORG-ETHIN ESTRA 0.25-0.035 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norgestimate-Ethinyl Estradiol|Norgestimate-Ethinyl Estradiol","basis":"generic"},"part_b":null}, {"ndc":"46287003515","name":"NORLIQVA 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-035-15","proprietary_name":"NORLIQVA","nonproprietary_name":"amlodipine","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"CMP Pharma, Inc.","package_description":"150 mL in 1 BOTTLE (46287-035-15)","pharm_classes":["Calcium Channel Antagonists [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":3.21723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Norliqva|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"46287003701","name":"NORLIQVA 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-037-01","proprietary_name":"NORLIQVA","nonproprietary_name":"amlodipine","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"CMP Pharma, Inc.","package_description":"150 mL in 1 BOTTLE (46287-037-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":3.21723,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Norliqva|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"00555900867","name":"NORTREL 0.5-35-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9008-67","proprietary_name":"Nortrel 28 Day","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9008-67) / 1 BLISTER PACK in 1 POUCH (0555-9008-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.48747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555900879","name":"NORTREL 0.5-35-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.48747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555900942","name":"NORTREL 1-35 21 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9009-42","proprietary_name":"Nortrel 21 Day","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1; .035 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9009-42) / 1 BLISTER PACK in 1 POUCH (0555-9009-80) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.37339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555900980","name":"NORTREL 1-35 21 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555901058","name":"NORTREL 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9010-58","proprietary_name":"Nortrel 28 Day","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9010-58) / 1 BLISTER PACK in 1 POUCH (0555-9010-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555901079","name":"NORTREL 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555901258","name":"NORTREL 7-7-7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9012-58","proprietary_name":"Nortrel 7/7/7 (28 Day Regimen)","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9012-58) / 1 BLISTER PACK in 1 POUCH (0555-9012-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555901279","name":"NORTREL 7-7-7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortrel|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00121067816","name":"NORTRIPTYLINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0678-16","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0678-16)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.26165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888015739","name":"NORTRIPTYLINE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-157-39","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Advagen Pharma Ltd","package_description":"473 mL in 1 BOTTLE (72888-157-39)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.26165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093081001","name":"NORTRIPTYLINE HCL 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0810-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0810-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.11272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00093081005","name":"NORTRIPTYLINE HCL 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0810-05","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-0810-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.11272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687090001","name":"NORTRIPTYLINE HCL 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-900-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-900-01) / 1 CAPSULE in 1 BLISTER PACK (60687-900-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.11272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687090011","name":"NORTRIPTYLINE HCL 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907006901","name":"NORTRIPTYLINE HCL 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-069-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (75907-069-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.11272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907006905","name":"NORTRIPTYLINE HCL 10 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-069-05","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (75907-069-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.11272,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00093081101","name":"NORTRIPTYLINE HCL 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0811-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0811-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00093081105","name":"NORTRIPTYLINE HCL 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0811-05","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-0811-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687091101","name":"NORTRIPTYLINE HCL 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-911-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-911-01) / 1 CAPSULE in 1 BLISTER PACK (60687-911-11)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687091111","name":"NORTRIPTYLINE HCL 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907007001","name":"NORTRIPTYLINE HCL 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-070-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (75907-070-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907007005","name":"NORTRIPTYLINE HCL 25 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-070-05","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (75907-070-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.15607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00093081201","name":"NORTRIPTYLINE HCL 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0812-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0812-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.20739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00093081205","name":"NORTRIPTYLINE HCL 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0812-05","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-0812-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.20739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907007101","name":"NORTRIPTYLINE HCL 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-071-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (75907-071-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.20739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907007105","name":"NORTRIPTYLINE HCL 50 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-071-05","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (75907-071-05)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.20739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00093081301","name":"NORTRIPTYLINE HCL 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0813-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0813-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907007201","name":"NORTRIPTYLINE HCL 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-072-01","proprietary_name":"Nortriptyline Hydrochloride","nonproprietary_name":"Nortriptyline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (75907-072-01)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":0.27241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nortriptyline HCl|Nortriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00069154068","name":"NORVASC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-1540-68","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"PFIZER LABORATORIES DIV PFIZER INC","package_description":"90 TABLET in 1 BOTTLE (0069-1540-68)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":11.94157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035532","name":"NORVASC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.94157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035577","name":"NORVASC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-355-77","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET in 1 BOTTLE (58151-355-77)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":11.94157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035588","name":"NORVASC 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-355-88","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (58151-355-88) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":11.94157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"00069152068","name":"NORVASC 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0069-1520-68","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"PFIZER LABORATORIES DIV PFIZER INC","package_description":"90 TABLET in 1 BOTTLE (0069-1520-68)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":8.70379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035377","name":"NORVASC 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58151-353-77","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET in 1 BOTTLE (58151-353-77)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":8.70379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01061,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"00069153068","name":"NORVASC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-1530-68","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"PFIZER LABORATORIES DIV PFIZER INC","package_description":"90 TABLET in 1 BOTTLE (0069-1530-68)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":8.69312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"00069153072","name":"NORVASC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.69312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035430","name":"NORVASC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-354-30","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Viatris Specialty LLC","package_description":"300 TABLET in 1 BOTTLE (58151-354-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":8.69312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035432","name":"NORVASC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.69312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035477","name":"NORVASC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-354-77","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET in 1 BOTTLE (58151-354-77)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":8.69312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"58151035488","name":"NORVASC 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-354-88","proprietary_name":"Norvasc","nonproprietary_name":"amlodipine besylate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (58151-354-88) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":8.69312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvasc|Amlodipine Besylate","basis":"brand"},"part_b":null}, {"ndc":"00074234030","name":"NORVIR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2340-30","proprietary_name":"Norvir","nonproprietary_name":"Ritonavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AbbVie Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0074-2340-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":8.3489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.60659,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norvir|Ritonavir","basis":"brand"},"part_b":null}, {"ndc":"55566150201","name":"NOVAREL 5,000 UNIT VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55566-1502-1","proprietary_name":"Novarel","nonproprietary_name":"gonadotrophin, chorionic","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ferring Pharmaceuticals Inc.","package_description":"1 KIT in 1 CARTON (55566-1502-1) * 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL * 10 mL in 1 VIAL (55566-1700-0)"},"nadac":{"value":171.64714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Novarel|Chorionic Gonadotropin, Human","basis":"brand"},"part_b":{"hcpcs":"J0725","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0725 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (55566-1502-1) * 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL * 10 mL in 1 VIAL (55566-1700-0)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00169183711","name":"NOVOLIN 70-30 100 UNIT/ML VIAL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-1837-11","proprietary_name":"Novolin 70/30","nonproprietary_name":"Human Insulin","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"1 VIAL in 1 CARTON (0169-1837-11) / 10 mL in 1 VIAL","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":4.62659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169300715","name":"NOVOLIN 70-30 FLEXPEN","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3007-15","proprietary_name":"Novolin 70/30","nonproprietary_name":"Human Insulin","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-3007-15) / 3 mL in 1 SYRINGE, PLASTIC (0169-3007-01)","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":5.82502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169300415","name":"NOVOLIN N 100 UNIT/ML FLEXPEN","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3004-15","proprietary_name":"Novolin N","nonproprietary_name":"Human Insulin","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-3004-15) / 3 mL in 1 SYRINGE, PLASTIC (0169-3004-01)","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":5.82446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Novolin N Flexpen|Insulin NPh Human Isophane","basis":"brand"},"part_b":null}, {"ndc":"00169183411","name":"NOVOLIN N 100 UNIT/ML VIAL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-1834-11","proprietary_name":"Novolin N","nonproprietary_name":"Human Insulin","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"1 VIAL in 1 CARTON (0169-1834-11) / 10 mL in 1 VIAL","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":4.62258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Novolin N|Insulin NPh Human Isophane","basis":"brand"},"part_b":null}, {"ndc":"00169300315","name":"NOVOLIN R 100 UNIT/ML FLEXPEN","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3003-15","proprietary_name":"Novolin R","nonproprietary_name":"Human Insulin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-3003-15) / 3 mL in 1 SYRINGE, PLASTIC (0169-3003-01)","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":5.81495,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Novolin R Flexpen|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"00169183311","name":"NOVOLIN R 100 UNIT/ML VIAL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-1833-11","proprietary_name":"Novolin R","nonproprietary_name":"Human Insulin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"1 VIAL in 1 CARTON (0169-1833-11) / 10 mL in 1 VIAL","pharm_classes":["Insulin [CS]","Insulin [EPC]"]},"nadac":{"value":4.62465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Novolin R|Insulin Regular, Human","basis":"brand"},"part_b":null}, {"ndc":"00169633910","name":"NOVOLOG 100 UNIT/ML FLEXPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-6339-10","proprietary_name":"NOVOLOG","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-6339-10) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.93506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Novolog Flexpen|Insulin Aspart","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 SYRINGE, PLASTIC in 1 CARTON (0169-6339-10) / 3 mL in 1 SYRINGE, PLASTIC) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00169750111","name":"NOVOLOG 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-7501-11","proprietary_name":"NOVOLOG","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"1 VIAL, GLASS in 1 CARTON (0169-7501-11) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.93519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Novolog|Insulin Aspart","basis":"brand"},"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0169-7501-11) / 10 mL in 1 VIAL, GLASS) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00169369619","name":"NOVOLOG MIX 70-30 FLEXPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3696-19","proprietary_name":"NovoLog Mix 70/30","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"5 SYRINGE in 1 CARTON (0169-3696-19) / 3 mL in 1 SYRINGE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.93705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169368512","name":"NOVOLOG MIX 70-30 VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3685-12","proprietary_name":"NovoLog Mix 70/30","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SUSPENSION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"1 VIAL, GLASS in 1 CARTON (0169-3685-12) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":6.92869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169330312","name":"NOVOLOG PENFILL 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-3303-12","proprietary_name":"NOVOLOG","nonproprietary_name":"insulin aspart","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Novo Nordisk","package_description":"5 CARTRIDGE in 1 CARTON (0169-3303-12) / 3 mL in 1 CARTRIDGE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":8.56929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1817","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1817 (50 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (6 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 CARTRIDGE in 1 CARTON (0169-3303-12) / 3 mL in 1 CARTRIDGE) gives 15 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":5,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42192032801","name":"NP THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-328-01","proprietary_name":"NP Thyroid 120","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"76 ug/1; 18 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-328-01)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032830","name":"NP THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-328-30","proprietary_name":"NP Thyroid 120","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"76 ug/1; 18 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (42192-328-30)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032890","name":"NP THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-328-90","proprietary_name":"NP Thyroid 120","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"76 ug/1; 18 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (42192-328-90)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032701","name":"NP THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-327-01","proprietary_name":"NP Thyroid 15","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"9.5 ug/1; 2.25 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-327-01)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032730","name":"NP THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-327-30","proprietary_name":"NP Thyroid 15","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"9.5 ug/1; 2.25 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (42192-327-30)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032790","name":"NP THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-327-90","proprietary_name":"NP Thyroid 15","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"9.5 ug/1; 2.25 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (42192-327-90)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032901","name":"NP THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-329-01","proprietary_name":"NP Thyroid 30","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"19 ug/1; 4.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-329-01)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032910","name":"NP THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-329-10","proprietary_name":"NP Thyroid 30","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"19 ug/1; 4.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (42192-329-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032930","name":"NP THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-329-30","proprietary_name":"NP Thyroid 30","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"19 ug/1; 4.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (42192-329-30)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192032990","name":"NP THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-329-90","proprietary_name":"NP Thyroid 30","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"19 ug/1; 4.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (42192-329-90)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033001","name":"NP THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-330-01","proprietary_name":"NP Thyroid 60","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"38 ug/1; 9 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-330-01)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033010","name":"NP THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-330-10","proprietary_name":"NP Thyroid 60","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"38 ug/1; 9 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (42192-330-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033030","name":"NP THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-330-30","proprietary_name":"NP Thyroid 60","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"38 ug/1; 9 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (42192-330-30)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033090","name":"NP THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-330-90","proprietary_name":"NP Thyroid 60","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"38 ug/1; 9 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (42192-330-90)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033101","name":"NP THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-331-01","proprietary_name":"NP Thyroid 90","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"57 ug/1; 13.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (42192-331-01)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033110","name":"NP THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-331-10","proprietary_name":"NP Thyroid 90","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"57 ug/1; 13.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (42192-331-10)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033130","name":"NP THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-331-30","proprietary_name":"NP Thyroid 90","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"57 ug/1; 13.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (42192-331-30)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033190","name":"NP THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-331-90","proprietary_name":"NP Thyroid 90","nonproprietary_name":"LEVOTHYROXINE, LIOTHYRONINE","dosage_form":"TABLET","route":"ORAL","strength":"57 ug/1; 13.5 ug/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (42192-331-90)","pharm_classes":["Thyroxine [CS]","Triiodothyronine [CS]","l-Thyroxine [EPC]","l-Triiodothyronine [EPC]"]},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59148005316","name":"NUEDEXTA 20-10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-053-16","proprietary_name":"Nuedexta","nonproprietary_name":"dextromethorphan hydrobromide and quinidine sulfate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"20 mg/1; 10 mg/1","labeler":"Otsuka America Pharmaceutical, Inc","package_description":"60 CAPSULE, GELATIN COATED in 1 BOTTLE (59148-053-16)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 2D6 Inhibitor [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":26.63535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuedexta|Dextromethorphan HBr/Quinidine","basis":"brand"},"part_b":null}, {"ndc":"64597030160","name":"NUEDEXTA 20-10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":26.63535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuedexta|Dextromethorphan HBr/Quinidine","basis":"brand"},"part_b":null}, {"ndc":"68220011810","name":"NULEV 0.125 MG CHEWABLE MELT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68220-118-10","proprietary_name":"NuLev","nonproprietary_name":"hyoscyamine sulfate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":".125 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (68220-118-10)"},"nadac":{"value":0.14421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nulev|Hyoscyamine Sulfate","basis":"brand"},"part_b":null}, {"ndc":"63090034030","name":"NUPLAZID 34 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63090-340-30","proprietary_name":"NUPLAZID","nonproprietary_name":"pimavanserin tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"34 mg/1","labeler":"Acadia Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (63090-340-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":170.496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuplazid|Pimavanserin Tartrate","basis":"brand"},"part_b":null}, {"ndc":"72618300002","name":"NURTEC ODT 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72618-3000-2","proprietary_name":"NURTEC ODT","nonproprietary_name":"rimegepant sulfate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"75 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 BLISTER PACK in 1 CARTON (72618-3000-2) / 8 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":128.66977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nurtec ODT|Rimegepant Sulfate","basis":"brand"},"part_b":null}, {"ndc":"78206014601","name":"NUVARING VAGINAL RING","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":155.70283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"78206014603","name":"NUVARING VAGINAL RING","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-146-03","proprietary_name":"NuvaRing","nonproprietary_name":"etonogestrel and ethinyl estradiol","dosage_form":"INSERT, EXTENDED RELEASE","route":"VAGINAL","strength":".12 mg/d; .015 mg/d","labeler":"Organon LLC","package_description":"3 POUCH in 1 BOX (78206-146-03) / 21 d in 1 POUCH (78206-146-01)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":155.70283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":46.3541,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00642746605","name":"NUVESSA VAGINAL 1.3% GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-7466-05","proprietary_name":"Nuvessa","nonproprietary_name":"metronidazole","dosage_form":"GEL","route":"TOPICAL","strength":"65 mg/5g","labeler":"Exeltis USA, Inc.","package_description":"1 APPLICATOR in 1 CARTON (0642-7466-05) / 5 g in 1 APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":43.02733,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nuvessa|Metronidazole","basis":"brand"},"part_b":null}, {"ndc":"60505484703","name":"NUVIGIL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4847-3","proprietary_name":"Nuvigil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4847-3)"},"nadac":{"value":34.752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.78762,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuvigil|Armodafinil","basis":"brand"},"part_b":null}, {"ndc":"63459021530","name":"NUVIGIL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63459-215-30","proprietary_name":"Nuvigil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Cephalon, LLC","package_description":"30 TABLET in 1 BOTTLE (63459-215-30)"},"nadac":{"value":34.752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.78762,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuvigil|Armodafinil","basis":"brand"},"part_b":null}, {"ndc":"60505484903","name":"NUVIGIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4849-3","proprietary_name":"Nuvigil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4849-3)"},"nadac":{"value":35.0624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.8028,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuvigil|Armodafinil","basis":"brand"},"part_b":null}, {"ndc":"63459022030","name":"NUVIGIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":35.0624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.8028,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuvigil|Armodafinil","basis":"brand"},"part_b":null}, {"ndc":"60505485003","name":"NUVIGIL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4850-3","proprietary_name":"Nuvigil","nonproprietary_name":"Armodafinil","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4850-3)"},"nadac":{"value":34.77173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.90818,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nuvigil|Armodafinil","basis":"brand"},"part_b":null}, {"ndc":"00832046515","name":"NYAMYC 100,000 UNIT/GM POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0465-15","proprietary_name":"Nyamyc","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0832-0465-15) / 15 g in 1 BOTTLE, PLASTIC","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nyamyc|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"00832046530","name":"NYAMYC 100,000 UNIT/GM POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0465-30","proprietary_name":"Nyamyc","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0832-0465-30) / 30 g in 1 BOTTLE, PLASTIC","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nyamyc|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"00832046560","name":"NYAMYC 100,000 UNIT/GM POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0465-60","proprietary_name":"Nyamyc","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0832-0465-60) / 60 g in 1 BOTTLE, PLASTIC","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nyamyc|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"65862089828","name":"NYLIA 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nylia|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862089888","name":"NYLIA 1-35 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-898-88","proprietary_name":"Nylia 1/35","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-898-88) / 1 BLISTER PACK in 1 POUCH (65862-898-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.20265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nylia|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862089728","name":"NYLIA 7-7-7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nylia|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862089788","name":"NYLIA 7-7-7-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-897-88","proprietary_name":"Nylia 7/7/7","nonproprietary_name":"Norethindrone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 POUCH in 1 CARTON (65862-897-88) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.21612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Nylia|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00713067815","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0678-15","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin Cream","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0678-15) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713067831","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0678-31","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin Cream","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0678-31) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.15101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668059501","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-595-01","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 U/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"15 g in 1 TUBE (13668-595-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668059502","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-595-02","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 U/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 g in 1 TUBE (13668-595-02)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.15101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342046915","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-469-15","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 1/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-469-15) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342046930","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-469-30","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 1/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-469-30) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.15101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005911","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-059-11","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-059-11) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.15101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005935","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-059-35","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-059-35) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128901","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1289-1","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1289-1) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128902","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1289-2","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1289-2) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.15101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651090714","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-907-14","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-907-14) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59651090730","name":"NYSTATIN 100,000 UNIT/GM CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-907-30","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-907-30) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.15101,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472016615","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0166-15","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0166-15) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00472016630","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0166-30","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0166-30) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713068615","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0686-15","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin Ointment","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0686-15) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713068631","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0686-31","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin Ointment","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0686-31) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668053401","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-534-01","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 U/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"15 g in 1 TUBE (13668-534-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13668053402","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-534-02","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 U/g","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 g in 1 TUBE (13668-534-02)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048115","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-481-15","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 1/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-481-15) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048130","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-481-30","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 1/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-481-30) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004811","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-048-11","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-048-11) / 30 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004835","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-048-35","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-048-35) / 15 g in 1 TUBE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008901","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-089-01","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 U/g","labeler":"Viona Pharmaceuticals Inc","package_description":"15 g in 1 TUBE (72578-089-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008904","name":"NYSTATIN 100,000 UNIT/GM OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-089-04","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 U/g","labeler":"Viona Pharmaceuticals Inc","package_description":"30 g in 1 TUBE (72578-089-04)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23754,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68382037001","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-370-01","proprietary_name":"NYSTATIN","nonproprietary_name":"nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"15 g in 1 BOTTLE, PLASTIC (68382-370-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68382037002","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-370-02","proprietary_name":"NYSTATIN","nonproprietary_name":"nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 g in 1 BOTTLE, PLASTIC (68382-370-02)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68382037003","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-370-03","proprietary_name":"NYSTATIN","nonproprietary_name":"nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 g in 1 BOTTLE, PLASTIC (68382-370-03)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69315030615","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-306-15","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Leading Pharma, LLC","package_description":"15 g in 1 BOTTLE, PLASTIC (69315-306-15)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69315030630","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-306-30","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Leading Pharma, LLC","package_description":"30 g in 1 BOTTLE, PLASTIC (69315-306-30)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69315030660","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-306-60","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Leading Pharma, LLC","package_description":"60 g in 1 BOTTLE, PLASTIC (69315-306-60)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603049101","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-491-01","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Northstar Rx LLC","package_description":"15 g in 1 BOTTLE, PLASTIC (72603-491-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603049102","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-491-02","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Northstar Rx LLC","package_description":"30 g in 1 BOTTLE, PLASTIC (72603-491-02)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603049103","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-491-03","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Northstar Rx LLC","package_description":"60 g in 1 BOTTLE, PLASTIC (72603-491-03)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75907006030","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-060-30","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Dr. Reddy's Labratories Inc.","package_description":"30 g in 1 BOTTLE, PLASTIC (75907-060-30)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75907006044","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-060-44","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Dr. Reddy's Labratories Inc.","package_description":"15 g in 1 BOTTLE, PLASTIC (75907-060-44)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75907006060","name":"NYSTATIN 100,000 UNIT/GM POWD","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-060-60","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Dr. Reddy's Labratories Inc.","package_description":"60 g in 1 BOTTLE, PLASTIC (75907-060-60)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00121086802","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0868-02","proprietary_name":"Nystatin","nonproprietary_name":"NYSTATIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 [USP'U]/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"60 mL in 1 BOTTLE, DROPPER (0121-0868-02)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.13995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121086816","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0868-16","proprietary_name":"Nystatin","nonproprietary_name":"NYSTATIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 [USP'U]/mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0868-16)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.05693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135081346","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-813-46","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 U/mL","labeler":"Chartwell RX, LLC","package_description":"60 mL in 1 BOTTLE (62135-813-46)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.13995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135081347","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-813-47","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 U/mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-813-47)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.05693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950037247","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-372-47","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 [USP'U]/mL","labeler":"Genus Lifesciences Inc.","package_description":"473 mL in 1 BOTTLE (64950-372-47)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.05693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315050447","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-504-47","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 [USP'U]/mL","labeler":"Leading Pharma, LLC","package_description":"473 mL in 1 BOTTLE (69315-504-47)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.05693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315050460","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-504-60","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 [USP'U]/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE in 1 PACKAGE (69315-504-60) / 60 mL in 1 BOTTLE","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.13995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"85742001311","name":"NYSTATIN 100,000 UNIT/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85742-013-11","proprietary_name":"NYSTATIN","nonproprietary_name":"NYSTATIN","dosage_form":"SUSPENSION","route":"ORAL","strength":"100000 U/mL","labeler":"Kanchan Healthcare Inc","package_description":"473 mL in 1 BOTTLE (85742-013-11)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.05693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093098301","name":"NYSTATIN 500,000 UNIT ORAL TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0983-01","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500000 [USP'U]/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-0983-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.39704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155005101","name":"NYSTATIN 500,000 UNIT ORAL TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-051-01","proprietary_name":"nystatin","nonproprietary_name":"nystatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500000 [USP'U]/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (23155-051-01)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.39704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135074190","name":"NYSTATIN 500,000 UNIT ORAL TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-741-90","proprietary_name":"Nystatin","nonproprietary_name":"Nystatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500000 [USP'U]/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-741-90)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.39704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342048215","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-482-15","proprietary_name":"Nystatin and triamcinolone acetonide","nonproprietary_name":"Nystatin and triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-482-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.28932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048230","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-482-30","proprietary_name":"Nystatin and triamcinolone acetonide","nonproprietary_name":"Nystatin and triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-482-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048260","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-482-60","proprietary_name":"Nystatin and triamcinolone acetonide","nonproprietary_name":"Nystatin and triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-482-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802088014","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-880-14","proprietary_name":"NYSTATIN AND TRIAMCINOLONE ACETONIDE","nonproprietary_name":"nystatin, triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-880-14) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.28932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802088094","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-880-94","proprietary_name":"NYSTATIN AND TRIAMCINOLONE ACETONIDE","nonproprietary_name":"nystatin, triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-880-94) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802088096","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-880-96","proprietary_name":"NYSTATIN AND TRIAMCINOLONE ACETONIDE","nonproprietary_name":"nystatin, triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-880-96) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126301","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1263-1","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1263-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.28932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126302","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1263-2","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1263-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126303","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1263-3","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1263-3) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332060615","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-606-15","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-606-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.28932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332060630","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-606-30","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-606-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332060660","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-606-60","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-606-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180054502","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-545-02","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-545-02) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.22465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180054503","name":"NYSTATIN-TRIAMCINOLONE CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-545-03","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (68180-545-03) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.19156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922003104","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-031-04","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-031-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.34479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922003105","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-031-05","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-031-05) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.26518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922003107","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-031-07","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-031-07) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802024414","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-244-14","proprietary_name":"nystatin and triamcinolone acetonide","nonproprietary_name":"nystatin and triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-244-14) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.34479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802024494","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-244-94","proprietary_name":"nystatin and triamcinolone acetonide","nonproprietary_name":"nystatin and triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-244-94) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.26518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802024496","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-244-96","proprietary_name":"nystatin and triamcinolone acetonide","nonproprietary_name":"nystatin and triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-244-96) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008801","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-088-01","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-088-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.34479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008802","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-088-02","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-088-02) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72578008804","name":"NYSTATIN-TRIAMCINOLONE OINTM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-088-04","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-088-04) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.26518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048315","name":"NYSTATIN-TRIAMCINOLONE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-483-15","proprietary_name":"Nystatin and triamcinolone acetonide","nonproprietary_name":"Nystatin and triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-483-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.34479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048330","name":"NYSTATIN-TRIAMCINOLONE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-483-30","proprietary_name":"Nystatin and triamcinolone acetonide","nonproprietary_name":"Nystatin and triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-483-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.26518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342048360","name":"NYSTATIN-TRIAMCINOLONE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-483-60","proprietary_name":"Nystatin and triamcinolone acetonide","nonproprietary_name":"Nystatin and triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-483-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332058515","name":"NYSTATIN-TRIAMCINOLONE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-585-15","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-585-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.34479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332058530","name":"NYSTATIN-TRIAMCINOLONE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-585-30","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-585-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.26518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"62332058560","name":"NYSTATIN-TRIAMCINOLONE OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-585-60","proprietary_name":"Nystatin and Triamcinolone Acetonide","nonproprietary_name":"Nystatin and Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100000 [USP'U]/g; 1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-585-60) / 60 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.23536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574200802","name":"NYSTOP 100,000 UNIT/GM POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2008-02","proprietary_name":"Nystop","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis US LLC","package_description":"60 g in 1 BOTTLE, PLASTIC (0574-2008-02)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.25738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nystop|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"00574200815","name":"NYSTOP 100,000 UNIT/GM POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2008-15","proprietary_name":"Nystop","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis US LLC","package_description":"15 g in 1 BOTTLE, PLASTIC (0574-2008-15)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.42143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nystop|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"00574200830","name":"NYSTOP 100,000 UNIT/GM POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2008-30","proprietary_name":"Nystop","nonproprietary_name":"Nystatin","dosage_form":"POWDER","route":"TOPICAL","strength":"100000 [USP'U]/g","labeler":"Padagis US LLC","package_description":"30 g in 1 BOTTLE, PLASTIC (0574-2008-30)","pharm_classes":["Polyene Antifungal [EPC]","Polyenes [CS]"]},"nadac":{"value":0.31335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Nystop|Nystatin","basis":"brand"},"part_b":null}, {"ndc":"68025005930","name":"OB COMPLETE PETITE SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":7.89328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641617701","name":"OCTREOTIDE 1,000 MCG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6177-01","proprietary_name":"Octreotide Acetate","nonproprietary_name":"Octreotide Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"200 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0641-6177-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":5.3404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0641-6177-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155068531","name":"OCTREOTIDE 1,000 MCG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23155-685-31","proprietary_name":"OCTREOTIDE ACETATE","nonproprietary_name":"octreotide acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; INTRAVENOUS","strength":"200 ug/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"5 mL in 1 VIAL, GLASS (23155-685-31)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":5.3404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, GLASS (23155-685-31)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021046605","name":"OCTREOTIDE 1,000 MCG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":5.3404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"63323037805","name":"OCTREOTIDE 1,000 MCG/5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-378-05","proprietary_name":"Octreotide","nonproprietary_name":"OCTREOTIDE ACETATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"200 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (63323-378-05) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":5.3404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (63323-378-05) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457024501","name":"OCTREOTIDE ACET 100 MCG/ML SYR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-245-01","proprietary_name":"Octreotide Acetate","nonproprietary_name":"octreotide acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 ug/mL","labeler":"Mylan Institutional LLC","package_description":"10 SYRINGE in 1 CARTON (67457-245-01) / 1 mL in 1 SYRINGE (67457-245-00)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":5.24,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 SYRINGE in 1 CARTON (67457-245-01) / 1 mL in 1 SYRINGE (67457-245-00)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641617510","name":"OCTREOTIDE ACET 100 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6175-10","proprietary_name":"Octreotide Acetate","nonproprietary_name":"Octreotide Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0641-6175-10) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6175-01)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.53458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0641-6175-10) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6175-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155068841","name":"OCTREOTIDE ACET 100 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-688-41","proprietary_name":"OCTREOTIDE ACETATE","nonproprietary_name":"octreotide acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 ug/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 VIAL, GLASS in 1 CARTON (23155-688-41) / 1 mL in 1 VIAL, GLASS (23155-688-31)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.53458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (23155-688-41) / 1 mL in 1 VIAL, GLASS (23155-688-31)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021046401","name":"OCTREOTIDE ACET 100 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":2.53458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"63323037601","name":"OCTREOTIDE ACET 100 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-376-01","proprietary_name":"Octreotide","nonproprietary_name":"OCTREOTIDE ACETATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 TRAY (63323-376-01) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-376-00)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.53458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 TRAY (63323-376-01) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-376-00)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323037604","name":"OCTREOTIDE ACET 100 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-376-04","proprietary_name":"Octreotide","nonproprietary_name":"OCTREOTIDE ACETATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 ug/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 TRAY (63323-376-04) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-376-41)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.53458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 TRAY (63323-376-04) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-376-41)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"68462089610","name":"OCTREOTIDE ACET 100 MCG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-896-10","proprietary_name":"Octreotide Acetate","nonproprietary_name":"Octreotide Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"100 ug/mL","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"10 VIAL in 1 CARTON (68462-896-10) / 1 mL in 1 VIAL (68462-896-01)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.53458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (68462-896-10) / 1 mL in 1 VIAL (68462-896-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641617410","name":"OCTREOTIDE ACET 50 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6174-10","proprietary_name":"Octreotide Acetate","nonproprietary_name":"Octreotide Acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"50 ug/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0641-6174-10) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6174-01)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.6422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (0641-6174-10) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-6174-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155068741","name":"OCTREOTIDE ACET 50 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"23155-687-41","proprietary_name":"OCTREOTIDE ACETATE","nonproprietary_name":"octreotide acetate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"50 ug/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 VIAL, GLASS in 1 CARTON (23155-687-41) / 1 mL in 1 VIAL, GLASS (23155-687-31)","pharm_classes":["Somatostatin Analog [EPC]","Somatostatin Receptor Agonists [MoA]"]},"nadac":{"value":2.6422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (23155-687-41) / 1 mL in 1 VIAL, GLASS (23155-687-31)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021046301","name":"OCTREOTIDE ACET 50 MCG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":2.6422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Octreotide Acetate|Octreotide Acetate","basis":"generic"},"part_b":{"hcpcs":"J2354","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2354 (25 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"52709170101","name":"ODACTRA 12 SQ-HDM SL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.71125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Odactra|Mite,D.Farinae-D.Pteronyssinus","basis":"brand"},"part_b":null}, {"ndc":"52709170103","name":"ODACTRA 12 SQ-HDM SL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52709-1701-3","proprietary_name":"Odactra","nonproprietary_name":"DERMATOPHAGOIDES PTERONYSSINUS and DERMATOPHAGOIDES FARINAE","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"6 [arb'U]/1; 6 [arb'U]/1","labeler":"ALK-Abello A S","package_description":"3 BLISTER PACK in 1 CARTON (52709-1701-3) / 10 TABLET in 1 BLISTER PACK (52709-1701-1)","pharm_classes":["Allergens [CS]","Antigens, Dermatophagoides [CS]","Cell-mediated Immunity [PE]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Insect Proteins [CS]","Standardized Insect Allergenic Extract [EPC]"]},"nadac":{"value":11.71125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Odactra|Mite,D.Farinae-D.Pteronyssinus","basis":"brand"},"part_b":null}, {"ndc":"61958210101","name":"ODEFSEY TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2101-1","proprietary_name":"ODEFSEY","nonproprietary_name":"emtricitabine, rilpivirine hydrochloride, and tenofovir alafenamide","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1; 25 mg/1; 25 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2101-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":130.49198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208041005","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-410-05","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-410-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208041010","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-410-10","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-410-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505036301","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0363-1","proprietary_name":"Ofloxacin Otic","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Apotex Corp.","package_description":"5 mL in 1 BOTTLE, DROPPER (60505-0363-1)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505036302","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0363-2","proprietary_name":"Ofloxacin Otic","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Apotex Corp.","package_description":"10 mL in 1 BOTTLE, DROPPER (60505-0363-2)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980043201","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-432-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (64980-432-01) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980043205","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-432-05","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (64980-432-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145014301","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-143-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Otic","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-143-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145014401","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-144-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Otic solution","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-144-01) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238161503","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1615-3","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69238-1615-3) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238161606","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1616-6","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69238-1616-6) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032005","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-320-05","proprietary_name":"OFLOXACIN","nonproprietary_name":"OFLOXACIN","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"5 mL in 1 BOTTLE, DROPPER (69315-320-05)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032010","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-320-10","proprietary_name":"OFLOXACIN","nonproprietary_name":"OFLOXACIN","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"10 mL in 1 BOTTLE, DROPPER (69315-320-10)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069068601","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-686-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-686-01) / 5 mL in 1 BOTTLE","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069068701","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-687-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-687-01) / 10 mL in 1 BOTTLE","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756060915","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-609-15","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"5 mL in 1 BOTTLE, DROPPER (70756-609-15)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756061030","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-610-30","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"10 mL in 1 BOTTLE, DROPPER (70756-610-30)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603018601","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-186-01","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"NorthStar RxLLC","package_description":"5 mL in 1 BOTTLE, DROPPER (72603-186-01)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.10981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603018602","name":"OFLOXACIN 0.3% EAR DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-186-02","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin otic","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"3 mg/mL","labeler":"NorthStar RxLLC","package_description":"10 mL in 1 BOTTLE, DROPPER (72603-186-02)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":0.97895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904743405","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7434-05","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0904-7434-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"00904743410","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7434-10","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0904-7434-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"24208043405","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-434-05","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-434-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"24208043410","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-434-10","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-434-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"60505056000","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0560-0","proprietary_name":"Ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0560-0) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"60505056001","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0560-1","proprietary_name":"Ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60505-0560-1) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"64980051501","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-515-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (64980-515-01) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"64980051505","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-515-05","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (64980-515-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"65145014101","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-141-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Ophthalmic Solution USP, 0.3%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Caplin Steriles Limited","package_description":"5 mL in 1 BOTTLE, DROPPER (65145-141-01)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"65145014201","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-142-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Ophthalmic Solution USP, 0.3%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Caplin Steriles Limited","package_description":"10 mL in 1 BOTTLE, DROPPER (65145-142-01)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"69315032705","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-327-05","proprietary_name":"OFLOXACIN","nonproprietary_name":"OFLOXACIN","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"5 mL in 1 BOTTLE, DROPPER (69315-327-05)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"69315032710","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-327-10","proprietary_name":"OFLOXACIN","nonproprietary_name":"OFLOXACIN","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Leading Pharma, LLC","package_description":"10 mL in 1 BOTTLE, DROPPER (69315-327-10)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"70069041101","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-411-01","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-411-01) / 5 mL in 1 BOTTLE","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"70512079305","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-793-05","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Ophthalmic Solution USP, 0.3%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 BOX (70512-793-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"70512079310","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-793-10","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin Ophthalmic Solution USP, 0.3%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 BOX (70512-793-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"70756060730","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-607-30","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-607-30) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"70756065030","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-650-30","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-650-30) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"72485061310","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-613-10","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-613-10) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"72485061311","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-613-11","proprietary_name":"Ofloxacin","nonproprietary_name":"Ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"ARMAS PHARMACEUTICALS INC.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72485-613-11) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"72603019201","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-192-01","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"NorthStar RxLLC","package_description":"5 mL in 1 BOTTLE, DROPPER (72603-192-01)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.24141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"72603019202","name":"OFLOXACIN 0.3% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-192-02","proprietary_name":"ofloxacin","nonproprietary_name":"ofloxacin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"NorthStar RxLLC","package_description":"10 mL in 1 BOTTLE, DROPPER (72603-192-02)","pharm_classes":["Quinolone Antimicrobial [EPC]","Quinolones [CS]"]},"nadac":{"value":1.11355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ofloxacin*|Ofloxacin","basis":"generic"},"part_b":null}, {"ndc":"00904637661","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6376-61","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6376-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342007007","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-070-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-070-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342007015","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-070-15","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-070-15)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"43598016605","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-166-05","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-166-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"43598016630","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-166-30","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-166-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311300","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3113-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3113-0) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311308","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3113-8","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-3113-8)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084074001","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-740-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-740-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-740-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084074011","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-740","inner_of":["68084-740-01"]},"part_b":null}, {"ndc":"72241005411","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-054-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-054-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005422","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-054-22","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-054-22)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303083801","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0838-1","proprietary_name":"OLANZAPINE","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (72303-0838-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015701","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-157-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-157-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015702","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-157-02","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-157-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015703","name":"OLANZAPINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-157-03","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-157-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.10905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00121107255","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1072-55","proprietary_name":"Olanzapine Intramuscular","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"1 VIAL in 1 CARTON (0121-1072-55) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0121-1072-55) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00143919901","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9199-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9199-01) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9199-01) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00517095501","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-0955-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"American Regent, Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (0517-0955-01) / 2 mL in 1 VIAL, GLASS","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0517-0955-01) / 2 mL in 1 VIAL, GLASS) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781315972","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-3159-72","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"Sandoz Inc","package_description":"1 VIAL in 1 CARTON (0781-3159-72) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0781-3159-72) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781910572","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-9105-72","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"Sandoz Inc","package_description":"1 VIAL in 1 CARTON (0781-9105-72) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0781-9105-72) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722030801","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-308-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 VIAL in 1 CARTON (31722-308-01) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"39822180001","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39822-1800-1","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"XGen Pharmaceuticals DJB, Inc.","package_description":"1 VIAL in 1 CARTON (39822-1800-1) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (39822-1800-1) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55150030801","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-308-01","proprietary_name":"OLANZAPINE","nonproprietary_name":"OLANZAPINE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/1","labeler":"Eugia US LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (55150-308-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (55150-308-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462095210","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-952-10","proprietary_name":"OLANZAPINE","nonproprietary_name":"OLANZAPINE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"1 VIAL in 1 CARTON (68462-952-10) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (68462-952-10) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72603018101","name":"OLANZAPINE 10 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-181-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"10 mg/2mL","labeler":"NorthStar RxLLC","package_description":"1 VIAL in 1 CARTON (72603-181-01) / 2 mL in 1 VIAL","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.923,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2359","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2359 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (72603-181-01) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904628661","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6286-61","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6286-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342007107","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-071-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-071-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342007115","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-071-15","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-071-15)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111016705","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-167-05","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Dr. Reddy's Laboratories Ltd.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (55111-167-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111016730","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-167-30","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Dr. Reddy's Laboratories Ltd.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-167-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311400","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3114-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3114-0) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311403","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3114-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3114-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311408","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3114-8","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-3114-8)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084052801","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-528-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-528-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-528-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084052811","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-528","inner_of":["68084-528-01"]},"part_b":null}, {"ndc":"72241005511","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-055-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-055-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005522","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-055-22","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-055-22)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303083901","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0839-1","proprietary_name":"OLANZAPINE","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (72303-0839-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015801","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-158-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-158-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015802","name":"OLANZAPINE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-158-02","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-158-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.13454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342006707","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-067-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-067-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342006744","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-067-44","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-067-44)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111016305","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-163-05","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Dr. Reddy's Laboratories Ltd.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (55111-163-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111016330","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-163-30","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Dr. Reddy's Laboratories Ltd.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-163-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311000","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3110-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3110-0) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311003","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3110-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3110-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311008","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3110-8","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-3110-8)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084052501","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-525-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-525-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-525-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084052511","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-525","inner_of":["68084-525-01"]},"part_b":null}, {"ndc":"72241005111","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-051-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-051-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005122","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-051-22","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-051-22)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303083501","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0835-1","proprietary_name":"OLANZAPINE","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (72303-0835-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015401","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-154-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-154-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015402","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-154-02","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-154-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015403","name":"OLANZAPINE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-154-03","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-154-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00904628761","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6287-61","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6287-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342007207","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-072-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-072-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342007215","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-072-15","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-072-15)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111016805","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-168-05","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Ltd.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (55111-168-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111016830","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-168-30","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Ltd.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-168-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505314000","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3140-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3140-0) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505314003","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3140-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-3140-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505314008","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3140-8","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-3140-8)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084052901","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-529-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-529-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-529-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084052911","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-529","inner_of":["68084-529-01"]},"part_b":null}, {"ndc":"72241005611","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-056-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-056-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005622","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-056-22","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-056-22)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303084001","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0840-1","proprietary_name":"OLANZAPINE","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (72303-0840-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015901","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-159-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-159-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015902","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-159-02","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-159-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015903","name":"OLANZAPINE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-159-03","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-159-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00904637761","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6377-61","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6377-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342006807","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-068-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-068-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342006844","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-068-44","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-068-44)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"43598016405","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-164-05","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-164-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"43598016430","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-164-30","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-164-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311100","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3111-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3111-0) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311108","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3111-8","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-3111-8)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084072301","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-723-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-723-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-723-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"68084072311","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68084-723","inner_of":["68084-723-01"]},"part_b":null}, {"ndc":"72241005211","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-052-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-052-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005222","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-052-22","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-052-22)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303083601","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0836-1","proprietary_name":"OLANZAPINE","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (72303-0836-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015501","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-155-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-155-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015502","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-155-02","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-155-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015503","name":"OLANZAPINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-155-03","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72603-155-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342006907","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-069-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-069-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342006944","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-069-44","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-069-44)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"43598016505","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-165-05","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43598-165-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"43598016530","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-165-30","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-165-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311200","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3112-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3112-0) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505311208","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3112-8","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-3112-8)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005311","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-053-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (72241-053-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72241005322","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-053-22","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-053-22)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303083701","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0837-1","proprietary_name":"OLANZAPINE","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (72303-0837-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72603015601","name":"OLANZAPINE 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-156-01","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-156-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.09436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine*|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524619","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524665","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5246-65","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-5246-65) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5246-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"13668008830","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-088-30","proprietary_name":"OLANZAPINE","nonproprietary_name":"OLANZAPINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-088-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008407","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-084-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-084-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008411","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-084-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-084-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026379","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-263-79","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (55111-263-79)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026381","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-263-81","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-263-81) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327600","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3276-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3276-0) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327603","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3276-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (60505-3276-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017301","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017302","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-173-02","proprietary_name":"Olanzapine","nonproprietary_name":"olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"3 BLISTER PACK in 1 CARTON (64380-173-02) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (64380-173-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303084201","name":"OLANZAPINE ODT 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0842-1","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (72303-0842-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.36633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524719","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524765","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5247-65","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-5247-65) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5247-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"13668008930","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-089-30","proprietary_name":"OLANZAPINE","nonproprietary_name":"OLANZAPINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-089-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008507","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-085-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-085-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008511","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-085-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-085-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026479","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-264-79","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (55111-264-79)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026481","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-264-81","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-264-81) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327700","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3277-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3277-0) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327703","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3277-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (60505-3277-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017401","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017402","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-174-02","proprietary_name":"Olanzapine","nonproprietary_name":"olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"Strides Pharma Science Limited","package_description":"3 BLISTER PACK in 1 CARTON (64380-174-02) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (64380-174-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303084301","name":"OLANZAPINE ODT 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0843-1","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"15 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (72303-0843-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.63877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524819","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524865","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5248-65","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-5248-65) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5248-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"13668009030","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-090-30","proprietary_name":"OLANZAPINE","nonproprietary_name":"OLANZAPINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-090-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008607","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-086-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-086-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008611","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-086-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-086-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026579","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-265-79","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (55111-265-79)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026581","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-265-81","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-265-81) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327800","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3278-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3278-0) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327803","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3278-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (60505-3278-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017501","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017502","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-175-02","proprietary_name":"Olanzapine","nonproprietary_name":"olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"3 BLISTER PACK in 1 CARTON (64380-175-02) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (64380-175-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303084401","name":"OLANZAPINE ODT 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0844-1","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"20 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (72303-0844-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.72217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524519","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093524565","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5245-65","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 BLISTER PACK in 1 CARTON (0093-5245-65) / 1 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0093-5245-19)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"13668008630","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-086-30","proprietary_name":"OLANZAPINE","nonproprietary_name":"OLANZAPINE","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (13668-086-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008307","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-083-07","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-083-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"33342008311","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-083-11","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 CONTAINER (33342-083-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026279","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-262-79","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (55111-262-79)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"55111026281","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-262-81","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-262-81) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327500","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3275-0","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"10 BLISTER PACK in 1 CARTON (60505-3275-0) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"60505327503","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3275-3","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (60505-3275-3)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017201","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"64380017202","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-172-02","proprietary_name":"Olanzapine","nonproprietary_name":"olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"3 BLISTER PACK in 1 CARTON (64380-172-02) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (64380-172-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"72303084101","name":"OLANZAPINE ODT 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0841-1","proprietary_name":"Olanzapine","nonproprietary_name":"Olanzapine","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (72303-0841-1)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.30355,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine ODT|Olanzapine","basis":"generic"},"part_b":null}, {"ndc":"00093550656","name":"OLANZAPINE-FLUOXETINE 12-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5506-56","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"Olanzapine and Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"12 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-5506-56)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":9.92953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884025211","name":"OLANZAPINE-FLUOXETINE 12-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-252-11","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"olanzapine and fuoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"12 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (49884-252-11)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":9.92953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093550756","name":"OLANZAPINE-FLUOXETINE 12-50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5507-56","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"Olanzapine and Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"12 mg/1; 50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-5507-56)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":6.53416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884025311","name":"OLANZAPINE-FLUOXETINE 12-50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-253-11","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"olanzapine and fuoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"12 mg/1; 50 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (49884-253-11)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":6.53416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093550356","name":"OLANZAPINE-FLUOXETINE 3-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5503-56","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"Olanzapine and Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-5503-56)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.43649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884027711","name":"OLANZAPINE-FLUOXETINE 3-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-277-11","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"olanzapine and fuoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (49884-277-11)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":3.43649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093550456","name":"OLANZAPINE-FLUOXETINE 6-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5504-56","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"Olanzapine and Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-5504-56)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.05968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884025011","name":"OLANZAPINE-FLUOXETINE 6-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-250-11","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"olanzapine and fuoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (49884-250-11)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.05968,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093550556","name":"OLANZAPINE-FLUOXETINE 6-50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5505-56","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"Olanzapine and Fluoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1; 50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-5505-56)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.43098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884025111","name":"OLANZAPINE-FLUOXETINE 6-50 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-251-11","proprietary_name":"Olanzapine and Fluoxetine","nonproprietary_name":"olanzapine and fuoxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1; 50 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (49884-251-11)","pharm_classes":["Atypical Antipsychotic [EPC]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":4.43098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olanzapine-Fluoxetine HCl|Olanzapine/Fluoxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00527242632","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2426-32","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-2426-32)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"00527242646","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2426-46","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-2426-46)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722085330","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-853-30","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"OLMESARTAN MEDOXOMIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-853-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722085390","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-853-90","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"OLMESARTAN MEDOXOMIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-853-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"33342017910","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-179-10","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-179-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"43547030003","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-300-03","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC.","package_description":"30 TABLET in 1 BOTTLE (43547-300-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"43547030009","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-300-09","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC.","package_description":"90 TABLET in 1 BOTTLE (43547-300-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228034010","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-340-10","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-340-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228034030","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-340-30","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-340-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228034090","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-340-90","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-340-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"59746046530","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-465-30","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59746-465-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"59746046590","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-465-90","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59746-465-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62332013230","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-132-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-132-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62332013290","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-132-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-132-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"64980060203","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-602-03","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (64980-602-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"64980060209","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-602-09","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (64980-602-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"65862074230","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-742-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-742-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"65862074290","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-742-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-742-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"67877044630","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-446-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (67877-446-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"67877044690","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-446-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (67877-446-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"68462043730","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-437-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-437-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"68462043790","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-437-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-437-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016630","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-166-30","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-166-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016666","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-166-66","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-166-66)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016690","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-166-90","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-166-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72241007904","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-079-04","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-079-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72303084901","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0849-1","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0849-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72303084902","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0849-2","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0849-2)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"82009007490","name":"OLMESARTAN MEDOXOMIL 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-074-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-074-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"00527242732","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2427-32","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-2427-32)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"00527242746","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2427-46","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-2427-46)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"16729032215","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-322-15","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Accord Healthcare Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16729-322-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722085430","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-854-30","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"OLMESARTAN MEDOXOMIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-854-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722085490","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-854-90","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"OLMESARTAN MEDOXOMIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-854-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"33342018007","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-180-07","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-180-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"33342018010","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-180-10","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-180-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"43547030103","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-301-03","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC.","package_description":"30 TABLET in 1 BOTTLE (43547-301-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"43547030109","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-301-09","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC.","package_description":"90 TABLET in 1 BOTTLE (43547-301-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228034110","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-341-10","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-341-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228034130","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-341-30","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-341-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228034190","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-341-90","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-341-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"59746046630","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-466-30","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59746-466-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"59746046690","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-466-90","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59746-466-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62332013330","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-133-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-133-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62332013390","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-133-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-133-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"64980060303","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-603-03","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (64980-603-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"64980060309","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-603-09","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (64980-603-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"65862074330","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-743-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-743-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"65862074390","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-743-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-743-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"67877044730","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-447-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (67877-447-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"67877044790","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-447-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (67877-447-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"68462043830","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-438-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-438-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"68462043890","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-438-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-438-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016730","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-167-30","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-167-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016766","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-167-66","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-167-66)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016790","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-167-90","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-167-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72241008004","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-080-04","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-080-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72303085001","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0850-1","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0850-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72303085002","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0850-2","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0850-2)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"82009007590","name":"OLMESARTAN MEDOXOMIL 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-075-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-075-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.11097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"00527242532","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2425-32","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-2425-32)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"00527242546","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2425-46","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0527-2425-46)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"16729032010","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-320-10","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (16729-320-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722085230","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-852-30","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"OLMESARTAN MEDOXOMIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-852-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722085290","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-852-90","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"OLMESARTAN MEDOXOMIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-852-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"33342017807","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-178-07","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-178-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"43547029903","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-299-03","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC.","package_description":"30 TABLET in 1 BOTTLE (43547-299-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228033910","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-339-10","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-339-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228033930","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-339-30","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-339-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"50228033990","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-339-90","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-339-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"59746046330","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-463-30","proprietary_name":"olmesartan medoxomil","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59746-463-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62135088030","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-880-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-880-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62332013130","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-131-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-131-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"62332013190","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-131-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-131-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"64980066503","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-665-03","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (64980-665-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"64980066509","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-665-09","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"olmesartan medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (64980-665-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"65862074130","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-741-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-741-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"67877044530","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-445-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (67877-445-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"68462043630","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-436-30","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-436-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"68462043690","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-436-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-436-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016530","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-165-30","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-165-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72205016590","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-165-90","proprietary_name":"Olmesartan medoxomil","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-165-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72241007804","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-078-04","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-078-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72303084801","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0848-1","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0848-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"72303084802","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0848-2","proprietary_name":"OLMESARTAN MEDOXOMIL","nonproprietary_name":"Olmesartan medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0848-2)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"82009007390","name":"OLMESARTAN MEDOXOMIL 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-073-90","proprietary_name":"Olmesartan Medoxomil","nonproprietary_name":"Olmesartan Medoxomil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-073-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.05748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan Medoxomil|Olmesartan Medoxomil","basis":"generic"},"part_b":null}, {"ndc":"31722088630","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-886-30","proprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-886-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"31722088690","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-886-90","proprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-886-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342017307","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-173-07","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-173-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342017310","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-173-10","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-173-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039103","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-391-03","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-391-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039109","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-391-09","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-391-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332014930","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-149-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-149-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332014990","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-149-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-149-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862077930","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-779-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-779-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862077990","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-779-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-779-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"67877045330","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-453-30","proprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-453-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"67877045390","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-453-90","proprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-453-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70756081230","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-812-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-812-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70756081290","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-812-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (70756-812-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72205014730","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-147-30","proprietary_name":"olmesartan medoxomil-hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-147-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72205014790","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-147-90","proprietary_name":"olmesartan medoxomil-hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-147-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72603029001","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-290-01","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-290-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72603029002","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-290-02","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 12.5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-290-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.16502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"31722088730","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-887-30","proprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-887-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"31722088790","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-887-90","proprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-887-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342017407","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-174-07","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-174-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342017410","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-174-10","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-174-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039203","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-392-03","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-392-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039209","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-392-09","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-392-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332015030","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-150-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-150-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332015090","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-150-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-150-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862078030","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-780-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-780-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862078090","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-780-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-780-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"67877045230","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-452-30","proprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-452-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"67877045290","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-452-90","proprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-452-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70756081330","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-813-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-813-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70756081390","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-813-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (70756-813-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72205014830","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-148-30","proprietary_name":"olmesartan medoxomil-hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-148-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72205014890","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-148-90","proprietary_name":"olmesartan medoxomil-hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-148-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72603029101","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-291-01","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-291-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72603029102","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-291-02","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-291-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.21959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"31722088830","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-888-30","proprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-888-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"31722088890","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-888-90","proprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-888-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342017507","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-175-07","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-175-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342017510","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-175-10","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-175-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039303","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-393-03","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-393-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547039309","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-393-09","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"olmesartan medoxomil and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-393-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332015130","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-151-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-151-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332015190","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-151-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-151-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862078130","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-781-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-781-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862078190","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-781-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-781-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"67877045130","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-451-30","proprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-451-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"67877045190","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-451-90","proprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-451-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70756081430","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-814-30","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-814-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"70756081490","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-814-90","proprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Lifestar Pharma LLC","package_description":"90 TABLET in 1 BOTTLE (70756-814-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72205014930","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-149-30","proprietary_name":"olmesartan medoxomil-hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-149-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72205014990","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-149-90","proprietary_name":"olmesartan medoxomil-hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil-hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-149-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72603029201","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-292-01","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72603-292-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72603029202","name":"OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-292-02","proprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","nonproprietary_name":"OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 25 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-292-02)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.20907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olmesartan-Hydrochlorothiazide|Olmesartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00093500556","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5005-56","proprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5005-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089230","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-892-30","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-892-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089290","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-892-90","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-892-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024307","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-243-07","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-243-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024310","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-243-10","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-243-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078609","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-786-09","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Par Health USA, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (49884-786-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078611","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-786-11","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-786-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001404","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 20-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-014-04","proprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70436-014-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.77624,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093500356","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5003-56","proprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5003-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089530","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-895-30","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-895-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089590","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-895-90","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-895-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024607","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-246-07","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-246-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024610","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-246-10","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-246-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078909","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-789-09","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Par Health USA, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (49884-789-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078911","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-789-11","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-789-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001704","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-017-04","proprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 12.5 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70436-017-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.15137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093500256","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5002-56","proprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5002-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089630","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-896-30","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-896-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089690","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-896-90","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-896-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024707","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-247-07","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-247-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024710","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-247-10","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-247-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884079009","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-790-09","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (49884-790-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884079011","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-790-11","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-790-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001804","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-10-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-018-04","proprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70436-018-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093500656","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5006-56","proprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5006-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089330","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-893-30","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-893-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089390","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-893-90","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-893-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024407","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-244-07","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-244-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024410","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-244-10","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-244-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078709","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-787-09","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Par Health USA, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (49884-787-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078711","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-787-11","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-787-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001504","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-12.5","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-015-04","proprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70436-015-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093500456","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5004-56","proprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5004-56)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089430","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-894-30","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-894-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722089490","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-894-90","proprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil, amlodipine and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-894-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024507","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-245-07","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-245-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342024510","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-245-10","proprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","nonproprietary_name":"Olmesartan medoxomil Amlodipine and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-245-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078809","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-788-09","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (49884-788-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884078811","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-788-11","proprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49884-788-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436001604","name":"OLMSRTN-AMLDPN-HYDROCHLOROTHIAZIDE 40-5-25 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-016-04","proprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","nonproprietary_name":"olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 25 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70436-016-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.99481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802010401","name":"OLOPATADINE 665 MCG NASAL SPRY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-104-01","proprietary_name":"olopatadine hydrochloride","nonproprietary_name":"Olopatadine Hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"665 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-104-01) / 240 SPRAY in 1 BOTTLE","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.8495,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Olopatadine HCl*|Olopatadine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505084505","name":"OLOPATADINE 665 MCG NASAL SPRY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0845-5","proprietary_name":"Olopatadine Hydrochloride","nonproprietary_name":"olopatadine hydrochloride","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"665 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-0845-5) / 240 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.8495,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Olopatadine HCl*|Olopatadine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162089023","name":"OLOPATADINE 665 MCG NASAL SPRY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-890-23","proprietary_name":"Olopatadine Hydrochloride","nonproprietary_name":"Olopatadine Hydrochloride","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"665 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE, SPRAY in 1 CARTON (65162-890-23) / 665 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":0.8495,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Olopatadine HCl*|Olopatadine HCl","basis":"generic"},"part_b":null}, {"ndc":"16571088205","name":"OLOPATADINE HCL 0.1% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-882-05","proprietary_name":"olopatadine hydrochloride","nonproprietary_name":"olopatadine hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 CONTAINER in 1 CARTON (16571-882-05) / 5 mL in 1 CONTAINER","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000071701","name":"OLOPATADINE HCL 0.1% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0717-1","proprietary_name":"Leader Olopatadine Hydrochloride Ophthalmic Solution","nonproprietary_name":"Olopatadine Hydrochloride Ophthalmic Solution","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"CARDINAL HEALTH","package_description":"1 BOTTLE in 1 CARTON (70000-0717-1) / 5 mL in 1 BOTTLE","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069001701","name":"OLOPATADINE HCL 0.1% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-017-01","proprietary_name":"Olopatadine","nonproprietary_name":"Olopatadine","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70069-017-01) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70512052005","name":"OLOPATADINE HCL 0.1% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-520-05","proprietary_name":"Olopatadine Hcl","nonproprietary_name":"Olopatadine Hcl","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Sola Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70512-520-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536144540","name":"OLOPATADINE HCL 0.1% EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1445-40","proprietary_name":"Olopatadine Hydrochloride","nonproprietary_name":"Olopatadine Hydrochloride Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"RUGBY LABORATORIES","package_description":"1 BOTTLE in 1 CARTON (0536-1445-40) / 5 mL in 1 BOTTLE","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598076507","name":"OLOPATADINE HCL 0.1% EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-765-07","proprietary_name":"Olopatadine Hydrochloride Ophthalmic Solution","nonproprietary_name":"Olopatadine Hydrochloride Ophthalmic","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (43598-765-07) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536130723","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1307-23","proprietary_name":"Olopatadine Hydrochloride","nonproprietary_name":"Olopatadine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0536-1307-23) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571086125","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-861-25","proprietary_name":"olopatadine hydrochloride","nonproprietary_name":"olopatadine hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 CONTAINER in 1 CARTON (16571-861-25) / 2.5 mL in 1 CONTAINER","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598076402","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-764-02","proprietary_name":"Olopatadine Hydrochloride Ophthalmic Solution","nonproprietary_name":"Olopatadine Hydrochloride Ophthalmic","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (43598-764-02) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68001053069","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-530-69","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (68001-530-69) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68001067492","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-674-92","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (68001-674-92) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000071601","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0716-1","proprietary_name":"LEADER OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"CARDINAL HEALTH","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0716-1) / 3.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":1.98349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069049101","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-491-01","proprietary_name":"OLOPATADINE HYDROCHLORIDE","nonproprietary_name":"Olopatadine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70069-491-01) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324012025","name":"OLOPATADINE HCL 0.2% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-120-25","proprietary_name":"Olopatadine Hydrochloride Ophthalmic Solution","nonproprietary_name":"Olopatadine Hydrochloride Ophthalmic","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Chain Drug Marketing Association INC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-120-25) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00002418230","name":"OLUMIANT 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-4182-30","proprietary_name":"Olumiant","nonproprietary_name":"baricitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Eli Lilly and Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0002-4182-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":92.54333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olumiant|Baricitinib","basis":"brand"},"part_b":null}, {"ndc":"00002447930","name":"OLUMIANT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-4479-30","proprietary_name":"Olumiant","nonproprietary_name":"baricitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Eli Lilly and Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0002-4479-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":184.66233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Olumiant|Baricitinib","basis":"brand"},"part_b":null}, {"ndc":"00904749506","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7495-06","proprietary_name":"OMEGA-3-ACID ETHYL ESTERS","nonproprietary_name":"Omega-3-acid ethyl esters","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7495-06) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"24658035012","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-350-12","proprietary_name":"OMEGA-3-ACID ETHYL ESTERS","nonproprietary_name":"OMEGA-3-ACID ETHYL ESTERS","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (24658-350-12)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"31722093612","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-936-12","proprietary_name":"Omega-3-acid ethyl esters","nonproprietary_name":"Omega-3-acid ethyl esters","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (31722-936-12)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"42806055212","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-552-12","proprietary_name":"OMEGA-3-ACID ETHYL ESTERS","nonproprietary_name":"OMEGA-3-ACID ETHYL ESTERS","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"EPIC PHARMA, LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (42806-552-12)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"60687084611","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"60687084665","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-846-65","proprietary_name":"omega-3-acid ethyl esters","nonproprietary_name":"omega-3-acid ethyl esters","dosage_form":"CAPSULE","route":"ORAL","strength":"900 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-846-65) / 1 CAPSULE in 1 BLISTER PACK (60687-846-11)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"62135078012","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-780-12","proprietary_name":"omega-3-acid ethyl esters","nonproprietary_name":"omega-3-acid ethyl esters","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"900 mg/1","labeler":"Chartwell RX, LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (62135-780-12)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"64380076111","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-761-11","proprietary_name":"omega-3-acid ethyl esters","nonproprietary_name":"omega-3-acid ethyl esters","dosage_form":"CAPSULE","route":"ORAL","strength":"900 mg/1","labeler":"Strides Pharma Science Limited","package_description":"120 CAPSULE in 1 BOTTLE (64380-761-11)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"65162003416","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756042322","name":"OMEGA-3 ETHYL ESTERS 1 GM CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-423-22","proprietary_name":"OMEGA-3-ACID ETHYL ESTERS","nonproprietary_name":"Omega-3-acid ethyl esters","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 g/1","labeler":"Lifestar Pharma LLC","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE (70756-423-22)","pharm_classes":["Fatty Acids, Omega-3 [CS]","Omega-3 Fatty Acid [EPC]"]},"nadac":{"value":0.17111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omega-3 Acid Ethyl Esters|Omega-3 Acid Ethyl Esters","basis":"generic"},"part_b":null}, {"ndc":"16714063001","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-630-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-630-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714071401","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-714-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-714-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015701","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-157-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-157-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015730","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-157-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-157-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064301","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-643-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-643-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064330","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-643-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-643-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000101","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-001-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-001-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000130","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-001-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-001-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505014502","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0145-2","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (60505-0145-2)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135055930","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-559-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (62135-559-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382041101","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-411-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-411-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039501","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-395-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-395-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039530","name":"OMEPRAZOLE DR 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-395-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-395-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.07662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781286810","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2868-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0781-2868-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781286831","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2868-31","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0781-2868-31)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781286892","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2868-92","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (0781-2868-92)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904691761","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6917-61","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6917-61) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714063401","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-634-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-634-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714063402","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-634-02","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-634-02)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714063403","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-634-03","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-634-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015801","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-158-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-158-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015810","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-158-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-158-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015830","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-158-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-158-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015834","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-158-34","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"12 BOTTLE in 1 CARTON (55111-158-34) / 30 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064401","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-644-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-644-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064410","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-644-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-644-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064430","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-644-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-644-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237016130","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-161-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57237-161-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237016190","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-161-90","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57237-161-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237016199","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-161-99","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57237-161-99)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000205","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-002-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-002-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000290","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-002-90","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-002-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000299","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-002-99","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-002-99)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505006501","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0065-1","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (60505-0065-1)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505006502","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0065-2","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (60505-0065-2)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687059701","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-597-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-597-01) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (60687-597-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687059711","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382041201","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-412-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-412-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382041205","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-412-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-412-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039601","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-396-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-396-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039610","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-396-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-396-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039630","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-396-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-396-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039690","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-396-90","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-396-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700015001","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-150-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Xiromed, LLC","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-150-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700015010","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-150-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Xiromed, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-150-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700015030","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-150-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Xiromed, LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-150-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009002210","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-022-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-022-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009018310","name":"OMEPRAZOLE DR 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-183-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-183-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.02945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113052055","name":"OMEPRAZOLE DR 20 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0520-55","proprietary_name":"good sense omeprazole","nonproprietary_name":"omeprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"L. Perrigo Company","package_description":"3 CARTON in 1 CARTON (0113-0520-55) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.4682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122061604","name":"OMEPRAZOLE DR 20 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-616-04","proprietary_name":"good neighbor pharmacy omeprazole","nonproprietary_name":"omeprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"3 CARTON in 1 CARTON (46122-616-04) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.4682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000038101","name":"OMEPRAZOLE DR 20 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0381-1","proprietary_name":"Leader Omeprazole","nonproprietary_name":"omeprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"14 BLISTER PACK in 1 CARTON (70000-0381-1) / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.4682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000038102","name":"OMEPRAZOLE DR 20 MG ODT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0381-2","proprietary_name":"Leader Omeprazole","nonproprietary_name":"omeprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"3 CARTON in 1 CARTON (70000-0381-2) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.4682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536144813","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1448-13","proprietary_name":"rugby omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rugby Laboratories","package_description":"3 BOTTLE in 1 CARTON (0536-1448-13) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536144888","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1448-88","proprietary_name":"rugby omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1448-88) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802088830","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-888-30","proprietary_name":"omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"2 CARTON in 1 CARTON (45802-888-30) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802088855","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-888-55","proprietary_name":"omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 CARTON in 1 CARTON (45802-888-55) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122002903","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-029-03","proprietary_name":"good neighbor pharmacy omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"2 CARTON in 1 CARTON (46122-029-03) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122002904","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-029-04","proprietary_name":"good neighbor pharmacy omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"3 CARTON in 1 CARTON (46122-029-04) / 14 BLISTER PACK in 1 CARTON / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122002974","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-029-74","proprietary_name":"good neighbor pharmacy omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"14 BLISTER PACK in 1 CARTON (46122-029-74) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122002999","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122028104","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-281-04","proprietary_name":"good neighbor pharmacy omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"3 BOTTLE in 1 CARTON (46122-281-04) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122028174","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-281-74","proprietary_name":"good neighbor pharmacy omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (46122-281-74) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660002914","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-029-14","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"1 BOTTLE in 1 CARTON (51660-029-14) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660002927","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-029-27","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"2 BOTTLE in 1 CARTON (51660-029-27) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660002944","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-029-44","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"OHM LABORATORIES INC.","package_description":"3 BOTTLE in 1 CARTON (51660-029-44) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001044139","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-441-39","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"2 BOTTLE in 1 CARTON (68001-441-39) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-441-55)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001044140","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-441-40","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"3 BOTTLE in 1 CARTON (68001-441-40) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-441-55)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001044198","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-441-98","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BOTTLE in 1 CARTON (68001-441-98) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE (68001-441-55)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072301","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0723-1","proprietary_name":"leader omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0723-1) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072302","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0723-2","proprietary_name":"leader omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"14 BLISTER PACK in 1 CARTON (70000-0723-2) / 14 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000072303","name":"OMEPRAZOLE DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0723-3","proprietary_name":"leader omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"3 BOTTLE in 1 CARTON (70000-0723-3) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.3832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714012301","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-123-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-123-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714012302","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-123-02","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-123-02)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714012303","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-123-03","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (16714-123-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268065711","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268065715","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-657-15","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-657-15) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (50268-657-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015901","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-159-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-159-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015905","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-159-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-159-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015910","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-159-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-159-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111015930","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-159-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-159-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064501","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-645-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-645-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064505","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-645-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-645-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064510","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-645-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-645-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064530","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-645-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (55111-645-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111064534","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-645-34","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"12 BOTTLE in 1 CARTON (55111-645-34) / 30 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237016230","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-162-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57237-162-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237016250","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-162-50","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57237-162-50)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237016290","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-162-90","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57237-162-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000305","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-003-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-003-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651000330","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-003-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59651-003-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505014601","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0146-1","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (60505-0146-1)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505014602","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0146-2","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (60505-0146-2)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687060801","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-608-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-608-01) / 1 CAPSULE, DELAYED RELEASE in 1 BLISTER PACK (60687-608-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687060811","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382050001","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-500-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-500-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382050005","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-500-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-500-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382050010","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-500-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68382-500-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039701","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-397-01","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-397-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039710","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-397-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-397-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039730","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-397-30","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-397-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462039790","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-397-90","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 CAPSULE, DELAYED RELEASE in 1 BOTTLE (68462-397-90)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700015110","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-151-10","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Xiromed, LLC","package_description":"1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE (70700-151-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009002305","name":"OMEPRAZOLE DR 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-023-05","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 CAPSULE, DELAYED RELEASE in 1 BOTTLE (82009-023-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04982,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011714","name":"OMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-117-14","proprietary_name":"Omeprazole Magnesium","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Chain Drug Marketing Association","package_description":"1 BOTTLE in 1 CARTON (83324-117-14) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011742","name":"OMEPRAZOLE MAG DR 20 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-117-42","proprietary_name":"Omeprazole Magnesium","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Chain Drug Marketing Association","package_description":"3 BOTTLE in 1 CARTON (83324-117-42) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132213","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1322-13","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rugby Laboratories","package_description":"3 BOTTLE in 1 CARTON (0536-1322-13) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132271","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1322-71","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rugby Laboratories","package_description":"2 BOTTLE in 1 CARTON (0536-1322-71) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132288","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1322-88","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1322-88) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230031831","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230031835","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-318-35","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"1 BOTTLE in 1 CARTON (69230-318-35) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230031836","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-318-36","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"2 BOTTLE in 1 CARTON (69230-318-36) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230031837","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-318-37","proprietary_name":"Omeprazole","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Consumer Care Inc","package_description":"3 BOTTLE in 1 CARTON (69230-318-37) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000052102","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0521-2","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health","package_description":"1 BLISTER PACK in 1 CARTON (70000-0521-2) / 14 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000052103","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0521-3","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health","package_description":"2 BOTTLE in 1 CARTON (70000-0521-3) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000052104","name":"OMEPRAZOLE MAG DR 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0521-4","proprietary_name":"Acid Reducer","nonproprietary_name":"Omeprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Cardinal Health","package_description":"3 BOTTLE in 1 CARTON (70000-0521-4) / 14 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.47306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039727","name":"OMEPRAZOLE MAG DR 20.6 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-397-27","proprietary_name":"Omeprazole Magnesium","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"2 BOTTLE in 1 CARTON (55111-397-27) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039733","name":"OMEPRAZOLE MAG DR 20.6 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-397-33","proprietary_name":"Omeprazole Magnesium","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BOTTLE in 1 CARTON (55111-397-33) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111039752","name":"OMEPRAZOLE MAG DR 20.6 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-397-52","proprietary_name":"Omeprazole Magnesium","nonproprietary_name":"Omeprazole Magnesium","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-397-52) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.39509,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241003103","name":"OMEPRAZOLE-BICARB 20-1,100 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-031-03","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1; 1100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (27241-031-03)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.62862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"69097091302","name":"OMEPRAZOLE-BICARB 20-1,100 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-913-02","proprietary_name":"omeprazole sodium bicarbonate","nonproprietary_name":"omeprazole sodium bicarbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1; 1100 mg/1","labeler":"Cipla USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (69097-913-02)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.62862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367019530","name":"OMEPRAZOLE-BICARB 20-1,100 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241002931","name":"OMEPRAZOLE-BICARB 20-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-029-31","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"20 mg/1; 1680 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (27241-029-31)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.11251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"27241002962","name":"OMEPRAZOLE-BICARB 20-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-029-62","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"20 mg/1; 1680 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1 FOR SUSPENSION in 1 PACKET (27241-029-62)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.11251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"64380018202","name":"OMEPRAZOLE-BICARB 20-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-182-02","proprietary_name":"Omeprazole/Sodium Bicarbonate","nonproprietary_name":"omeprazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"20 mg/1700mg; 1680 mg/1700mg","labeler":"Strides Pharma Science Limited","package_description":"30 POUCH in 1 CARTON (64380-182-02) / 20 mg in 1 POUCH (64380-182-01)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.11251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954079720","name":"OMEPRAZOLE-BICARB 20-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-797-20","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"20 mg/1; 1680 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-797-20) / 1 POWDER, FOR SUSPENSION in 1 PACKET (70954-797-10)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":8.11251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"27241003203","name":"OMEPRAZOLE-BICARB 40-1,100 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-032-03","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1; 1100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (27241-032-03)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.56222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"69097091402","name":"OMEPRAZOLE-BICARB 40-1,100 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-914-02","proprietary_name":"omeprazole sodium bicarbonate","nonproprietary_name":"omeprazole sodium bicarbonate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1; 1100 mg/1","labeler":"Cipla USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (69097-914-02)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.56222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367019630","name":"OMEPRAZOLE-BICARB 40-1,100 CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-196-30","proprietary_name":"Omeprazole/Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"40 mg/1; 1100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE, PLASTIC (69367-196-30)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.56222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"27241003031","name":"OMEPRAZOLE-BICARB 40-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-030-31","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/1; 1680 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (27241-030-31)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":7.90411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"27241003062","name":"OMEPRAZOLE-BICARB 40-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-030-62","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/1; 1680 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1 FOR SUSPENSION in 1 PACKET (27241-030-62)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":7.90411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"64380018302","name":"OMEPRAZOLE-BICARB 40-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-183-02","proprietary_name":"Omeprazole/Sodium Bicarbonate","nonproprietary_name":"omeprazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/1720mg; 1680 mg/1720mg","labeler":"Strides Pharma Science Limited","package_description":"30 POUCH in 1 CARTON (64380-183-02) / 40 mg in 1 POUCH (64380-183-01)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":7.90411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954079820","name":"OMEPRAZOLE-BICARB 40-1,680 PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-798-20","proprietary_name":"Omeprazole and Sodium Bicarbonate","nonproprietary_name":"Omeprazole and Sodium Bicarbonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/1; 1680 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (70954-798-20) / 1 POWDER, FOR SUSPENSION in 1 PACKET (70954-798-10)","pharm_classes":["Alkalinizing Activity [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":7.90411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Omeprazole-Sodium Bicarbonate|Omeprazole/Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"70515070101","name":"OMNARIS 50 MCG NASAL SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-701-01","proprietary_name":"Omnaris","nonproprietary_name":"ciclesonide","dosage_form":"SPRAY","route":"NASAL","strength":"50 ug/1","labeler":"Covis Pharma US, Inc","package_description":"1 POUCH in 1 CARTON (70515-701-01) / 1 BOTTLE, GLASS in 1 POUCH / 120 SPRAY in 1 BOTTLE, GLASS"},"nadac":{"value":22.5531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Omnaris|Ciclesonide","basis":"brand"},"part_b":null}, {"ndc":"00781300107","name":"OMNITROPE 5 MG/1.5 ML CRTG","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-3001-07","proprietary_name":"Omnitrope","nonproprietary_name":"Somatropin","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"5 mg/1.5mL","labeler":"Sandoz Inc","package_description":"1 CARTRIDGE in 1 CARTON (0781-3001-07) / 1.5 mL in 1 CARTRIDGE","pharm_classes":["Human Growth Hormone [CS]","Recombinant Human Growth Hormone [EPC]"]},"nadac":{"value":430.36341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781400436","name":"OMNITROPE 5.8 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-4004-36","proprietary_name":"Omnitrope","nonproprietary_name":"Somatropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Sandoz Inc","package_description":"1 KIT in 1 CARTON (0781-4004-36) * 1 mL in 1 VIAL (0781-4014-71) * 1.14 mL in 1 VIAL (0781-4024-72)"},"nadac":{"value":326.24846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054006447","name":"ONDANSETRON 4 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0064-47","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"4 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (0054-0064-47) / 50 mL in 1 BOTTLE, GLASS","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.28641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121088251","name":"ONDANSETRON 4 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0882-51","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"SOLUTION","route":"ORAL","strength":"4 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"50 mL in 1 BOTTLE, PLASTIC (0121-0882-51)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.28641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714067102","name":"ONDANSETRON 4 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-671-02","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"4 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (16714-671-02) / 50 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.28641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, PLASTIC in 1 CARTON (16714-671-02) / 50 mL in 1 BOTTLE, PLASTIC) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62135055558","name":"ONDANSETRON 4 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-555-58","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"4 mg/5mL","labeler":"Chartwell RX, LLC.","package_description":"50 mL in 1 BOTTLE (62135-555-58)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.28641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 mL in 1 BOTTLE (62135-555-58)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65162069179","name":"ONDANSETRON 4 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-691-79","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"SOLUTION","route":"ORAL","strength":"4 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"50 mL in 1 BOTTLE (65162-691-79)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.28641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60687025246","name":"ONDANSETRON 4 MG/5 ML SOLUTION CUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.28641,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409475901","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4759-01","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hospira, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0409-4759-01) / 20 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0409-4759-01) / 20 mL in 1 VIAL, MULTI-DOSE) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641607901","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6079-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"20 mL in 1 CARTON (0641-6079-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (20 mL in 1 CARTON (0641-6079-01)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641628601","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6286-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"20 mL in 1 VIAL, MULTI-DOSE (0641-6286-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (20 mL in 1 VIAL, MULTI-DOSE (0641-6286-01)) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155054931","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-549-31","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1 VIAL in 1 CARTON (23155-549-31) / 20 mL in 1 VIAL","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (23155-549-31) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155055031","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-550-31","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1 VIAL in 1 CARTON (23155-550-31) / 20 mL in 1 VIAL","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (23155-550-31) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323037420","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-374-20","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON HYDROCHLORIDE","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL in 1 BOX (63323-374-20) / 20 mL in 1 VIAL","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 BOX (63323-374-20) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266012401","name":"ONDANSETRON 40 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-124-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"1 VIAL in 1 CARTON (72266-124-01) / 20 mL in 1 VIAL","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (72266-124-01) / 20 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00904655161","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6551-61","proprietary_name":"ondansetron","nonproprietary_name":"ondansetron hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6551-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-6551-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16714015901","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-159-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-159-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (16714-159-01)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"50268062111","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268062115","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-621-15","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-621-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-621-11)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 BLISTER PACK in 1 BOX (50268-621-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-621-11)) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55111015330","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-153-30","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-153-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (55111-153-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"57237007530","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-075-30","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-075-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237007550","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-075-50","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-075-50)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135035005","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-350-05","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-350-05)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"62135035030","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-350-30","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-350-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET in 1 BOTTLE (62135-350-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65862018703","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-187-03","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-187-03) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862018730","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-187-30","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-187-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084022001","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-220-01","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-220-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-220-11)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (400 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-220-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-220-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084022011","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462010530","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-105-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-105-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (68462-105-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69339017101","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-171-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Natco Pharma USA LLC","package_description":"100 TABLET in 1 BOTTLE (69339-171-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017103","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-171-03","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Natco Pharma USA LLC","package_description":"30 TABLET in 1 BOTTLE (69339-171-03)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017105","name":"ONDANSETRON HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-171-05","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Natco Pharma USA LLC","package_description":"500 TABLET in 1 BOTTLE (69339-171-05)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409000925","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-0009-25","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-0009-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-0009-02)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-0009-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-0009-02)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409227125","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-2271-25","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-2271-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-2271-02)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-2271-25) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-2271-02)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409475503","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4755-03","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-4755-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-4755-18)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 TRAY (0409-4755-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0409-4755-18)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641607825","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6078-25","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6078-25) / 2 mL in 1 VIAL (0641-6078-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6078-25) / 2 mL in 1 VIAL (0641-6078-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641608025","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6080-25","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6080-25) / 2 mL in 1 VIAL (0641-6080-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6080-25) / 2 mL in 1 VIAL (0641-6080-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155054742","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-547-42","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (23155-547-42) / 2 mL in 1 VIAL (23155-547-31)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (23155-547-42) / 2 mL in 1 VIAL (23155-547-31)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155054842","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-548-42","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (23155-548-42) / 2 mL in 1 VIAL (23155-548-31)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (23155-548-42) / 2 mL in 1 VIAL (23155-548-31)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021077702","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-777-02","proprietary_name":"ondansetron","nonproprietary_name":"ondansetron hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-777-02) / 2 mL in 1 VIAL","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-777-02) / 2 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"36000001225","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-012-25","proprietary_name":"ONDANSETRON HYDROCHLORIDE","nonproprietary_name":"ONDANSETRON HYDROCHLORIDE","dosage_form":"SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (36000-012-25) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (36000-012-25) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60505613005","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6130-5","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Apotex Corp.","package_description":"25 VIAL, SINGLE-USE in 1 CARTON (60505-6130-5) / 2 mL in 1 VIAL, SINGLE-USE (60505-6130-0)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 CARTON (60505-6130-5) / 2 mL in 1 VIAL, SINGLE-USE (60505-6130-0)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323037302","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-373-02","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON HYDROCHLORIDE","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-373-02) / 2 mL in 1 VIAL (63323-373-00)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (63323-373-02) / 2 mL in 1 VIAL (63323-373-00)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65219032302","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-323-02","proprietary_name":"Ondansetron","nonproprietary_name":"ONDANSETRON HYDROCHLORIDE","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (65219-323-02) / 2 mL in 1 VIAL (65219-323-00)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (65219-323-02) / 2 mL in 1 VIAL (65219-323-00)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266012325","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-123-25","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"25 VIAL in 1 CARTON (72266-123-25) / 2 mL in 1 VIAL (72266-123-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72266-123-25) / 2 mL in 1 VIAL (72266-123-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72572052025","name":"ONDANSETRON HCL 4 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72572-520-25","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"2 mg/mL","labeler":"Civica, Inc.","package_description":"25 VIAL in 1 CARTON (72572-520-25) / 2 mL in 1 VIAL (72572-520-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.17588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2405","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2405 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72572-520-25) / 2 mL in 1 VIAL (72572-520-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00904655261","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6552-61","proprietary_name":"ondansetron","nonproprietary_name":"ondansetron hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6552-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":800,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-6552-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16714016001","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-160-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-160-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (16714-160-01)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"50268062211","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268062215","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-622-15","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-622-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-622-11)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":400,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (800 per item) x PKG QTY (800), but FDA's strength 8 mg/1 x 50 EA per NDC / 1 MG = 400 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 BLISTER PACK in 1 BOX (50268-622-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-622-11)) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55111015430","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-154-30","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-154-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (55111-154-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"57237007630","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-076-30","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-076-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237007650","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-076-50","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-076-50)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135035105","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-351-05","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Chartwell RX, LLC","package_description":"500 TABLET in 1 BOTTLE (62135-351-05)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":4000,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET in 1 BOTTLE (62135-351-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135035130","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-351-30","proprietary_name":"ONDANSETRON","nonproprietary_name":"ONDANSETRON","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-351-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET in 1 BOTTLE (62135-351-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65862018803","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-188-03","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-188-03) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862018830","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-188-30","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-188-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084022101","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-221-01","proprietary_name":"Ondansetron Hydrochloride","nonproprietary_name":"Ondansetron Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-221-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-221-11)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":800,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-221-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-221-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084022111","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462010630","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-106-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-106-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (68462-106-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"69339017201","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-172-01","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Natco Pharma USA LLC","package_description":"100 TABLET in 1 BOTTLE (69339-172-01)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69339017203","name":"ONDANSETRON HCL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69339-172-03","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Natco Pharma USA LLC","package_description":"30 TABLET in 1 BOTTLE (69339-172-03)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.07811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714020010","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"16714020030","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-200-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"NorthStar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-200-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (16714-200-10)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 BLISTER PACK in 1 CARTON (16714-200-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (16714-200-10)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"57237007710","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-077-10","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-077-10) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"57237007730","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-077-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (57237-077-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"57237007750","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-077-50","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (57237-077-50)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"62135012130","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-121-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62135-121-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62135-121-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62756024060","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"65862039010","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-390-10","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-390-10) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"68001024604","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-246-04","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (68001-246-04)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (68001-246-04)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001024616","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-246-16","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"BluePoint Laboratories","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68001-246-16)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"68001024617","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-246-17","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68001-246-17)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68001-246-17)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462015713","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-157-13","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68462-157-13)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68462-157-13)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462015740","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"83980001213","name":"ONDANSETRON ODT 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-012-13","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Ipca Laboratories Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (83980-012-13)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"16714020110","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-201-10","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"NorthStar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-201-10) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (16714-201-10) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16714020130","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-201-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"NorthStar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-201-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (3 BLISTER PACK in 1 CARTON (16714-201-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"57237007810","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-078-10","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-078-10) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"57237007830","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-078-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (57237-078-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"57237007850","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-078-50","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (57237-078-50)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"62135012230","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-122-30","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62135-122-30)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (62135-122-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65862039110","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-391-10","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-391-10) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"68001024704","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-247-04","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (68001-247-04)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (68001-247-04)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001024716","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-247-16","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"BluePoint Laboratories","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68001-247-16)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"68001024717","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-247-17","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68001-247-17)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68001-247-17)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462015811","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-158-11","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"10 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68462-158-11)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":80,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (80 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68462-158-11)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462015813","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-158-13","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68462-158-13)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":{"hcpcs":"Q0162","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q0162 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, ORALLY DISINTEGRATING in 1 BOX, UNIT-DOSE (68462-158-13)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68462015840","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"83980001313","name":"ONDANSETRON ODT 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-013-13","proprietary_name":"Ondansetron","nonproprietary_name":"Ondansetron","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"8 mg/1","labeler":"Ipca Laboratories Limited","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (83980-013-13)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":0.16863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ondansetron ODT|Ondansetron","basis":"generic"},"part_b":null}, {"ndc":"67386031401","name":"ONFI 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67386-314-01","proprietary_name":"Onfi","nonproprietary_name":"clobazam","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lundbeck Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (67386-314-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":29.91293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24265,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67386031321","name":"ONFI 2.5 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67386-313-21","proprietary_name":"Onfi","nonproprietary_name":"clobazam","dosage_form":"SUSPENSION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Lundbeck Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (67386-313-21) / 120 mL in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":12.47305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.17304,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67386031501","name":"ONFI 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67386-315-01","proprietary_name":"Onfi","nonproprietary_name":"clobazam","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lundbeck Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (67386-315-01) / 100 TABLET in 1 BOTTLE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":59.81597,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896040201","name":"ONGENTYS 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"64896-402-01","proprietary_name":"ONGENTYS","nonproprietary_name":"opicapone","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE in 1 BOTTLE (64896-402-01)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":24.66795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ongentys|Opicapone","basis":"brand"},"part_b":null}, {"ndc":"70370302502","name":"ONGENTYS 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":24.66795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ongentys|Opicapone","basis":"brand"},"part_b":null}, {"ndc":"64896040301","name":"ONGENTYS 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64896-403-01","proprietary_name":"ONGENTYS","nonproprietary_name":"opicapone","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE in 1 BOTTLE (64896-403-01)","pharm_classes":["Catechol O-Methyltransferase Inhibitors [MoA]","Catechol-O-Methyltransferase Inhibitor [EPC]"]},"nadac":{"value":24.76028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ongentys|Opicapone","basis":"brand"},"part_b":null}, {"ndc":"70370305002","name":"ONGENTYS 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":24.76028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ongentys|Opicapone","basis":"brand"},"part_b":null}, {"ndc":"24478014803","name":"ONYDA XR 0.1 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-148-03","proprietary_name":"ONYDA XR","nonproprietary_name":"Clonidine hydrochloride","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":".1 mg/mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"30 mL in 1 BOTTLE (24478-148-03)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":13.37962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113810101","name":"OPILL 0.075 MG TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8101-01","proprietary_name":"Opill","nonproprietary_name":"norgestrel","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"L. Perrigo Company","package_description":"1 BLISTER PACK in 1 CARTON (0113-8101-01) / 28 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.59851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00113810103","name":"OPILL 0.075 MG TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-8101-03","proprietary_name":"Opill","nonproprietary_name":"norgestrel","dosage_form":"TABLET","route":"ORAL","strength":".075 mg/1","labeler":"L. Perrigo Company","package_description":"3 BLISTER PACK in 1 CARTON (0113-8101-03) / 28 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.49912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799021701","name":"OPIUM TINCTURE 10 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-217-01","proprietary_name":"Opium Tincture Deodorized","nonproprietary_name":"Morphine","dosage_form":"TINCTURE","route":"ORAL","strength":"10 mg/mL","labeler":"Edenbridge Pharmaceuticals, LLC","package_description":"118 mL in 1 BOTTLE, PLASTIC (42799-217-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.85763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559015304","name":"OPIUM TINCTURE 10 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-153-04","proprietary_name":"Opium Tincture Deodorized","nonproprietary_name":"morphine tincture","dosage_form":"SOLUTION","route":"ORAL","strength":"1 g/100mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"118 mL in 1 BOTTLE (62559-153-04)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.85763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00113200312","name":"OPTION 2 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2003-12","proprietary_name":"Option 2","nonproprietary_name":"levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"L. Perrigo Company","package_description":"1 BLISTER PACK in 1 CARTON (0113-2003-12) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine Device [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"12496000302","name":"OPVEE 2.7 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"12496-0003-2","proprietary_name":"OPVEE","nonproprietary_name":"nalmefene hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"2.7 mg/100uL","labeler":"Indivior Inc.","package_description":"2 BLISTER PACK in 1 CARTON (12496-0003-2) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK (12496-0003-1) / 100 uL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":46.78808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Opvee|Nalmefene HCl","basis":"brand"},"part_b":null}, {"ndc":"50881000705","name":"OPZELURA 1.5% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50881-007-05","proprietary_name":"OPZELURA","nonproprietary_name":"ruxolitinib","dosage_form":"CREAM","route":"TOPICAL","strength":"15 mg/g","labeler":"Incyte Corporation","package_description":"1 TUBE in 1 CARTON (50881-007-05) / 60 g in 1 TUBE","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]","Kinase Inhibitor [EPC]"]},"nadac":{"value":34.01191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Opzelura|Ruxolitinib Phosphate","basis":"brand"},"part_b":null}, {"ndc":"00299382230","name":"ORACEA 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0299-3822-30","proprietary_name":"ORACEA","nonproprietary_name":"DOXYCYCLINE","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Galderma Laboratories, L.P.","package_description":"30 CAPSULE in 1 BOTTLE (0299-3822-30)","pharm_classes":["Tetracycline-class Drug [EPC]","Tetracyclines [CS]"]},"nadac":{"value":29.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.67065,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oracea|Doxycycline Monohydrate","basis":"brand"},"part_b":null}, {"ndc":"46287001401","name":"ORACIT ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-014-01","proprietary_name":"Oracit","nonproprietary_name":"Citric Acid and Sodium Citrate","dosage_form":"SOLUTION","route":"ORAL","strength":"640 mg/5mL; 490 mg/5mL","labeler":"CMP Pharma, Inc.","package_description":"500 mL in 1 BOTTLE (46287-014-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.07676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Oracit|Citric Acid/Sodium Citrate","basis":"brand"},"part_b":null}, {"ndc":"00003218811","name":"ORENCIA 125 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-2188-11","proprietary_name":"ORENCIA","nonproprietary_name":"abatacept","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"125 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"4 SYRINGE, GLASS in 1 CARTON (0003-2188-11) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased Cytokine Activity [PE]","Recombinant Fusion Proteins [CS]","Selective T Cell Costimulation Modulator [EPC]"]},"nadac":{"value":1469.228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0129","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0129 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (4 SYRINGE, GLASS in 1 CARTON (0003-2188-11) / 1 mL in 1 SYRINGE, GLASS) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":4,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00003218851","name":"ORENCIA CLICKJECT 125 MG/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0003-2188-51","proprietary_name":"ORENCIA","nonproprietary_name":"abatacept","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"125 mg/mL","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"4 SYRINGE, GLASS in 1 CARTON (0003-2188-51) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Decreased Cytokine Activity [PE]","Recombinant Fusion Proteins [CS]","Selective T Cell Costimulation Modulator [EPC]"]},"nadac":{"value":1471.08642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J0129","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0129 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (12.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (4 SYRINGE, GLASS in 1 CARTON (0003-2188-51) / 1 mL in 1 SYRINGE, GLASS) gives 4 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":4,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00074101756","name":"ORIAHNN 300-1-0.5 MG/300 MG CAPS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-1017-56","proprietary_name":"Oriahnn","nonproprietary_name":"Elagolix and Estradiol and Norethisterone","dosage_form":"KIT","route":null,"strength":null,"labeler":"AbbVie Inc.","package_description":"4 BLISTER PACK in 1 CARTON (0074-1017-56) / 1 KIT in 1 BLISTER PACK * 7 CAPSULE in 1 BLISTER PACK * 7 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":22.00439,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oriahnn|Elagolix/Estradiol/Norethindrn","basis":"brand"},"part_b":null}, {"ndc":"00074003828","name":"ORILISSA 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-0038-28","proprietary_name":"Orilissa","nonproprietary_name":"Elagolix","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"AbbVie Inc.","package_description":"4 BLISTER PACK in 1 CARTON (0074-0038-28) / 7 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":43.80871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Orilissa|Elagolix Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074003956","name":"ORILISSA 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-0039-56","proprietary_name":"Orilissa","nonproprietary_name":"Elagolix","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"AbbVie Inc.","package_description":"4 BLISTER PACK in 1 CARTON (0074-0039-56) / 14 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased GnRH Secretion [PE]","Gonadotropin Releasing Hormone Receptor Antagonist [EPC]","Gonadotropin Releasing Hormone Receptor Antagonists [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":21.93174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Orilissa|Elagolix Sodium","basis":"brand"},"part_b":null}, {"ndc":"61269056590","name":"ORLISTAT 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-565-90","proprietary_name":"ORLISTAT","nonproprietary_name":"orlistat","dosage_form":"CAPSULE","route":"ORAL","strength":"120 mg/1","labeler":"H2-Pharma LLC","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (61269-565-90)","pharm_classes":["Intestinal Lipase Inhibitor [EPC]","Lipase Inhibitors [MoA]"]},"nadac":{"value":6.9989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Orlistat|Orlistat","basis":"generic"},"part_b":null}, {"ndc":"00641618210","name":"ORPHENADRINE 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":5.73029,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Orphenadrine Citrate|Orphenadrine Citrate","basis":"generic"},"part_b":{"hcpcs":"J2360","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2360 (60 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00641618225","name":"ORPHENADRINE 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-6182-25","proprietary_name":"Orphenadrine citrate","nonproprietary_name":"Orphenadrine citrate","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"60 mg/2mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 BOX in 1 BOX (0641-6182-25) / 10 VIAL in 1 BOX (0641-6182-10) / 2 mL in 1 VIAL (0641-6182-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":7.0744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Orphenadrine Citrate|Orphenadrine Citrate","basis":"generic"},"part_b":{"hcpcs":"J2360","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2360 (60 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"25021065102","name":"ORPHENADRINE 60 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-651-02","proprietary_name":"Orphenadrine Citrate","nonproprietary_name":"orphenadrine citrate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"30 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-651-02) / 2 mL in 1 VIAL","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":5.73029,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Orphenadrine Citrate|Orphenadrine Citrate","basis":"generic"},"part_b":{"hcpcs":"J2360","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2360 (60 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-651-02) / 2 mL in 1 VIAL) gives 20 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00185002201","name":"ORPHENADRINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0185-0022-01","proprietary_name":"Orphenadrine Citrate","nonproprietary_name":"Orphenadrine Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0185-0022-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Orphenadrine Citrate ER|Orphenadrine Citrate","basis":"generic"},"part_b":null}, {"ndc":"43386048024","name":"ORPHENADRINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-480-24","proprietary_name":"ORPHENADRINE CITRATE","nonproprietary_name":"ORPHENADRINE CITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (43386-480-24)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Orphenadrine Citrate ER|Orphenadrine Citrate","basis":"generic"},"part_b":null}, {"ndc":"43386048026","name":"ORPHENADRINE ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-480-26","proprietary_name":"ORPHENADRINE CITRATE","nonproprietary_name":"ORPHENADRINE CITRATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (43386-480-26)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":0.45364,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Orphenadrine Citrate ER|Orphenadrine Citrate","basis":"generic"},"part_b":null}, {"ndc":"70700031684","name":"ORQUIDEA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"70700031685","name":"ORQUIDEA 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-316-85","proprietary_name":"Orquidea","nonproprietary_name":"norethindrone","dosage_form":"TABLET","route":"ORAL","strength":".35 mg/1","labeler":"Xiromed, LLC","package_description":"3 POUCH in 1 CARTON (70700-316-85) / 1 BLISTER PACK in 1 POUCH (70700-316-84) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Norethindrone|Norethindrone","basis":"generic"},"part_b":null}, {"ndc":"68047025201","name":"OSCIMIN 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-252-01","proprietary_name":"OSCIMIN","nonproprietary_name":"Hyoscyamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Larken Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (68047-252-01)"},"nadac":{"value":0.14589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oscimin|Hyoscyamine Sulfate","basis":"brand"},"part_b":null}, {"ndc":"68047025301","name":"OSCIMIN SL 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68047-253-01","proprietary_name":"OSCIMIN","nonproprietary_name":"Hyoscyamine Sulfate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":".125 mg/1","labeler":"Larken Laboratories, Inc.","package_description":"100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (68047-253-01)"},"nadac":{"value":0.17066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093818064","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8180-64","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BOTTLE in 1 CARTON (0093-8180-64) / 60 mL in 1 BOTTLE","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527513762","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-5137-62","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Lannett Company, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0527-5137-62) / 60 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27241013909","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-139-09","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Ajanta Pharma USA Inc.","package_description":"1 POUCH in 1 CARTON (27241-139-09) / 1 BOTTLE in 1 POUCH / 60 mL in 1 BOTTLE","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"47781038426","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-384-26","proprietary_name":"Oseltamivir Phosphate for Oral Suspension","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Alvogen Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (47781-384-26) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651059760","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-597-60","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"OSELTAMIVIR PHOSPHATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE, GLASS in 1 CARTON (59651-597-60) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180067801","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-678-01","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (68180-678-01) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238127306","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1273-6","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (69238-1273-6) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710116506","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1165-6","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"oseltamivir phosphate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1165-6) / 60 mL in 1 BOTTLE","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205006078","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-060-78","proprietary_name":"oseltamivir phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 mL in 1 BOTTLE, GLASS (72205-060-78)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72516002901","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-029-01","proprietary_name":"Oseltamivir Phosphate for Oral Suspension","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Oryza Pharmaceuticals Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (72516-029-01) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"76282073952","name":"OSELTAMIVIR 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-739-52","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"OSELTAMIVIR PHOSPHATE","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (76282-739-52) / 60 mL in 1 BOTTLE","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00527459113","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4591-13","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Lannett Company, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0527-4591-13) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722063031","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-630-31","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 CAPSULE in 1 CARTON (31722-630-31)"},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342025666","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-256-66","proprietary_name":"oseltamivir phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-256-66) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781046813","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-468-13","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Alvogen Inc.","package_description":"1 BLISTER PACK in 1 CARTON (47781-468-13) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219126401","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1264-1","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (60219-1264-1) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332041310","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-413-10","proprietary_name":"OSELTAMIVIR","nonproprietary_name":"OSELTAMIVIR","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CARTON in 1 BLISTER PACK (62332-413-10) / 10 CAPSULE in 1 CARTON","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380079701","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-797-01","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Strides Pharma Science Limited","package_description":"10 CAPSULE in 1 BLISTER PACK (64380-797-01)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180067511","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-675-11","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-675-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238126401","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1264-1","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BLISTER PACK in 1 CARTON (69238-1264-1) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710100802","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1008-2","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (70710-1008-2) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205004211","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-042-11","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (72205-042-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282070245","name":"OSELTAMIVIR PHOS 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-702-45","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"OSELTAMIVIR PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"10 CAPSULE in 1 BLISTER PACK (76282-702-45)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.67955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527459213","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4592-13","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Lannett Company, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0527-4592-13) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722063131","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-631-31","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 CAPSULE in 1 CARTON (31722-631-31)"},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342025766","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-257-66","proprietary_name":"oseltamivir phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-257-66) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781046913","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-469-13","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Alvogen Inc.","package_description":"1 BLISTER PACK in 1 CARTON (47781-469-13) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219126501","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1265-1","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (60219-1265-1) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332041410","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-414-10","proprietary_name":"OSELTAMIVIR","nonproprietary_name":"OSELTAMIVIR","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CARTON in 1 BLISTER PACK (62332-414-10) / 10 CAPSULE in 1 CARTON","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380079801","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-798-01","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Strides Pharma Science Limited","package_description":"10 CAPSULE in 1 BLISTER PACK (64380-798-01)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180067611","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-676-11","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-676-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238126501","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1265-1","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BLISTER PACK in 1 CARTON (69238-1265-1) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710100902","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1009-2","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (70710-1009-2) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205004311","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-043-11","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (72205-043-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282070345","name":"OSELTAMIVIR PHOS 45 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-703-45","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"OSELTAMIVIR PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"45 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"10 CAPSULE in 1 BLISTER PACK (76282-703-45)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.7872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527459313","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4593-13","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Lannett Company, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0527-4593-13) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722063231","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-632-31","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 CAPSULE in 1 CARTON (31722-632-31)"},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342025866","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-258-66","proprietary_name":"oseltamivir phosphate","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-258-66) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806055501","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-555-01","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"OSELTAMIVIR PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-555-01)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781047013","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-470-13","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alvogen Inc.","package_description":"1 BLISTER PACK in 1 CARTON (47781-470-13) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219126601","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1266-1","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (60219-1266-1) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332041510","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-415-10","proprietary_name":"OSELTAMIVIR","nonproprietary_name":"OSELTAMIVIR","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 CARTON in 1 BLISTER PACK (62332-415-10) / 10 CAPSULE in 1 CARTON","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380079901","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-799-01","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Strides Pharma Science Limited","package_description":"10 CAPSULE in 1 BLISTER PACK (64380-799-01)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180067711","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-677-11","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68180-677-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238126601","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1266-1","proprietary_name":"Oseltamivir Phosphate","nonproprietary_name":"Oseltamivir","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BLISTER PACK in 1 CARTON (69238-1266-1) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710101002","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1010-2","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (70710-1010-2) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205004411","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-044-11","proprietary_name":"Oseltamivir phosphate","nonproprietary_name":"Oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (72205-044-11) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282070445","name":"OSELTAMIVIR PHOS 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-704-45","proprietary_name":"OSELTAMIVIR PHOSPHATE","nonproprietary_name":"OSELTAMIVIR PHOSPHATE","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"10 CAPSULE in 1 BLISTER PACK (76282-704-45)","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55494058030","name":"OSPHENA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55494-580-30","proprietary_name":"Osphena","nonproprietary_name":"Ospemifene","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Duchesnay USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55494-580-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":8.17284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Osphena|Ospemifene","basis":"brand"},"part_b":null}, {"ndc":"55494058090","name":"OSPHENA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55494-580-90","proprietary_name":"Osphena","nonproprietary_name":"Ospemifene","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Duchesnay USA, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55494-580-90)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":8.17284,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Osphena|Ospemifene","basis":"brand"},"part_b":null}, {"ndc":"55513036955","name":"OTEZLA 10-20-30 MG START 28 DAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-369-55","proprietary_name":"Otezla","nonproprietary_name":"apremilast","dosage_form":"KIT","route":null,"strength":null,"labeler":"Amgen, Inc","package_description":"1 BLISTER PACK in 1 CARTON (55513-369-55) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":98.55082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Otezla|Apremilast","basis":"brand"},"part_b":null}, {"ndc":"55513049760","name":"OTEZLA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-497-60","proprietary_name":"Otezla","nonproprietary_name":"apremilast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Amgen, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55513-497-60)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":89.95216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Otezla|Apremilast","basis":"brand"},"part_b":null}, {"ndc":"55513013760","name":"OTEZLA 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-137-60","proprietary_name":"Otezla","nonproprietary_name":"apremilast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Amgen, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55513-137-60)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":90.57171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Otezla|Apremilast","basis":"brand"},"part_b":null}, {"ndc":"55513051930","name":"OTEZLA XR 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-519-30","proprietary_name":"Otezla","nonproprietary_name":"apremilast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Amgen, Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55513-519-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":181.1953,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"44087115001","name":"OVIDREL 250 MCG/0.5 ML SYRG","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44087-1150-1","proprietary_name":"Ovidrel","nonproprietary_name":"choriogonadotropin alfa","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/.5mL","labeler":"EMD Serono, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (44087-1150-1) / .5 mL in 1 SYRINGE, GLASS","pharm_classes":["Gonadotropin [EPC]","Gonadotropins [CS]"]},"nadac":{"value":485.432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55111017001","name":"OXAPROZIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-170-01","proprietary_name":"Oxaprozin","nonproprietary_name":"Oxaprozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (55111-170-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.47536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxaprozin|Oxaprozin","basis":"generic"},"part_b":null}, {"ndc":"55111017005","name":"OXAPROZIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-170-05","proprietary_name":"Oxaprozin","nonproprietary_name":"Oxaprozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (55111-170-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.47536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxaprozin|Oxaprozin","basis":"generic"},"part_b":null}, {"ndc":"62135017660","name":"OXAPROZIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-176-60","proprietary_name":"OXAPROZIN","nonproprietary_name":"OXAPROZIN","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 TABLET in 1 BOTTLE (62135-176-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.47536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxaprozin|Oxaprozin","basis":"generic"},"part_b":null}, {"ndc":"69238112001","name":"OXAPROZIN 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1120-1","proprietary_name":"Oxaprozin","nonproprietary_name":"Oxaprozin","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1120-1)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.47536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxaprozin|Oxaprozin","basis":"generic"},"part_b":null}, {"ndc":"00228206710","name":"OXAZEPAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2067-10","proprietary_name":"Oxazepam","nonproprietary_name":"Oxazepam","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0228-2067-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.72474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"62584081201","name":"OXAZEPAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-812-01","proprietary_name":"Oxazepam","nonproprietary_name":"Oxazepam","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (62584-812-01) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (62584-812-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.72474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"62584081211","name":"OXAZEPAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"69315091101","name":"OXAZEPAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-911-01","proprietary_name":"OXAZEPAM","nonproprietary_name":"OXAZEPAM","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69315-911-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.72474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"00228206910","name":"OXAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2069-10","proprietary_name":"Oxazepam","nonproprietary_name":"Oxazepam","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"15 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BLISTER PACK (0228-2069-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.88374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"62584081301","name":"OXAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-813-01","proprietary_name":"Oxazepam","nonproprietary_name":"Oxazepam","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (62584-813-01) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (62584-813-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.88374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"62584081311","name":"OXAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.88374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"69315091201","name":"OXAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-912-01","proprietary_name":"OXAZEPAM","nonproprietary_name":"OXAZEPAM","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69315-912-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.88374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"00228207310","name":"OXAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2073-10","proprietary_name":"Oxazepam","nonproprietary_name":"Oxazepam","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (0228-2073-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.34943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"62584081401","name":"OXAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-814-01","proprietary_name":"Oxazepam","nonproprietary_name":"Oxazepam","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (62584-814-01) / 1 CAPSULE, GELATIN COATED in 1 BLISTER PACK (62584-814-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.34943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"62584081411","name":"OXAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.34943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"69315091301","name":"OXAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-913-01","proprietary_name":"OXAZEPAM","nonproprietary_name":"OXAZEPAM","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (69315-913-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.34943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxazepam|Oxazepam","basis":"generic"},"part_b":null}, {"ndc":"00904726261","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7262-61","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7262-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722002301","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-023-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-023-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268067911","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268067915","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-679-15","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-679-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-679-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991005301","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-053-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51991-053-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991005305","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-053-05","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-053-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991029201","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-292-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51991-292-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991029205","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-292-05","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-292-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071101","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-711-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-711-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-711-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687071111","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559022001","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-220-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62559-220-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462013701","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-137-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-137-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888008701","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-087-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-087-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888008705","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-087-05","proprietary_name":"Oxcarbazepine","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-087-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046201","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-462-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-462-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046202","name":"OXCARBAZEPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-462-02","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"500 TABLET in 1 BOTTLE (72888-462-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904726361","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7263-61","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7263-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722002401","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-024-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-024-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722002405","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-024-05","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-024-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068011","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068015","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-680-15","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-680-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-680-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991005401","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-054-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51991-054-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991005405","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-054-05","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-054-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991029301","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-293-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51991-293-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991029305","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-293-05","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-293-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072201","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-722-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-722-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-722-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072211","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559022101","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-221-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62559-221-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559022105","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-221-05","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62559-221-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462013801","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-138-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-138-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027101","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-271-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72603-271-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027102","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-271-02","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-271-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888008801","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-088-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-088-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888008805","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-088-05","proprietary_name":"Oxcarbazepine","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-088-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046001","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-460-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-460-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046002","name":"OXCARBAZEPINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-460-02","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"500 TABLET in 1 BOTTLE (72888-460-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722068725","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-687-25","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"SUSPENSION","route":"ORAL","strength":"60 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-687-25) / 250 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42806060022","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-600-22","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"300 mg/5mL","labeler":"EPIC PHARMA, LLC","package_description":"1 BOTTLE in 1 CARTON (42806-600-22) / 250 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135084154","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-841-54","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"300 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"250 mL in 1 BOTTLE (62135-841-54)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162064978","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-649-78","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"300 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-649-78) / 250 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877053258","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-532-58","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"60 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"250 mL in 1 BOTTLE (67877-532-58)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452012550","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-125-50","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"300 mg/5mL","labeler":"Bionpharma Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (69452-125-50) / 250 mL in 1 BOTTLE, GLASS","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452012551","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-125-51","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"300 mg/5mL","labeler":"Bionpharma Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (69452-125-51) / 250 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70377011711","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-117-11","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"SUSPENSION","route":"ORAL","strength":"60 mg/mL","labeler":"Biocon Pharma Inc.","package_description":"1 BOTTLE in 1 CARTON (70377-117-11) / 250 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603025201","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-252-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"SUSPENSION","route":"ORAL","strength":"60 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-252-01) / 250 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888007414","name":"OXCARBAZEPINE 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-074-14","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"SUSPENSION","route":"ORAL","strength":"300 mg/5mL","labeler":"Advagen Pharma Ltd","package_description":"1 BOTTLE in 1 CARTON (72888-074-14) / 250 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904726461","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7264-61","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7264-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722002501","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-025-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-025-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068111","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068115","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-681-15","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-681-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-681-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991005501","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-055-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51991-055-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991005505","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-055-05","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-055-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991029401","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-294-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (51991-294-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991029405","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-294-05","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (51991-294-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073301","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-733-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-733-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-733-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073311","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559022201","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-222-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62559-222-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559022205","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-222-05","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62559-222-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462013901","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-139-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-139-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027201","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-272-01","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72603-272-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603027202","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-272-02","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72603-272-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888008901","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-089-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72888-089-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888008905","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-089-05","proprietary_name":"Oxcarbazepine","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-089-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046101","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-461-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"500 TABLET in 1 BOTTLE (72888-461-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888046102","name":"OXCARBAZEPINE 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-461-02","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"100 TABLET in 1 BOTTLE (72888-461-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241023701","name":"OXCARBAZEPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-237-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-237-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.49768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"27241030401","name":"OXCARBAZEPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":3.49768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"50742061101","name":"OXCARBAZEPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-611-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-611-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.49768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"60505412807","name":"OXCARBAZEPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4128-7","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-4128-7)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.49768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"27241023801","name":"OXCARBAZEPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-238-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-238-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.73052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"27241030501","name":"OXCARBAZEPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":4.73052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"50742061201","name":"OXCARBAZEPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-612-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-612-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.73052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"60505412907","name":"OXCARBAZEPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4129-7","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-4129-7)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.73052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"27241023901","name":"OXCARBAZEPINE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-239-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-239-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.5783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"27241030601","name":"OXCARBAZEPINE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":9.5783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"50742061301","name":"OXCARBAZEPINE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-613-01","proprietary_name":"Oxcarbazepine","nonproprietary_name":"Oxcarbazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (50742-613-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.5783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"60505413007","name":"OXCARBAZEPINE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4130-7","proprietary_name":"OXCARBAZEPINE","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-4130-7)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.5783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxcarbazepine ER|Oxcarbazepine","basis":"generic"},"part_b":null}, {"ndc":"00168035830","name":"OXICONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0358-30","proprietary_name":"Oxiconazole Nitrate","nonproprietary_name":"Oxiconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"30 g in 1 TUBE (0168-0358-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":4.10237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Oxiconazole Nitrate|Oxiconazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"00168035890","name":"OXICONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0358-90","proprietary_name":"Oxiconazole Nitrate","nonproprietary_name":"Oxiconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"90 g in 1 TUBE (0168-0358-90)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":3.73081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Oxiconazole Nitrate|Oxiconazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"51672135902","name":"OXICONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1359-2","proprietary_name":"Oxiconazole Nitrate","nonproprietary_name":"Oxiconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1359-2) / 30 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":4.10237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Oxiconazole Nitrate|Oxiconazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"51672135908","name":"OXICONAZOLE NITRATE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1359-8","proprietary_name":"Oxiconazole Nitrate","nonproprietary_name":"Oxiconazole Nitrate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1359-8) / 90 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":3.73081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Oxiconazole Nitrate|Oxiconazole Nitrate","basis":"generic"},"part_b":null}, {"ndc":"62559028560","name":"OXISTAT 1% LOTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62559-285-60","proprietary_name":"Oxistat","nonproprietary_name":"oxiconazole nitrate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (62559-285-60) / 60 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":11.36693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Oxistat|Oxiconazole Nitrate","basis":"brand"},"part_b":null}, {"ndc":"17772012101","name":"OXTELLAR XR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-121-01","proprietary_name":"OXTELLAR XR","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (17772-121-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.02471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.49768,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxtellar XR|Oxcarbazepine","basis":"brand"},"part_b":null}, {"ndc":"17772012201","name":"OXTELLAR XR 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-122-01","proprietary_name":"OXTELLAR XR","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (17772-122-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":12.75205,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.73052,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxtellar XR|Oxcarbazepine","basis":"brand"},"part_b":null}, {"ndc":"17772012301","name":"OXTELLAR XR 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-123-01","proprietary_name":"OXTELLAR XR","nonproprietary_name":"OXCARBAZEPINE","dosage_form":"TABLET","route":"ORAL","strength":"600 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (17772-123-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":23.29894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.5783,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxtellar XR|Oxcarbazepine","basis":"brand"},"part_b":null}, {"ndc":"64380019001","name":"OXYBUTYNIN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-190-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-190-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.96614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980053101","name":"OXYBUTYNIN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-531-01","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"100 TABLET in 1 BOTTLE (64980-531-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.96614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832003800","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0038-00","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0832-0038-00)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832003801","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832003810","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0038-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE (0832-0038-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832003850","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0038-50","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (0832-0038-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00832003889","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00904702761","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7027-61","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7027-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"10702020101","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-201-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (10702-201-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"10702020110","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-201-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (10702-201-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"10702020150","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-201-50","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (10702-201-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"14539065301","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"14539065305","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"14539065310","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155081001","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-810-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-810-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155081005","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-810-05","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (23155-810-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155081010","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-810-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (23155-810-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155091301","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-913-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23155-913-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155091305","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-913-05","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (23155-913-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155091310","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-913-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (23155-913-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50111045601","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-456-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-456-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50111045602","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-456-02","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (50111-456-02)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50111045603","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-456-03","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-456-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"52817026010","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-260-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (52817-260-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"52817026050","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-260-50","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TruPharma LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (52817-260-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"60687089901","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-899-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-899-01) / 1 TABLET in 1 BLISTER PACK (60687-899-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"60687089911","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64380016201","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-162-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-162-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64380016202","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-162-02","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (64380-162-02)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64380016203","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-162-03","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-162-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64380078108","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-781-08","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-781-08)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980043101","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-431-01","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"100 TABLET in 1 BOTTLE (64980-431-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980043110","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-431-10","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"1000 TABLET in 1 BOTTLE (64980-431-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980043150","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-431-50","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"RISING PHARMA HOLDINGS, INC.","package_description":"500 TABLET in 1 BOTTLE (64980-431-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"69315018201","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-182-01","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (69315-182-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"69315018205","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-182-05","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Leading Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (69315-182-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"69315018210","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-182-10","proprietary_name":"OXYBUTYNIN CHLORIDE","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Leading Pharma, LLC","package_description":"1000 TABLET in 1 BOTTLE (69315-182-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"70954000510","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-005-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-005-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"70954000520","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-005-20","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (70954-005-20)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"70954000530","name":"OXYBUTYNIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-005-30","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (70954-005-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.04798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135052047","name":"OXYBUTYNIN 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-520-47","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-520-47)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.03271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54838051080","name":"OXYBUTYNIN 5 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54838-510-80","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"SYRUP","route":"ORAL","strength":"5 mg/5mL","labeler":"Lannett Company, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (54838-510-80)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.03271,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27241015604","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-156-04","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-156-04)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"27241015608","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-156-08","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-156-08)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50268062811","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50268062815","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-628-15","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-628-15) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-628-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135050890","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-508-90","proprietary_name":"oxybutynin chloride","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-508-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62175027137","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-271-37","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-271-37)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62175027141","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-271-41","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-271-41)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980021001","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-210-01","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-210-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980021005","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-210-05","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-210-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68084061011","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68084061021","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-610-21","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-610-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (68084-610-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68382025601","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-256-01","proprietary_name":"oxybutynin","nonproprietary_name":"oxybutynin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-256-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382025605","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-256-05","proprietary_name":"oxybutynin","nonproprietary_name":"oxybutynin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-256-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452012020","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888003101","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-031-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-031-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"72888003105","name":"OXYBUTYNIN CL ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-031-05","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-031-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.09973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"27241015704","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-157-04","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-157-04)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50268062911","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50268062913","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-629-13","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-629-13) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-629-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135050990","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-509-90","proprietary_name":"oxybutynin chloride","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-509-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62175027237","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-272-37","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-272-37)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62175027241","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-272-41","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-272-41)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980021101","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-211-01","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-211-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68382025701","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-257-01","proprietary_name":"oxybutynin","nonproprietary_name":"oxybutynin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-257-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452012120","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888003201","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-032-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-032-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"72888003205","name":"OXYBUTYNIN CL ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-032-05","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-032-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00904657004","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6570-04","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6570-04) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00904657006","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6570-06","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6570-06) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00904657061","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6570-61","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6570-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"16729031716","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-317-16","proprietary_name":"oxybutynin chloride","nonproprietary_name":"oxybutynin chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Accord Healthcare, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-317-16)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"27241015504","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-155-04","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-155-04)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"27241015508","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-155-08","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-155-08)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50268062711","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"50268062715","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-627-15","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-627-15) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (50268-627-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135050790","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-507-90","proprietary_name":"oxybutynin chloride","nonproprietary_name":"OXYBUTYNIN CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-507-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62175027037","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-270-37","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-270-37)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"62175027041","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-270-41","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (62175-270-41)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980020901","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-209-01","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-209-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"64980020905","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-209-05","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-209-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"65162037110","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-371-10","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-371-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68084048001","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-480-01","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-480-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (68084-480-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68084048011","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68084048065","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-480-65","proprietary_name":"Oxybutynin Chloride Extended Release","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-480-65) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (68084-480-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"68382025501","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-255-01","proprietary_name":"oxybutynin","nonproprietary_name":"oxybutynin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-255-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382025505","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-255-05","proprietary_name":"oxybutynin","nonproprietary_name":"oxybutynin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68382-255-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452011920","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888003001","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-030-01","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-030-01)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"72888003005","name":"OXYBUTYNIN CL ER 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-030-05","proprietary_name":"Oxybutynin Chloride","nonproprietary_name":"Oxybutynin Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (72888-030-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.08414,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxybutynin Chloride ER|Oxybutynin Chloride","basis":"generic"},"part_b":null}, {"ndc":"00406851001","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8510-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8510-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406851023","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8510-23","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-8510-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406851062","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8510-62","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-8510-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702005601","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-056-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH,INC","package_description":"100 TABLET in 1 BOTTLE (10702-056-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702005650","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-056-50","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"KVK-TECH,INC","package_description":"500 TABLET in 1 BOTTLE (10702-056-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722048501","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-485-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (31722-485-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722048505","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-485-05","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (31722-485-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858000201","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-002-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-002-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858000210","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-002-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"10 BLISTER PACK in 1 CARTON (42858-002-10) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026001","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-260-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-260-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026002","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162004810","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-048-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-048-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084096801","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-968-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-968-01) / 1 TABLET in 1 BLISTER PACK (68084-968-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084096811","name":"OXYCODONE HCL (IR) 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406851501","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8515-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8515-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406851523","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8515-23","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-8515-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406851562","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8515-62","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-8515-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904718061","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7180-61","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7180-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000801","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-008-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"KVK-TECH,INC","package_description":"100 TABLET in 1 BOTTLE (10702-008-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000850","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-008-50","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"KVK-TECH,INC","package_description":"500 TABLET in 1 BOTTLE (10702-008-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107005601","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-056-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-056-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722091701","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-917-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (31722-917-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722091705","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-917-05","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (31722-917-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858000301","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-003-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-003-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781026401","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-264-01","proprietary_name":"Oxycodone hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Alvogen, Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-264-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781026405","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-264-05","proprietary_name":"Oxycodone hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Alvogen, Inc.","package_description":"500 TABLET in 1 BOTTLE (47781-264-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026101","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-261-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-261-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026102","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-261-02","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (64380-261-02)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162004910","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-049-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-049-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162004950","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-049-50","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-049-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084097501","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-975-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-975-01) / 1 TABLET in 1 BLISTER PACK (68084-975-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084097511","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094000559","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68094000561","name":"OXYCODONE HCL (IR) 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-005-61","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Precision Dose, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (68094-005-61) / 10 TABLET in 1 BLISTER PACK (68094-005-59)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406852001","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8520-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8520-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702005701","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-057-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"KVK-TECH,INC","package_description":"100 TABLET in 1 BOTTLE (10702-057-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702005750","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-057-50","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"KVK-TECH,INC","package_description":"500 TABLET in 1 BOTTLE (10702-057-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722048601","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-486-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (31722-486-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722048605","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-486-05","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (31722-486-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858000401","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-004-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-004-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026201","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-262-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-262-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026202","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162005010","name":"OXYCODONE HCL (IR) 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-050-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-050-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.24642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406853001","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8530-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-8530-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406853023","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8530-23","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-8530-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406853062","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8530-62","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-8530-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000901","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-009-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"KVK-TECH,INC","package_description":"100 TABLET in 1 BOTTLE (10702-009-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000950","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-009-50","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"KVK-TECH,INC","package_description":"500 TABLET in 1 BOTTLE (10702-009-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107005701","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-057-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-057-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722091801","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-918-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (31722-918-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722091805","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-918-05","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (31722-918-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858000501","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-005-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-005-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781026501","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-265-01","proprietary_name":"Oxycodone hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Alvogen, Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-265-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781026505","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-265-05","proprietary_name":"Oxycodone hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Alvogen, Inc.","package_description":"500 TABLET in 1 BOTTLE (47781-265-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026301","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-263-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-263-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380026302","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-263-02","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (64380-263-02)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162005110","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-051-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-051-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084098301","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-983-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-983-01) / 1 TABLET in 1 BLISTER PACK (68084-983-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084098311","name":"OXYCODONE HCL (IR) 30 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702002301","name":"OXYCODONE HCL (IR) 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-023-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH, INC.","package_description":"100 CAPSULE in 1 BOTTLE (10702-023-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.37462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559016701","name":"OXYCODONE HCL (IR) 5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-167-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62559-167-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.37462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406055201","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0552-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0552-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406055223","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0552-23","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0552-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406055262","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0552-62","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0552-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904696661","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6966-61","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6966-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702001801","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-018-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH,INC","package_description":"100 TABLET in 1 BOTTLE (10702-018-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702001850","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-018-50","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"KVK-TECH,INC","package_description":"500 TABLET in 1 BOTTLE (10702-018-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13107005501","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-055-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-055-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722048401","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-484-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (31722-484-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722048405","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-484-05","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (31722-484-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858000110","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-001-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"10 BLISTER PACK in 1 CARTON (42858-001-10) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781026301","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-263-01","proprietary_name":"Oxycodone hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alvogen, Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-263-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47781026305","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-263-05","proprietary_name":"Oxycodone hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Alvogen, Inc.","package_description":"500 TABLET in 1 BOTTLE (47781-263-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380025901","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-259-01","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-259-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380025902","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-259-02","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (64380-259-02)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162004710","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-047-10","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-047-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162004750","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-047-50","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-047-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084035401","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-354-01","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-354-01) / 1 TABLET in 1 BLISTER PACK (68084-354-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084035411","name":"OXYCODONE HCL (IR) 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406855730","name":"OXYCODONE HCL 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8557-30","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"SpecGx LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0406-8557-30) / 30 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.19009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752013703","name":"OXYCODONE HCL 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-137-03","proprietary_name":"OXYCODONE HYDROCHLORIDE","nonproprietary_name":"OXYCODONE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 BOTTLE in 1 CARTON (70752-137-03) / 30 mL in 1 BOTTLE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.19009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71930002330","name":"OXYCODONE HCL 100 MG/5 ML CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-023-30","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"Eywa Pharma Inc","package_description":"1 BOTTLE in 1 CARTON (71930-023-30) / 30 mL in 1 BOTTLE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.19009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054039063","name":"OXYCODONE HCL 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0390-63","proprietary_name":"oxycodone hydrochloride","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Hikma Pharmceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE (0054-0390-63)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.07353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00406855605","name":"OXYCODONE HCL 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-8556-05","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"SpecGx LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0406-8556-05) / 500 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.07353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904667840","name":"OXYCODONE HCL 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6678-40","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"MAJOR PHARMACEUTICALS","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-6678-40) / 500 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.07353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559015116","name":"OXYCODONE HCL 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-151-16","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (62559-151-16) / 473 mL in 1 BOTTLE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.04907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950035450","name":"OXYCODONE HCL 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-354-50","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Genus Lifesciences Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (64950-354-50) / 500 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.07353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71930002243","name":"OXYCODONE HCL 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-022-43","proprietary_name":"Oxycodone Hydrochloride","nonproprietary_name":"Oxycodone Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Eywa Pharma Inc","package_description":"1 BOTTLE in 1 CARTON (71930-022-43) / 473 mL in 1 BOTTLE","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.04907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00406052301","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0523-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0523-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052305","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0523-05","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0523-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052323","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0523-23","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0523-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052362","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0523-62","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0523-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107004601","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-046-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-046-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858010401","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-104-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-104-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858010450","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-104-50","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (42858-104-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781023001","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-230-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-230-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781023005","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-230-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"500 TABLET in 1 BOTTLE (47781-230-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781023063","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-230-63","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"250 TABLET in 1 BOTTLE (47781-230-63)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746020401","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-204-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-204-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"68084071001","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-710-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-710-01) / 1 TABLET in 1 BLISTER PACK (68084-710-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"68084071011","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00904709561","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7095-61","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7095-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018701","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-187-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-187-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018750","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-187-50","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-187-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107004605","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-046-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-046-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722019401","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-194-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-194-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722095101","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-951-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-951-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722095105","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-951-05","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-951-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268064611","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268064615","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-646-15","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1; 10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-646-15) / 1 TABLET in 1 BLISTER PACK (50268-646-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746020405","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-204-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-204-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850062301","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-623-01","proprietary_name":"Oxycodone Hydrochloride and Acetaminophen","nonproprietary_name":"Oxycodone Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-623-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70010067001","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-670-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-670-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004712","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-047-12","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-047-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004752","name":"OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-047-52","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-047-52)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018401","name":"OXYCODONE-ACETAMINOPHEN 2.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-184-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-184-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.76157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094801","name":"OXYCODONE-ACETAMINOPHEN 2.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-948-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-948-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.76157,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406051201","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0512-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0512-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406051205","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0512-05","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0512-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406051223","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0512-23","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0512-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406051262","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0512-62","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0512-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781019601","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-196-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-196-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781019605","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-196-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"500 TABLET in 1 BOTTLE (47781-196-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268064411","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268064415","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-644-15","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-644-15) / 1 TABLET in 1 BLISTER PACK (50268-644-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746020301","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-203-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-203-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746020305","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-203-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-203-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00904709361","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7093-61","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7093-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018501","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-185-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-185-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018550","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-185-50","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-185-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107004401","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-044-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-044-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107004405","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-044-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-044-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722019205","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-192-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-192-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094901","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-949-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-949-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722094905","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-949-05","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-949-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858010201","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-102-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-102-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858010250","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-102-50","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (42858-102-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687064201","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-642-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-642-01) / 1 TABLET in 1 BLISTER PACK (60687-642-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"60687064211","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850062101","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-621-01","proprietary_name":"Oxycodone Hydrochloride and Acetaminophen","nonproprietary_name":"Oxycodone Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-621-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70010066801","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-668-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-668-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004512","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-045-12","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-045-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004552","name":"OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-045-52","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-045-52)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052201","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0522-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (0406-0522-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052205","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0522-05","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"500 TABLET in 1 BOTTLE (0406-0522-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052223","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0522-23","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"1 TABLET in 1 BLISTER PACK (0406-0522-23)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00406052262","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-0522-62","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BLISTER PACK (0406-0522-62)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"00904709461","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7094-61","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7094-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"10702018601","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-186-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-186-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107004501","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-045-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (13107-045-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"13107004505","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-045-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Aurolife Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (13107-045-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722019301","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-193-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-193-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722019305","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-193-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-193-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722095001","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-950-01","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-950-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"31722095005","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-950-05","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-950-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858010301","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-103-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (42858-103-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"42858010350","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-103-50","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Rhodes Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (42858-103-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781022901","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-229-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"100 TABLET in 1 BOTTLE (47781-229-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"47781022905","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-229-05","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Alvogen, Inc.","package_description":"500 TABLET in 1 BOTTLE (47781-229-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268064511","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268064515","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-645-15","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-645-15) / 1 TABLET in 1 BLISTER PACK (50268-645-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"64850062201","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-622-01","proprietary_name":"Oxycodone Hydrochloride and Acetaminophen","nonproprietary_name":"Oxycodone Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-622-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65162020710","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-207-10","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-207-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65162020750","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-207-50","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-207-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"68084069901","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-699-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-699-01) / 1 TABLET in 1 BLISTER PACK (68084-699-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"68084069911","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"70010066901","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-669-01","proprietary_name":"Oxycodone and Acetaminophen","nonproprietary_name":"Oxycodone and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-669-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004612","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-046-12","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET in 1 BOTTLE (71930-046-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"71930004652","name":"OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-046-52","proprietary_name":"OXYCODONE AND ACETAMINOPHEN","nonproprietary_name":"oxycodone and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"Eywa Pharma Inc","package_description":"500 TABLET in 1 BOTTLE (71930-046-52)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxycodone-Acetaminophen|Oxycodone HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"59011041010","name":"OXYCONTIN ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-410-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-410-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":5.8746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011041020","name":"OXYCONTIN ER 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-410-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-410-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":5.8746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011041510","name":"OXYCONTIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-415-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-415-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.6604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011041520","name":"OXYCONTIN ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-415-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-415-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":8.6604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011042010","name":"OXYCONTIN ER 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-420-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-420-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.95464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011042020","name":"OXYCONTIN ER 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-420-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-420-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.95464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011043010","name":"OXYCONTIN ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-430-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-430-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":15.22234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011043020","name":"OXYCONTIN ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-430-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-430-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":15.22234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011044010","name":"OXYCONTIN ER 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-440-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-440-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":18.77426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011044020","name":"OXYCONTIN ER 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-440-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-440-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":18.77426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011046010","name":"OXYCONTIN ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-460-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-460-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":26.5371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011046020","name":"OXYCONTIN ER 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-460-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-460-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":26.5371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011048010","name":"OXYCONTIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-480-10","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Knoa Pharma LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59011-480-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":32.65782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59011048020","name":"OXYCONTIN ER 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59011-480-20","proprietary_name":"OxyContin","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Knoa Pharma LLC","package_description":"2 BLISTER PACK in 1 CARTON (59011-480-20) / 10 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":32.65782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023615301","name":"OXYTROL 3.9 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":81.28545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxytrol|Oxybutynin","basis":"brand"},"part_b":null}, {"ndc":"00023615308","name":"OXYTROL 3.9 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6153-08","proprietary_name":"OXYTROL","nonproprietary_name":"Oxybutynin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"3.9 mg/d","labeler":"Allergan, Inc.","package_description":"8 POUCH in 1 BOX (0023-6153-08) / 1 PATCH in 1 POUCH / 4 d in 1 PATCH","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":81.28545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Oxytrol|Oxybutynin","basis":"brand"},"part_b":null}, {"ndc":"00023963701","name":"OXYTROL FOR WOMEN 3.9 MG/24HR","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.7424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023963704","name":"OXYTROL FOR WOMEN 3.9 MG/24HR","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9637-04","proprietary_name":"Oxytrol for Women","nonproprietary_name":"Oxybutynin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"3.9 mg/d","labeler":"Allergan, Inc.","package_description":"16 PATCH in 1 CARTON (0023-9637-04) / 4 d in 1 PATCH","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":2.7424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023963708","name":"OXYTROL FOR WOMEN 3.9 MG/24HR","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9637-08","proprietary_name":"Oxytrol for Women","nonproprietary_name":"Oxybutynin","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"3.9 mg/d","labeler":"Allergan, Inc.","package_description":"32 PATCH in 1 CARTON (0023-9637-08) / 4 d in 1 PATCH","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":2.7424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169418103","name":"OZEMPIC 0.25-0.5 MG/DOSE (2 MG/3 ML) PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":331.99085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169418113","name":"OZEMPIC 0.25-0.5 MG/DOSE (2 MG/3 ML) PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4181-13","proprietary_name":"Ozempic","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".68 mg/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (0169-4181-13) / 3 mL in 1 SYRINGE, PLASTIC (0169-4181-03)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":331.99085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169413001","name":"OZEMPIC 1 MG/DOSE (4 MG/3 ML) PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":331.90037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169413013","name":"OZEMPIC 1 MG/DOSE (4 MG/3 ML) PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4130-13","proprietary_name":"Ozempic","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1.34 mg/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (0169-4130-13) / 3 mL in 1 SYRINGE, PLASTIC (0169-4130-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":331.90037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169171530","name":"OZEMPIC 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-1715-30","proprietary_name":"OZEMPIC","nonproprietary_name":"oral semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-1715-30)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":33.12635,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169477211","name":"OZEMPIC 2 MG/DOSE (8 MG/3 ML) PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":331.97208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169477212","name":"OZEMPIC 2 MG/DOSE (8 MG/3 ML) PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4772-12","proprietary_name":"Ozempic","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"2.68 mg/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"1 SYRINGE, PLASTIC in 1 CARTON (0169-4772-12) / 3 mL in 1 SYRINGE, PLASTIC (0169-4772-11)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":331.97208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169170430","name":"OZEMPIC 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-1704-30","proprietary_name":"OZEMPIC","nonproprietary_name":"oral semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-1704-30)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":33.17974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169170930","name":"OZEMPIC 9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-1709-30","proprietary_name":"OZEMPIC","nonproprietary_name":"oral semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"9 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-1709-30)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":33.17868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245014401","name":"PACERONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0144-01","proprietary_name":"Pacerone","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0245-0144-01) / 1 TABLET in 1 BLISTER PACK (0245-0144-89)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.7762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"00245014430","name":"PACERONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0144-30","proprietary_name":"Pacerone","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (0245-0144-30)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.7762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"00245014489","name":"PACERONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.7762,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.37584,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"00245014701","name":"PACERONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0147-01","proprietary_name":"Pacerone","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 BLISTER PACK in 1 CARTON (0245-0147-01) / 1 TABLET in 1 BLISTER PACK (0245-0147-89)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12488,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"00245014715","name":"PACERONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0147-15","proprietary_name":"Pacerone","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (0245-0147-15)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12488,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"00245014789","name":"PACERONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":0.12488,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"00245014790","name":"PACERONE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0147-90","proprietary_name":"Pacerone","nonproprietary_name":"Amiodarone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (0245-0147-90)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.12488,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pacerone|Amiodarone HCl","basis":"brand"},"part_b":null}, {"ndc":"46122039078","name":"PAIN RELIEF 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-390-78","proprietary_name":"Pain Relief Regular Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"AmeriSource Bergen","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (46122-390-78) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536132601","name":"PAIN RELIEVER PLS 250-250-65 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1326-01","proprietary_name":"Pain Reliever Plus","nonproprietary_name":"Acetaminophen, Aspirin, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1; 65 mg/1; 250 mg/1","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1326-01) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Methylxanthine [EPC]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536110145","name":"PAIN RELIEVING 1%-15% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1101-45","proprietary_name":"Rugby Pain Relieving Analgesic","nonproprietary_name":"Menthol, Unspecified Form and Methyl Salicylate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g; 150 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1101-45) / 85 g in 1 TUBE"},"nadac":{"value":0.04398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000074401","name":"PAIN RELIEVING 10% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0744-1","proprietary_name":"Pain Relieving","nonproprietary_name":"Trolamine Salicylate","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 TUBE in 1 CARTON (70000-0744-1) / 85 g in 1 TUBE"},"nadac":{"value":0.0344,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000036801","name":"PAIN RELIEVING 3.1-6-10% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0368-1","proprietary_name":"Pain Relief Patches","nonproprietary_name":"CAMPHOR, MENTHOL, METHYL SALICYLATE","dosage_form":"PATCH","route":"TOPICAL","strength":"3.1 g/100g; 6 g/100g; 10 g/100g","labeler":"Cardinal Health, 110 dba LEADER","package_description":"6 PATCH in 1 BOX (70000-0368-1) / 9 g in 1 PATCH"},"nadac":{"value":0.66456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714086601","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-866-01","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-866-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"27808022201","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-222-01","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Tris Pharma Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-222-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"31722031730","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-317-30","proprietary_name":"PALIPERIDONE","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-317-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"43975034903","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-349-03","proprietary_name":"PALIPERIDONE","nonproprietary_name":"PALIPERIDONE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43975-349-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"47335074483","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-744-83","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-744-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"62332080330","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-803-30","proprietary_name":"paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-803-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"65162028003","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-280-03","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-280-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"69367043230","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-432-30","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-432-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"72819015703","name":"PALIPERIDONE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.82039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"00904693561","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6935-61","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6935-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"16714086701","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-867-01","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-867-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"27808022301","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-223-01","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Tris Pharma Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-223-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"31722031830","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-318-30","proprietary_name":"PALIPERIDONE","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-318-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"43975035003","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-350-03","proprietary_name":"PALIPERIDONE","nonproprietary_name":"PALIPERIDONE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43975-350-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"47335076583","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-765-83","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-765-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"60687045901","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-459-01","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-459-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-459-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"60687045911","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"62332080430","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-804-30","proprietary_name":"paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-804-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"65162028103","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-281-03","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-281-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"69367043330","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-433-30","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-433-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"72819015803","name":"PALIPERIDONE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-158-03","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Archis Pharma LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (72819-158-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.9719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"00904693661","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6936-61","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6936-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"16714086801","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-868-01","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-868-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"27808022401","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-224-01","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Tris Pharma Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-224-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"31722031930","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-319-30","proprietary_name":"PALIPERIDONE","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-319-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"43975035103","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-351-03","proprietary_name":"PALIPERIDONE","nonproprietary_name":"PALIPERIDONE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43975-351-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"47335076683","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-766-83","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-766-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"60687047001","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-470-01","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-470-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-470-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"60687047011","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"62332080530","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-805-30","proprietary_name":"paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-805-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"65162028203","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-282-03","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-282-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"69367043430","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-434-30","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-434-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"72819015903","name":"PALIPERIDONE ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-159-03","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Archis Pharma LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (72819-159-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.04602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"00904693761","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6937-61","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6937-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"16714086901","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-869-01","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (16714-869-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"27808022501","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-225-01","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Tris Pharma Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27808-225-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"31722032030","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-320-30","proprietary_name":"PALIPERIDONE","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-320-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"43975035203","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-352-03","proprietary_name":"PALIPERIDONE","nonproprietary_name":"PALIPERIDONE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43975-352-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"47335076783","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-767-83","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-767-83)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"62332080630","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-806-30","proprietary_name":"paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-806-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"65162028303","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-283-03","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (65162-283-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"69367043530","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-435-30","proprietary_name":"Paliperidone","nonproprietary_name":"Paliperidone","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-435-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"72819016003","name":"PALIPERIDONE ER 9 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72819-160-03","proprietary_name":"Paliperidone","nonproprietary_name":"paliperidone","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"9 mg/1","labeler":"Archis Pharma LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (72819-160-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.05566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paliperidone ER|Paliperidone","basis":"generic"},"part_b":null}, {"ndc":"27241025611","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-256-11","proprietary_name":"Pantoprazole sodium","nonproprietary_name":"Pantoprazole sodium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1 FOR SUSPENSION in 1 PACKET (27241-256-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241025638","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-256-38","proprietary_name":"Pantoprazole sodium","nonproprietary_name":"Pantoprazole sodium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 FOR SUSPENSION in 1 CARTON (27241-256-38)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722003231","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722003232","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-032-32","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (31722-032-32) / 1 GRANULE, DELAYED RELEASE in 1 PACKET","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799095230","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-952-30","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 PACKET in 1 CARTON (42799-952-30) / 1 GRANULE, DELAYED RELEASE in 1 PACKET (42799-952-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651067130","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-671-30","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 PACKET in 1 CARTON (59651-671-30) / 1 GRANULE, DELAYED RELEASE in 1 PACKET","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687076727","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-767-27","proprietary_name":"Pantoprazole sodium","nonproprietary_name":"Pantoprazole sodium","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 PACKET in 1 CARTON (60687-767-27) / 1 FOR SUSPENSION in 1 PACKET (60687-767-99)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687076799","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756007160","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62756007164","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62756-071-64","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 PACKET in 1 CARTON (62756-071-64) / 1 GRANULE, DELAYED RELEASE in 1 PACKET (62756-071-60)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097053153","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-531-53","proprietary_name":"PANTOPRAZOLE SODIUM DELAYED-RELEASE delayed release","nonproprietary_name":"pantoprazole sodium granules","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/1","labeler":"Cipla USA Inc.","package_description":"30 PACKET in 1 CARTON (69097-531-53) / 1 SUSPENSION in 1 PACKET (69097-531-31)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603031701","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603031730","name":"PANTOPRAZOLE DR 40 MG SUSP PKT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-317-30","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 PACKET in 1 CARTON (72603-317-30) / 1 GRANULE, DELAYED RELEASE in 1 PACKET (72603-317-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378668877","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6688-77","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0378-6688-77)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904745861","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7458-61","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7458-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668009690","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-096-90","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-096-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722071290","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-712-90","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (31722-712-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342001910","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268058511","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268058515","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-585-15","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-585-15) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (50268-585-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111033290","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-332-90","proprietary_name":"Pantoprazole","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (55111-332-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687072501","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-725-01","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-725-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-725-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687072511","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135053390","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-533-90","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (62135-533-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62175061846","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-618-46","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (62175-618-46)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980067609","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-676-09","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (64980-676-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162063609","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-636-09","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (65162-636-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862055990","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-559-90","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (65862-559-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010019009","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-190-09","proprietary_name":"pantoprazole sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (70010-190-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603017701","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-177-01","proprietary_name":"Pantoprazole","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-177-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009001090","name":"PANTOPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-010-90","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (82009-010-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"00378668910","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6689-10","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0378-6689-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378668977","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6689-77","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (0378-6689-77)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904647406","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6474-06","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6474-06) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904647461","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6474-61","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6474-61) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904687045","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6870-45","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6870-45) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668042905","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-429-05","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-429-05)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668042990","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-429-90","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-429-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722071310","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-713-10","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (31722-713-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"31722071390","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-713-90","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (31722-713-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"35573042851","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573042880","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-428-80","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"10 BLISTER PACK in 1 CARTON (35573-428-80) / 10 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268063911","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268063915","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-639-15","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-639-15) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (50268-639-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079005101","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079005120","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-051-20","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-051-20) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (51079-051-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111033310","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-333-10","proprietary_name":"Pantoprazole","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (55111-333-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"55111033390","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-333-90","proprietary_name":"Pantoprazole","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Dr.Reddy's Laboratories Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (55111-333-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687073601","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-736-01","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-736-01) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-736-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073609","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-736-09","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 CARTON (60687-736-09) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-736-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073611","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687073665","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-736-65","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-736-65) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-736-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135053408","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-534-08","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"450 TABLET, DELAYED RELEASE in 1 BOTTLE (62135-534-08)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135053490","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-534-90","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (62135-534-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62175061743","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-617-43","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (62175-617-43)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62175061746","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-617-46","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (62175-617-46)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980067709","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-677-09","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (64980-677-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980067710","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-677-10","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (64980-677-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162063709","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-637-09","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (65162-637-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162063711","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-637-11","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (65162-637-11)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862056090","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-560-90","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (65862-560-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862056099","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-560-99","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (65862-560-99)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68645059654","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010019109","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-191-09","proprietary_name":"pantoprazole sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (70010-191-09)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010019110","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-191-10","proprietary_name":"pantoprazole sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (70010-191-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70756001912","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-019-12","proprietary_name":"Pantoprazole sodium delayed-release","nonproprietary_name":"Pantoprazole sodium delayed-release","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-019-12)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603017801","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-178-01","proprietary_name":"Pantoprazole","nonproprietary_name":"Pantoprazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-178-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"72603074601","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-746-01","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-746-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603074602","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-746-02","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (72603-746-02)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82009001110","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-011-10","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, DELAYED RELEASE in 1 BOTTLE (82009-011-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009001190","name":"PANTOPRAZOLE SOD DR 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-011-90","proprietary_name":"PANTOPRAZOLE SODIUM","nonproprietary_name":"PANTOPRAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (82009-011-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pantoprazole Sodium*|Pantoprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"00143928410","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9284-10","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0143-9284-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL (0143-9284-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143930010","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0143-9300-10","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 VIAL in 1 CARTON (0143-9300-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL (0143-9300-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"25021075110","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"25021-751-10","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/10mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-751-10) / 10 mL in 1 VIAL","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722020410","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-204-10","proprietary_name":"pantoprazole sodium","nonproprietary_name":"pantoprazole sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (31722-204-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (31722-204-31)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55150020210","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-202-10","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/1","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-202-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (55150-202-00)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65219043315","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66794025841","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66794-258-41","proprietary_name":"PANTOPRAZOLE SODIUM I.V.","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/10mL","labeler":"Piramal Critical Care","package_description":"1 VIAL in 1 CARTON (66794-258-41) / 10 mL in 1 VIAL","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70095002402","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70095-024-02","proprietary_name":"Pantoprazole sodium","nonproprietary_name":"Pantoprazole sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/10mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"10 CARTON in 1 PACKAGE (70095-024-02) / 1 VIAL in 1 CARTON / 10 mL in 1 VIAL (70095-024-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71288060011","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-600-11","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/10mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (71288-600-11) / 10 mL in 1 VIAL, SINGLE-DOSE (71288-600-10)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71839012210","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71839-122-10","proprietary_name":"Pantoprazole sodium","nonproprietary_name":"Pantoprazole sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/10mL","labeler":"BE Pharmaceuticals Inc.","package_description":"10 CARTON in 1 PACKAGE (71839-122-10) / 1 VIAL in 1 CARTON / 10 mL in 1 VIAL","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603012810","name":"PANTOPRAZOLE SODIUM 40 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72603-128-10","proprietary_name":"Pantoprazole Sodium","nonproprietary_name":"Pantoprazole Sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"40 mg/10mL","labeler":"Northstar Rx LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72603-128-10) / 10 mL in 1 VIAL, SINGLE-DOSE (72603-128-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":2.374,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483068703","name":"PARICALCITOL 1 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-687-03","proprietary_name":"Paricalcitol","nonproprietary_name":"Paricalcitol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 ug/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (49483-687-03)","pharm_classes":["Ergocalciferols [CS]","Vitamin D2 Analog [EPC]"]},"nadac":{"value":1.27717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paricalcitol*|Paricalcitol","basis":"generic"},"part_b":null}, {"ndc":"65862093630","name":"PARICALCITOL 1 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-936-30","proprietary_name":"Paricalcitol","nonproprietary_name":"Paricalcitol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (65862-936-30)","pharm_classes":["Ergocalciferols [CS]","Vitamin D Analog [EPC]","Vitamin D2 Analog [EPC]"]},"nadac":{"value":1.27717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paricalcitol*|Paricalcitol","basis":"generic"},"part_b":null}, {"ndc":"69452014513","name":"PARICALCITOL 1 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-145-13","proprietary_name":"Paricalcitol","nonproprietary_name":"Paricalcitol","dosage_form":"CAPSULE","route":"ORAL","strength":"1 ug/1","labeler":"Bionpharma Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (69452-145-13)","pharm_classes":["Ergocalciferols [CS]","Vitamin D Analog [EPC]","Vitamin D2 Analog [EPC]"]},"nadac":{"value":1.27717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paricalcitol*|Paricalcitol","basis":"generic"},"part_b":null}, {"ndc":"49483068803","name":"PARICALCITOL 2 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-688-03","proprietary_name":"Paricalcitol","nonproprietary_name":"Paricalcitol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 ug/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (49483-688-03)","pharm_classes":["Ergocalciferols [CS]","Vitamin D2 Analog [EPC]"]},"nadac":{"value":2.58862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paricalcitol*|Paricalcitol","basis":"generic"},"part_b":null}, {"ndc":"65862093730","name":"PARICALCITOL 2 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-937-30","proprietary_name":"Paricalcitol","nonproprietary_name":"Paricalcitol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, LIQUID FILLED in 1 BOTTLE (65862-937-30)","pharm_classes":["Ergocalciferols [CS]","Vitamin D Analog [EPC]","Vitamin D2 Analog [EPC]"]},"nadac":{"value":2.58862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paricalcitol*|Paricalcitol","basis":"generic"},"part_b":null}, {"ndc":"69452014613","name":"PARICALCITOL 2 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-146-13","proprietary_name":"Paricalcitol","nonproprietary_name":"Paricalcitol","dosage_form":"CAPSULE","route":"ORAL","strength":"2 ug/1","labeler":"Bionpharma Inc.","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (69452-146-13)","pharm_classes":["Ergocalciferols [CS]","Vitamin D Analog [EPC]","Vitamin D2 Analog [EPC]"]},"nadac":{"value":2.58862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paricalcitol*|Paricalcitol","basis":"generic"},"part_b":null}, {"ndc":"60505131603","name":"PAROXETINE CR 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1316-3","proprietary_name":"PAROXETINE HYDROCHLORIDE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-1316-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine Cr|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505131703","name":"PAROXETINE CR 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1317-3","proprietary_name":"PAROXETINE HYDROCHLORIDE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-1317-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine Cr|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505131803","name":"PAROXETINE CR 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1318-3","proprietary_name":"PAROXETINE HYDROCHLORIDE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-1318-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.3974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine Cr|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135042530","name":"PAROXETINE ER 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-425-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-425-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62175047032","name":"PAROXETINE ER 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-470-32","proprietary_name":"Paroxetine Hydrochloride","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-470-32)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367033530","name":"PAROXETINE ER 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-335-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69367-335-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241002922","name":"PAROXETINE ER 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-029-22","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72241-029-22)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.52008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135042630","name":"PAROXETINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-426-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-426-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62175047132","name":"PAROXETINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-471-32","proprietary_name":"Paroxetine Hydrochloride","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-471-32)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367033630","name":"PAROXETINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-336-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69367-336-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003022","name":"PAROXETINE ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-030-22","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72241-030-22)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.38562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135042730","name":"PAROXETINE ER 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-427-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62135-427-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.3974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62175047232","name":"PAROXETINE ER 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-472-32","proprietary_name":"Paroxetine Hydrochloride","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62175-472-32)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.3974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367033730","name":"PAROXETINE ER 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-337-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69367-337-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.3974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241003122","name":"PAROXETINE ER 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-031-22","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72241-031-22)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.3974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine ER|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700110","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7001-10","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7001-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700193","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7001-93","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7001-93)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904567661","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5676-61","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5676-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015405","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-154-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-154-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015430","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-154-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-154-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015490","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-154-90","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurolife Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13107-154-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018101","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-181-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-181-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018102","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-181-02","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-181-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018103","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018104","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-181-04","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-181-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018105","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-181-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-181-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034703","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-347-03","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-347-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034709","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-347-09","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-347-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034711","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-347-11","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-347-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034750","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-347-50","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43547-347-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268064011","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268064015","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-640-15","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-640-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-640-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505009701","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0097-1","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0097-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505009702","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0097-2","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0097-2)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505009704","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0097-4","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0097-4)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135054190","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-541-90","proprietary_name":"PAROXETINE","nonproprietary_name":"PAROXETINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-541-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862015430","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-154-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-154-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004401","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-044-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-044-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-044-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004411","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004465","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-044-65","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-044-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-044-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009705","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-097-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-097-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009706","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-097-06","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-097-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009710","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-097-10","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-097-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009716","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-097-16","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-097-16)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067103","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-671-03","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69584-671-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067109","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-671-09","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69584-671-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067150","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-671-50","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69584-671-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067190","name":"PAROXETINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-671-90","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69584-671-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06189,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"70954031910","name":"PAROXETINE HCL 10 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-319-10","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"SUSPENSION","route":"ORAL","strength":"10 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"250 mL in 1 BOTTLE (70954-319-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.40007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378700210","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7002-10","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7002-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700293","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7002-93","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7002-93)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904567761","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5677-61","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5677-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015505","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-155-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-155-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015530","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-155-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-155-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015590","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-155-90","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurolife Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13107-155-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015599","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-155-99","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurolife Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13107-155-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018201","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-182-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-182-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018203","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-182-03","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-182-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018204","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-182-04","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-182-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034803","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-348-03","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-348-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034809","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-348-09","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-348-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034811","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-348-11","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-348-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034850","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-348-50","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43547-348-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008301","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0083-1","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0083-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008302","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0083-2","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0083-2)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008304","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0083-4","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0083-4)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135054290","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-542-90","proprietary_name":"PAROXETINE","nonproprietary_name":"PAROXETINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-542-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862015505","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-155-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-155-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862015530","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-155-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-155-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862015599","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-155-99","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-155-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004501","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-045-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-045-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-045-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004511","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009801","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-098-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-098-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009805","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-098-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-098-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009806","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-098-06","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-098-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009810","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-098-10","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-098-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009816","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-098-16","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-098-16)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067203","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-672-03","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69584-672-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067209","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-672-09","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69584-672-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067210","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-672-10","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69584-672-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067250","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-672-50","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69584-672-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067290","name":"PAROXETINE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-672-90","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69584-672-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700310","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7003-10","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7003-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700393","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7003-93","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7003-93)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015605","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-156-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-156-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015630","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-156-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-156-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015690","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-156-90","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13107-156-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015699","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-156-99","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurolife Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13107-156-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018301","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-183-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-183-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018302","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-183-02","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-183-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018303","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-183-03","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-183-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034903","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-349-03","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-349-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034909","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-349-09","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-349-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034911","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-349-11","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-349-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547034950","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-349-50","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43547-349-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268064211","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268064215","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-642-15","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-642-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-642-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008401","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0084-1","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0084-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008402","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0084-2","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0084-2)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008404","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0084-4","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0084-4)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135054390","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-543-90","proprietary_name":"PAROXETINE","nonproprietary_name":"PAROXETINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-543-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862015630","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-156-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-156-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004601","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-046-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-046-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-046-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004611","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009905","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-099-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-099-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009906","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-099-06","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-099-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009910","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-099-10","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-099-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382009916","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-099-16","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-099-16)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067303","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-673-03","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69584-673-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067309","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-673-09","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69584-673-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067350","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-673-50","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69584-673-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067390","name":"PAROXETINE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-673-90","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69584-673-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700410","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7004-10","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7004-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378700493","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-7004-93","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-7004-93)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015705","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-157-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (13107-157-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015730","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-157-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurolife Pharma LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13107-157-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015790","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-157-90","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurolife Pharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13107-157-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"13107015799","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-157-99","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurolife Pharma LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (13107-157-99)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018401","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-184-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-184-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018402","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-184-02","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-184-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018404","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-184-04","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-184-04)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714018405","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-184-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-184-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035003","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-350-03","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43547-350-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035009","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-350-09","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-350-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035011","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-350-11","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43547-350-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547035050","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-350-50","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine hydrochloride hemihydrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (43547-350-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268064311","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268064315","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-643-15","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-643-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-643-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505010101","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0101-1","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-0101-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505010102","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0101-2","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60505-0101-2)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505010104","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0101-4","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60505-0101-4)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135054490","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-544-90","proprietary_name":"PAROXETINE","nonproprietary_name":"PAROXETINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-544-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862015730","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-157-30","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-157-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004701","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-047-01","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-047-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-047-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084004711","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382000105","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-001-05","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-001-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382000106","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-001-06","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-001-06)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382000116","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-001-16","proprietary_name":"Paroxetine","nonproprietary_name":"Paroxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68382-001-16)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067403","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-674-03","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69584-674-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067409","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-674-09","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69584-674-09)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067450","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-674-50","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69584-674-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"69584067490","name":"PAROXETINE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-674-90","proprietary_name":"paroxetine hydrochloride","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69584-674-90)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine HCl|Paroxetine HCl","basis":"generic"},"part_b":null}, {"ndc":"00574027930","name":"PAROXETINE MESYLATE 7.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0279-30","proprietary_name":"Paroxetine","nonproprietary_name":"paroxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Padagis US LLC","package_description":"30 CAPSULE in 1 BOTTLE (0574-0279-30)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":2.62233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine Mesylate|Paroxetine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"43547040903","name":"PAROXETINE MESYLATE 7.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-409-03","proprietary_name":"PAROXETINE","nonproprietary_name":"paroxetine","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"30 CAPSULE in 1 BOTTLE (43547-409-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":2.62233,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paroxetine Mesylate|Paroxetine Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00065815001","name":"PATADAY ONCE DAILY 0.2% DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0065-8150-01","proprietary_name":"PATADAY ONCE DAILY RELIEF","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0065-8150-01) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":5.89285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":2.96362,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065081604","name":"PATADAY ONCE DAILY 0.7% DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0065-0816-04","proprietary_name":"PATADAY ONCE DAILY RELIEF","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"7 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0065-0816-04) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":6.2023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065427401","name":"PATADAY TWICE DAILY 0.1% DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0065-4274-01","proprietary_name":"PATADAY TWICE A DAY RELIEF","nonproprietary_name":"OLOPATADINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0065-4274-01) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":2.48198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.27369,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505451803","name":"PAXIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4518-3","proprietary_name":"PAXIL","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4518-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":10.73717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06108,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxil|Paroxetine HCl","basis":"brand"},"part_b":null}, {"ndc":"60505451903","name":"PAXIL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4519-3","proprietary_name":"PAXIL","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4519-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":10.80717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.09543,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxil|Paroxetine HCl","basis":"brand"},"part_b":null}, {"ndc":"60505452003","name":"PAXIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4520-3","proprietary_name":"PAXIL","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4520-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":11.50448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.09655,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxil|Paroxetine HCl","basis":"brand"},"part_b":null}, {"ndc":"60505437803","name":"PAXIL CR 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4378-3","proprietary_name":"PAXIL CR","nonproprietary_name":"paroxetine hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-4378-3)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":10.79833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.38562,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxil Cr|Paroxetine HCl","basis":"brand"},"part_b":null}, {"ndc":"00069543420","name":"PAXLOVID 150-100 MG DOSE PACK (MODERATE RENAL DOSE)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-5434-20","proprietary_name":"Paxlovid","nonproprietary_name":"nirmatrelvir and ritonavir","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"10 BLISTER PACK in 1 CARTON (0069-5434-20) / 1 KIT in 1 BLISTER PACK (0069-5434-02) * 1 TABLET, FILM COATED in 1 BLISTER PACK (0069-2085-11) * 1 TABLET, FILM COATED in 1 BLISTER PACK (0069-1345-11)"},"nadac":{"value":73.78524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxlovid|Nirmatrelvir/Ritonavir","basis":"brand"},"part_b":null}, {"ndc":"00069504530","name":"PAXLOVID 300-100 MG DOSE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-5045-30","proprietary_name":"Paxlovid","nonproprietary_name":"nirmatrelvir and ritonavir","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"10 BLISTER PACK in 1 CARTON (0069-5045-30) / 1 KIT in 1 BLISTER PACK (0069-5045-06) * 2 TABLET, FILM COATED in 1 BLISTER PACK (0069-2085-02) * 1 TABLET, FILM COATED in 1 BLISTER PACK (0069-1345-11)"},"nadac":{"value":49.23712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxlovid|Nirmatrelvir/Ritonavir","basis":"brand"},"part_b":null}, {"ndc":"00069052111","name":"PAXLOVID 300/150-100 MG DOSE PACK (SEVERE RENAL DOSE)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":133.96709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxlovid|Nirmatrelvir/Ritonavir","basis":"brand"},"part_b":null}, {"ndc":"00069545011","name":"PAXLOVID 300/150-100 MG DOSE PACK (SEVERE RENAL DOSE)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-5450-11","proprietary_name":"Paxlovid","nonproprietary_name":"nirmatrelvir and ritonavir","dosage_form":"KIT","route":null,"strength":null,"labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 BLISTER PACK in 1 CARTON (0069-5450-11) / 1 KIT in 1 BLISTER PACK * 6 TABLET, FILM COATED in 1 BLISTER PACK (0069-2085-06) * 5 TABLET, FILM COATED in 1 BLISTER PACK (0069-1345-05)"},"nadac":{"value":133.96709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Paxlovid|Nirmatrelvir/Ritonavir","basis":"brand"},"part_b":null}, {"ndc":"10572030201","name":"PEG 3350-ELECTROLYTE SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10572-302-01","proprietary_name":"PEG-3350, sodium chloride, sodium bicarbonate and potassium chloride","nonproprietary_name":"polyethylene glycol 3350, sodium chloride, sodium bicarbonate, potassium chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"420 g/4L; 11.2 g/4L; 5.72 g/4L; 1.48 g/4L","labeler":"Affordable Pharmaceuticals, LLC","package_description":"4 L in 1 BOTTLE (10572-302-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536030201","name":"PEG 3350-ELECTROLYTE SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-302-01","proprietary_name":"PEG 3350, sodium chloride, sodium bicarbonate and potassium chloride","nonproprietary_name":"polyethylene glycol 3350, sodium chloride, sodium bicarbonate, potassium chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"420 g/4L; 11.2 g/4L; 5.72 g/4L; 1.48 g/4L","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"4 L in 1 BOTTLE (52536-302-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380076921","name":"PEG 3350-ELECTROLYTE SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-769-21","proprietary_name":"Polyethylene Glycol 3350, Sodium Chloride, Sodium Bicarbonate and Potassium Chloride with Lemon Flavor","nonproprietary_name":"Polyethylene Glycol 3350, Sodium Chloride, Sodium Bicarbonate and Potassium Chloride with Lemon Flavor","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"420 g/4L; 11.2 g/4L; 5.72 g/4L; 1.48 g/4L","labeler":"Strides Pharma Science Limited","package_description":"4 L in 1 JUG (64380-769-21)","pharm_classes":["Alkalinizing Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"10572010001","name":"PEG-3350 AND ELECTROLYTES SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10572-100-01","proprietary_name":"PEG-3350 and Electrolytes","nonproprietary_name":"Polyethylene Glycol 3350, Sodium Sulfate Anhydrous, Sodium Bicarbonate, Sodium Chloride, Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"236 g/4L; 22.74 g/4L; 6.74 g/4L; 5.86 g/4L; 2.97 g/4L","labeler":"Affordable Pharmaceuticals, LLC","package_description":"4 L in 1 JUG (10572-100-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"PEG-3350 And Electrolytes|PEG3350/Sod Sulf,Bicarb,Cl/KCl","basis":"brand"},"part_b":null}, {"ndc":"52536023601","name":"PEG-3350 AND ELECTROLYTES SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-236-01","proprietary_name":"PEG 3350 and Electrolytes","nonproprietary_name":"Polyethylene Glycol 3350, Sodium Sulfate Anhydrous, Sodium Bicarbonate, Sodium Chloride, Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"236 g/4L; 22.74 g/4L; 6.74 g/4L; 5.86 g/4L; 2.97 g/4L","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"4 L in 1 JUG (52536-236-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380076621","name":"PEG-3350 AND ELECTROLYTES SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-766-21","proprietary_name":"Polyethylene Glycol 3350 and electrolytes with Lemon Flavor","nonproprietary_name":"Polyethylene Glycol 3350 and electrolytes with Lemon Flavor","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"236 g/4L; 22.74 g/4L; 6.74 g/4L; 5.86 g/4L; 2.97 g/4L","labeler":"Strides Pharma Science Limited","package_description":"4 L in 1 JUG (64380-766-21)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093356026","name":"PEG3350-SOD SUL-NACL-KCL-ASCB-C 100-7.5-2.691-1.015-5.9-4.7G","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3560-26","proprietary_name":"PEG-3350, SODIUM SULFATE, SODIUM CHLORIDE, POTASSIUM CHLORIDE, SODIUM ASCORBATE AND ASCORBIC ACID","nonproprietary_name":"PEG-3350, SODIUM SULFATE, SODIUM CHLORIDE, POTASSIUM CHLORIDE, SODIUM ASCORBATE AND ASCORBIC ACID","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 CARTON in 1 CARTON (0093-3560-26) / 1 KIT in 1 CARTON (0093-3560-19) * 1 L in 1 POUCH (0093-9043-19) * 1 L in 1 POUCH * 1 L in 1 POUCH (0093-9044-19)"},"nadac":{"value":79.53417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093318620","name":"PENCICLOVIR 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3186-20","proprietary_name":"Penciclovir","nonproprietary_name":"Penciclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 TUBE in 1 CARTON (0093-3186-20) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":52.1538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Penciclovir|Penciclovir","basis":"generic"},"part_b":null}, {"ndc":"00378089655","name":"PENCICLOVIR 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0896-55","proprietary_name":"Penciclovir","nonproprietary_name":"penciclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-0896-55) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":52.1538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Penciclovir|Penciclovir","basis":"generic"},"part_b":null}, {"ndc":"13668066110","name":"PENCICLOVIR 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":52.1538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Penciclovir|Penciclovir","basis":"generic"},"part_b":null}, {"ndc":"45802044075","name":"PENCICLOVIR 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-440-75","proprietary_name":"PENCICLOVIR","nonproprietary_name":"penciclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-440-75) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":52.1538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Penciclovir|Penciclovir","basis":"generic"},"part_b":null}, {"ndc":"69238179107","name":"PENCICLOVIR 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1791-7","proprietary_name":"Penciclovir","nonproprietary_name":"Penciclovir","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 TUBE in 1 CARTON (69238-1791-7) / 5 g in 1 TUBE","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":52.1538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Penciclovir|Penciclovir","basis":"generic"},"part_b":null}, {"ndc":"00093412573","name":"PENICILLIN VK 125 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4125-73","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"125 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4125-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.07771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093412574","name":"PENICILLIN VK 125 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4125-74","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"125 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"200 mL in 1 BOTTLE (0093-4125-74)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.04987,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093117201","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1172-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1172-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093117210","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1172-10","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1172-10)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143983701","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9837-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0143-9837-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143983710","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9837-10","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0143-9837-10)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714023401","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-234-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-234-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714023402","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-234-02","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-234-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004001","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-040-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Health, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-040-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004099","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-040-99","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Health, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-040-99)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862017501","name":"PENICILLIN VK 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-175-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-175-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.06082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093412773","name":"PENICILLIN VK 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4127-73","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 mL in 1 BOTTLE (0093-4127-73)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.05897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093412774","name":"PENICILLIN VK 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4127-74","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"200 mL in 1 BOTTLE (0093-4127-74)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.0443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093117401","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1174-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1174-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093117410","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1174-10","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1174-10)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143983601","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9836-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0143-9836-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143983610","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9836-10","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0143-9836-10)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714023501","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-235-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-235-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714023502","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-235-02","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-235-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004101","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-041-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Health, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (57237-041-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004105","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-041-05","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Health, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-041-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237004199","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-041-99","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Health, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-041-99)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862017601","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-176-01","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-176-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862017605","name":"PENICILLIN VK 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-176-05","proprietary_name":"Penicillin V Potassium","nonproprietary_name":"Penicillin V Potassium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-176-05)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]"]},"nadac":{"value":0.09847,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"54092018981","name":"PENTASA 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-189-81","proprietary_name":"Pentasa","nonproprietary_name":"mesalamine","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"240 CAPSULE in 1 BOTTLE (54092-189-81)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":2.90086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pentasa|Mesalamine","basis":"brand"},"part_b":null}, {"ndc":"54092019112","name":"PENTASA 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54092-191-12","proprietary_name":"Pentasa","nonproprietary_name":"mesalamine","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"120 CAPSULE in 1 BOTTLE (54092-191-12)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":5.82619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pentasa|Mesalamine","basis":"brand"},"part_b":null}, {"ndc":"00591039501","name":"PENTAZOCINE-NALOXONE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0395-01","proprietary_name":"Pentazocine and naloxone","nonproprietary_name":"Pentazocine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; .5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0395-01)","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":2.0619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pentazocine-Naloxone HCl|Pentazocine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"43386068001","name":"PENTAZOCINE-NALOXONE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-680-01","proprietary_name":"PENTAZOCINE HYDROCHLORIDE AND NALOXONE HYDROCHLORIDE","nonproprietary_name":"pentazocine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; .5 mg/1","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"100 TABLET in 1 BOTTLE (43386-680-01)","pharm_classes":["Competitive Opioid Antagonists [MoA]","Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist/Antagonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":2.0619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pentazocine-Naloxone HCl|Pentazocine HCl/Naloxone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904544861","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5448-61","proprietary_name":"PENTOXIFYLLINE","nonproprietary_name":"PENTOXIFYLLINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-5448-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571085601","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-856-01","proprietary_name":"Pentoxifylline","nonproprietary_name":"Pentoxifylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-856-01)","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571085650","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-856-50","proprietary_name":"Pentoxifylline","nonproprietary_name":"Pentoxifylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-856-50)","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505003306","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0033-6","proprietary_name":"PENTOXIFYLLINE","nonproprietary_name":"PENTOXIFYLLINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-0033-6)","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505003307","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0033-7","proprietary_name":"PENTOXIFYLLINE","nonproprietary_name":"PENTOXIFYLLINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (60505-0033-7)","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954066810","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-668-10","proprietary_name":"Pentoxifylline","nonproprietary_name":"Pentoxifylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70954-668-10)","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954066820","name":"PENTOXIFYLLINE ER 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-668-20","proprietary_name":"Pentoxifylline","nonproprietary_name":"Pentoxifylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70954-668-20)","pharm_classes":["Blood Viscosity Reducer [EPC]","Hematologic Activity Alteration [PE]"]},"nadac":{"value":0.22728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672425609","name":"PERAMPANEL 0.5 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4256-9","proprietary_name":"PERAMPANEL","nonproprietary_name":"PERAMPANEL","dosage_form":"SUSPENSION","route":"ORAL","strength":".5 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4256-9) / 340 mL in 1 BOTTLE","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":3.94521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205007179","name":"PERAMPANEL 0.5 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-071-79","proprietary_name":"PERAMPANEL","nonproprietary_name":"PERAMPANEL","dosage_form":"SUSPENSION","route":"ORAL","strength":".5 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"340 mL in 1 BOTTLE (72205-071-79)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":3.94521,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00480706756","name":"PERAMPANEL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7067-56","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-7067-56)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":15.64335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672420806","name":"PERAMPANEL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4208-6","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51672-4208-6)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":15.64335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205022530","name":"PERAMPANEL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-225-30","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-225-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":15.64335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480706856","name":"PERAMPANEL 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7068-56","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-7068-56)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":14.39738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672420906","name":"PERAMPANEL 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4209-6","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51672-4209-6)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":14.39738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205022630","name":"PERAMPANEL 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-226-30","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-226-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":14.39738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480706256","name":"PERAMPANEL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7062-56","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-7062-56)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":6.43174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672420406","name":"PERAMPANEL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4204-6","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51672-4204-6)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":6.43174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205022130","name":"PERAMPANEL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-221-30","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-221-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":6.43174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480706356","name":"PERAMPANEL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7063-56","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-7063-56)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":14.43393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672420506","name":"PERAMPANEL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4205-6","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51672-4205-6)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":14.43393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205022230","name":"PERAMPANEL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-222-30","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-222-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":14.43393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480706556","name":"PERAMPANEL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7065-56","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-7065-56)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":18.30465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672420606","name":"PERAMPANEL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4206-6","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51672-4206-6)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":18.30465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205022330","name":"PERAMPANEL 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-223-30","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"6 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-223-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":18.30465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480706656","name":"PERAMPANEL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-7066-56","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-7066-56)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":18.37646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672420706","name":"PERAMPANEL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4207-6","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51672-4207-6)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":18.37646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205022430","name":"PERAMPANEL 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-224-30","proprietary_name":"Perampanel","nonproprietary_name":"Perampanel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-224-30)","pharm_classes":["AMPA Receptor Antagonists [MoA]","Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Noncompetitive AMPA Glutamate Receptor Antagonist [EPC]","UGT1A9 Inhibitors [MoA]","UGT2B7 Inhibitors [MoA]"]},"nadac":{"value":18.37646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63481062970","name":"PERCOCET 10-325 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63481-629-70","proprietary_name":"PERCOCET","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (63481-629-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":41.39519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.23081,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Percocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"63481062370","name":"PERCOCET 5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63481-623-70","proprietary_name":"PERCOCET","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (63481-623-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":29.31652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11705,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Percocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"63481062870","name":"PERCOCET 7.5-325 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63481-628-70","proprietary_name":"PERCOCET","nonproprietary_name":"oxycodone hydrochloride and acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1; 325 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE (63481-628-70)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":31.60483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18251,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Percocet|Oxycodone HCl/Acetaminophen","basis":"brand"},"part_b":null}, {"ndc":"49502060530","name":"PERFOROMIST 20 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"49502-605-30","proprietary_name":"Perforomist","nonproprietary_name":"formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Viatris Specialty LLC","package_description":"30 POUCH in 1 CARTON (49502-605-30) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.04859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.27321,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Perforomist|Formoterol Fumarate","basis":"brand"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (49502-605-30) / 1 VIAL in 1 POUCH / 2 mL in 1 VIAL) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"49502060561","name":"PERFOROMIST 20 MCG/2 ML SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"49502-605-61","proprietary_name":"Perforomist","nonproprietary_name":"formoterol fumarate dihydrate","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"20 ug/2mL","labeler":"Viatris Specialty LLC","package_description":"60 POUCH in 1 CARTON (49502-605-61) / 1 VIAL in 1 POUCH (49502-605-95) / 2 mL in 1 VIAL","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":10.1156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.33557,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Perforomist|Formoterol Fumarate","basis":"brand"},"part_b":{"hcpcs":"J7606","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7606 (20 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 POUCH in 1 CARTON (49502-605-61) / 1 VIAL in 1 POUCH (49502-605-95) / 2 mL in 1 VIAL) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":60,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65862028601","name":"PERINDOPRIL ERBUMINE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-286-01","proprietary_name":"Perindopril Erbumine","nonproprietary_name":"Perindopril Erbumine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-286-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.48838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perindopril Erbumine|Perindopril Erbumine","basis":"generic"},"part_b":null}, {"ndc":"65862028701","name":"PERINDOPRIL ERBUMINE 4 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-287-01","proprietary_name":"Perindopril Erbumine","nonproprietary_name":"Perindopril Erbumine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-287-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.49469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perindopril Erbumine|Perindopril Erbumine","basis":"generic"},"part_b":null}, {"ndc":"65862028801","name":"PERINDOPRIL ERBUMINE 8 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-288-01","proprietary_name":"Perindopril Erbumine","nonproprietary_name":"Perindopril Erbumine","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-288-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.54204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perindopril Erbumine|Perindopril Erbumine","basis":"generic"},"part_b":null}, {"ndc":"16714089701","name":"PERMETHRIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-897-01","proprietary_name":"Permethrin","nonproprietary_name":"Permethrin","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Northstar Rx LLC","package_description":"1 TUBE in 1 CONTAINER (16714-897-01) / 60 g in 1 TUBE","pharm_classes":["Pyrethrins [CS]","Pyrethroid [EPC]"]},"nadac":{"value":0.22919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Permethrin|Permethrin","basis":"generic"},"part_b":null}, {"ndc":"21922002107","name":"PERMETHRIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-021-07","proprietary_name":"Permethrin","nonproprietary_name":"Permethrin Cream 5% w/w","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-021-07) / 60 g in 1 TUBE","pharm_classes":["Pyrethrins [CS]","Pyrethroid [EPC]"]},"nadac":{"value":0.22919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"43598048160","name":"PERMETHRIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-481-60","proprietary_name":"Permethrin","nonproprietary_name":"Permethrin","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/100g","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"1 TUBE in 1 CARTON (43598-481-60) / 60 g in 1 TUBE","pharm_classes":["Pyrethrins [CS]","Pyrethroid [EPC]"]},"nadac":{"value":0.22919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Permethrin|Permethrin","basis":"generic"},"part_b":null}, {"ndc":"45802026937","name":"PERMETHRIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-269-37","proprietary_name":"Permethrin","nonproprietary_name":"Permethrin","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-269-37) / 60 g in 1 TUBE","pharm_classes":["Pyrethrins [CS]","Pyrethroid [EPC]"]},"nadac":{"value":0.22919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Permethrin|Permethrin","basis":"generic"},"part_b":null}, {"ndc":"84386007360","name":"PERMETHRIN 5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-073-60","proprietary_name":"PERMETHRIN","nonproprietary_name":"PERMETHRIN","dosage_form":"CREAM","route":"TOPICAL","strength":"50 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (84386-073-60) / 60 g in 1 TUBE","pharm_classes":["Pyrethrins [CS]","Pyrethroid [EPC]"]},"nadac":{"value":0.22919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Permethrin|Permethrin","basis":"generic"},"part_b":null}, {"ndc":"00591410401","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4104-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"16 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0591-4104-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00603506321","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5063-21","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"16 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0603-5063-21)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00781804901","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8049-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"16 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8049-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"23155080201","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-802-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-802-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"33342045111","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-451-11","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-451-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"52536017001","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-170-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"16 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52536-170-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"64980029301","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-293-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"16 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-293-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68382059401","name":"PERPHENAZINE 16 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-594-01","proprietary_name":"perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"16 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-594-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.3911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00591410101","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4101-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0591-4101-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00603506021","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5060-21","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0603-5060-21)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00781804601","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8046-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8046-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00904659961","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6599-61","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6599-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"23155079901","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-799-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-799-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"33342044811","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-448-11","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-448-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"52536016201","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-162-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52536-162-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"64980029001","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-290-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-290-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68382059101","name":"PERPHENAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-591-01","proprietary_name":"perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-591-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.19667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00591410201","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4102-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0591-4102-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00603506121","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5061-21","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0603-5061-21)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00603506128","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5061-28","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0603-5061-28)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00781804701","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8047-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8047-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00904660061","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6600-61","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6600-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"23155080001","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-800-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-800-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"33342044911","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-449-11","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-449-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"52536016401","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-164-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52536-164-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"62135079990","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-799-90","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-799-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"64980029101","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-291-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-291-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68084060201","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-602-01","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-602-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-602-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68084060211","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68382059201","name":"PERPHENAZINE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-592-01","proprietary_name":"perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-592-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00591410301","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4103-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0591-4103-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00603506221","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5062-21","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0603-5062-21)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00603506228","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5062-28","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0603-5062-28)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00781804801","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8048-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8048-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"00904660161","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6601-61","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6601-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"23155080101","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-801-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-801-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"33342045011","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-450-11","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-450-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"52536016801","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-168-01","proprietary_name":"Perphenazine","nonproprietary_name":"Perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (52536-168-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"64980029201","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-292-01","proprietary_name":"PERPHENAZINE","nonproprietary_name":"PERPHENAZINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64980-292-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68084060701","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-607-01","proprietary_name":"Perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-607-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-607-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68084060711","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"68382059301","name":"PERPHENAZINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-593-01","proprietary_name":"perphenazine","nonproprietary_name":"perphenazine","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-593-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.13539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Perphenazine|Perphenazine","basis":"generic"},"part_b":null}, {"ndc":"12496012001","name":"PERSERIS ER 120 MG SYRINGE KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2764.705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2798","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2798 (0.5 mg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (240 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"12496009002","name":"PERSERIS ER 90 MG POWDER SYRNG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2081.28889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"12496009001","name":"PERSERIS ER 90 MG SYRINGE KIT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2081.28889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2798","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2798 (0.5 mg) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"59767001601","name":"PERTZYE DR 16,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59767-016-01","proprietary_name":"PERTZYE","nonproprietary_name":"pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"16000 [USP'U]/1; 60500 [USP'U]/1; 57500 [USP'U]/1","labeler":"Digestive Care, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59767-016-01)"},"nadac":{"value":5.32867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59767001602","name":"PERTZYE DR 16,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59767-016-02","proprietary_name":"PERTZYE","nonproprietary_name":"pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"16000 [USP'U]/1; 60500 [USP'U]/1; 57500 [USP'U]/1","labeler":"Digestive Care, Inc.","package_description":"250 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59767-016-02)"},"nadac":{"value":5.32867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59767002401","name":"PERTZYE DR 24,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59767-024-01","proprietary_name":"PERTZYE","nonproprietary_name":"pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"24000 [USP'U]/1; 90750 [USP'U]/1; 86250 [USP'U]/1","labeler":"Digestive Care, Inc.","package_description":"80 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59767-024-01)"},"nadac":{"value":8.03883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59767002402","name":"PERTZYE DR 24,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59767-024-02","proprietary_name":"PERTZYE","nonproprietary_name":"pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"24000 [USP'U]/1; 90750 [USP'U]/1; 86250 [USP'U]/1","labeler":"Digestive Care, Inc.","package_description":"200 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59767-024-02)"},"nadac":{"value":8.03883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59767000801","name":"PERTZYE DR 8,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59767-008-01","proprietary_name":"PERTZYE","nonproprietary_name":"pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"8000 [USP'U]/1; 30250 [USP'U]/1; 28750 [USP'U]/1","labeler":"Digestive Care, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59767-008-01)"},"nadac":{"value":2.66451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59767000802","name":"PERTZYE DR 8,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59767-008-02","proprietary_name":"PERTZYE","nonproprietary_name":"pancrelipase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"8000 [USP'U]/1; 30250 [USP'U]/1; 28750 [USP'U]/1","labeler":"Digestive Care, Inc.","package_description":"250 CAPSULE, DELAYED RELEASE in 1 BOTTLE (59767-008-02)"},"nadac":{"value":2.66451,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536114397","name":"PETROLATUM 42% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1143-97","proprietary_name":"Rugby Petrolatum Hydrating Skin Protectant","nonproprietary_name":"Petrolatum","dosage_form":"OINTMENT","route":"TOPICAL","strength":"420 mg/g","labeler":"Rugby Laboratories","package_description":"100 g in 1 JAR (0536-1143-97)"},"nadac":{"value":0.04985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536114398","name":"PETROLATUM 42% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1143-98","proprietary_name":"Rugby Petrolatum Hydrating Skin Protectant","nonproprietary_name":"Petrolatum","dosage_form":"OINTMENT","route":"TOPICAL","strength":"420 mg/g","labeler":"Rugby Laboratories","package_description":"454 g in 1 JAR (0536-1143-98)"},"nadac":{"value":0.02623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000048701","name":"PETROLEUM JELLY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0487-1","proprietary_name":"White Petrolatum","nonproprietary_name":"Skin Protectant","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/g","labeler":"Cardinal Health","package_description":"12 JAR in 1 CASE (70000-0487-1) / 390 g in 1 JAR"},"nadac":{"value":0.00733,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000048703","name":"PETROLEUM JELLY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0487-3","proprietary_name":"White Petrolatum","nonproprietary_name":"Skin Protectant","dosage_form":"OINTMENT","route":"TOPICAL","strength":"100 g/100g","labeler":"Cardinal Health","package_description":"48 JAR in 1 CASE (70000-0487-3) / 106 g in 1 JAR"},"nadac":{"value":0.01315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00132021112","name":"PHAZYME 250 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0132-0211-12","proprietary_name":"PHAZYME","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"250 mg/1","labeler":"C.B. Fleet Company, Inc.","package_description":"1 BLISTER PACK in 1 BOX (0132-0211-12) / 12 CAPSULE, GELATIN COATED in 1 BLISTER PACK","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.2581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536122858","name":"PHENASEPTIC 1.4% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1228-58","proprietary_name":"Rugby Cherry Flavor","nonproprietary_name":"Phenol","dosage_form":"SPRAY","route":"ORAL","strength":"1.4 g/100mL","labeler":"RUGBY LABORATORIES","package_description":"177 mL in 1 BOTTLE, SPRAY (0536-1228-58)"},"nadac":{"value":0.01244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162068110","name":"PHENAZOPYRIDINE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-681-10","proprietary_name":"Phenazopyridine Hydrochloride","nonproprietary_name":"Phenazopyridine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-681-10)"},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenazopyridine HCl|Phenazopyridine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367061101","name":"PHENAZOPYRIDINE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-611-01","proprietary_name":"Phenazopyridine Hydrochloride","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-611-01)"},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenazopyridine HCl|Phenazopyridine HCl","basis":"generic"},"part_b":null}, {"ndc":"75826011410","name":"PHENAZOPYRIDINE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-114-10","proprietary_name":"Phenazopyridine Hydrochloride","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Winder Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-114-10)"},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenazopyridine HCl|Phenazopyridine HCl","basis":"generic"},"part_b":null}, {"ndc":"65162068210","name":"PHENAZOPYRIDINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-682-10","proprietary_name":"Phenazopyridine Hydrochloride","nonproprietary_name":"Phenazopyridine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-682-10)"},"nadac":{"value":0.17596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenazopyridine HCl|Phenazopyridine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367061201","name":"PHENAZOPYRIDINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-612-01","proprietary_name":"Phenazopyridine Hydrochloride","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-612-01)"},"nadac":{"value":0.17596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenazopyridine HCl|Phenazopyridine HCl","basis":"generic"},"part_b":null}, {"ndc":"75826011510","name":"PHENAZOPYRIDINE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-115-10","proprietary_name":"Phenazopyridine Hydrochloride","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Winder Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-115-10)"},"nadac":{"value":0.17596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenazopyridine HCl|Phenazopyridine HCl","basis":"generic"},"part_b":null}, {"ndc":"00536141107","name":"PHENAZOPYRIDINE HCL 95 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1411-07","proprietary_name":"Rugby Phenazopyridine HCl Urinary Tract Analgesic","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"95 mg/1","labeler":"Rugby Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (0536-1411-07) / 30 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.13162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702004510","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-045-10","proprietary_name":"Phendimetrazine Tartrate","nonproprietary_name":"Phendimetrazine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"KVK-TECH, INC","package_description":"1000 TABLET in 1 BOTTLE (10702-045-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702007701","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-077-01","proprietary_name":"Phendimetrazine Tartrate","nonproprietary_name":"Phendimetrazine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"KVK-TECH, INC","package_description":"100 TABLET in 1 BOTTLE (10702-077-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702007710","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-077-10","proprietary_name":"Phendimetrazine Tartrate","nonproprietary_name":"Phendimetrazine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"KVK-TECH, INC","package_description":"1000 TABLET in 1 BOTTLE (10702-077-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702007810","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-078-10","proprietary_name":"Phendimetrazine Tartrate","nonproprietary_name":"Phendimetrazine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"KVK-TECH, INC","package_description":"1000 TABLET in 1 BOTTLE (10702-078-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850044001","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-440-01","proprietary_name":"PHENDIMETRAZINE TARTRATE","nonproprietary_name":"Phendimetrazine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Elite Laboratories, Inc","package_description":"100 TABLET in 1 BOTTLE (64850-440-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64850044010","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-440-10","proprietary_name":"PHENDIMETRAZINE TARTRATE","nonproprietary_name":"Phendimetrazine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Elite Laboratories, Inc","package_description":"1000 TABLET in 1 BOTTLE (64850-440-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69543041010","name":"PHENDIMETRAZINE 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69543-410-10","proprietary_name":"PHENDIMETRAZINE TARTRATE","nonproprietary_name":"PHENDIMETRAZINE TARTRATE","dosage_form":"TABLET","route":"ORAL","strength":"35 mg/1","labeler":"Virtus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69543-410-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.13204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72989040930","name":"PHENDIMETRAZINE ER 105 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72989-409-30","proprietary_name":"PHENDIMETRAZINE TARTRATE","nonproprietary_name":"PHENDIMETRAZINE TARTRATE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"105 mg/1","labeler":"Acertis Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72989-409-30)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.38207,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762011901","name":"PHENELZINE SULFATE 15 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0119-1","proprietary_name":"phenelzine sulfate","nonproprietary_name":"Phenelzine Sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59762-0119-1)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.5862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenelzine Sulfate|Phenelzine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00143145801","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1458-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1458-01)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00143145805","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1458-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (0143-1458-05)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069401","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13517-694-01","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"e5 Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13517-694-01)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069405","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030310","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-303-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-303-10)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030350","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-303-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13811-303-50)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571066901","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-669-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-669-01)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571066950","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-669-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-669-50)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044501","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-445-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-445-01)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044505","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-445-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-445-05)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069401","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-694-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-694-01)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069405","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-694-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-694-05)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014310","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-143-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-143-10)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014350","name":"PHENOBARBITAL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-143-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (75826-143-50)"},"nadac":{"value":0.21266,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00143149501","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1495-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1495-01)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00143149505","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1495-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (0143-1495-05)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069101","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517069105","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811030010","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-300-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-300-10)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030050","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-300-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13811-300-50)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067050","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-670-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-670-50)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367043801","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-438-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-438-01)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367043805","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-438-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-438-05)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069101","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-691-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-691-01)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069105","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-691-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-691-05)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013610","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-136-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-136-10)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013650","name":"PHENOBARBITAL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-136-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (75826-136-50)"},"nadac":{"value":0.07659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00603516521","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5165-21","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5165-21)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517011001","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517011010","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062501","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062510","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811030410","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-304-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-304-10)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030452","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-304-52","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (13811-304-52)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067101","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-671-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-671-01)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067110","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-671-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-671-10)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367021101","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367021110","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367043901","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-439-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-439-01)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367043910","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-439-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-439-10)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062501","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-625-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-625-01)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062510","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-625-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-625-10)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013700","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-137-00","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (75826-137-00)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013710","name":"PHENOBARBITAL 16.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-137-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"16.2 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-137-10)"},"nadac":{"value":0.0559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517020716","name":"PHENOBARBITAL 20 MG/5 ML ELIX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"13811029908","name":"PHENOBARBITAL 20 MG/5 ML ELIX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-299-08","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"ELIXIR","route":"ORAL","strength":"20 mg/5mL","labeler":"Trigen Laboratories, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (13811-299-08)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380016601","name":"PHENOBARBITAL 20 MG/5 ML ELIX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-166-01","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"ELIXIR","route":"ORAL","strength":"20 mg/5mL","labeler":"Strides Pharma Science Limited","package_description":"473 mL in 1 BOTTLE, PLASTIC (64380-166-01)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367017216","name":"PHENOBARBITAL 20 MG/5 ML ELIX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367036716","name":"PHENOBARBITAL 20 MG/5 ML ELIX","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-367-16","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"ELIXIR","route":"ORAL","strength":"20 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (69367-367-16)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121094216","name":"PHENOBARBITAL 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0942-16","proprietary_name":"Phenobarbital Oral Solution","nonproprietary_name":"Phenobarbital Oral","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE, PLASTIC (0121-0942-16)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571067516","name":"PHENOBARBITAL 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-675-16","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE (16571-675-16)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135096247","name":"PHENOBARBITAL 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-962-47","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-962-47)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367035716","name":"PHENOBARBITAL 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-357-16","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (69367-357-16)"},"nadac":{"value":0.04697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143150001","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1500-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1500-01)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00143150005","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1500-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (0143-1500-05)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069201","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13517-692-01","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"e5 Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13517-692-01)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069205","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030110","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-301-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-301-10)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030150","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-301-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13811-301-50)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067201","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-672-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-672-01)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067250","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-672-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-672-50)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044001","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-440-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-440-01)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044005","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-440-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-440-05)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069201","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-692-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-692-01)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069205","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-692-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-692-05)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013810","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-138-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-138-10)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013850","name":"PHENOBARBITAL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-138-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (75826-138-50)"},"nadac":{"value":0.14164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00603516621","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5166-21","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5166-21)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00904657561","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6575-61","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6575-61) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517011101","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517011110","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062601","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062610","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811030510","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-305-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-305-10)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030552","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-305-52","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (13811-305-52)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067301","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-673-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-673-01)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067310","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-673-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-673-10)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367021201","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367021210","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367044101","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-441-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-441-01)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044110","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-441-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-441-10)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062601","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-626-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-626-01)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062610","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-626-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-626-10)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013900","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-139-00","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (75826-139-00)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826013910","name":"PHENOBARBITAL 32.4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-139-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"32.4 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-139-10)"},"nadac":{"value":0.07856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00143145501","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1455-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0143-1455-01)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00143145505","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-1455-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (0143-1455-05)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069301","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13517-693-01","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"e5 Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13517-693-01)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517069305","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13517-693-05","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"e5 Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13517-693-05)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030210","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-302-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-302-10)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030250","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-302-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (13811-302-50)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067401","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-674-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-674-01)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571067450","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-674-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (16571-674-50)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044201","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-442-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-442-01)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044205","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-442-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-442-05)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069301","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-693-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-693-01)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367069305","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-693-05","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69367-693-05)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014010","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-140-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-140-10)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014050","name":"PHENOBARBITAL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-140-50","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (75826-140-50)"},"nadac":{"value":0.18086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00603516721","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5167-21","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5167-21)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517011201","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062701","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062710","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811030610","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-306-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-306-10)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030652","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-306-52","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (13811-306-52)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571066701","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-667-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-667-01)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571066710","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-667-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (16571-667-10)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367021301","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367021310","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367044301","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-443-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-443-01)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044310","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-443-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-443-10)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062701","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-627-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-627-01)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062710","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-627-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-627-10)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014100","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-141-00","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (75826-141-00)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014110","name":"PHENOBARBITAL 64.8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-141-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"64.8 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-141-10)"},"nadac":{"value":0.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"00603516821","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5168-21","proprietary_name":"Phenobarbital","nonproprietary_name":"phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5168-21)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13517011310","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062801","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13517062810","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13811030710","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-307-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (13811-307-10)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"13811030752","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-307-52","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (13811-307-52)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"16571066801","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-668-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (16571-668-01)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367021401","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367021410","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367044401","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-444-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-444-01)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367044410","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-444-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-444-10)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062801","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-628-01","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-628-01)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"69367062810","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-628-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-628-10)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014200","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-142-00","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (75826-142-00)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"75826014210","name":"PHENOBARBITAL 97.2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75826-142-10","proprietary_name":"Phenobarbital","nonproprietary_name":"Phenobarbital","dosage_form":"TABLET","route":"ORAL","strength":"97.2 mg/1","labeler":"WINDER LABORATORIES, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (75826-142-10)"},"nadac":{"value":0.11769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenobarbital|Phenobarbital","basis":"generic"},"part_b":null}, {"ndc":"10702002601","name":"PHENTERMINE 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-026-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (10702-026-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002610","name":"PHENTERMINE 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-026-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (10702-026-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534015701","name":"PHENTERMINE 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-157-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 CAPSULE in 1 BOTTLE (11534-157-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534015703","name":"PHENTERMINE 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-157-03","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"1000 CAPSULE in 1 BOTTLE (11534-157-03)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094080250","name":"PHENTERMINE 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-802-50","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Precision Dose Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68094-802-50)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094080270","name":"PHENTERMINE 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-802-70","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Precision Dose Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (68094-802-70)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002701","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-027-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (10702-027-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002710","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-027-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (10702-027-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002801","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-028-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (10702-028-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002810","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-028-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (10702-028-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534017601","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-176-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 CAPSULE in 1 BOTTLE (11534-176-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534017603","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-176-03","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"1000 CAPSULE in 1 BOTTLE (11534-176-03)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094091050","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-910-50","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Precision Dose Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68094-910-50)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094091070","name":"PHENTERMINE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-910-70","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Precision Dose Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (68094-910-70)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002901","name":"PHENTERMINE 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-029-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (10702-029-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.1051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002903","name":"PHENTERMINE 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-029-03","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (10702-029-03)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.1051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002910","name":"PHENTERMINE 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-029-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (10702-029-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.1051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534015901","name":"PHENTERMINE 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-159-01","proprietary_name":"Phentermine hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 CAPSULE in 1 BOTTLE (11534-159-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.1051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534015903","name":"PHENTERMINE 37.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-159-03","proprietary_name":"Phentermine hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"1000 CAPSULE in 1 BOTTLE (11534-159-03)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.1051,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002501","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-025-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-025-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"10702002510","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-025-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"KVK-TECH, Inc.","package_description":"1000 TABLET in 1 BOTTLE (10702-025-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534016001","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-160-01","proprietary_name":"Phentermine hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"100 TABLET in 1 BOTTLE (11534-160-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534016003","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-160-03","proprietary_name":"Phentermine hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"1000 TABLET in 1 BOTTLE (11534-160-03)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"11534016030","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-160-30","proprietary_name":"Phentermine hydrochloride","nonproprietary_name":"phentermine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"30 TABLET in 1 BOTTLE (11534-160-30)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547040410","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-404-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43547-404-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"43547040411","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-404-11","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (43547-404-11)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"53489067601","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-676-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-676-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"53489067610","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-676-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (53489-676-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"64850081001","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-810-01","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"100 TABLET in 1 BOTTLE (64850-810-01)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"64850081010","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-810-10","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64850-810-10)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"68094070270","name":"PHENTERMINE 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-702-70","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Precision Dose Inc.","package_description":"1000 TABLET in 1 BOTTLE (68094-702-70)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.07268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135095990","name":"PHENTERMINE 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-959-90","proprietary_name":"Phentermine Hydrochloride","nonproprietary_name":"Phentermine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-959-90)","pharm_classes":["Appetite Suppression [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":0.61814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phentermine HCl|Phentermine HCl","basis":"generic"},"part_b":null}, {"ndc":"00480229956","name":"PHENTERMINE-TOPIRAMATE ER 11.25-69 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2299-56","proprietary_name":"Phentermine and topiramate","nonproprietary_name":"Phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"11.25 mg/1; 69 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2299-56)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.09074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598062630","name":"PHENTERMINE-TOPIRAMATE ER 11.25-69 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-626-30","proprietary_name":"Phentermine and Topiramate Extended-Release","nonproprietary_name":"Phentermine and Topiramate Extended-Release","dosage_form":"CAPSULE","route":"ORAL","strength":"11.25 mg/1; 69 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE in 1 BOTTLE (43598-626-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.09074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993078230","name":"PHENTERMINE-TOPIRAMATE ER 11.25-69 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-782-30","proprietary_name":"phentermine and topiramate","nonproprietary_name":"phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"11.25 mg/1; 69 mg/1","labeler":"Prasco Laboratories","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (66993-782-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.09074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480329556","name":"PHENTERMINE-TOPIRAMATE ER 15-92 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3295-56","proprietary_name":"Phentermine and topiramate","nonproprietary_name":"Phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1; 92 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3295-56)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":2.84725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598062730","name":"PHENTERMINE-TOPIRAMATE ER 15-92 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-627-30","proprietary_name":"Phentermine and Topiramate Extended-Release","nonproprietary_name":"Phentermine and Topiramate Extended-Release","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1; 92 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE in 1 BOTTLE (43598-627-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":2.84725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993078330","name":"PHENTERMINE-TOPIRAMATE ER 15-92 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-783-30","proprietary_name":"phentermine and topiramate","nonproprietary_name":"phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1; 92 mg/1","labeler":"Prasco Laboratories","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, UNIT-DOSE (66993-783-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":2.84725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480329756","name":"PHENTERMINE-TOPIRAMATE ER 3.75-23 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3297-56","proprietary_name":"Phentermine and topiramate","nonproprietary_name":"Phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 23 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3297-56)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":2.98584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598062430","name":"PHENTERMINE-TOPIRAMATE ER 3.75-23 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-624-30","proprietary_name":"Phentermine and Topiramate Extended-Release","nonproprietary_name":"Phentermine and Topiramate Extended-Release","dosage_form":"CAPSULE","route":"ORAL","strength":"3.75 mg/1; 23 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE in 1 BOTTLE (43598-624-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":2.98584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993078030","name":"PHENTERMINE-TOPIRAMATE ER 3.75-23 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-780-30","proprietary_name":"phentermine and topiramate","nonproprietary_name":"phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1; 23 mg/1","labeler":"Prasco Laboratories","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, UNIT-DOSE (66993-780-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":2.98584,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480329656","name":"PHENTERMINE-TOPIRAMATE ER 7.5-46 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3296-56","proprietary_name":"Phentermine and topiramate","nonproprietary_name":"Phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 46 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-3296-56)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.0564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598062530","name":"PHENTERMINE-TOPIRAMATE ER 7.5-46 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-625-30","proprietary_name":"Phentermine and Topiramate Extended-Release","nonproprietary_name":"Phentermine and Topiramate Extended-Release","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1; 46 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE in 1 BOTTLE (43598-625-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.0564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993078130","name":"PHENTERMINE-TOPIRAMATE ER 7.5-46 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-781-30","proprietary_name":"phentermine and topiramate","nonproprietary_name":"phentermine and topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"7.5 mg/1; 46 mg/1","labeler":"Prasco Laboratories","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, UNIT-DOSE (66993-781-30)","pharm_classes":["Appetite Suppression [PE]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic Amine Anorectic [EPC]"]},"nadac":{"value":3.0564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00065034302","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0343-02","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0343-02) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"42702010305","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42702-103-05","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"phenylephrine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Paragon BioTeck, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (42702-103-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"65145015001","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-150-01","proprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"phenylephrine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-150-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315032405","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-324-05","proprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-324-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70512086605","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-866-05","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70512-866-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756061430","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-614-30","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-614-30) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603053001","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-530-01","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72603-530-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"75907013023","name":"PHENYLEPHRINE 10% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-130-23","proprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Dr.Reddy's Laboratories Inc.,","package_description":"1 BOTTLE, DROPPER in 1 CARTON (75907-130-23) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":5.23834,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00065034905","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0349-05","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0349-05) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"65145014801","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-148-01","proprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"phenylephrine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE, DROPPER in 1 CARTON (65145-148-01) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"69315032308","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-323-08","proprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"Leading Pharma, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69315-323-08) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70512086502","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70512-865-02","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"SOLA Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70512-865-02) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756062925","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-629-25","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-629-25) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603052001","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-520-01","proprietary_name":"Phenylephrine Hydrochloride","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72603-520-01) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"75907012907","name":"PHENYLEPHRINE 2.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-129-07","proprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","nonproprietary_name":"PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"25 mg/mL","labeler":"Dr.Reddy's Laboratories Inc.,","package_description":"1 BOTTLE, DROPPER in 1 CARTON (75907-129-07) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":9.29238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Phenylephrine HCl*|Phenylephrine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378267001","name":"PHENYTEK 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2670-01","proprietary_name":"Phenytek","nonproprietary_name":"extended phenytoin sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0378-2670-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.4026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenytek|Phenytoin Sodium Extended","basis":"brand"},"part_b":null}, {"ndc":"00378267093","name":"PHENYTEK 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2670-93","proprietary_name":"Phenytek","nonproprietary_name":"extended phenytoin sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0378-2670-93)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.4026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenytek|Phenytoin Sodium Extended","basis":"brand"},"part_b":null}, {"ndc":"00378375001","name":"PHENYTEK 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3750-01","proprietary_name":"Phenytek","nonproprietary_name":"phenytoin sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0378-3750-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.09778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenytek|Phenytoin Sodium Extended","basis":"brand"},"part_b":null}, {"ndc":"00378375093","name":"PHENYTEK 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3750-93","proprietary_name":"Phenytek","nonproprietary_name":"phenytoin sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0378-3750-93)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.09778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phenytek|Phenytoin Sodium Extended","basis":"brand"},"part_b":null}, {"ndc":"51672406901","name":"PHENYTOIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.07485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672406902","name":"PHENYTOIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4069-2","proprietary_name":"Phenytoin","nonproprietary_name":"Phenytoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BOTTLE in 1 CARTON (51672-4069-2) / 237 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762053102","name":"PHENYTOIN 125 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0531-2","proprietary_name":"Phenytoin","nonproprietary_name":"Phenytoin","dosage_form":"SUSPENSION","route":"ORAL","strength":"125 mg/5mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (59762-0531-2) / 237 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993037202","name":"PHENYTOIN 50 MG INFATAB CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-372-02","proprietary_name":"Phenytoin Infatabs","nonproprietary_name":"Phenytoin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (66993-372-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904719907","name":"PHENYTOIN 50 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7199-07","proprietary_name":"Phenytoin","nonproprietary_name":"Phenytoin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7199-07) / 1 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672414601","name":"PHENYTOIN 50 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4146-1","proprietary_name":"Phenytoin","nonproprietary_name":"Phenytoin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (51672-4146-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687015625","name":"PHENYTOIN 50 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-156-25","proprietary_name":"Phenytoin","nonproprietary_name":"Phenytoin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-156-25) / 1 TABLET, CHEWABLE in 1 BLISTER PACK (60687-156-95)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687015695","name":"PHENYTOIN 50 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980057301","name":"PHENYTOIN 50 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-573-01","proprietary_name":"Phenytoin","nonproprietary_name":"Phenytoin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (64980-573-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.20122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904741661","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7416-61","proprietary_name":"Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7416-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268071911","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268071913","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-719-13","proprietary_name":"Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 CARTON (50268-719-13) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-719-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672411101","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4111-1","proprietary_name":"Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51672-4111-1)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672411103","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4111-3","proprietary_name":"Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51672-4111-3)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687084101","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-841-01","proprietary_name":"Extended Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-841-01) / 1 CAPSULE in 1 BLISTER PACK (60687-841-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687084111","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862069201","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-692-01","proprietary_name":"Extended Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-692-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862069299","name":"PHENYTOIN SOD EXT 100 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-692-99","proprietary_name":"Extended Phenytoin Sodium","nonproprietary_name":"Phenytoin Sodium","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (65862-692-99)","pharm_classes":["Anti-epileptic Agent [EPC]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inducers [MoA]","Cytochrome P450 3A Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69751010112","name":"PHEXX 1.8-1-0.4% VAGINAL GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69751-101-12","proprietary_name":"Phexx","nonproprietary_name":"lactic acid, L-, citric acid monohydrate, and potassium bitartrate","dosage_form":"GEL","route":"VAGINAL","strength":"90 mg/5g; 50 mg/5g; 20 mg/5g","labeler":"Evofem, Inc.","package_description":"12 APPLICATOR in 1 BOX (69751-101-12) / 5 g in 1 APPLICATOR (69751-101-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":6.05411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69751010012","name":"PHEXXI 1.8-1-0.4% VAGINAL GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69751-100-12","proprietary_name":"Phexxi","nonproprietary_name":"lactic acid, L-, citric acid monohydrate, and potassium bitartrate","dosage_form":"GEL","route":"VAGINAL","strength":"90 mg/5g; 50 mg/5g; 20 mg/5g","labeler":"Evofem, Inc.","package_description":"12 APPLICATOR in 1 BOX (69751-100-12) / 5 g in 1 APPLICATOR (69751-100-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":6.05411,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Phexxi|Lactic Acid/Citric/Potassium","basis":"brand"},"part_b":null}, {"ndc":"16714034701","name":"PHILITH 0.4-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-347-01","proprietary_name":"Philith","nonproprietary_name":"Norethindrone and Ethinyl Estradiol Tablets","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-347-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Philith|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714034704","name":"PHILITH 0.4-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-347-04","proprietary_name":"Philith","nonproprietary_name":"Norethindrone and Ethinyl Estradiol Tablets","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-347-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Philith|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"64980010401","name":"PHOSPHA 250 NEUTRAL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-104-01","proprietary_name":"Dibasic Sodium Phosphate, Monobasic Potassium Phosphate and Monobasic Sodium Phosphate","nonproprietary_name":"Dibasic Sodium Phosphate, Monobasic Potassium Phosphate and Monobasic Sodium Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"852 mg/1; 155 mg/1; 130 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-104-01)"},"nadac":{"value":0.39756,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980072901","name":"PHOSPHA 250 NEUTRAL TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-729-01","proprietary_name":"PHOSPHA 250 NEUTRAL","nonproprietary_name":"Dibasic Sodium Phosphate, Monobasic Potassium Phosphate and Monobasic Sodium Phosphate","dosage_form":"TABLET","route":"ORAL","strength":"852 mg/1; 155 mg/1; 130 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-729-01)"},"nadac":{"value":0.39756,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904688210","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6882-10","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-6882-10) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"16714097302","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-973-02","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Northstar Rx LLC.","package_description":"1 BOTTLE in 1 CARTON (16714-973-02) / 30 TABLET in 1 BOTTLE","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"60687038111","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-381","inner_of":["60687-381-94"]},"part_b":null}, {"ndc":"60687038194","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-381-94","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-381-94) / 1 TABLET in 1 BLISTER PACK (60687-381-11)","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"69097099902","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-999-02","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA., Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-999-02)","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"69097099907","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-999-07","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Cipla USA., Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-999-07)","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"69238105103","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1051-3","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1051-3) / 30 TABLET in 1 BOTTLE","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"70710101401","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1014-1","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (70710-1014-1) / 100 TABLET in 1 BOTTLE","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"70710101403","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1014-3","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1014-3)","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"76282074030","name":"PHYTONADIONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-740-30","proprietary_name":"Phytonadione","nonproprietary_name":"Phytonadione","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (76282-740-30) / 30 TABLET in 1 BOTTLE","pharm_classes":["Increased Prothrombin Activity [PE]","Reversed Anticoagulation Activity [PE]","Vitamin K [CS]","Vitamin K [EPC]","Warfarin Reversal Agent [EPC]"]},"nadac":{"value":8.8257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Phytonadione*|Phytonadione (Vit K1)","basis":"generic"},"part_b":null}, {"ndc":"00006306901","name":"PIFELTRO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-3069-01","proprietary_name":"PIFELTRO","nonproprietary_name":"doravirine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-3069-01)","pharm_classes":["Human Immunodeficiency Virus 1 Non-Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Non-Nucleoside Analog [EXT]","Non-Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":60.78687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pifeltro|Doravirine","basis":"brand"},"part_b":null}, {"ndc":"61314020315","name":"PILOCARPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-203-15","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"pilocarpine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-203-15) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":3.44852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238174508","name":"PILOCARPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1745-8","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1745-8) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":3.44852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069018101","name":"PILOCARPINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-181-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-181-01) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":3.44852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314020415","name":"PILOCARPINE 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-204-15","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"pilocarpine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-204-15) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":2.81441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238174608","name":"PILOCARPINE 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1746-8","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1746-8) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":2.81441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069019101","name":"PILOCARPINE 2% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-191-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"20 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-191-01) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":2.81441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314020615","name":"PILOCARPINE 4% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-206-15","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"pilocarpine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"40 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-206-15) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":3.37591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238174708","name":"PILOCARPINE 4% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1747-8","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE in 1 CARTON (69238-1747-8) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":3.37591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069020101","name":"PILOCARPINE 4% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-201-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"40 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-201-01) / 15 mL in 1 BOTTLE","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":3.37591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219236602","name":"PILOCARPINE HCL 1.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2366-2","proprietary_name":"Pilocarpine Hydrochloride Ophthalmic","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"12.5 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-2366-2) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":24.74,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219264901","name":"PILOCARPINE HCL 1.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2649-1","proprietary_name":"Pilocarpine Hydrochloride Ophthalmic","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"12.5 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60219-2649-1) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":19.39133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115592201","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228280111","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2801-11","proprietary_name":"Pilocarpine hydrochloride","nonproprietary_name":"Pilocarpine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0228-2801-11)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527131301","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1313-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0527-1313-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268065211","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268065212","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-652-12","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-652-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-652-11)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651022401","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-224-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"pilocarpine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-224-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219592201","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-5922-1","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"PILOCARPINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60219-5922-1)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084092825","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-928-25","proprietary_name":"Pilocarpine hydrochloride","nonproprietary_name":"Pilocarpine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-928-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-928-95)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084092895","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69292026501","name":"PILOCARPINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-265-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"PILOCARPINE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69292-265-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.33849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228283711","name":"PILOCARPINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2837-11","proprietary_name":"Pilocarpine hydrochloride","nonproprietary_name":"Pilocarpine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0228-2837-11)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.35404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527140701","name":"PILOCARPINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1407-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"Pilocarpine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0527-1407-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.35404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651022501","name":"PILOCARPINE HCL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-225-01","proprietary_name":"Pilocarpine Hydrochloride","nonproprietary_name":"pilocarpine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-225-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Muscarinic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]"]},"nadac":{"value":0.35404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591294430","name":"PIMECROLIMUS 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2944-30","proprietary_name":"pimecrolimus","nonproprietary_name":"pimecrolimus","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"30 g in 1 TUBE (0591-2944-30)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.31494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Pimecrolimus|Pimecrolimus","basis":"generic"},"part_b":null}, {"ndc":"00591294460","name":"PIMECROLIMUS 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2944-60","proprietary_name":"pimecrolimus","nonproprietary_name":"pimecrolimus","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"60 g in 1 TUBE (0591-2944-60)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.10475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Pimecrolimus|Pimecrolimus","basis":"generic"},"part_b":null}, {"ndc":"00591294487","name":"PIMECROLIMUS 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2944-87","proprietary_name":"pimecrolimus","nonproprietary_name":"pimecrolimus","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"100 g in 1 TUBE (0591-2944-87)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.3861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Pimecrolimus|Pimecrolimus","basis":"generic"},"part_b":null}, {"ndc":"68462060935","name":"PIMECROLIMUS 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-609-35","proprietary_name":"Pimecrolimus","nonproprietary_name":"Pimecrolimus","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-609-35) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.31494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Pimecrolimus|Pimecrolimus","basis":"generic"},"part_b":null}, {"ndc":"68462060965","name":"PIMECROLIMUS 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-609-65","proprietary_name":"Pimecrolimus","nonproprietary_name":"Pimecrolimus","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-609-65) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.10475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Pimecrolimus|Pimecrolimus","basis":"generic"},"part_b":null}, {"ndc":"68462060994","name":"PIMECROLIMUS 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-609-94","proprietary_name":"Pimecrolimus","nonproprietary_name":"Pimecrolimus","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-609-94) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.3861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Pimecrolimus|Pimecrolimus","basis":"generic"},"part_b":null}, {"ndc":"49884034701","name":"PIMOZIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-347-01","proprietary_name":"Pimozide","nonproprietary_name":"Pimozide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-347-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.23492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pimozide|Pimozide","basis":"generic"},"part_b":null}, {"ndc":"70954085310","name":"PIMOZIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-853-10","proprietary_name":"Pimozide","nonproprietary_name":"Pimozide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-853-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.23492,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pimozide|Pimozide","basis":"generic"},"part_b":null}, {"ndc":"49884034801","name":"PIMOZIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-348-01","proprietary_name":"Pimozide","nonproprietary_name":"Pimozide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (49884-348-01)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.63995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pimozide|Pimozide","basis":"generic"},"part_b":null}, {"ndc":"70954085410","name":"PIMOZIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-854-10","proprietary_name":"Pimozide","nonproprietary_name":"Pimozide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-854-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.63995,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pimozide|Pimozide","basis":"generic"},"part_b":null}, {"ndc":"16714040401","name":"PIMTREA 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-404-01","proprietary_name":"PIMTREA","nonproprietary_name":"desogestrel/ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-404-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pimtrea|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714040404","name":"PIMTREA 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-404-04","proprietary_name":"PIMTREA","nonproprietary_name":"desogestrel/ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-404-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pimtrea|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"57664065688","name":"PINDOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-656-88","proprietary_name":"Pindolol","nonproprietary_name":"Pindolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (57664-656-88)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.85399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"62559056101","name":"PINDOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-561-01","proprietary_name":"Pindolol","nonproprietary_name":"Pindolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-561-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.85399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"69367042201","name":"PINDOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-422-01","proprietary_name":"Pindolol","nonproprietary_name":"Pindolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-422-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.85399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"76385013201","name":"PINDOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-132-01","proprietary_name":"Pindolol","nonproprietary_name":"pindolol","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-132-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.85399,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"57664065588","name":"PINDOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-655-88","proprietary_name":"Pindolol","nonproprietary_name":"Pindolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (57664-655-88)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.59694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"62559056001","name":"PINDOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-560-01","proprietary_name":"Pindolol","nonproprietary_name":"Pindolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-560-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.59694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"69367042101","name":"PINDOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-421-01","proprietary_name":"Pindolol","nonproprietary_name":"Pindolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-421-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.59694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"76385013101","name":"PINDOLOL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-131-01","proprietary_name":"Pindolol","nonproprietary_name":"pindolol","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-131-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.59694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pindolol|Pindolol","basis":"generic"},"part_b":null}, {"ndc":"24385001758","name":"PINK BISMUTH CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-017-58","proprietary_name":"GNP Pink Bismuth","nonproprietary_name":"Bismuth Subsalicylate","dosage_form":"TABLET","route":"ORAL","strength":"262 mg/1","labeler":"Amerisource Bergen","package_description":"1 BOTTLE in 1 CARTON (24385-017-58) / 40 TABLET in 1 BOTTLE"},"nadac":{"value":0.09302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093727105","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7271-05","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-7271-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727156","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7271-56","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-7271-56)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727198","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7271-98","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-7271-98)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904709061","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7090-61","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7090-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064501","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-645-01","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-645-01)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064502","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-645-02","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-645-02)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064503","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-645-03","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-645-03)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005407","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-054-07","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-054-07)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005410","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-054-10","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-054-10)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005415","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-054-15","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-054-15)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237021905","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-219-05","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (57237-219-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237021930","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-219-30","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-219-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237021990","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-219-90","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-219-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687039101","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-391-01","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-391-01) / 1 TABLET in 1 BLISTER PACK (60687-391-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687039111","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135080430","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-804-30","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-804-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051205","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-512-05","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-512-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051230","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-512-30","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-512-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051290","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-512-90","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (65862-512-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"76385017850","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-178-50","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (76385-178-50)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"76385017890","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-178-90","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE (76385-178-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"82009010305","name":"PIOGLITAZONE HCL 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-103-05","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET in 1 BOTTLE (82009-103-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.06749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727205","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7272-05","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-7272-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727256","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7272-56","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-7272-56)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727298","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7272-98","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-7272-98)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904709661","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7096-61","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7096-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064601","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-646-01","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-646-01)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064602","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-646-02","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-646-02)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064603","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-646-03","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-646-03)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005507","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-055-07","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-055-07)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005510","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-055-10","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-055-10)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005515","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-055-15","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-055-15)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237022005","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-220-05","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (57237-220-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237022030","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-220-30","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-220-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237022090","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-220-90","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-220-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687090511","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687090521","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-905-21","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-905-21) / 1 TABLET in 1 BLISTER PACK (60687-905-11)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135080530","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-805-30","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-805-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051305","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-513-05","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-513-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051330","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-513-30","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-513-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"76385017950","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-179-50","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (76385-179-50)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"76385017990","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-179-90","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE (76385-179-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"82009010405","name":"PIOGLITAZONE HCL 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-104-05","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET in 1 BOTTLE (82009-104-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.09301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727305","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7273-05","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-7273-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727356","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7273-56","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-7273-56)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"00093727398","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7273-98","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-7273-98)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064701","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-647-01","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-647-01)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064702","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-647-02","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-647-02)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714064703","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-647-03","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-647-03)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005607","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-056-07","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-056-07)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005610","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-056-10","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-056-10)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342005615","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-056-15","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-056-15)","pharm_classes":["PPAR alpha [CS]","PPAR gamma [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor Activity [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237022105","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-221-05","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (57237-221-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237022130","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-221-30","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (57237-221-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"57237022190","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-221-90","proprietary_name":"Pioglitazone","nonproprietary_name":"Pioglitazone","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-221-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135080630","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-806-30","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-806-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051405","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-514-05","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-514-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862051430","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-514-30","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-514-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"76385018050","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-180-50","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET in 1 BOTTLE (76385-180-50)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"76385018090","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-180-90","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"PIOGLITAZONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET in 1 BOTTLE (76385-180-90)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"82009010505","name":"PIOGLITAZONE HCL 45 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-105-05","proprietary_name":"PIOGLITAZONE HYDROCHLORIDE","nonproprietary_name":"pioglitazone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"45 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 TABLET in 1 BOTTLE (82009-105-05)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.11448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone HCl|Pioglitazone HCl","basis":"generic"},"part_b":null}, {"ndc":"66993082130","name":"PIOGLITAZONE-GLIMEPIRIDE 30-2","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"66993-821-30","proprietary_name":"pioglitazone and glimepiride","nonproprietary_name":"pioglitazone and glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1; 2 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET in 1 BOTTLE (66993-821-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":10.75973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Glimepiride|Pioglitazone HCl/Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"66993082230","name":"PIOGLITAZONE-GLIMEPIRIDE 30-4","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-822-30","proprietary_name":"pioglitazone and glimepiride","nonproprietary_name":"pioglitazone and glimepiride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1; 4 mg/1","labeler":"Prasco Laboratories","package_description":"30 TABLET in 1 BOTTLE (66993-822-30)","pharm_classes":["Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Sulfonylurea Compounds [CS]","Sulfonylurea [EPC]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":10.51761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Glimepiride|Pioglitazone HCl/Glimepiride","basis":"generic"},"part_b":null}, {"ndc":"33342017609","name":"PIOGLITAZONE-METFORMIN 15-500","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-176-09","proprietary_name":"Pioglitazone and metformin hydrochloride","nonproprietary_name":"Pioglitazone and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; 15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-176-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.2835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"33342017657","name":"PIOGLITAZONE-METFORMIN 15-500","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-176-57","proprietary_name":"Pioglitazone and metformin hydrochloride","nonproprietary_name":"Pioglitazone and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; 15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (33342-176-57)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.2835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237021760","name":"PIOGLITAZONE-METFORMIN 15-500","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-217-60","proprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","nonproprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-217-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.2835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052518","name":"PIOGLITAZONE-METFORMIN 15-500","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-525-18","proprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","nonproprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (65862-525-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.2835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052560","name":"PIOGLITAZONE-METFORMIN 15-500","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-525-60","proprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","nonproprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-525-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.2835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"33342017709","name":"PIOGLITAZONE-METFORMIN 15-850","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-177-09","proprietary_name":"Pioglitazone and metformin hydrochloride","nonproprietary_name":"Pioglitazone and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1; 15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-177-09)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.23908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"33342017757","name":"PIOGLITAZONE-METFORMIN 15-850","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-177-57","proprietary_name":"Pioglitazone and metformin hydrochloride","nonproprietary_name":"Pioglitazone and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"850 mg/1; 15 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (33342-177-57)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.23908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237021860","name":"PIOGLITAZONE-METFORMIN 15-850","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-218-60","proprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","nonproprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 850 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (57237-218-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.23908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052618","name":"PIOGLITAZONE-METFORMIN 15-850","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-526-18","proprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","nonproprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 850 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (65862-526-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.23908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052660","name":"PIOGLITAZONE-METFORMIN 15-850","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-526-60","proprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","nonproprietary_name":"Pioglitazone Hydrochloride and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 850 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-526-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Peroxisome Proliferator Receptor alpha Agonist [EPC]","Peroxisome Proliferator Receptor gamma Agonist [EPC]","Peroxisome Proliferator-activated Receptor alpha Agonists [MoA]","Peroxisome Proliferator-activated Receptor gamma Agonists [MoA]","Thiazolidinedione [EPC]","Thiazolidinediones [CS]"]},"nadac":{"value":0.23908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pioglitazone-Metformin|Pioglitazone HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00781311395","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-3113-95","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"Piperacillin and Tazobactam","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS; PARENTERAL","strength":"3 g/15mL; .375 g/15mL","labeler":"Sandoz Inc","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (0781-3113-95) / 15 mL in 1 VIAL, SINGLE-USE (0781-3113-90)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (0781-3113-95) / 15 mL in 1 VIAL, SINGLE-USE (0781-3113-90)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"44567080210","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"44567-802-10","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"PIPERACILLIN SODIUM,TAZOBACTAM SODIUM","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/1; .375 g/1","labeler":"WG Critical Care, LLC","package_description":"10 VIAL in 1 BOX (44567-802-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 BOX (44567-802-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55150012030","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55150-120-30","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"Piperacillin Sodium and Tazobactam Sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/1; .375 g/1","labeler":"Eugia US LLC","package_description":"10 VIAL in 1 BOX (55150-120-30) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 BOX (55150-120-30) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60505615704","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-6157-4","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"PIPERACILLIN and TAZOBACTAM","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Apotex Corp.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (60505-6157-4) / 15 mL in 1 VIAL, SINGLE-DOSE (60505-6157-0)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (60505-6157-4) / 15 mL in 1 VIAL, SINGLE-DOSE (60505-6157-0)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"61990012002","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"63323098321","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-983-21","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"Piperacillin and Tazobactam","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (63323-983-21) / 15 mL in 1 VIAL, SINGLE-USE (63323-983-23)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (63323-983-21) / 15 mL in 1 VIAL, SINGLE-USE (63323-983-23)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63323098353","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-983-53","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"Piperacillin and Tazobactam","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-USE in 1 CARTON (63323-983-53) / 15 mL in 1 VIAL, SINGLE-USE (63323-983-41)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-USE in 1 CARTON (63323-983-53) / 15 mL in 1 VIAL, SINGLE-USE (63323-983-41)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65219043620","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65219-436-20","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"Piperacillin and Tazobactam","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Fresenius Kabi USA, LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (65219-436-20) / 15 mL in 1 VIAL, SINGLE-DOSE (65219-436-02)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (65219-436-20) / 15 mL in 1 VIAL, SINGLE-DOSE (65219-436-02)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68001050782","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68001-507-82","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"PIPERACILLIN and TAZOBACTAM","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"BluePoint Laboratories","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (68001-507-82) / 15 mL in 1 VIAL, SINGLE-DOSE (68001-507-53)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (68001-507-82) / 15 mL in 1 VIAL, SINGLE-DOSE (68001-507-53)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72485040310","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72485-403-10","proprietary_name":"piperacillin and tazobactam","nonproprietary_name":"piperacillin and tazobactam","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 BOX (72485-403-10) / 15 mL in 1 VIAL, SINGLE-DOSE (72485-403-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 BOX (72485-403-10) / 15 mL in 1 VIAL, SINGLE-DOSE (72485-403-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572057310","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72572-573-10","proprietary_name":"Piperacillin and Tazobactam","nonproprietary_name":"piperacillin sodium and tazobactam sodium","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Civica, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72572-573-10) / 15 mL in 1 VIAL, SINGLE-DOSE (72572-573-01)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72572-573-10) / 15 mL in 1 VIAL, SINGLE-DOSE (72572-573-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"81284015210","name":"PIPERACIL-TAZOBACT 3.375 GM VL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"81284-152-10","proprietary_name":"PIPERACILLIN AND TAZOBACTAM","nonproprietary_name":"Piperacillin sodium and Tazobactam sodium","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"3 g/15mL; .375 g/15mL","labeler":"Provepharm Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (81284-152-10) / 15 mL in 1 VIAL, SINGLE-DOSE (81284-152-00)","pharm_classes":["Penicillin-class Antibacterial [EPC]","Penicillins [CS]","beta Lactamase Inhibitor [EPC]","beta Lactamase Inhibitors [MoA]"]},"nadac":{"value":3.49257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piperacillin-Tazobactam|Piperacillin Sodium/Tazobactam","basis":"generic"},"part_b":{"hcpcs":"J2543","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2543 (1.125 GM) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (81284-152-10) / 15 mL in 1 VIAL, SINGLE-DOSE (81284-152-00)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480361087","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3610-87","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (0480-3610-87)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00781808532","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8085-32","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Sandoz Inc","package_description":"270 TABLET, FILM COATED in 1 CARTON (0781-8085-32)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00904739753","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7397-53","proprietary_name":"PIRFENIDONE","nonproprietary_name":"PIRFENIDONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"3 BOTTLE in 1 CARTON (0904-7397-53) / 90 TABLET, FILM COATED in 1 BOTTLE (0904-7397-89)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00904739789","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"31722087227","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-872-27","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"3 BOTTLE in 1 CARTON (31722-872-27) / 90 TABLET, FILM COATED in 1 BOTTLE (31722-872-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"42385092490","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"42385092499","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-924-99","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Laurus Labs Limited","package_description":"3 BOTTLE in 1 CARTON (42385-924-99) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"42571033539","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-335-39","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Micro Labs Limited","package_description":"3 TABLET, FILM COATED in 1 CARTON (42571-335-39)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"59651023827","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-238-27","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET","route":"ORAL","strength":"267 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BOTTLE in 1 CARTON (59651-238-27) / 90 TABLET in 1 BOTTLE (59651-238-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"59651023890","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"60219164008","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1640-8","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"3 BOTTLE, PLASTIC in 1 CARTON (60219-1640-8) / 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60219-1640-9)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"60219164009","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"60505468107","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4681-7","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET","route":"ORAL","strength":"267 mg/1","labeler":"Apotex Corp.","package_description":"270 TABLET in 1 BOTTLE (60505-4681-7)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"62332047964","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-479-64","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"267 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"3 BOTTLE in 1 CARTON (62332-479-64) / 90 TABLET, COATED in 1 BOTTLE","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"62332047990","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"69097098793","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-987-93","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"267 mg/1","labeler":"Cipla USA Inc.","package_description":"270 TABLET, COATED in 1 BOTTLE (69097-987-93)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"70954086930","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-869-30","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (70954-869-30)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"72205018126","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-181-26","proprietary_name":"PIRFENIDONE","nonproprietary_name":"PIRFENIDONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"3 BOTTLE in 1 CARTON (72205-181-26) / 90 TABLET, FILM COATED in 1 BOTTLE (72205-181-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"72205018130","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"72603025801","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"72603025803","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-258-03","proprietary_name":"PIRFENIDONE","nonproprietary_name":"PIRFENIDONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"267 mg/1","labeler":"Northstar Rx LLC","package_description":"3 BOTTLE in 1 CARTON (72603-258-03) / 90 TABLET, FILM COATED in 1 BOTTLE (72603-258-01)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"76282071727","name":"PIRFENIDONE 267 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-717-27","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"267 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"270 TABLET, COATED in 1 BOTTLE (76282-717-27)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":0.68549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00480361198","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3611-98","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3611-98)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00781808692","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8086-92","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Sandoz Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0781-8086-92)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00904739889","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7398-89","proprietary_name":"PIRFENIDONE","nonproprietary_name":"PIRFENIDONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0904-7398-89)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"31722087390","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-873-90","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-873-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"42385092690","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-926-90","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Laurus Labs Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42385-926-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"42571033690","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-336-90","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Micro Labs Limited","package_description":"90 BOTTLE in 1 CARTON (42571-336-90) / 90 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"59651023990","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-239-90","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET","route":"ORAL","strength":"801 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-239-90) / 90 TABLET in 1 BOTTLE","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"60219164109","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1641-9","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60219-1641-9) / 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"60505468209","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4682-9","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET","route":"ORAL","strength":"801 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET in 1 BOTTLE (60505-4682-9)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"62332048090","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-480-90","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"801 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (62332-480-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"69097098805","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-988-05","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"801 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (69097-988-05)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"70954087010","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-870-10","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70954-870-10)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"72205018290","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-182-90","proprietary_name":"PIRFENIDONE","nonproprietary_name":"PIRFENIDONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-182-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"72603025901","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-259-01","proprietary_name":"PIRFENIDONE","nonproprietary_name":"PIRFENIDONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"801 mg/1","labeler":"Northstar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-259-01)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"76282071690","name":"PIRFENIDONE 801 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-716-90","proprietary_name":"Pirfenidone","nonproprietary_name":"Pirfenidone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"801 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"90 TABLET, COATED in 1 BOTTLE (76282-716-90)","pharm_classes":["Pyridone [EPC]","Pyridones [CS]"]},"nadac":{"value":1.96184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pirfenidone|Pirfenidone","basis":"generic"},"part_b":null}, {"ndc":"00093075601","name":"PIROXICAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0756-01","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0756-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.15768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"29300025501","name":"PIROXICAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-255-01","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (29300-255-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.15768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"42571017601","name":"PIROXICAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-176-01","proprietary_name":"PIROXICAM","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-176-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.15768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"64380084206","name":"PIROXICAM 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-842-06","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE (64380-842-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.15768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"00093075701","name":"PIROXICAM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0757-01","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-0757-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.21465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"00093075705","name":"PIROXICAM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0757-05","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-0757-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.21465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"29300025601","name":"PIROXICAM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-256-01","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (29300-256-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.21465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"42571017701","name":"PIROXICAM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-177-01","proprietary_name":"PIROXICAM","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Micro Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42571-177-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.21465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"64380084306","name":"PIROXICAM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-843-06","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE (64380-843-06)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.21465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"64380084307","name":"PIROXICAM 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-843-07","proprietary_name":"Piroxicam","nonproprietary_name":"Piroxicam","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 CAPSULE in 1 BOTTLE (64380-843-07)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.21465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Piroxicam|Piroxicam","basis":"generic"},"part_b":null}, {"ndc":"00378505577","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5055-77","proprietary_name":"Pitavastatin Calcium","nonproprietary_name":"pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5055-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480363198","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3631-98","proprietary_name":"Pitavastatin","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.045 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3631-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00832604890","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6048-90","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (0832-6048-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722087590","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-875-90","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.045 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-875-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65162002909","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-029-09","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65162-029-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862081290","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-812-90","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-812-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382048116","name":"PITAVASTATIN 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-481-16","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-481-16)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.90443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378505677","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5056-77","proprietary_name":"Pitavastatin Calcium","nonproprietary_name":"pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5056-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480363298","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3632-98","proprietary_name":"Pitavastatin","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.09 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3632-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00832604990","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6049-90","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (0832-6049-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722087690","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-876-90","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.09 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-876-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65162003009","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-030-09","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65162-030-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862081390","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-813-90","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-813-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382048216","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-482-16","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-482-16)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603047901","name":"PITAVASTATIN 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-479-01","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.09 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-479-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.95425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00378505777","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5057-77","proprietary_name":"Pitavastatin Calcium","nonproprietary_name":"pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5057-77)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00480363398","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3633-98","proprietary_name":"Pitavastatin","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4.18 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-3633-98)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00832605090","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-6050-90","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (0832-6050-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722087790","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-877-90","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4.18 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-877-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65162003109","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-031-09","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65162-031-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862081490","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-814-90","proprietary_name":"Pitavastatin","nonproprietary_name":"Pitavastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-814-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68382048316","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-483-16","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-483-16)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603048001","name":"PITAVASTATIN 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-480-01","proprietary_name":"pitavastatin calcium","nonproprietary_name":"pitavastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4.18 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72603-480-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":1.02909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pitavastatin Calcium|Pitavastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"00024117190","name":"PLAVIX 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-1171-90","proprietary_name":"Plavix","nonproprietary_name":"clopidogrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Sanofi-Aventis U.S. LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0024-1171-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":8.22931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Plavix|Clopidogrel Bisulfate","basis":"brand"},"part_b":null}, {"ndc":"42192032130","name":"PNV-DHA SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-321-30","proprietary_name":"PNV-DHA","nonproprietary_name":"ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, pyridoxine, folic acid, cyanocobalamin, calcium, ferrous fumarate, magnesium, doconexent","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"85 [iU]/1; 200 [iU]/1; 10 [iU]/1; 25 [iU]/1; 1 mg/1; 12 ug/1; 140 mg/1; 27 mg/1; 45 mg/1; 300 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (42192-321-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Calcium [CS]","Calcium [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.9857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192033230","name":"PNV-OMEGA SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-332-30","proprietary_name":"PNV-Omega","nonproprietary_name":"ascorbic acid, cholecalciferol, .alpha.-tocopherol, pyridoxine hydrochloride, folic acid, cyanocobalamin, calcium corbonate, ferrous fumarate, potassium iodide, magnesium, doconexent, icosapent","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"85 mg/1; 200 [iU]/1; 10 [iU]/1; 25 mg/1; 1 mg/1; 12 ug/1; 250 ug/1; 140 mg/1; 28 mg/1; 150 ug/1; 45 mg/1; 300 mg/1; 40 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (42192-332-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Calculi Dissolution Agent [EPC]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":1.12187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"PNV-Omega|Mv-Mins 71/Iron/Folic No.1/DHA","basis":"brand"},"part_b":null}, {"ndc":"42192032090","name":"PNV-SELECT TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-320-90","proprietary_name":"PNV-Select","nonproprietary_name":"VITAMIN A ACETATE, ASCORBIC ACID, CHOLECALCIFEROL, ALPHA-TOCOPHEROL ACETATE, DL, THIAMINE MONONITRATE, RIBOFLAVIN, NIACINAMIDE, PYRIDOXINE HYDROCHLORIDE, FOLIC ACID, CYANOCOBALAMIN, BIOTIN, CALCIUM PANTOTHENATE, CALCIUM CARBONATE, FERROUS FUMARATE, POTASSIUM IODIDE, MAGNESIUM OXIDE, ZINC OXIDE and CUPRIC OXIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2500 [iU]/1; 80 mg/1; 400 [iU]/1; 10 [iU]/1; 3 mg/1; 3.4 mg/1; 20 mg/1; 20 mg/1; 1 mg/1; 12 ug/1; 300 ug/1; 6 mg/1; 120 mg/1; 27 mg/1; 150 ug/1; 30 ug/1; 15 ug/1; 2 mg/1","labeler":"Acella Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (42192-320-90)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Calculi Dissolution Agent [EPC]","Cations, Divalent [CS]","Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":1.90621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574062105","name":"PODOFILOX 0.5% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0621-05","proprietary_name":"Podofilox","nonproprietary_name":"Podofilox","dosage_form":"GEL","route":"TOPICAL","strength":"5 mg/g","labeler":"Padagis US LLC","package_description":"3.5 g in 1 TUBE, WITH APPLICATOR (0574-0621-05)","pharm_classes":["Decreased Mitosis [PE]"]},"nadac":{"value":129.98552,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00574061105","name":"PODOFILOX 0.5% TOPICAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0611-05","proprietary_name":"PODOFILOX","nonproprietary_name":"PODOFILOX","dosage_form":"SOLUTION","route":"TOPICAL","strength":"5 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (0574-0611-05) / 3.5 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Mitosis [PE]"]},"nadac":{"value":15.01798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000039801","name":"POISON IVY WASH 1% CLEANSER","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0398-1","proprietary_name":"Leader Poison Ivy Wash","nonproprietary_name":"pramoxine hydrochloride lotion","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL","labeler":"Cardinal Health, 110 dba Leader","package_description":"177 mL in 1 CONTAINER (70000-0398-1)"},"nadac":{"value":0.04028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"15370030501","name":"POKONZA 10 MEQ PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":28.26208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"15370030530","name":"POKONZA 10 MEQ PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"15370-305-30","proprietary_name":"POKONZA","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":".75 g/.79g","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"30 POUCH in 1 CARTON (15370-305-30) / .79 g in 1 POUCH (15370-305-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":28.26208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"15370030560","name":"POKONZA 10 MEQ PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"15370-305-60","proprietary_name":"POKONZA","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":".75 g/.79g","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"60 POUCH in 1 CARTON (15370-305-60) / .79 g in 1 POUCH (15370-305-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":28.26208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000009301","name":"POLY BACITRACIN OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0093-1","proprietary_name":"Leader Poly Bacitracin","nonproprietary_name":"FIRST AID ANTIBIOTIC","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g; 10000 [USP'U]/g","labeler":"Cardinal Health 110, Inc.","package_description":"1 TUBE in 1 CARTON (70000-0093-1) / 14 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.15857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"50991062601","name":"POLY HIST FORTE 10.5-10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50991-626-01","proprietary_name":"Poly Hist Forte","nonproprietary_name":"Doxylamine Succinate and Phenylephrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10.5 mg/1; 10 mg/1","labeler":"Poly Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (50991-626-01)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.66371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536105224","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1052-24","proprietary_name":"rugby PEG 3350","nonproprietary_name":"POLYETHYLENE GLYCOL 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Rugby Laboratories","package_description":"238 g in 1 BOTTLE (0536-1052-24)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536105227","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1052-27","proprietary_name":"rugby PEG 3350","nonproprietary_name":"POLYETHYLENE GLYCOL 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Rugby Laboratories","package_description":"510 g in 1 BOTTLE (0536-1052-27)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536105260","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1052-60","proprietary_name":"rugby PEG 3350","nonproprietary_name":"POLYETHYLENE GLYCOL 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Rugby Laboratories","package_description":"119 g in 1 BOTTLE (0536-1052-60)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536105284","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1052-84","proprietary_name":"rugby PEG 3350","nonproprietary_name":"POLYETHYLENE GLYCOL 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Rugby Laboratories","package_description":"850 g in 1 BOTTLE (0536-1052-84)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904693126","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6931-26","proprietary_name":"Polyethylene glycol 3350","nonproprietary_name":"Polyethylene glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Major Pharmaceuticals","package_description":"14 PACKET in 1 CARTON (0904-6931-26) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904693176","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6931-76","proprietary_name":"Polyethylene glycol 3350","nonproprietary_name":"Polyethylene glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Major Pharmaceuticals","package_description":"30 PACKET in 1 CARTON (0904-6931-76) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904693181","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6931-81","proprietary_name":"Polyethylene glycol 3350","nonproprietary_name":"Polyethylene glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Major Pharmaceuticals","package_description":"100 PACKET in 1 CARTON (0904-6931-81) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904693186","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6931-86","proprietary_name":"Polyethylene glycol 3350","nonproprietary_name":"Polyethylene glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Major Pharmaceuticals","package_description":"17 g in 1 PACKET (0904-6931-86)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11534018028","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-180-28","proprietary_name":"POLYETHYLENE GLYCOL 3350 NF","nonproprietary_name":"polyethylene glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"238 g in 1 BOTTLE (11534-180-28)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"11534018050","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-180-50","proprietary_name":"POLYETHYLENE GLYCOL 3350 NF","nonproprietary_name":"polyethylene glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"SUNRISE PHARMACEUTICAL, INC","package_description":"510 g in 1 BOTTLE (11534-180-50)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802086800","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802086801","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-868-01","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"119 g in 1 BOTTLE (45802-868-01)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802086802","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-868-02","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"238 g in 1 BOTTLE (45802-868-02)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802086803","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-868-03","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"510 g in 1 BOTTLE (45802-868-03)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802086866","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-868-66","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"14 PACKET in 1 CARTON (45802-868-66) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079030601","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079030630","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-306-30","proprietary_name":"Polyethylene Glycol (3350)","nonproprietary_name":"polyethylene glycol (3350)","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Mylan Institutional Inc.","package_description":"30 POUCH in 1 CARTON (51079-306-30) / 17 g in 1 POUCH (51079-306-01)"},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559015710","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-157-10","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 PACKET in 1 CARTON (62559-157-10) / 17 g in 1 PACKET (62559-157-17)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559015717","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559015730","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-157-30","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 PACKET in 1 CARTON (62559-157-30) / 17 g in 1 PACKET (62559-157-17)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001050555","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-505-55","proprietary_name":"Polyethylene Glycol","nonproprietary_name":"Polyethylene Glycol","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"17 g/17g","labeler":"BluePoint Laboratories","package_description":"238 g in 1 BOTTLE (68001-505-55)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001050569","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-505-69","proprietary_name":"Polyethylene Glycol","nonproprietary_name":"Polyethylene Glycol","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"17 g/17g","labeler":"BluePoint Laboratories","package_description":"510 g in 1 BOTTLE (68001-505-69)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001060755","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-607-55","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"BluePoint Laboratories","package_description":"238 g in 1 BOTTLE (68001-607-55)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001060769","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-607-69","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"BluePoint Laboratories","package_description":"510 g in 1 BOTTLE (68001-607-69)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69230032431","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69230032434","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-324-34","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Camber Consumer Care Inc","package_description":"119 g in 1 BOTTLE (69230-324-34)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69230032435","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-324-35","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Camber Consumer Care Inc","package_description":"238 g in 1 BOTTLE (69230-324-35)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69230032436","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-324-36","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Camber Consumer Care Inc","package_description":"510 g in 1 BOTTLE (69230-324-36)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69230032437","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69230-324-37","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Camber Consumer Care Inc","package_description":"14 PACKET in 1 CARTON (69230-324-37) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603030201","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603030202","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-302-02","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"NorthStar Rx LLC","package_description":"14 PACKET in 1 CARTON (72603-302-02) / 17 g in 1 PACKET (72603-302-01)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603030203","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-302-03","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"NorthStar Rx LLC","package_description":"30 PACKET in 1 CARTON (72603-302-03) / 17 g in 1 PACKET (72603-302-01)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603030204","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-302-04","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"NorthStar Rx LLC","package_description":"100 PACKET in 1 CARTON (72603-302-04) / 17 g in 1 PACKET (72603-302-01)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033076201","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-762-01","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Kesin Pharma Corporation","package_description":"100 PACKET in 1 CARTON (81033-762-01) / 17 g in 1 PACKET (81033-762-17)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033076217","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033076230","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-762-30","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Kesin Pharma Corporation","package_description":"30 PACKET in 1 CARTON (81033-762-30) / 17 g in 1 PACKET (81033-762-17)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"84386012514","name":"POLYETHYLENE GLYCOL 3350 POWD","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-125-14","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"Aurobindo Pharma Limited","package_description":"14 PACKET in 1 CARTON (84386-125-14) / 17 g in 1 PACKET","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":1.22444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208031510","name":"POLYMYXIN B-TMP EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-315-10","proprietary_name":"Polymyxin B Sulfate and Trimethoprim","nonproprietary_name":"Polymyxin B Sulfate and Trimethoprim Sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10000 [USP'U]/mL; 1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-315-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.45211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Polymyxin B Sul-Trimethoprim|Polymyxin B Sulf/Trimethoprim","basis":"generic"},"part_b":null}, {"ndc":"61314062810","name":"POLYMYXIN B-TMP EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-628-10","proprietary_name":"Polymyxin B Sulfate and Trimethoprim","nonproprietary_name":"Polymyxin B Sulfate and Trimethoprim","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10000 [USP'U]/mL; 1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-628-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.45211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Polymyxin B Sul-Trimethoprim|Polymyxin B Sulf/Trimethoprim","basis":"generic"},"part_b":null}, {"ndc":"70069031101","name":"POLYMYXIN B-TMP EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-311-01","proprietary_name":"polymyxin b sulfate and trimethoprim sulfate","nonproprietary_name":"polymyxin b sulfate and trimethoprim sulfate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10000 [iU]/mL; 1 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-311-01) / 10 mL in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.45211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Polymyxin B Sul-Trimethoprim|Polymyxin B Sulf/Trimethoprim","basis":"generic"},"part_b":null}, {"ndc":"50991013216","name":"POLYTUSSIN DM 7.5-5-12.5 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50991-132-16","proprietary_name":"Polytussin DM","nonproprietary_name":"Dextromethorphan HBr, Phenylephrine HCl, Pyrilamine Maleate","dosage_form":"SYRUP","route":"ORAL","strength":"7.5 mg/5mL; 12.5 mg/5mL; 5 mg/5mL","labeler":"Poly Pharmaceuticals, Inc.","package_description":"480 mL in 1 BOTTLE (50991-132-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536140894","name":"POLYVINYL ALCOHOL 1.4% EYEDROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1408-94","proprietary_name":"Rugby Polyvinyl Alcohol 1.4% Lubricating Eye Drops","nonproprietary_name":"Polyvinyl alcohol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1.4 g/100mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE, DROPPER in 1 BOX (0536-1408-94) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.34162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50268067815","name":"POLYVINYL ALCOHOL 1.4% EYEDROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-678-15","proprietary_name":"Polyvinyl Alcohol","nonproprietary_name":"Polyvinyl Alcohol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"14 mg/mL","labeler":"AvPAK","package_description":"15 mL in 1 BOTTLE (50268-678-15)"},"nadac":{"value":0.34162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00555902058","name":"PORTIA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9020-58","proprietary_name":"Portia","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9020-58) / 1 BLISTER PACK in 1 POUCH (0555-9020-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Portia|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555902079","name":"PORTIA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Portia|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00254204502","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0254-2045-02","proprietary_name":"POSACONAZOLE","nonproprietary_name":"posaconazole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"ENDO USA, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (0254-2045-02)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406771160","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-7711-60","proprietary_name":"POSACONAZOLE","nonproprietary_name":"posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"SpecGx LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (0406-7711-60)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527213335","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2133-35","proprietary_name":"POSACONAZOLE","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lannett Company Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (0527-2133-35)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904714904","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7149-04","proprietary_name":"POSACONAZOLE","nonproprietary_name":"POSACONAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7149-04) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904714910","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7149-10","proprietary_name":"POSACONAZOLE","nonproprietary_name":"POSACONAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-7149-10) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714053501","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-535-01","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (16714-535-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067760","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-677-60","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (31722-677-60)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598047060","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-470-60","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (43598-470-60)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068311","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068312","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-683-12","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-683-12) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (50268-683-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651059660","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-596-60","proprietary_name":"POSACONAZOLE","nonproprietary_name":"POSACONAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (59651-596-60)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687052311","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687052321","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-523-21","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-523-21) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-523-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687052394","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-523-94","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-523-94) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (60687-523-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135042960","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-429-60","proprietary_name":"POSACONAZOLE","nonproprietary_name":"Posaconazole Delayed-Release","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-429-60)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238147606","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1476-6","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (69238-1476-6)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367024806","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003811","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-038-11","proprietary_name":"POSACONAZOLE","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (70377-038-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748025807","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-258-07","proprietary_name":"POSACONAZOLE","nonproprietary_name":"POSACONAZOLE","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (70748-258-07)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205016860","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-168-60","proprietary_name":"posaconazole","nonproprietary_name":"posaconazole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, COATED in 1 BOTTLE (72205-168-60)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72319002302","name":"POSACONAZOLE DR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-023-02","proprietary_name":"Posaconazole","nonproprietary_name":"Posaconazole","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET, DELAYED RELEASE in 1 BOTTLE (72319-023-02)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.03152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657031116","name":"POTASS CIT-SOD CIT-CITRIC SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.0314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121094816","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0948-16","proprietary_name":"Potassium Chloride","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"20 meq/15mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0948-16)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00603154258","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571035707","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651095947","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-959-47","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"Potassium Chloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 meq/15mL","labeler":"Aurobindo Pharma Limited","package_description":"473 mL in 1 BOTTLE (59651-959-47)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64950032047","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64950-320-47","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 meq/15mL","labeler":"Genus Lifesciences","package_description":"473 mL in 1 BOTTLE, PLASTIC (64950-320-47)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238145902","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1459-2","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"SOLUTION","route":"ORAL","strength":"1.5 g/15mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"473 mL in 1 BOTTLE (69238-1459-2)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70010007244","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-072-44","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"20 meq/15mL","labeler":"Granules Pharmaceuticals Inc.","package_description":"473 mL in 1 BOTTLE (70010-072-44)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656002116","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-021-16","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE ORAL","dosage_form":"SOLUTION","route":"ORAL","strength":"1.5 g/15mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (71656-021-16)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888004113","name":"POTASSIUM CHLORIDE 10% (20 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-041-13","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"20 meq/15mL","labeler":"Advagen Pharma Limited","package_description":"473 mL in 1 BOTTLE, PLASTIC (72888-041-13)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.04085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121284716","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-2847-16","proprietary_name":"Potassium Chloride","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"40 meq/15mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-2847-16)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00603154358","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571035807","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651096047","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-960-47","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"Potassium Chloride","dosage_form":"SOLUTION","route":"ORAL","strength":"40 meq/15mL","labeler":"Aurobindo Pharma Limited","package_description":"473 mL in 1 BOTTLE (59651-960-47)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238145802","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1458-2","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"SOLUTION","route":"ORAL","strength":"3 g/15mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"473 mL in 1 BOTTLE (69238-1458-2)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70010007344","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-073-44","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"40 meq/15mL","labeler":"Granules Pharmaceuticals Inc.","package_description":"473 mL in 1 BOTTLE (70010-073-44)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656002216","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-022-16","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"3 g/15mL","labeler":"Saptalis Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (71656-022-16)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72888004213","name":"POTASSIUM CHLORIDE 20% (40 MEQ/15 ML) ORAL LIQUID","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-042-13","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"40 meq/15mL","labeler":"Advagen Pharma Limited","package_description":"473 mL in 1 BOTTLE, PLASTIC (72888-042-13)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.07285,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121067616","name":"POTASSIUM CIT-CITRIC ACID SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0676-16","proprietary_name":"Potassium Citrate and Citric Acid","nonproprietary_name":"Potassium Citrate and Citric Acid Monohydrate","dosage_form":"SOLUTION","route":"ORAL","strength":"1100 mg/5mL; 334 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0676-16)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.0517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Potassium Citrate-Citric Acid|Potassium Citrate/Citric Acid","basis":"generic"},"part_b":null}, {"ndc":"58657031216","name":"POTASSIUM CIT-CITRIC ACID SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.0517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Potassium Citrate-Citric Acid|Potassium Citrate/Citric Acid","basis":"generic"},"part_b":null}, {"ndc":"62135043547","name":"POTASSIUM CIT-CITRIC ACID SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-435-47","proprietary_name":"Potassium Citrate and Citric Acid","nonproprietary_name":"Potassium Citrate and Citric Acid","dosage_form":"SOLUTION","route":"ORAL","strength":"1100 mg/5mL; 334 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-435-47)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.0517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Potassium Citrate-Citric Acid|Potassium Citrate/Citric Acid","basis":"generic"},"part_b":null}, {"ndc":"00245007111","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0071-11","proprietary_name":"Potassium Citrate","nonproprietary_name":"potassium citrate","dosage_form":"TABLET","route":"ORAL","strength":"10 meq/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0245-0071-11)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591272901","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2729-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0591-2729-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"16571086501","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-865-01","proprietary_name":"POTASSIUM CITRATE","nonproprietary_name":"potassium citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1080 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-865-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722013001","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-130-01","proprietary_name":"POTASSIUM CITRATE","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-130-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"42543040701","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-407-01","proprietary_name":"POTASSIUM CITRATE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"10 meq/1","labeler":"Strides Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (42543-407-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"44523041001","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44523-410-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"potassium citrate","dosage_form":"TABLET","route":"ORAL","strength":"10 meq/1","labeler":"Biocomp Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (44523-410-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"62559029101","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-291-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62559-291-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"68084085032","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-850-32","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-850-32) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (68084-850-33)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"68084085033","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"68382053701","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-537-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-537-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"69452019320","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"71930004912","name":"POTASSIUM CITRATE ER 10 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591274201","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2742-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 meq/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0591-2742-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722013201","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-132-01","proprietary_name":"POTASSIUM CITRATE","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 meq/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-132-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"42543040801","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-408-01","proprietary_name":"POTASSIUM CITRATE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"15 meq/1","labeler":"Strides Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (42543-408-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"44523041501","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44523-415-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"potassium citrate","dosage_form":"TABLET","route":"ORAL","strength":"15 meq/1","labeler":"Biocomp Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (44523-415-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"62559029201","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-292-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 meq/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62559-292-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"68382053801","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-538-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 meq/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-538-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"69452019420","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"71930005012","name":"POTASSIUM CITRATE ER 15 MEQ TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17423,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"00245007011","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0070-11","proprietary_name":"Potassium Citrate","nonproprietary_name":"potassium citrate","dosage_form":"TABLET","route":"ORAL","strength":"5 meq/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (0245-0070-11)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591268201","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2682-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 meq/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0591-2682-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"16571086401","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-864-01","proprietary_name":"POTASSIUM CITRATE","nonproprietary_name":"potassium citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"540 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (16571-864-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722012901","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-129-01","proprietary_name":"POTASSIUM CITRATE","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 meq/1","labeler":"Camber Pharmaceuticals, Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-129-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"42543040601","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42543-406-01","proprietary_name":"POTASSIUM CITRATE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"5 meq/1","labeler":"Strides Pharma Inc.","package_description":"100 TABLET in 1 BOTTLE (42543-406-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"68382053601","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-536-01","proprietary_name":"Potassium Citrate","nonproprietary_name":"Potassium Citrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 meq/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-536-01)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"71930004812","name":"POTASSIUM CITRATE ER 5 MEQ TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Citrate ER|Potassium Citrate","basis":"generic"},"part_b":null}, {"ndc":"00603155404","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-1554-04","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Endo USA, Inc.","package_description":"100 POUCH in 1 CARTON (0603-1554-04) / 1.58 g in 1 POUCH (0603-1554-10)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603155410","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603155416","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-1554-16","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Endo USA, Inc.","package_description":"30 POUCH in 1 CARTON (0603-1554-16) / 1.58 g in 1 POUCH (0603-1554-10)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085675","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085676","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085677","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-856-77","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 POUCH in 1 CARTON (23155-856-77) / 1.58 g in 1 POUCH (23155-856-75)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806009401","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-094-01","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.77g","labeler":"Epic Pharma, LLC","package_description":"100 PACKET in 1 CARTON (42806-094-01) / 1.77 g in 1 PACKET (42806-094-99)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806009430","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-094-30","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.77g","labeler":"Epic Pharma, LLC","package_description":"30 PACKET in 1 CARTON (42806-094-30) / 1.77 g in 1 PACKET (42806-094-99)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219161701","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219161703","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1617-3","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 POUCH in 1 CARTON (60219-1617-3) / 1.58 g in 1 POUCH (60219-1617-1)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219161708","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1617-8","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 POUCH in 1 CARTON (60219-1617-8) / 1.58 g in 1 POUCH (60219-1617-1)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085527","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-855-27","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"American Health Packaging","package_description":"30 POUCH in 1 CARTON (60687-855-27) / 1.58 g in 1 POUCH (60687-855-99)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085592","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-855-92","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"American Health Packaging","package_description":"100 POUCH in 1 CARTON (60687-855-92) / 1.58 g in 1 POUCH (60687-855-99)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687085599","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380087569","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-875-69","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Strides Pharma Science Limited","package_description":"30 POUCH in 1 CARTON (64380-875-69) / 1.58 g in 1 POUCH (64380-875-00)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380087570","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-875-70","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Strides Pharma Science Limited","package_description":"100 POUCH in 1 CARTON (64380-875-70) / 1.58 g in 1 POUCH (64380-875-00)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238161701","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238161703","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238161708","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010007142","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-071-42","proprietary_name":"Potassium Chloride for Oral Solution","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (70010-071-42) / 1.58 g in 1 POUCH"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Chloride*|Potassium Chloride","basis":"generic"},"part_b":null}, {"ndc":"70010007143","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-071-43","proprietary_name":"Potassium Chloride for Oral Solution","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 POUCH in 1 CARTON (70010-071-43) / 1.58 g in 1 POUCH"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Chloride*|Potassium Chloride","basis":"generic"},"part_b":null}, {"ndc":"70069082301","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-823-01","proprietary_name":"Potassium Chloride for Oral Solution","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Somerset Therapeutics, LLC","package_description":"1.58 g in 1 POUCH (70069-823-01)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Chloride*|Potassium Chloride","basis":"generic"},"part_b":null}, {"ndc":"70069082310","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-823-10","proprietary_name":"Potassium Chloride for Oral Solution","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Somerset Therapeutics, LLC","package_description":"100 POUCH in 1 CARTON (70069-823-10) / 1.58 g in 1 POUCH"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Chloride*|Potassium Chloride","basis":"generic"},"part_b":null}, {"ndc":"70069082330","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-823-30","proprietary_name":"Potassium Chloride for Oral Solution","nonproprietary_name":"Potassium Chloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Somerset Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (70069-823-30) / 1.58 g in 1 POUCH"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Potassium Chloride*|Potassium Chloride","basis":"generic"},"part_b":null}, {"ndc":"72603040701","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-407-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Northstar Rx LLC","package_description":"1.58 g in 1 POUCH (72603-407-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603040702","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-407-02","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Northstar Rx LLC","package_description":"30 POUCH in 1 CARTON (72603-407-02) / 1.58 g in 1 POUCH","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603040703","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-407-03","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Northstar Rx LLC","package_description":"100 POUCH in 1 CARTON (72603-407-03) / 1.58 g in 1 POUCH","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888002406","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888002407","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-024-07","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Advagen Pharma Limited","package_description":"30 POUCH in 1 CARTON (72888-024-07) / 1.58 g in 1 POUCH (72888-024-06)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888002410","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-024-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Advagen Pharma Limited","package_description":"100 POUCH in 1 CARTON (72888-024-10) / 1.58 g in 1 POUCH (72888-024-06)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888002443","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-024-43","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Advagen Pharma Limited","package_description":"50 POUCH in 1 CARTON (72888-024-43) / 1.58 g in 1 POUCH (72888-024-06)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033041301","name":"POTASSIUM CL 20 MEQ PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-413-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"1.5 g/1.58g","labeler":"Kesin Pharma Corporation","package_description":"100 POUCH in 1 CARTON (81033-413-01) / 1.58 g in 1 POUCH (81033-413-20)"},"nadac":{"value":0.62416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904754361","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7543-61","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7543-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547055310","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-553-10","proprietary_name":"potassium chloride","nonproprietary_name":"potassium chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43547-553-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547055350","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-553-50","proprietary_name":"potassium chloride","nonproprietary_name":"potassium chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Solco Healthcare LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43547-553-50)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268067111","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268067113","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-671-13","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-671-13) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-671-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746054201","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-542-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (53746-542-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746054205","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-542-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (53746-542-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746054210","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-542-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (53746-542-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687065301","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-653-01","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-653-01) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-653-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687065311","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687065321","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-653-21","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-653-21) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-653-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62037056001","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-560-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (62037-560-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62037056005","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-560-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (62037-560-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62037056010","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-560-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (62037-560-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304009001","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-090-01","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (63304-090-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304009005","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-090-05","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (63304-090-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001061900","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-619-00","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68001-619-00)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001061903","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-619-03","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68001-619-03)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010014801","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-148-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-148-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010014805","name":"POTASSIUM CL ER 10 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-148-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-148-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.13741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378456105","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4561-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-4561-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378456177","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4561-77","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 meq/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-4561-77)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532310","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5323-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0832-5323-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532311","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5323-11","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0832-5323-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532410","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5324-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-SmithLaboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-5324-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532411","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5324-11","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-SmithLaboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-5324-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904721661","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7216-61","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7216-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904754761","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7547-61","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7547-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571084301","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-843-01","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-843-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571084350","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-843-50","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-843-50)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979023001","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-230-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-230-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979023003","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-230-03","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-230-03)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979023101","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-231-01","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-231-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979023102","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-231-02","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-231-02)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979023103","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-231-03","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-231-03)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722013301","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-133-01","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"Potassium CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-133-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722013305","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-133-05","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"Potassium CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-133-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806042301","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-423-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-423-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806042305","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-423-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-423-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806042310","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-423-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-423-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687063201","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-632-01","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-632-01) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-632-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687063211","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687081009","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-810-09","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 CARTON (60687-810-09) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (60687-810-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687081011","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304007601","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-076-01","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-076-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304007605","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-076-05","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-076-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304007610","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-076-10","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-076-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380086106","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-861-06","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64380-861-06)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380086107","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-861-07","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (64380-861-07)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380086108","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-861-08","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (64380-861-08)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862098701","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-987-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-987-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862098799","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-987-99","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-987-99)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001051800","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-518-00","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-518-00)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001051808","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-518-08","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68001-518-08)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001056600","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-566-00","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Bluepoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-566-00)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001056603","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-566-03","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Bluepoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-566-03)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462047101","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680013300","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680013392","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680013393","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010002201","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-022-01","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-022-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010002205","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-022-05","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-022-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010002210","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-022-10","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-022-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013601","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-136-01","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-136-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013605","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-136-05","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-136-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013610","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-136-10","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-136-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603033701","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-337-01","proprietary_name":"potassium chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72603-337-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.12716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888007500","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-075-00","proprietary_name":"Potassium chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-075-00)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888007501","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-075-01","proprietary_name":"Potassium chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-075-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888007505","name":"POTASSIUM CL ER 10 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-075-05","proprietary_name":"Potassium chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-075-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532510","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5325-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-SmithLaboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-5325-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532511","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5325-11","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-SmithLaboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-5325-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532515","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5325-15","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-SmithLaboratories, LLC","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (0832-5325-15)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904729361","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7293-61","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7293-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904754861","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7548-61","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7548-61) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979023201","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-232-01","proprietary_name":"Potassium Chloride Extended-Release","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (24979-232-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.18593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722013501","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-135-01","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-135-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722013505","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-135-05","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-135-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687075609","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-756-09","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 CARTON (60687-756-09) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-756-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687075611","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62037072001","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-720-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (62037-720-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62037072010","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62037-720-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (62037-720-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304098701","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-987-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-987-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304098705","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-987-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-987-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304098710","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-987-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"20 meq/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (63304-987-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001056700","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-567-00","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET","route":"ORAL","strength":"1500 mg/1","labeler":"Bluepoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-567-00)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001056703","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-567-03","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET","route":"ORAL","strength":"1500 mg/1","labeler":"Bluepoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-567-03)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462047201","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462047205","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238106905","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680013400","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.18593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013501","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-135-01","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-135-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013505","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-135-05","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-135-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010013510","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-135-10","proprietary_name":"Potassium Chloride Extended-release","nonproprietary_name":"Potassium Chloride Extended-release","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-135-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.14078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70436015301","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-153-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70436-153-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.18593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888007601","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-076-01","proprietary_name":"Potassium chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-076-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.18593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888007605","name":"POTASSIUM CL ER 20 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-076-05","proprietary_name":"Potassium chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1500 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-076-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.18593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547055210","name":"POTASSIUM CL ER 8 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-552-10","proprietary_name":"potassium chloride","nonproprietary_name":"potassium chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Solco Healthcare LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43547-552-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.09981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"63304007801","name":"POTASSIUM CL ER 8 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-078-01","proprietary_name":"POTASSIUM CHLORIDE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (63304-078-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.09981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010014701","name":"POTASSIUM CL ER 8 MEQ CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-147-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-147-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.09981,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378456005","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378456077","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4560-77","proprietary_name":"Potassium Chloride","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 meq/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-4560-77)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532210","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5322-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0832-5322-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832532211","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-5322-11","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0832-5322-11)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571084201","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-842-01","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-842-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571084250","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-842-50","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"potassium chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (16571-842-50)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979022901","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-229-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-229-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24979022903","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-229-03","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (24979-229-03)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806042201","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-422-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-422-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806042205","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-422-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-422-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806042210","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-422-10","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42806-422-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862098601","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-986-01","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-986-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862098605","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-986-05","proprietary_name":"Potassium Chloride","nonproprietary_name":"Potassium Chloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (65862-986-05)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70010002101","name":"POTASSIUM CL ER 8 MEQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-021-01","proprietary_name":"POTASSIUM CHLORIDE EXTENDED RELEASE","nonproprietary_name":"POTASSIUM CHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70010-021-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]"]},"nadac":{"value":0.10279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904110309","name":"POVIDONE-IODINE 10% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-1103-09","proprietary_name":"povidone iodine","nonproprietary_name":"povidone iodine","dosage_form":"SOLUTION","route":"TOPICAL","strength":"100 mg/mL","labeler":"Major Pharmaceuticals","package_description":"237 mL in 1 BOTTLE (0904-1103-09)"},"nadac":{"value":0.01433,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904763954","name":"POVIDONE-IODINE 10% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7639-54","proprietary_name":"Povidone-Iodine","nonproprietary_name":"Povidone-Iodine","dosage_form":"SOLUTION","route":"TOPICAL","strength":"100 mg/mL","labeler":"Major Pharmaceuticals","package_description":"237 mL in 1 BOTTLE, PLASTIC (0904-7639-54)"},"nadac":{"value":0.02034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000006001","name":"POVIDONE-IODINE 10% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0060-1","proprietary_name":"Leader Povidone-Iodine 10% Topical Solution","nonproprietary_name":"Povidone Iodine Prep Solution 10%","dosage_form":"LIQUID","route":"TOPICAL","strength":"10 mg/mL","labeler":"Cardinal Health","package_description":"237 mL in 1 BOTTLE (70000-0060-1)"},"nadac":{"value":0.02034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00597010854","name":"PRADAXA 110 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0597-0108-54","proprietary_name":"Pradaxa","nonproprietary_name":"dabigatran etexilate mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (0597-0108-54) / 60 CAPSULE in 1 BOTTLE","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":3.16648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pradaxa|Dabigatran Etexilate Mesylate","basis":"brand"},"part_b":null}, {"ndc":"00597010860","name":"PRADAXA 110 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0597-0108-60","proprietary_name":"Pradaxa","nonproprietary_name":"dabigatran etexilate mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"110 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals Inc.","package_description":"10 BLISTER PACK in 1 CARTON (0597-0108-60) / 6 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":3.16648,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.93752,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pradaxa|Dabigatran Etexilate Mesylate","basis":"brand"},"part_b":null}, {"ndc":"00597036055","name":"PRADAXA 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0360-55","proprietary_name":"Pradaxa","nonproprietary_name":"dabigatran etexilate mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (0597-0360-55) / 60 CAPSULE in 1 BOTTLE","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":3.1597,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pradaxa|Dabigatran Etexilate Mesylate","basis":"brand"},"part_b":null}, {"ndc":"00597036082","name":"PRADAXA 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0360-82","proprietary_name":"Pradaxa","nonproprietary_name":"dabigatran etexilate mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0597-0360-82) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":3.1597,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.79456,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pradaxa|Dabigatran Etexilate Mesylate","basis":"brand"},"part_b":null}, {"ndc":"00597035509","name":"PRADAXA 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0355-09","proprietary_name":"Pradaxa","nonproprietary_name":"dabigatran etexilate mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (0597-0355-09) / 60 CAPSULE in 1 BOTTLE","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":3.16697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pradaxa|Dabigatran Etexilate Mesylate","basis":"brand"},"part_b":null}, {"ndc":"00597035556","name":"PRADAXA 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0355-56","proprietary_name":"Pradaxa","nonproprietary_name":"dabigatran etexilate mesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals Inc.","package_description":"60 BLISTER PACK in 1 CARTON (0597-0355-56) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Direct Thrombin Inhibitor [EPC]","Thrombin Inhibitors [MoA]"]},"nadac":{"value":3.16697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.75027,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pradaxa|Dabigatran Etexilate Mesylate","basis":"brand"},"part_b":null}, {"ndc":"61755002102","name":"PRALUENT 150 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61755-021-02","proprietary_name":"Praluent","nonproprietary_name":"alirocumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"Regeneron Pharmaceuticals, Inc.","package_description":"2 SYRINGE, GLASS in 1 CARTON (61755-021-02) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Antibodies, Monoclonal [CS]","PCSK9 Inhibitor [EPC]","PCSK9 Inhibitors [MoA]"]},"nadac":{"value":258.00732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Praluent Pen|Alirocumab","basis":"brand"},"part_b":null}, {"ndc":"61755002002","name":"PRALUENT 75 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61755-020-02","proprietary_name":"Praluent","nonproprietary_name":"alirocumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"75 mg/mL","labeler":"Regeneron Pharmaceuticals, Inc.","package_description":"2 SYRINGE, GLASS in 1 CARTON (61755-020-02) / 1 mL in 1 SYRINGE, GLASS","pharm_classes":["Antibodies, Monoclonal [CS]","PCSK9 Inhibitor [EPC]","PCSK9 Inhibitors [MoA]"]},"nadac":{"value":257.7316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Praluent Pen|Alirocumab","basis":"brand"},"part_b":null}, {"ndc":"13668009105","name":"PRAMIPEXOLE 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-091-05","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-091-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.03943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009190","name":"PRAMIPEXOLE 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-091-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-091-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.03943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50228012610","name":"PRAMIPEXOLE 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-126-10","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-126-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.03943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"57237018090","name":"PRAMIPEXOLE 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-180-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-180-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.03943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074605","name":"PRAMIPEXOLE 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-746-05","proprietary_name":"pramipexole dihydrochloride","nonproprietary_name":"pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE (64380-746-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.03943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033090","name":"PRAMIPEXOLE 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-330-90","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-330-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.03943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"00904670461","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6704-61","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6704-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009205","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-092-05","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-092-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009290","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-092-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-092-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50228012710","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-127-10","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"ScieGen Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (50228-127-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"57237018190","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-181-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-181-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"60687057001","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-570-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-570-01) / 1 TABLET in 1 BLISTER PACK (60687-570-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"60687057011","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074705","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-747-05","proprietary_name":"pramipexole dihydrochloride","nonproprietary_name":"pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE (64380-747-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033190","name":"PRAMIPEXOLE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-331-90","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-331-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009305","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-093-05","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-093-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009390","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-093-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-093-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"57237018290","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-182-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-182-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"60687058111","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"60687058121","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-581-21","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-581-21) / 1 TABLET in 1 BLISTER PACK (60687-581-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"64380074805","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-748-05","proprietary_name":"pramipexole dihydrochloride","nonproprietary_name":"pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE (64380-748-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033290","name":"PRAMIPEXOLE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-332-90","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-332-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.05665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668018405","name":"PRAMIPEXOLE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-184-05","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-184-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.07211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668018490","name":"PRAMIPEXOLE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-184-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-184-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.07211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"57237018390","name":"PRAMIPEXOLE 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-183-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":".75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-183-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.07211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009405","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-094-05","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-094-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009490","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-094-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-094-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"57237018490","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-184-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-184-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"60687059211","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"60687059221","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-592-21","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-592-21) / 1 TABLET in 1 BLISTER PACK (60687-592-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"64380075005","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-750-05","proprietary_name":"pramipexole dihydrochloride","nonproprietary_name":"pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE (64380-750-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033390","name":"PRAMIPEXOLE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-333-90","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-333-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009505","name":"PRAMIPEXOLE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-095-05","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-095-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"13668009590","name":"PRAMIPEXOLE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-095-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (13668-095-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342003510","name":"PRAMIPEXOLE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-035-10","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-035-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"57237018590","name":"PRAMIPEXOLE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-185-90","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET in 1 BOTTLE (57237-185-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"64380075105","name":"PRAMIPEXOLE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-751-05","proprietary_name":"pramipexole dihydrochloride","nonproprietary_name":"pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"90 TABLET in 1 BOTTLE (64380-751-05)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"68462033490","name":"PRAMIPEXOLE 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-334-90","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-334-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.06049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole Dihydrochloride|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"16714091601","name":"PRAMIPEXOLE ER 0.375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-916-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-916-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.94832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342020807","name":"PRAMIPEXOLE ER 0.375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-208-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-208-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.94832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033130","name":"PRAMIPEXOLE ER 0.375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-331-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-331-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.94832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"55111061130","name":"PRAMIPEXOLE ER 0.375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-611-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-611-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.94832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332015430","name":"PRAMIPEXOLE ER 0.375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-154-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-154-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.94832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"69680014530","name":"PRAMIPEXOLE ER 0.375 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-145-30","proprietary_name":"Pramipexole Dihydrochloride Extended-Release","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".375 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69680-145-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.94832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"16714091701","name":"PRAMIPEXOLE ER 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-917-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".75 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-917-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.71785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342020907","name":"PRAMIPEXOLE ER 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-209-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-209-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.71785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033230","name":"PRAMIPEXOLE ER 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-332-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".75 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-332-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.71785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"55111061230","name":"PRAMIPEXOLE ER 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-612-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".75 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-612-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.71785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332015530","name":"PRAMIPEXOLE ER 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-155-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-155-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.71785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"69680014630","name":"PRAMIPEXOLE ER 0.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-146-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":".75 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69680-146-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.71785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"16714091801","name":"PRAMIPEXOLE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-918-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-918-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.68274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342021007","name":"PRAMIPEXOLE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-210-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-210-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.68274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033330","name":"PRAMIPEXOLE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-333-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-333-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.68274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"55111061330","name":"PRAMIPEXOLE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-613-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-613-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.68274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332015630","name":"PRAMIPEXOLE ER 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-156-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-156-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.68274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"16714091901","name":"PRAMIPEXOLE ER 2.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-919-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.25 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-919-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.46337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342021107","name":"PRAMIPEXOLE ER 2.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-211-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-211-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.46337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033430","name":"PRAMIPEXOLE ER 2.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-334-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-334-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.46337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332015730","name":"PRAMIPEXOLE ER 2.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-157-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2.25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-157-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.46337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"16714092001","name":"PRAMIPEXOLE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-920-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-920-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.47943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342021207","name":"PRAMIPEXOLE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-212-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-212-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.47943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033530","name":"PRAMIPEXOLE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-335-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-335-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.47943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"55111061430","name":"PRAMIPEXOLE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-614-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-614-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.47943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332015830","name":"PRAMIPEXOLE ER 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-158-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-158-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.47943,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342021307","name":"PRAMIPEXOLE ER 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"33342-213-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-213-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":2.38933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033630","name":"PRAMIPEXOLE ER 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50742-336-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-336-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":2.38933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332016030","name":"PRAMIPEXOLE ER 3.75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62332-160-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"3.75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-160-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":2.38933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"16714092201","name":"PRAMIPEXOLE ER 4.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-922-01","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4.5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (16714-922-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.65977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"33342021407","name":"PRAMIPEXOLE ER 4.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-214-07","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-214-07)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.65977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"50742033730","name":"PRAMIPEXOLE ER 4.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-337-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (50742-337-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.65977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"55111061530","name":"PRAMIPEXOLE ER 4.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-615-30","proprietary_name":"Pramipexole dihydrochloride","nonproprietary_name":"Pramipexole dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4.5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (55111-615-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.65977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"62332015930","name":"PRAMIPEXOLE ER 4.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-159-30","proprietary_name":"Pramipexole Dihydrochloride","nonproprietary_name":"Pramipexole Dihydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-159-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.65977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pramipexole ER|Pramipexole Di-HCl","basis":"generic"},"part_b":null}, {"ndc":"00378518693","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5186-93","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5186-93)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"29300030213","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-302-13","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (29300-302-13)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"60505464303","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4643-3","proprietary_name":"PRASUGREL","nonproprietary_name":"PRASUGREL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4643-3)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"60505485603","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4856-3","proprietary_name":"PRASUGREL","nonproprietary_name":"PRASUGREL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4856-3)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"60687088311","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"60687088321","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-883-21","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-883-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-883-11)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"65862083030","name":"PRASUGREL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-830-30","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-830-30)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.26297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"00378518593","name":"PRASUGREL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5185-93","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5185-93)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"29300030113","name":"PRASUGREL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-301-13","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (29300-301-13)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"60505464203","name":"PRASUGREL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4642-3","proprietary_name":"PRASUGREL","nonproprietary_name":"PRASUGREL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4642-3)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"65862082930","name":"PRASUGREL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-829-30","proprietary_name":"Prasugrel","nonproprietary_name":"Prasugrel","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-829-30)","pharm_classes":["Decreased Platelet Aggregation [PE]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prasugrel HCl|Prasugrel HCl","basis":"generic"},"part_b":null}, {"ndc":"00904589161","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5891-61","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-5891-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714055801","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-558-01","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-558-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714055802","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-558-02","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-558-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"24689014002","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066511","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066515","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-665-15","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-665-15) / 1 TABLET in 1 BLISTER PACK (50268-665-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505016805","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0168-5","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET in 1 BOTTLE (60505-0168-5)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505016809","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0168-9","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET in 1 BOTTLE (60505-0168-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687088601","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-886-01","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-886-01) / 1 TABLET in 1 BLISTER PACK (60687-886-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687088611","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019505","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-195-05","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-195-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019590","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-195-90","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-195-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097078805","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-788-05","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"CIPLA USA INC.","package_description":"90 TABLET in 1 BOTTLE (69097-788-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097078812","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-788-12","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"CIPLA USA INC.","package_description":"500 TABLET in 1 BOTTLE (69097-788-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004512","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-045-12","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET in 1 BOTTLE (70377-045-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004514","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-045-14","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET in 1 BOTTLE (70377-045-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003190","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-031-90","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (84386-031-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003199","name":"PRAVASTATIN SODIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-031-99","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (84386-031-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093720110","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7201-10","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-7201-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904589261","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5892-61","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-5892-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714055901","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-559-01","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-559-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714055902","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-559-02","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-559-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"24689014102","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"24689014105","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066611","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066615","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-666-15","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-666-15) / 1 TABLET in 1 BLISTER PACK (50268-666-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505016907","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0169-7","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0169-7)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505016909","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0169-9","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET in 1 BOTTLE (60505-0169-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687089701","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-897-01","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-897-01) / 1 TABLET in 1 BLISTER PACK (60687-897-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687089711","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019605","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-196-05","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-196-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019690","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-196-90","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-196-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097078905","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-789-05","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"CIPLA USA INC.","package_description":"90 TABLET in 1 BOTTLE (69097-789-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097078912","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-789-12","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"CIPLA USA INC.","package_description":"500 TABLET in 1 BOTTLE (69097-789-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004612","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-046-12","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET in 1 BOTTLE (70377-046-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004614","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-046-14","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET in 1 BOTTLE (70377-046-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009000610","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-006-10","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Quallent","package_description":"1000 TABLET in 1 BOTTLE (82009-006-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003290","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-032-90","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (84386-032-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003299","name":"PRAVASTATIN SODIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-032-99","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (84386-032-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00904589361","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5893-61","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-5893-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714056001","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-560-01","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-560-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714056002","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-560-02","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-560-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"24689014202","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"24689014205","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066711","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066715","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-667-15","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-667-15) / 1 TABLET in 1 BLISTER PACK (50268-667-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505017007","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0170-7","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0170-7)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505017009","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0170-9","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET in 1 BOTTLE (60505-0170-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687090801","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-908-01","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-908-01) / 1 TABLET in 1 BLISTER PACK (60687-908-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60687090811","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019705","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-197-05","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET in 1 BOTTLE (68462-197-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019790","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-197-90","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-197-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097079105","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-791-05","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"CIPLA USA INC.","package_description":"90 TABLET in 1 BOTTLE (69097-791-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097079112","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-791-12","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"CIPLA USA INC.","package_description":"500 TABLET in 1 BOTTLE (69097-791-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004712","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-047-12","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET in 1 BOTTLE (70377-047-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004714","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-047-14","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc.","package_description":"1000 TABLET in 1 BOTTLE (70377-047-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009000710","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-007-10","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Quallent","package_description":"1000 TABLET in 1 BOTTLE (82009-007-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009000790","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-007-90","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Quallent","package_description":"90 TABLET in 1 BOTTLE (82009-007-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003390","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-033-90","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (84386-033-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003399","name":"PRAVASTATIN SODIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-033-99","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (84386-033-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.0828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714057001","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-570-01","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET in 1 BOTTLE (16714-570-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"16714057002","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-570-02","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"500 TABLET in 1 BOTTLE (16714-570-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"24689014301","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066811","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"50268066812","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-668-12","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-668-12) / 1 TABLET in 1 BLISTER PACK (50268-668-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505132305","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1323-5","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET in 1 BOTTLE (60505-1323-5)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505132309","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-1323-9","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET in 1 BOTTLE (60505-1323-9)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68462019890","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-198-90","proprietary_name":"Pravastatin Sodium","nonproprietary_name":"Pravastatin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-198-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097079205","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-792-05","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"CIPLA USA INC.","package_description":"90 TABLET in 1 BOTTLE (69097-792-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"69097079212","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-792-12","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"CIPLA USA INC.","package_description":"500 TABLET in 1 BOTTLE (69097-792-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004812","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-048-12","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc.","package_description":"90 TABLET in 1 BOTTLE (70377-048-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70377004813","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-048-13","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc.","package_description":"500 TABLET in 1 BOTTLE (70377-048-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"82009000805","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-008-05","proprietary_name":"PRAVASTATIN SODIUM","nonproprietary_name":"PRAVASTATIN SODIUM","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Quallent","package_description":"500 TABLET in 1 BOTTLE (82009-008-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003490","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-034-90","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (84386-034-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"84386003499","name":"PRAVASTATIN SODIUM 80 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84386-034-99","proprietary_name":"Pravastatin sodium","nonproprietary_name":"Pravastatin sodium","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (84386-034-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.14329,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pravastatin Sodium|Pravastatin Sodium","basis":"generic"},"part_b":null}, {"ndc":"49884023183","name":"PRAZIQUANTEL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-231-83","proprietary_name":"PRAZIQUANTEL","nonproprietary_name":"PRAZIQUANTEL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Par Health USA, LLC","package_description":"6 TABLET, FILM COATED in 1 BOTTLE (49884-231-83)","pharm_classes":["Anthelmintic [EPC]"]},"nadac":{"value":53.24776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Praziquantel|Praziquantel","basis":"generic"},"part_b":null}, {"ndc":"00093406701","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4067-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-4067-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093406710","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4067-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (0093-4067-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378110101","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1101-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-1101-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378110110","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1101-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-1101-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904702061","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7020-61","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7020-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079063001","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079063020","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-630-20","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-630-20) / 1 CAPSULE in 1 BLISTER PACK (51079-630-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027101","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-271-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-271-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027199","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-271-99","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (59651-271-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332069131","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-691-31","proprietary_name":"PRAZOSIN HYDROCHLORIDE","nonproprietary_name":"PRAZOSIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-691-31)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"66993043185","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-431-85","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Prasco Laboratories","package_description":"90 CAPSULE in 1 BOTTLE (66993-431-85)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084099601","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-996-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-996-01) / 1 CAPSULE in 1 BLISTER PACK (68084-996-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084099611","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010008401","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-084-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-084-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70377006611","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-066-11","proprietary_name":"Prazosin hydrochloride","nonproprietary_name":"Prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-066-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042911","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-429-11","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-429-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756042912","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-429-12","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 CAPSULE in 1 BOTTLE (70756-429-12)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954001910","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-019-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-019-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954001920","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-019-20","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (70954-019-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954001950","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-019-50","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (70954-019-50)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027590","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-275-90","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-275-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027591","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-275-91","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72205-275-91)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027599","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-275-99","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72205-275-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282072101","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-721-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Exelan Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (76282-721-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282072110","name":"PRAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-721-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Exelan Pharmaceuticals","package_description":"1000 CAPSULE in 1 BOTTLE (76282-721-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08417,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093406801","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4068-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-4068-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093406810","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4068-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (0093-4068-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378230201","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2302-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2302-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378230210","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2302-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE, PLASTIC (0378-2302-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904702161","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7021-61","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7021-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079063101","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079063120","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-631-20","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-631-20) / 1 CAPSULE in 1 BLISTER PACK (51079-631-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027201","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-272-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-272-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027299","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-272-99","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE in 1 BOTTLE (59651-272-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332069231","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-692-31","proprietary_name":"PRAZOSIN HYDROCHLORIDE","nonproprietary_name":"PRAZOSIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-692-31)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"66993043285","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-432-85","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Prasco Laboratories","package_description":"90 CAPSULE in 1 BOTTLE (66993-432-85)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084099701","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-997-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-997-01) / 1 CAPSULE in 1 BLISTER PACK (68084-997-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084099711","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010008501","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-085-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-085-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70377006711","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-067-11","proprietary_name":"Prazosin hydrochloride","nonproprietary_name":"Prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-067-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756043011","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-430-11","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-430-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756043012","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-430-12","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 CAPSULE in 1 BOTTLE (70756-430-12)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954002010","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-020-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-020-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954002020","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-020-20","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (70954-020-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027691","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-276-91","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72205-276-91)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027699","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-276-99","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 CAPSULE in 1 BOTTLE (72205-276-99)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282072201","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-722-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Exelan Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (76282-722-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282072210","name":"PRAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-722-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Exelan Pharmaceuticals","package_description":"1000 CAPSULE in 1 BOTTLE (76282-722-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.08634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093406901","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4069-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0093-4069-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093406905","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4069-05","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0093-4069-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00093406952","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4069-52","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"250 CAPSULE in 1 BOTTLE (0093-4069-52)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378320501","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3205-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-3205-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378320525","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3205-25","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"250 CAPSULE in 1 BOTTLE, PLASTIC (0378-3205-25)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"00904702261","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7022-61","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7022-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079063201","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"51079063220","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-632-20","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-632-20) / 1 CAPSULE in 1 BLISTER PACK (51079-632-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027301","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-273-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-273-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027325","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-273-25","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"250 CAPSULE in 1 BOTTLE (59651-273-25)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687057232","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-572-32","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-572-32) / 1 CAPSULE in 1 BLISTER PACK (60687-572-33)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"60687057233","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62332069331","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-693-31","proprietary_name":"PRAZOSIN HYDROCHLORIDE","nonproprietary_name":"PRAZOSIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-693-31)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"66993043385","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-433-85","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Prasco Laboratories","package_description":"90 CAPSULE in 1 BOTTLE (66993-433-85)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70010008601","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-086-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70010-086-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70377006811","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-068-11","proprietary_name":"Prazosin hydrochloride","nonproprietary_name":"Prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-068-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70756044011","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-440-11","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (70756-440-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954002110","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-021-10","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-021-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"70954002120","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-021-20","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"250 CAPSULE in 1 BOTTLE (70954-021-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027791","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-277-91","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (72205-277-91)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72205027795","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-277-95","proprietary_name":"prazosin hydrochloride","nonproprietary_name":"prazosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"250 CAPSULE in 1 BOTTLE (72205-277-95)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282072301","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-723-01","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals","package_description":"100 CAPSULE in 1 BOTTLE (76282-723-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282072325","name":"PRAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-723-25","proprietary_name":"Prazosin Hydrochloride","nonproprietary_name":"Prazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals","package_description":"250 CAPSULE in 1 BOTTLE (76282-723-25)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13371,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prazosin HCl|Prazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"11980018005","name":"PRED FORTE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"11980-180-05","proprietary_name":"PRED FORTE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11980-180-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.7132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":4.82733,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pred Forte|Prednisolone Acetate","basis":"brand"},"part_b":null}, {"ndc":"11980018010","name":"PRED FORTE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":30.83057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":4.72213,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pred Forte|Prednisolone Acetate","basis":"brand"},"part_b":null}, {"ndc":"11980017405","name":"PRED MILD 0.12% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11980-174-05","proprietary_name":"PRED MILD","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1.2 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11980-174-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.64983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pred Mild|Prednisolone Acetate","basis":"brand"},"part_b":null}, {"ndc":"11980017410","name":"PRED MILD 0.12% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11980-174-10","proprietary_name":"PRED MILD","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"1.2 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (11980-174-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.67471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pred Mild|Prednisolone Acetate","basis":"brand"},"part_b":null}, {"ndc":"00121077308","name":"PREDNISOLONE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0121-0773-08","proprietary_name":"Prednisolone Sodium Phosphate","nonproprietary_name":"Prednisolone Sodium Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"237 mL in 1 BOTTLE (0121-0773-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.43026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42799081201","name":"PREDNISOLONE 10 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42799-812-01","proprietary_name":"Prednisolone Sodium Phosphate","nonproprietary_name":"Prednisolone Sodium Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/5mL","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"237 mL in 1 BOTTLE, PLASTIC (42799-812-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.43026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121075908","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0759-08","proprietary_name":"Prednisolone Sodium Phosphate","nonproprietary_name":"Prednisolone Sodium Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"237 mL in 1 BOTTLE (0121-0759-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10345,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121088508","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0885-08","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"240 mL in 1 BOTTLE (0121-0885-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":144,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (144 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":240,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (240 mL in 1 BOTTLE (0121-0885-08)) gives 240 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00121088516","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0885-16","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"480 mL in 1 BOTTLE (0121-0885-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":288,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (288 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":480,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (480 mL in 1 BOTTLE (0121-0885-16)) gives 480 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155092751","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-927-51","proprietary_name":"Prednisolone","nonproprietary_name":"prednisolone oral solution","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"240 mL in 1 BOTTLE (23155-927-51)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":144,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (144 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":240,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (240 mL in 1 BOTTLE (23155-927-51)) gives 240 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155092752","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-927-52","proprietary_name":"Prednisolone","nonproprietary_name":"prednisolone oral solution","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"480 mL in 1 BOTTLE (23155-927-52)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":288,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (288 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":480,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (480 mL in 1 BOTTLE (23155-927-52)) gives 480 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42799081501","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-815-01","proprietary_name":"Prednisolone Sodium Phosphate","nonproprietary_name":"Prednisolone Sodium Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"237 mL in 1 BOTTLE, PLASTIC (42799-815-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10345,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52817086008","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-860-08","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone oral","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"TRUPHARMA, LLC","package_description":"240 mL in 1 BOTTLE (52817-860-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52817086016","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-860-16","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone oral","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"TRUPHARMA, LLC","package_description":"480 mL in 1 BOTTLE (52817-860-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135025037","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-250-37","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone oral","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"240 mL in 1 BOTTLE (62135-250-37)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":144,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (144 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":240,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (240 mL in 1 BOTTLE (62135-250-37)) gives 240 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"62135025047","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-250-47","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone oral","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"480 mL in 1 BOTTLE (62135-250-47)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":288,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (288 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":480,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (480 mL in 1 BOTTLE (62135-250-47)) gives 480 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69238212209","name":"PREDNISOLONE 15 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2122-9","proprietary_name":"Prednisolone Sodium Phosphate","nonproprietary_name":"Prednisolone Sodium Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"237 mL in 1 BOTTLE (69238-2122-9)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10345,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":143,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (143 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":237,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (237 mL in 1 BOTTLE (69238-2122-9)) gives 237 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00527540668","name":"PREDNISOLONE 15 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-5406-68","proprietary_name":"PrednisoLONE","nonproprietary_name":"Prednisolone","dosage_form":"SYRUP","route":"ORAL","strength":"15 mg/5mL","labeler":"Lannett Company, Inc.","package_description":"240 mL in 1 BOTTLE (0527-5406-68)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.5676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":144,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (144 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":240,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (240 mL in 1 BOTTLE (0527-5406-68)) gives 240 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00527540670","name":"PREDNISOLONE 15 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-5406-70","proprietary_name":"PrednisoLONE","nonproprietary_name":"Prednisolone","dosage_form":"SYRUP","route":"ORAL","strength":"15 mg/5mL","labeler":"Lannett Company, Inc.","package_description":"480 mL in 1 BOTTLE (0527-5406-70)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.61529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":288,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (288 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":480,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (480 mL in 1 BOTTLE (0527-5406-70)) gives 480 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42658016005","name":"PREDNISOLONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42658-160-05","proprietary_name":"PREDNISOLONE","nonproprietary_name":"PREDNISOLONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hisun Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (42658-160-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.48393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7510","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7510 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (42658-160-05)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651049101","name":"PREDNISOLONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-491-01","proprietary_name":"PREDNISOLONE","nonproprietary_name":"PREDNISOLONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-491-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.48393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135043730","name":"PREDNISOLONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-437-30","proprietary_name":"Prednisolone","nonproprietary_name":"Prednisolone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-437-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":8.48393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121110004","name":"PREDNISOLONE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1100-04","proprietary_name":"PrednisoLONE Sodium Phosphate","nonproprietary_name":"PrednisoLONE Sodium Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"5 mL in 1 BOTTLE (0121-1100-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135033041","name":"PREDNISOLONE 5 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-330-41","proprietary_name":"Prednisolone Sodium Phosphate","nonproprietary_name":"prednisolone sodium phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Chartwell RX, LLC.","package_description":"120 mL in 1 BOTTLE (62135-330-41)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.54905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219255001","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2550-1","proprietary_name":"prednisolone acetate","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60219-2550-1) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.82733,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60219255101","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2551-1","proprietary_name":"prednisolone acetate","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60219-2551-1) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.72213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60219255201","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2552-1","proprietary_name":"prednisolone acetate","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (60219-2552-1) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.45565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60758011905","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-119-05","proprietary_name":"PREDNISOLONE ACETATE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-119-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.82733,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60758011910","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-119-10","proprietary_name":"PREDNISOLONE ACETATE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-119-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.72213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"60758011915","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-119-15","proprietary_name":"PREDNISOLONE ACETATE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-119-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.45565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"61314063705","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-637-05","proprietary_name":"Prednisolone Acetate","nonproprietary_name":"Prednisolone Acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-637-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.82733,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"61314063710","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-637-10","proprietary_name":"Prednisolone Acetate","nonproprietary_name":"Prednisolone Acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-637-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.72213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"61314063715","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-637-15","proprietary_name":"Prednisolone Acetate","nonproprietary_name":"Prednisolone Acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-637-15) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.45565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"70748033202","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-332-02","proprietary_name":"PREDNISOLONE ACETATE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-332-02) / 5 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.82733,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"70748033203","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-332-03","proprietary_name":"PREDNISOLONE ACETATE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-332-03) / 10 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.72213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"70748033204","name":"PREDNISOLONE AC 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-332-04","proprietary_name":"PREDNISOLONE ACETATE","nonproprietary_name":"prednisolone acetate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-332-04) / 15 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.45565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Acetate|Prednisolone Acetate","basis":"generic"},"part_b":null}, {"ndc":"24208071510","name":"PREDNISOLONE SOD 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-715-10","proprietary_name":"PREDNISOLONE SODIUM PHOSPHATE","nonproprietary_name":"PREDNISOLONE SODIUM PHOSPHATE","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-715-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.56742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prednisolone Sodium Phosphate*|Prednisolone Sodium Phosphate","basis":"generic"},"part_b":null}, {"ndc":"00054474125","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4741-25","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4741-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0054-4741-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054474131","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4741-31","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0054-4741-31)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533521","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5335-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5335-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533532","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5335-32","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-5335-32)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048401","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-484-01","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-484-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048499","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-484-99","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-484-99)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170501","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1705-1","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-1705-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"62135047018","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-470-18","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-470-18)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":180,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (180 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":180,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (180 TABLET in 1 BOTTLE (62135-470-18)) gives 180 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135047090","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-470-90","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-470-90)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":90,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (90 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":90,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (90 TABLET in 1 BOTTLE (62135-470-90)) gives 90 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380078206","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-782-06","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-782-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (64380-782-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954005610","name":"PREDNISONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-056-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-056-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591544221","name":"PREDNISONE 10 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5442-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0591-5442-21) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":210,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (10 per item) x PKG QTY (10), but FDA's strength 10 mg/1 x 21 EA per NDC / 1 MG = 210 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0591-5442-21) / 21 TABLET in 1 BLISTER PACK) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00591544243","name":"PREDNISONE 10 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5442-43","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0591-5442-43) / 48 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":480,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (10 per item) x PKG QTY (10), but FDA's strength 10 mg/1 x 48 EA per NDC / 1 MG = 480 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":48,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0591-5442-43) / 48 TABLET in 1 BLISTER PACK) gives 48 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00603533815","name":"PREDNISONE 10 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5338-15","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"21 TABLET in 1 BOX, UNIT-DOSE (0603-5338-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533831","name":"PREDNISONE 10 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5338-31","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"48 TABLET in 1 BOX, UNIT-DOSE (0603-5338-31)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954005930","name":"PREDNISONE 10 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-059-30","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 BOX (70954-059-30) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954005940","name":"PREDNISONE 10 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-059-40","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 BOX (70954-059-40) / 48 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.58481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054981725","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-9817-25","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-9817-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (0054-9817-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054981729","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-9817-29","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (0054-9817-29)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET in 1 BOTTLE (0054-9817-29)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00378064101","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0641-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0641-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0378-0641-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00378064110","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0641-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0641-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 TABLET in 1 BOTTLE, PLASTIC (0378-0641-10)) gives 1000 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00591544201","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5442-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-5442-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591544205","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5442-05","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0591-5442-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591544210","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5442-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0591-5442-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533821","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5338-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5338-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533828","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5338-28","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0603-5338-28)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533832","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5338-32","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-5338-32)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00904692361","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6923-61","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6923-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-6923-61) / 1 TABLET in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59651048701","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-487-01","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-487-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048705","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-487-05","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-487-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170701","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1707-1","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-1707-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170705","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1707-5","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (60219-1707-5)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687013401","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"60687013411","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687091401","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-914-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-914-01) / 1 TABLET in 1 BLISTER PACK (60687-914-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687091411","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012101","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0121-1","proprietary_name":"PredniSONE Tablets, USP, 10 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Granulation Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (63561-0121-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012102","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0121-2","proprietary_name":"PredniSONE Tablets, USP, 10 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Granulation Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (63561-0121-2)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012105","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0121-5","proprietary_name":"PredniSONE Tablets, USP, 10 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Granulation Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (63561-0121-5)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"64380078406","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-784-06","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-784-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (64380-784-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380078407","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-784-07","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (64380-784-07)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET in 1 BOTTLE, PLASTIC (64380-784-07)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380078408","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-784-08","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-784-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 TABLET in 1 BOTTLE, PLASTIC (64380-784-08)) gives 1000 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954005910","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-059-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-059-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954005920","name":"PREDNISONE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-059-20","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (70954-059-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.05328,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054474225","name":"PREDNISONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-4742-25","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-4742-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0054-4742-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00603533621","name":"PREDNISONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5336-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5336-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048501","name":"PREDNISONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-485-01","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-485-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"64380083506","name":"PREDNISONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-835-06","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-835-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (64380-835-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954005710","name":"PREDNISONE 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-057-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-057-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054001825","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0018-25","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-0018-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054001829","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0018-29","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0054-0018-29)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00378064201","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0642-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0642-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0378-0642-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00378064205","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0642-05","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0642-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET in 1 BOTTLE, PLASTIC (0378-0642-05)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00378064210","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0642-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0642-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591544301","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5443-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-5443-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591544305","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5443-05","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE (0591-5443-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591544310","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5443-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0591-5443-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533921","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5339-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5339-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533928","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5339-28","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0603-5339-28)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533932","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5339-32","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-5339-32)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048801","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-488-01","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-488-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048805","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-488-05","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-488-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170801","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1708-1","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-1708-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170805","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1708-5","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (60219-1708-5)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687014501","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-145-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-145-01) / 1 TABLET in 1 BLISTER PACK (60687-145-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-145-01) / 1 TABLET in 1 BLISTER PACK (60687-145-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687014511","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687092501","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-925-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-925-01) / 1 TABLET in 1 BLISTER PACK (60687-925-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687092511","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"62135055330","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-553-30","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-553-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":600,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (600 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET in 1 BOTTLE (62135-553-30)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135055390","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-553-90","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-553-90)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":1800,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1800 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":90,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (90 TABLET in 1 BOTTLE (62135-553-90)) gives 90 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63561012201","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0122-1","proprietary_name":"PredniSONE Tablets, USP, 20 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Granulation Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (63561-0122-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012202","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0122-2","proprietary_name":"PredniSONE Tablets, USP, 20 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Granulation Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (63561-0122-2)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012205","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0122-5","proprietary_name":"PredniSONE Tablets, USP, 20 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Granulation Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (63561-0122-5)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"64380078506","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-785-06","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-785-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (64380-785-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380078507","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-785-07","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (64380-785-07)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":10000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 TABLET in 1 BOTTLE, PLASTIC (64380-785-07)) gives 500 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380078508","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-785-08","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-785-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":20000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 TABLET in 1 BOTTLE, PLASTIC (64380-785-08)) gives 1000 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954006010","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-060-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-060-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954006020","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-060-20","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (70954-060-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954006030","name":"PREDNISONE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-060-30","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (70954-060-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591505221","name":"PREDNISONE 5 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5052-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0591-5052-21) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":105,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (5 per item) x PKG QTY (5), but FDA's strength 5 mg/1 x 21 EA per NDC / 1 MG = 105 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0591-5052-21) / 21 TABLET in 1 BLISTER PACK) gives 21 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00591505243","name":"PREDNISONE 5 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5052-43","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0591-5052-43) / 48 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":240,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (5 per item) x PKG QTY (5), but FDA's strength 5 mg/1 x 48 EA per NDC / 1 MG = 240 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":48,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (0591-5052-43) / 48 TABLET in 1 BLISTER PACK) gives 48 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00603533715","name":"PREDNISONE 5 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5337-15","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"21 TABLET in 1 BOX, UNIT-DOSE (0603-5337-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533731","name":"PREDNISONE 5 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5337-31","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"48 TABLET in 1 BOX, UNIT-DOSE (0603-5337-31)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954005830","name":"PREDNISONE 5 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-058-30","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 BOX (70954-058-30) / 21 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954005840","name":"PREDNISONE 5 MG TAB DOSE PACK","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-058-40","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 BOX (70954-058-40) / 48 TABLET in 1 BLISTER PACK","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.33674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054982825","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-9828-25","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (0054-9828-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (0054-9828-25)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00054982831","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-9828-31","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (0054-9828-31)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 TABLET in 1 BOTTLE (0054-9828-31)) gives 1000 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00378064001","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0640-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0640-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (0378-0640-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00378064010","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0640-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0640-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 TABLET in 1 BOTTLE, PLASTIC (0378-0640-10)) gives 1000 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00591505201","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5052-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-5052-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00591505210","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5052-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0591-5052-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533721","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5337-21","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0603-5337-21)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00603533732","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5337-32","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0603-5337-32)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048601","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-486-01","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-486-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"59651048699","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-486-99","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-486-99)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170601","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1706-1","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60219-1706-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60219170607","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1706-7","proprietary_name":"prednisone","nonproprietary_name":"prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (60219-1706-7)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687012201","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-122-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-122-01) / 1 TABLET in 1 BLISTER PACK (60687-122-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-122-01) / 1 TABLET in 1 BLISTER PACK (60687-122-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687012211","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687090301","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-903-01","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-903-01) / 1 TABLET in 1 BLISTER PACK (60687-903-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687090311","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"62135047118","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-471-18","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-471-18)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":900,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (900 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":180,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (180 TABLET in 1 BOTTLE (62135-471-18)) gives 180 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"62135047190","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-471-90","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-471-90)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":450,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (450 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":90,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (90 TABLET in 1 BOTTLE (62135-471-90)) gives 90 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"63561012001","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0120-1","proprietary_name":"PredniSONE Tablets, USP, 5 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Granulation Technology, Inc.","package_description":"100 TABLET in 1 BOTTLE (63561-0120-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012002","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0120-2","proprietary_name":"PredniSONE Tablets, USP, 5 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Granulation Technology, Inc.","package_description":"1000 TABLET in 1 BOTTLE (63561-0120-2)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"63561012005","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63561-0120-5","proprietary_name":"PredniSONE Tablets, USP, 5 mg","nonproprietary_name":"PredniSONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Granulation Technology, Inc.","package_description":"500 TABLET in 1 BOTTLE (63561-0120-5)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"64380078306","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-783-06","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (64380-783-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE, PLASTIC (64380-783-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"64380078308","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-783-08","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (64380-783-08)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1000,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1000 TABLET in 1 BOTTLE, PLASTIC (64380-783-08)) gives 1000 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954005810","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-058-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-058-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"70954005820","name":"PREDNISONE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-058-20","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (70954-058-20)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054372250","name":"PREDNISONE 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3722-50","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 mL in 1 BOTTLE (0054-3722-50)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.4331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":120,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (120 mL in 1 BOTTLE (0054-3722-50)) gives 120 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00054372263","name":"PREDNISONE 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3722-63","proprietary_name":"PredniSONE","nonproprietary_name":"PredniSONE","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE (0054-3722-63)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.60543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":500,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (500 mL in 1 BOTTLE (0054-3722-63)) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59651048901","name":"PREDNISONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-489-01","proprietary_name":"PREDNISONE","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-489-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"60687085401","name":"PREDNISONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-854-01","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-854-01) / 1 TABLET in 1 BLISTER PACK (60687-854-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (60687-854-01) / 1 TABLET in 1 BLISTER PACK (60687-854-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687085411","name":"PREDNISONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"64380094906","name":"PREDNISONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-949-06","proprietary_name":"prednisone","nonproprietary_name":"PREDNISONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-949-06)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":5000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (64380-949-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70954006110","name":"PREDNISONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-061-10","proprietary_name":"Prednisone","nonproprietary_name":"Prednisone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-061-10)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.17117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prednisone|Prednisone","basis":"generic"},"part_b":null}, {"ndc":"00054372144","name":"PREDNISONE INTENSOL 5 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3721-44","proprietary_name":"PredniSONE Intensol","nonproprietary_name":"PredniSONE Intensol","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"5 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"30 mL in 1 BOTTLE, GLASS (0054-3721-44)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":3.21489,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7512","bill_units_per_package":{"value":150,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7512 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (150 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 mL in 1 BOTTLE, GLASS (0054-3721-44)) gives 30 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00904700161","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7001-61","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7001-61) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668036105","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-361-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-361-05)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061305","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-613-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-613-05)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061390","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-613-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-613-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547050909","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-509-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-509-09)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029466","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-294-66","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"5 BLISTER PACK in 1 CARTON (43598-294-66) / 10 CAPSULE in 1 BLISTER PACK (43598-294-79)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029479","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029490","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-294-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-294-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035390","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-353-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-353-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064805","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-648-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-648-05)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064890","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-648-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-648-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268050001","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-500-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"100 BLISTER PACK in 1 BOX (50268-500-01) / 1 CAPSULE in 1 BLISTER PACK (50268-500-11)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268050011","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687050601","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-506-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-506-01) / 1 CAPSULE in 1 BLISTER PACK (60687-506-11)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687050611","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62135044690","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-446-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-446-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012290","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-122-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-122-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041309","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-413-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 CARTON (64980-413-09)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041310","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-413-10","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 CARTON (64980-413-10)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862076190","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-761-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-761-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046505","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-465-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-465-05)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046590","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-465-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-465-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097068105","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-681-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-681-05)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131309","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1313-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1313-9)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367032709","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-327-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-327-09)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042705","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-427-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-427-05)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042709","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-427-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-427-09)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001490","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-014-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-014-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035501","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-355-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-355-01)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282057190","name":"PREGABALIN 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-571-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-571-90)"},"nadac":{"value":0.05709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904700261","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7002-61","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7002-61) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668036205","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-362-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-362-05)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061405","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-614-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-614-05)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061490","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-614-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-614-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547051009","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-510-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-510-09)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029566","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-295-66","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"5 BLISTER PACK in 1 CARTON (43598-295-66) / 10 CAPSULE in 1 BLISTER PACK (43598-295-79)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029579","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029590","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-295-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-295-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035490","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-354-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-354-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064905","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-649-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-649-05)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064990","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-649-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-649-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268050101","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-501-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"AvPAK","package_description":"100 BLISTER PACK in 1 BOX (50268-501-01) / 1 CAPSULE in 1 BLISTER PACK (50268-501-11)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268050111","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687051701","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-517-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-517-01) / 1 CAPSULE in 1 BLISTER PACK (60687-517-11)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687051711","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62135044790","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-447-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-447-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012390","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-123-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-123-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041409","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-414-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-414-09)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041410","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-414-10","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (64980-414-10)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862076290","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-762-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-762-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046605","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-466-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-466-05)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046690","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-466-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-466-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097068205","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-682-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-682-05)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131409","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1314-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1314-9)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367032809","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-328-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-328-09)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042805","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-428-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-428-05)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042809","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-428-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-428-09)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001590","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-015-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-015-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035601","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-356-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-356-01)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282057290","name":"PREGABALIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-572-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-572-90)"},"nadac":{"value":0.05421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"39328009016","name":"PREGABALIN 20 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-090-16","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"Patrin Pharma, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (39328-090-16) / 473 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.15295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762157601","name":"PREGABALIN 20 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1576-1","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-1576-1) / 473 mL in 1 BOTTLE"},"nadac":{"value":0.15295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877045747","name":"PREGABALIN 20 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-457-47","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"473 mL in 1 BOTTLE (67877-457-47)"},"nadac":{"value":0.15295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904700304","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7003-04","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7003-04) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668036305","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-363-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-363-05)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061505","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-615-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-615-05)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061590","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-615-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-615-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547051109","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-511-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-511-09)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029690","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-296-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-296-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035590","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-355-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-355-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228065005","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-650-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-650-05)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228065090","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-650-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-650-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012490","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-124-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-124-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041509","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-415-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-415-09)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862076390","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-763-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-763-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046705","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-467-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-467-05)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046790","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-467-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-467-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097068305","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-683-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-683-05)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131509","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1315-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1315-9)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367032909","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-329-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-329-09)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042905","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-429-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-429-05)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042909","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-429-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-429-09)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001690","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-016-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-016-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035701","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-357-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-357-01)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282057390","name":"PREGABALIN 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-573-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-573-90)"},"nadac":{"value":0.05935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904700404","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7004-04","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7004-04) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668036405","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-364-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-364-05)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061605","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-616-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-616-05)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061690","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-616-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-616-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547051209","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-512-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-512-09)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029790","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-297-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-297-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035690","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-356-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-356-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228065105","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-651-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-651-05)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228065190","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-651-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-651-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012590","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-125-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-125-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041609","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-416-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-416-09)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862076490","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-764-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-764-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046805","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-468-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-468-05)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046890","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-468-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-468-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097068405","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-684-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-684-05)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131609","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1316-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1316-9)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367033009","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-330-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-330-09)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367043009","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-430-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-430-09)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001790","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-017-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-017-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282057490","name":"PREGABALIN 225 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-574-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"225 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-574-90)"},"nadac":{"value":0.06349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904699104","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6991-04","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6991-04) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904699161","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6991-61","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6991-61) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668035805","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-358-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-358-05)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061005","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-610-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-610-05)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061090","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-610-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-610-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547050609","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-506-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-506-09)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029190","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-291-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-291-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035090","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-350-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-350-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064505","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-645-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-645-05)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064590","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-645-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-645-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268049701","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-497-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"100 BLISTER PACK in 1 BOX (50268-497-01) / 1 CAPSULE in 1 BLISTER PACK (50268-497-11)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268049711","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687047301","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-473-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-473-01) / 1 CAPSULE in 1 BLISTER PACK (60687-473-11)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687047311","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332011990","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-119-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-119-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041009","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-410-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-410-09)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862075890","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-758-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-758-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046205","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-462-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-462-05)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046290","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-462-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-462-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097067705","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-677-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-677-05)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131009","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1310-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1310-9)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367032409","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-324-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-324-09)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042405","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-424-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-424-05)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042409","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-424-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-424-09)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001190","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-011-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-011-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035201","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-352-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-352-01)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282056890","name":"PREGABALIN 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-568-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-568-90)"},"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904700504","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7005-04","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7005-04) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668036505","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-365-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-365-05)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061705","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-617-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-617-05)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061790","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-617-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-617-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547051309","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-513-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-513-09)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029890","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-298-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-298-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035790","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-357-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-357-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228065205","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-652-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-652-05)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228065290","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-652-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-652-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012690","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-126-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-126-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041709","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-417-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-417-09)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862076590","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-765-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-765-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046905","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-469-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-469-05)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046990","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-469-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-469-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097068505","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-685-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-685-05)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131709","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1317-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1317-9)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367033109","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-331-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-331-09)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367043105","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-431-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-431-05)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367043109","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-431-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-431-09)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001890","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-018-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-018-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035801","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-358-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-358-01)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282057590","name":"PREGABALIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-575-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-575-90)"},"nadac":{"value":0.06652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904699261","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6992-61","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6992-61) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668035905","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-359-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-359-05)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061105","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-611-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-611-05)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061190","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-611-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-611-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547050709","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-507-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-507-09)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029266","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-292-66","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"5 BLISTER PACK in 1 CARTON (43598-292-66) / 10 CAPSULE in 1 BLISTER PACK (43598-292-79)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029279","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029290","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-292-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-292-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035190","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-351-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-351-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064605","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-646-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-646-05)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064690","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-646-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-646-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268049801","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-498-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"100 BLISTER PACK in 1 BOX (50268-498-01) / 1 CAPSULE in 1 BLISTER PACK (50268-498-11)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268049811","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687048401","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-484-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-484-01) / 1 CAPSULE in 1 BLISTER PACK (60687-484-11)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687048411","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62135044490","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-444-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-444-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012090","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-120-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-120-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041109","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-411-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-411-09)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041110","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-411-10","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (64980-411-10)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862075990","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-759-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-759-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046305","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-463-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-463-05)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046390","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-463-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-463-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097067805","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-678-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-678-05)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131109","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1311-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1311-9)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367032509","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-325-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-325-09)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042505","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-425-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-425-05)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042509","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-425-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-425-09)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001290","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-012-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-012-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035301","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-353-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-353-01)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282056990","name":"PREGABALIN 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-569-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-569-90)"},"nadac":{"value":0.04708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"00904700061","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7000-61","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7000-61) / 1 CAPSULE in 1 BLISTER PACK"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"13668036005","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-360-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (13668-360-05)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061205","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-612-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (31722-612-05)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"31722061290","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-612-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-612-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43547050809","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-508-09","proprietary_name":"PREGABALIN","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 CAPSULE in 1 BOTTLE (43547-508-09)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029366","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-293-66","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"5 BLISTER PACK in 1 CARTON (43598-293-66) / 10 CAPSULE in 1 BLISTER PACK (43598-293-79)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029379","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"43598029390","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-293-90","proprietary_name":"pregabalin","nonproprietary_name":"pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE in 1 BOTTLE (43598-293-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228035290","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-352-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-352-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064705","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-647-05","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"500 CAPSULE in 1 BOTTLE (50228-647-05)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50228064790","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-647-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"90 CAPSULE in 1 BOTTLE (50228-647-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268049901","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-499-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"AvPAK","package_description":"100 BLISTER PACK in 1 BOX (50268-499-01) / 1 CAPSULE in 1 BLISTER PACK (50268-499-11)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"50268049911","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687049501","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-495-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-495-01) / 1 CAPSULE in 1 BLISTER PACK (60687-495-11)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"60687049511","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62135044590","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-445-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-445-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"62332012190","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-121-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (62332-121-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041209","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-412-09","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (64980-412-09)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"64980041210","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-412-10","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (64980-412-10)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"65862076090","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-760-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (65862-760-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046405","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-464-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-464-05)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"67877046490","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-464-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 CAPSULE in 1 BOTTLE (67877-464-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69097067905","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-679-05","proprietary_name":"PREGABALIN capsules, CV","nonproprietary_name":"PREGABALIN capsules, CV","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Cipla USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (69097-679-05)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69238131209","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1312-9","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1312-9)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367032609","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-326-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-326-09)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042605","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-426-05","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 CAPSULE in 1 BOTTLE (69367-426-05)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"69367042609","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-426-09","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 CAPSULE in 1 BOTTLE (69367-426-09)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205001390","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-013-90","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-013-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72603035401","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-354-01","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE in 1 BOTTLE (72603-354-01)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"76282057090","name":"PREGABALIN 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-570-90","proprietary_name":"Pregabalin","nonproprietary_name":"PREGABALIN","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"90 CAPSULE in 1 BOTTLE (76282-570-90)"},"nadac":{"value":0.05282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205007830","name":"PREGABALIN ER 165 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-078-30","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"165 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-078-30)"},"nadac":{"value":1.81428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin ER|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72888005030","name":"PREGABALIN ER 165 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-050-30","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"165 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-050-30)"},"nadac":{"value":1.81428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin ER|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205007930","name":"PREGABALIN ER 330 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-079-30","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"330 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-079-30)"},"nadac":{"value":2.12419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin ER|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72888005130","name":"PREGABALIN ER 330 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-051-30","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"330 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-051-30)"},"nadac":{"value":2.12419,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin ER|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72205007730","name":"PREGABALIN ER 82.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-077-30","proprietary_name":"PREGABALIN","nonproprietary_name":"PREGABALIN","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"82.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72205-077-30)"},"nadac":{"value":3.00438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin ER|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"72888004930","name":"PREGABALIN ER 82.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-049-30","proprietary_name":"Pregabalin","nonproprietary_name":"Pregabalin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"82.5 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72888-049-30)"},"nadac":{"value":3.00438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pregabalin ER|Pregabalin","basis":"generic"},"part_b":null}, {"ndc":"78206015001","name":"PREGNYL 10,000 UNIT VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-150-01","proprietary_name":"Pregnyl","nonproprietary_name":"CHORIOGONADOTROPIN ALFA","dosage_form":"KIT","route":null,"strength":null,"labeler":"Organon LLC","package_description":"1 KIT in 1 CARTON (78206-150-01) * 10 mL in 1 VIAL, MULTI-DOSE (78206-150-99) * 10 mL in 1 VIAL (78206-151-89)"},"nadac":{"value":171.52976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J0725","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0725 (1000 UNITS) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (78206-150-01) * 10 mL in 1 VIAL, MULTI-DOSE (78206-150-99) * 10 mL in 1 VIAL (78206-151-89)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"78206015099","name":"PREGNYL 10,000 UNIT VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":171.52976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00046110081","name":"PREMARIN 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1100-81","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".3 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0046-1100-81)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.94743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.37279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110091","name":"PREMARIN 0.3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1100-91","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".3 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BOTTLE in 1 CARTON (0046-1100-91) / 1000 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.94743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.37279,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110181","name":"PREMARIN 0.45 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1101-81","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".45 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0046-1101-81)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.95576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.4808,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110281","name":"PREMARIN 0.625 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1102-81","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".625 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0046-1102-81)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.94289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.46982,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110291","name":"PREMARIN 0.625 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1102-91","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".625 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BOTTLE in 1 CARTON (0046-1102-91) / 1000 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.94289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.46982,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110381","name":"PREMARIN 0.9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1103-81","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".9 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0046-1103-81)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.93133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.57252,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110481","name":"PREMARIN 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1104-81","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0046-1104-81)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.95373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.47658,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046110491","name":"PREMARIN 1.25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1104-91","proprietary_name":"Premarin","nonproprietary_name":"estrogens, conjugated","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1.25 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BOTTLE in 1 CARTON (0046-1104-91) / 1000 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":6.95373,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.47658,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premarin*|Estrogens, Conjugated","basis":"brand"},"part_b":null}, {"ndc":"00046087221","name":"PREMARIN VAGINAL CREAM-APPL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-0872-21","proprietary_name":"Premarin Vaginal","nonproprietary_name":"conjugated estrogens","dosage_form":"CREAM","route":"VAGINAL","strength":".625 mg/g","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0046-0872-21) / 30 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]"]},"nadac":{"value":15.07444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00046257512","name":"PREMPHASE 0.625-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0046-2575-12","proprietary_name":"Premphase","nonproprietary_name":"conjugated estrogens and medroxyprogesterone acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0046-2575-12) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":8.68135,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Premphase|Estrogen,Con/M-Progest Acet","basis":"brand"},"part_b":null}, {"ndc":"00046110511","name":"PREMPRO 0.3 MG-1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1105-11","proprietary_name":"Prempro","nonproprietary_name":"conjugated estrogens and medroxyprogesterone acetate","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":".3 mg/1; 1.5 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0046-1105-11) / 28 TABLET, SUGAR COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":8.67718,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prempro|Estrogen,Con/M-Progest Acet","basis":"brand"},"part_b":null}, {"ndc":"00046110611","name":"PREMPRO 0.45-1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1106-11","proprietary_name":"Prempro","nonproprietary_name":"conjugated estrogens and medroxyprogesterone acetate","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":".45 mg/1; 1.5 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0046-1106-11) / 28 TABLET, SUGAR COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":8.68361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prempro|Estrogen,Con/M-Progest Acet","basis":"brand"},"part_b":null}, {"ndc":"00046110711","name":"PREMPRO 0.625-2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1107-11","proprietary_name":"Prempro","nonproprietary_name":"conjugated estrogens and medroxyprogesterone acetate","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":".625 mg/1; 2.5 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0046-1107-11) / 28 TABLET, SUGAR COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":8.67824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prempro|Estrogen,Con/M-Progest Acet","basis":"brand"},"part_b":null}, {"ndc":"00046110811","name":"PREMPRO 0.625-5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0046-1108-11","proprietary_name":"Prempro","nonproprietary_name":"conjugated estrogens and medroxyprogesterone acetate","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":".625 mg/1; 5 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0046-1108-11) / 28 TABLET, SUGAR COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Estrogens, Conjugated (USP) [CS]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":8.66646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prempro|Estrogen,Con/M-Progest Acet","basis":"brand"},"part_b":null}, {"ndc":"39328010610","name":"PRENATAL VITAMIN PLUS LOW IRON","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-106-10","proprietary_name":"Prenatal Plus Vitamins","nonproprietary_name":"prenatal with ferrous fumarate and folic acid","dosage_form":"TABLET","route":"ORAL","strength":"924 ug/1; 276 ug/1; 120 mg/1; 10 ug/1; 10 mg/1; 1.84 mg/1; 3 mg/1; 20 mg/1; 10 mg/1; 1667 ug/1; 12 ug/1; 200 mg/1; 27 mg/1; 25 mg/1; 2 mg/1","labeler":"Patrin Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (39328-106-10)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":0.11256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prenatal Vitamin Plus Low Iron|PNV,Calcium 72/Iron/Folic Acid","basis":"brand"},"part_b":null}, {"ndc":"75854031230","name":"PRENATE DHA SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"75854-312-30","proprietary_name":"PRENATE DHA","nonproprietary_name":"ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, folic acid, levomefolate calcium, pyridoxine hydrochloride, cyanocobalamin, calcium formate, ferrous asparto glycinate, magnesium oxide and doconexent","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"600 ug/1; 90 mg/1; 10 ug/1; 18 mg/1; 400 ug/1; 26 mg/1; 25 ug/1; 160 mg/1; 18 mg/1; 50 mg/1; 300 mg/1","labeler":"Avion Pharmaceuticals, LLC","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (75854-312-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Calculi Dissolution Agent [EPC]","Cations, Divalent [CS]","Folate Analog [EPC]","Folic Acid [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":12.82081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75854030930","name":"PRENATE ENHANCE SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75854-309-30","proprietary_name":"PRENATE Enhance","nonproprietary_name":"ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, folic acid, pyridoxine hydrochloride, cyanocobalamin, biotin, calcium carbonate, ferrous fumarate, magnesium oxide, lactic acid and doconexent","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"85 mg/1; 1000 [iU]/1; 10 [iU]/1; 1 mg/1; 25 mg/1; 12 ug/1; 500 ug/1; 155 mg/1; 28 mg/1; 150 mg/1; 50 mg/1; 400 mg/1","labeler":"Avion Pharmaceuticals, LLC","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (75854-309-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Calculi Dissolution Agent [EPC]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":3.87642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75854031530","name":"PRENATE MINI SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75854-315-30","proprietary_name":"Prenate Mini","nonproprietary_name":"ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, pyridoxine hydrochloride, folic acid, levomefolate calcium, cyanocobalamin, biotin, calcium carbonate, ferrous asparto glycinate, iron, potassium iodide, magnesium oxide, doconexent and lowbush blueberry","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"280 ug/1; 80 mg/1; 5 mg/1; 13 mg/1; 150 ug/1; 25 mg/1; 350 mg/1; 25 mg/1; 600 ug/1; 60 mg/1; 25 ug/1; 4.5 mg/1; 26 mg/1; 400 ug/1; 13 ug/1","labeler":"Avion Pharmaceuticals, LLC","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (75854-315-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Blood Coagulation Factor [EPC]","Calcium [CS]","Calculi Dissolution Agent [EPC]","Cations, Divalent [CS]","Folate Analog [EPC]","Folic Acid [CS]","Increased Coagulation Factor Activity [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":12.77287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prenate Mini|Prenatal Vit 87/Iron/Folic/DHA","basis":"brand"},"part_b":null}, {"ndc":"75854031630","name":"PRENATE PIXIE SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"75854-316-30","proprietary_name":"Prenate Pixie","nonproprietary_name":"ascorbic acid, biotin, cholecalciferol, cyanocobalamin, levomefolate calcium, folic acid, ferrous asparto glycinate, potassium iodide, pyridoxine hydrochloride, .alpha.-tocopherol acetate, dl-, Docosahexaenoic acid, and blueberry","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1; 75 ug/1; 12.5 ug/1; 13 ug/1; 400 ug/1; 10 mg/1; 150 ug/1; 5 mg/1; 4.5 mg/1; 5 mg/1; 200 mg/1; 600 ug/1","labeler":"Avion Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (75854-316-30)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Folate Analog [EPC]","Folic Acid [CS]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":12.98191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764054311","name":"PREVACID DR 15 MG SOLUTAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-543-11","proprietary_name":"Prevacid SoluTab","nonproprietary_name":"lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (64764-543-11) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (64764-543-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":13.24954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764054330","name":"PREVACID DR 15 MG SOLUTAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":13.24954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.92192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764004613","name":"PREVACID DR 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-046-13","proprietary_name":"Prevacid","nonproprietary_name":"lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (64764-046-13)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":13.2194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1061,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764054411","name":"PREVACID DR 30 MG SOLUTAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-544-11","proprietary_name":"Prevacid SoluTab","nonproprietary_name":"lansoprazole","dosage_form":"TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (64764-544-11) / 10 TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE in 1 BLISTER PACK (64764-544-30)","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":13.21469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64764054430","name":"PREVACID DR 30 MG SOLUTAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":13.21469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.25583,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245003642","name":"PREVALITE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0036-42","proprietary_name":"Prevalite","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.5g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"42 PACKET in 1 CARTON (0245-0036-42) / 5.5 g in 1 PACKET (0245-0036-89)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245003660","name":"PREVALITE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0036-60","proprietary_name":"Prevalite","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.5g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 PACKET in 1 CARTON (0245-0036-60) / 5.5 g in 1 PACKET (0245-0036-89)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245003689","name":"PREVALITE PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83267,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245003623","name":"PREVALITE POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0036-23","proprietary_name":"Prevalite","nonproprietary_name":"cholestyramine","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4 g/5.5g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"231 g in 1 CAN (0245-0036-23)","pharm_classes":["Bile Acid Sequestrant [EPC]","Bile-acid Binding Activity [MoA]"]},"nadac":{"value":0.16976,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"59676057530","name":"PREZCOBIX 800 MG-150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-575-30","proprietary_name":"PREZCOBIX","nonproprietary_name":"DARUNAVIR ETHANOLATE and COBICISTAT","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1; 150 mg/1","labeler":"Janssen Products, LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59676-575-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":79.99382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prezcobix|Darunavir/Cobicistat","basis":"brand"},"part_b":null}, {"ndc":"59676056201","name":"PREZISTA 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-562-01","proprietary_name":"PREZISTA","nonproprietary_name":"darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Janssen Products LP","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59676-562-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":34.89014,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.16284,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prezista|Darunavir","basis":"brand"},"part_b":null}, {"ndc":"59676056630","name":"PREZISTA 800 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-566-30","proprietary_name":"PREZISTA","nonproprietary_name":"darunavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Janssen Products LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (59676-566-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":70.10727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.38195,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prezista|Darunavir","basis":"brand"},"part_b":null}, {"ndc":"00088210201","name":"PRIFTIN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.82801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Priftin|Rifapentine","basis":"brand"},"part_b":null}, {"ndc":"00088210224","name":"PRIFTIN 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0088-2102-24","proprietary_name":"Priftin","nonproprietary_name":"rifapentine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"sanofi-aventis U.S. LLC","package_description":"3 BLISTER PACK in 1 CARTON (0088-2102-24) / 8 TABLET, FILM COATED in 1 BLISTER PACK (0088-2102-01)","pharm_classes":["Rifamycin Antimycobacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":4.82801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Priftin|Rifapentine","basis":"brand"},"part_b":null}, {"ndc":"70515061001","name":"PRILOSEC DR 10 MG SUSPENSION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-610-01","proprietary_name":"Prilosec","nonproprietary_name":"omeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Covis Pharma US, Inc","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (70515-610-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":14.76352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70515062501","name":"PRILOSEC DR 2.5 MG SUSPENSION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-625-01","proprietary_name":"Prilosec","nonproprietary_name":"omeprazole magnesium","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"2.5 mg/1","labeler":"Covis Pharma US, Inc","package_description":"30 GRANULE, DELAYED RELEASE in 1 CARTON (70515-625-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":14.748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52817011710","name":"PRIMIDONE 125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-117-10","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"125 mg/1","labeler":"TruPharma LLC.","package_description":"100 TABLET in 1 BOTTLE (52817-117-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.37851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"00527123101","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1231-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-1231-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"00591532101","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5321-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5321-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"50268068711","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"50268068715","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-687-15","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-687-15) / 1 TABLET in 1 BLISTER PACK (50268-687-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"53746054501","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-545-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-545-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"68084020301","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-203-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-203-01) / 1 TABLET in 1 BLISTER PACK (68084-203-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"68084020311","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"69584068510","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-685-10","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69584-685-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"69584068550","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-685-50","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-685-50)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72603061001","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-610-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-610-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72888004601","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-046-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-046-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72888004605","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-046-05","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-046-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"80005011811","name":"PRIMIDONE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-118-11","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Carnegie Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (80005-118-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22758,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"00527130101","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1301-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-1301-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"00527130105","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1301-05","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lannett Company, Inc.","package_description":"500 TABLET in 1 BOTTLE (0527-1301-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"50268068611","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"50268068615","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-686-15","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-686-15) / 1 TABLET in 1 BLISTER PACK (50268-686-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"53746054401","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-544-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-544-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"53746054405","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-544-05","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-544-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"62135046890","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-468-90","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-468-90)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"68084020201","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-202-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-202-01) / 1 TABLET in 1 BLISTER PACK (68084-202-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"68084020211","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"69584068410","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-684-10","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69584-684-10)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"69584068450","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-684-50","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (69584-684-50)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72603060901","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-609-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-609-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72603060902","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-609-02","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-609-02)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72888004501","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-045-01","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (72888-045-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"72888004505","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-045-05","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (72888-045-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"80005011711","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-117-11","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Carnegie Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (80005-117-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"80005011714","name":"PRIMIDONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80005-117-14","proprietary_name":"Primidone","nonproprietary_name":"Primidone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Carnegie Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (80005-117-14)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.09137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Primidone|Primidone","basis":"generic"},"part_b":null}, {"ndc":"00008122201","name":"PRISTIQ ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1222-01","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1222-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.93397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008122214","name":"PRISTIQ ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1222-14","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"14 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1222-14)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.93397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008122230","name":"PRISTIQ ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1222-30","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1222-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.93397,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.4136,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008121030","name":"PRISTIQ ER 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1210-30","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1210-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.39851,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008121101","name":"PRISTIQ ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1211-01","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1211-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.96336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008121114","name":"PRISTIQ ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1211-14","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"14 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1211-14)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.96336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008121130","name":"PRISTIQ ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-1211-30","proprietary_name":"Pristiq Extended-Release","nonproprietary_name":"desvenlafaxine succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0008-1211-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":13.96336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.39649,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59310058020","name":"PROAIR RESPICLICK 90 MCG INHLR","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59310-580-20","proprietary_name":"ProAir RespiClick","nonproprietary_name":"Albuterol Sulfate","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"Teva Respiratory, LLC","package_description":"1 INHALER in 1 BOX (59310-580-20) / 200 POWDER, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":67.17954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Proair Respiclick|Albuterol Sulfate","basis":"brand"},"part_b":null}, {"ndc":"00527136701","name":"PROBENECID 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1367-01","proprietary_name":"Probenecid","nonproprietary_name":"Probenecid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0527-1367-01)"},"nadac":{"value":0.63614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid|Probenecid","basis":"generic"},"part_b":null}, {"ndc":"00527136710","name":"PROBENECID 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1367-10","proprietary_name":"Probenecid","nonproprietary_name":"Probenecid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Lannett Company, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0527-1367-10)"},"nadac":{"value":0.63614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid|Probenecid","basis":"generic"},"part_b":null}, {"ndc":"00591534701","name":"PROBENECID 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5347-01","proprietary_name":"Probenecid","nonproprietary_name":"Probenecid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-5347-01)"},"nadac":{"value":0.63614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid|Probenecid","basis":"generic"},"part_b":null}, {"ndc":"00591534710","name":"PROBENECID 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5347-10","proprietary_name":"Probenecid","nonproprietary_name":"Probenecid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-5347-10)"},"nadac":{"value":0.63614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid|Probenecid","basis":"generic"},"part_b":null}, {"ndc":"16571083101","name":"PROBENECID 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-831-01","proprietary_name":"Probenecid","nonproprietary_name":"Probenecid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 CONTAINER (16571-831-01)"},"nadac":{"value":0.63614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid|Probenecid","basis":"generic"},"part_b":null}, {"ndc":"16571083110","name":"PROBENECID 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-831-10","proprietary_name":"Probenecid","nonproprietary_name":"Probenecid","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 CONTAINER (16571-831-10)"},"nadac":{"value":0.63614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid|Probenecid","basis":"generic"},"part_b":null}, {"ndc":"00591532501","name":"PROBENECID-COLCHICINE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5325-01","proprietary_name":"Probenecid and Colchicine","nonproprietary_name":"Probenecid and Colchicine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; .5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5325-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid-Colchicine|Probenecid/Colchicine","basis":"generic"},"part_b":null}, {"ndc":"16571083201","name":"PROBENECID-COLCHICINE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-832-01","proprietary_name":"Probenecid and Colchicine","nonproprietary_name":"Probenecid and Colchicine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; .5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 CONTAINER (16571-832-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid-Colchicine|Probenecid/Colchicine","basis":"generic"},"part_b":null}, {"ndc":"50742026301","name":"PROBENECID-COLCHICINE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-263-01","proprietary_name":"Probenecid and Colchicine","nonproprietary_name":"Probenecid and Colchicine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1; .5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (50742-263-01)","pharm_classes":["Alkaloid [EPC]","Alkaloids [CS]"]},"nadac":{"value":0.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Probenecid-Colchicine|Probenecid/Colchicine","basis":"generic"},"part_b":null}, {"ndc":"21724070105","name":"PROCENTRA 5 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21724-701-05","proprietary_name":"PROCENTRA","nonproprietary_name":"dextroamphetamine sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/5mL","labeler":"INDEPENDENCE PHARMACEUTICALS, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (21724-701-05)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.61938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.14342,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904738206","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7382-06","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7382-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241028701","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-287-01","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-287-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068511","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068515","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-685-15","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-685-15) / 1 TABLET in 1 BLISTER PACK (50268-685-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651077401","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-774-01","proprietary_name":"prochlorperazine maleate","nonproprietary_name":"prochlorperazine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-774-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746011506","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-115-06","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59746-115-06)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219203901","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2039-1","proprietary_name":"prochlorperazine maleate","nonproprietary_name":"prochlorperazine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60219-2039-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687082511","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687082565","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-825-65","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-825-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-825-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135067490","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-674-90","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-674-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462094701","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-947-01","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"PROCHLORPERAZINE MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-947-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315026601","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-266-01","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"PROCHLORPERAZINE MALEATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69315-266-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452031020","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-310-20","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-310-20)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452047220","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-472-20","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-472-20)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710166801","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1668-1","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1668-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954068910","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-689-10","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70954-689-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603016901","name":"PROCHLORPERAZINE 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-169-01","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-169-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.16215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713013506","name":"PROCHLORPERAZINE 25 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.86511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prochlorperazine|Prochlorperazine","basis":"generic"},"part_b":null}, {"ndc":"00713013510","name":"PROCHLORPERAZINE 25 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0135-10","proprietary_name":"Prochlorperazine","nonproprietary_name":"Prochlorperazine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"25 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1000 BLISTER PACK in 1 CARTON (0713-0135-10) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":4.86511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prochlorperazine|Prochlorperazine","basis":"generic"},"part_b":null}, {"ndc":"00713013512","name":"PROCHLORPERAZINE 25 MG SUPP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0135-12","proprietary_name":"Prochlorperazine","nonproprietary_name":"Prochlorperazine","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"25 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (0713-0135-12) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":4.86511,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prochlorperazine|Prochlorperazine","basis":"generic"},"part_b":null}, {"ndc":"00904738106","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7381-06","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7381-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241028601","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-286-01","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET in 1 BOTTLE (27241-286-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068411","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268068415","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-684-15","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-684-15) / 1 TABLET in 1 BLISTER PACK (50268-684-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651077301","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-773-01","proprietary_name":"prochlorperazine maleate","nonproprietary_name":"prochlorperazine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-773-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59746011306","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-113-06","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59746-113-06)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219203801","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2038-1","proprietary_name":"prochlorperazine maleate","nonproprietary_name":"prochlorperazine maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60219-2038-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687081411","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687081465","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-814-65","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-814-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-814-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135067390","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-673-90","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-673-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462088901","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-889-01","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"PROCHLORPERAZINE MALEATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"GLENMARK PHARMACEUTICALS INC., USA","package_description":"100 TABLET in 1 BOTTLE (68462-889-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69315026501","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-265-01","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"PROCHLORPERAZINE MALEATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69315-265-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452030920","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-309-20","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (69452-309-20)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452047120","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-471-20","proprietary_name":"PROCHLORPERAZINE MALEATE","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE (69452-471-20)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710166701","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1667-1","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1667-1)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954068810","name":"PROCHLORPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-688-10","proprietary_name":"Prochlorperazine Maleate","nonproprietary_name":"Prochlorperazine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70954-688-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.11478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59676031001","name":"PROCRIT 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-310-01","proprietary_name":"PROCRIT","nonproprietary_name":"Erythropoietin","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [iU]/mL","labeler":"Janssen Products, LP","package_description":"6 VIAL, SINGLE-DOSE in 1 CARTON (59676-310-01) / 1 mL in 1 VIAL, SINGLE-DOSE (59676-310-00)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":259.86093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59676032004","name":"PROCRIT 20,000 UNITS/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-320-04","proprietary_name":"PROCRIT","nonproprietary_name":"Erythropoietin","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"20000 [iU]/mL","labeler":"Janssen Products, LP","package_description":"4 VIAL, MULTI-DOSE in 1 CARTON (59676-320-04) / 1 mL in 1 VIAL, MULTI-DOSE (59676-320-00)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":521.47167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59676030401","name":"PROCRIT 4,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-304-01","proprietary_name":"PROCRIT","nonproprietary_name":"Erythropoietin","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"4000 [iU]/mL","labeler":"Janssen Products, LP","package_description":"6 VIAL, SINGLE-DOSE in 1 CARTON (59676-304-01) / 1 mL in 1 VIAL, SINGLE-DOSE (59676-304-00)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":104.28166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59676034001","name":"PROCRIT 40,000 UNITS/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-340-01","proprietary_name":"PROCRIT","nonproprietary_name":"Erythropoietin","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"40000 [iU]/mL","labeler":"Janssen Products, LP","package_description":"4 VIAL, SINGLE-DOSE in 1 CARTON (59676-340-01) / 1 mL in 1 VIAL, SINGLE-DOSE (59676-340-00)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":1038.69886,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315031228","name":"PROCTO-MED HC 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-312-28","proprietary_name":"Procto-Med HC","nonproprietary_name":"HYDROCORTISONE","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"Leading Pharma, LLC","package_description":"1 TUBE in 1 CARTON (69315-312-28) / 28 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Procto-Med HC|Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"00037682315","name":"PROCTOFOAM 1% FOAM","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-6823-15","proprietary_name":"PROCTOFOAM NS","nonproprietary_name":"pramoxine hydrochloride","dosage_form":"AEROSOL, FOAM","route":"RECTAL","strength":"150 mg/15g","labeler":"Viatris Specialty LLC","package_description":"1 CANISTER in 1 CARTON (0037-6823-15) / 15 g in 1 CANISTER"},"nadac":{"value":6.56145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00037682210","name":"PROCTOFOAM-HC 1%-1% FOAM","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-6822-10","proprietary_name":"PROCTOFOAM HC","nonproprietary_name":"pramoxine hydrochloride hydrocortisone acetate","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"100 mg/10g; 100 mg/10g","labeler":"Viatris Specialty LLC","package_description":"1 CANISTER in 1 CARTON (0037-6822-10) / 10 g in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":19.38171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Proctofoam-HC|Hydrocortisone/Pramoxine","basis":"brand"},"part_b":null}, {"ndc":"10631040701","name":"PROCTOSOL-HC 2.5% CREAM","unit":"GM","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10631-407-01","proprietary_name":"Proctosol-HC","nonproprietary_name":"Hydrocortisone","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (10631-407-01) / 28.35 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.69837,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.23502,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Proctosol-HC|Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"57237033703","name":"PROCTOZONE-B 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-337-03","proprietary_name":"Proctozone-B","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (57237-337-03) / 5 SUPPOSITORY in 1 BLISTER PACK (57237-337-51)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033704","name":"PROCTOZONE-B 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033721","name":"PROCTOZONE-B 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-337-21","proprietary_name":"Proctozone-B","nonproprietary_name":"Bisacodyl","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-337-21) / 4 SUPPOSITORY in 1 BLISTER PACK (57237-337-04)","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033751","name":"PROCTOZONE-B 10 MG SUPPOSITORY","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033916","name":"PROCTOZONE-GMAX 2 GM SUPPOSIT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.21712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033921","name":"PROCTOZONE-GMAX 2 GM SUPPOSIT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57237-339-21","proprietary_name":"Proctozone GMax","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (57237-339-21) / 6 SUPPOSITORY in 1 BLISTER PACK (57237-339-16)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.21712,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033952","name":"PROCTOZONE-GMAX 2 GM SUPPOSIT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-339-52","proprietary_name":"Proctozone GMax","nonproprietary_name":"Glycerin","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"2 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (57237-339-52) / 5 SUPPOSITORY in 1 BLISTER PACK (57237-339-51)","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.10312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980032430","name":"PROCTOZONE-HC 2.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-324-30","proprietary_name":"PROCTOZONE-HC","nonproprietary_name":"hydrocortisone 2.5%","dosage_form":"CREAM","route":"TOPICAL","strength":"25 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 TUBE in 1 CARTON (64980-324-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Proctozone-HC|Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"00054082925","name":"PROGESTERONE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0829-25","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"100 CAPSULE in 1 BOTTLE (0054-0829-25)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714015701","name":"PROGESTERONE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-157-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-157-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651015201","name":"PROGESTERONE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-152-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-152-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162080710","name":"PROGESTERONE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-807-10","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (65162-807-10)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452023320","name":"PROGESTERONE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-233-20","proprietary_name":"PROGESTERONE","nonproprietary_name":"PROGESTERONE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-233-20)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700016201","name":"PROGESTERONE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-162-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Xiromed, LLC","package_description":"100 CAPSULE in 1 BOTTLE (70700-162-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462017533","name":"PROGESTERONE 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-175-33","proprietary_name":"PROGESTERONE VAGINAL INSERTS","nonproprietary_name":"progesterone","dosage_form":"INSERT","route":"VAGINAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"21 BLISTER PACK in 1 CARTON (68462-175-33) / 1 INSERT in 1 BLISTER PACK (68462-175-40)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462017540","name":"PROGESTERONE 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70095013601","name":"PROGESTERONE 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70095013602","name":"PROGESTERONE 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70095013603","name":"PROGESTERONE 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70095-136-03","proprietary_name":"PROGESTERONE","nonproprietary_name":"Progesterone","dosage_form":"INSERT","route":"VAGINAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 CARTON in 1 CARTON (70095-136-03) / 21 BLISTER PACK in 1 CARTON (70095-136-02) / 1 INSERT in 1 BLISTER PACK (70095-136-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700020170","name":"PROGESTERONE 100 MG VAG INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-201-70","proprietary_name":"Progesterone vaginal insert","nonproprietary_name":"Progesterone","dosage_form":"INSERT","route":"VAGINAL","strength":"100 mg/1","labeler":"XIROMED, LLC","package_description":"1 CARTON in 1 CARTON (70700-201-70) / 21 BLISTER PACK in 1 CARTON (70700-201-69) / 1 INSERT in 1 BLISTER PACK (70700-201-68)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":10.87559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054083025","name":"PROGESTERONE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0830-25","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"100 CAPSULE in 1 BOTTLE (0054-0830-25)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714015801","name":"PROGESTERONE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-158-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Northstar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-158-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651015301","name":"PROGESTERONE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-153-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-153-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162080810","name":"PROGESTERONE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-808-10","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (65162-808-10)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452023420","name":"PROGESTERONE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-234-20","proprietary_name":"PROGESTERONE","nonproprietary_name":"PROGESTERONE","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-234-20)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700016301","name":"PROGESTERONE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-163-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Xiromed, LLC","package_description":"100 CAPSULE in 1 BOTTLE (70700-163-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00143972501","name":"PROGESTERONE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9725-01","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 INJECTION in 1 BOX (0143-9725-01)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":1.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2675","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2675 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"00591312879","name":"PROGESTERONE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2675","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2675 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"55150030610","name":"PROGESTERONE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-306-10","proprietary_name":"Progesterone","nonproprietary_name":"Progesterone","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Eugia US LLC","package_description":"10 mL in 1 VIAL, MULTI-DOSE (55150-306-10)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":1.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2675","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2675 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 mL in 1 VIAL, MULTI-DOSE (55150-306-10)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323026110","name":"PROGESTERONE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-261-10","proprietary_name":"Progesterone","nonproprietary_name":"PROGESTERONE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (63323-261-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":1.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2675","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2675 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (63323-261-10) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700028622","name":"PROGESTERONE 500 MG/10 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-286-22","proprietary_name":"PROGESTERONE","nonproprietary_name":"PROGESTERONE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"XIROMED, LLC","package_description":"10 mL in 1 VIAL, MULTI-DOSE (70700-286-22)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":1.36055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2675","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2675 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 mL in 1 VIAL, MULTI-DOSE (70700-286-22)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00575620030","name":"PROGLYCEM 50 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0575-6200-30","proprietary_name":"Proglycem","nonproprietary_name":"diazoxide","dosage_form":"SUSPENSION","route":"ORAL","strength":"50 mg/mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 BOTTLE, DROPPER in 1 BOX (0575-6200-30) / 30 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":16.4826,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":7.3764,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Proglycem|Diazoxide","basis":"brand"},"part_b":null}, {"ndc":"00469123050","name":"PROGRAF 0.2 MG GRANULE PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-1230-50","proprietary_name":"Prograf","nonproprietary_name":"Tacrolimus","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":".2 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"50 PACKET in 1 CARTON (0469-1230-50) / 1 GRANULE, FOR SUSPENSION in 1 PACKET","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":5.01513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prograf*|Tacrolimus","basis":"brand"},"part_b":{"hcpcs":"J7521","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7521 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (2 per item) x PKG QTY (2), but FDA's strength .2 mg/1 x 50 EA per NDC / 0.1 MG = 100 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 PACKET in 1 CARTON (0469-1230-50) / 1 GRANULE, FOR SUSPENSION in 1 PACKET) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00469060773","name":"PROGRAF 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-0607-73","proprietary_name":"Prograf","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":".5 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-0607-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":3.65915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prograf*|Tacrolimus","basis":"brand"},"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (100 per item) x PKG QTY (100), but FDA's strength .5 mg/1 x 100 EA per NDC / 1 MG = 50 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (0469-0607-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00469061773","name":"PROGRAF 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-0617-73","proprietary_name":"Prograf","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"1 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-0617-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":7.32732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prograf*|Tacrolimus","basis":"brand"},"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (0469-0617-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00469133050","name":"PROGRAF 1 MG GRANULE PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-1330-50","proprietary_name":"Prograf","nonproprietary_name":"Tacrolimus","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"1 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"50 PACKET in 1 CARTON (0469-1330-50) / 1 GRANULE, FOR SUSPENSION in 1 PACKET","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":7.4446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prograf*|Tacrolimus","basis":"brand"},"part_b":{"hcpcs":"J7521","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7521 (0.1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Does not equal BILLUNITS (10 per item) x PKG QTY (10), but FDA's strength 1 mg/1 x 50 EA per NDC / 0.1 MG = 500 = BILLUNITSPKG, so BILLUNITSPKG is used and BILLUNITS is not.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (50 PACKET in 1 CARTON (0469-1330-50) / 1 GRANULE, FOR SUSPENSION in 1 PACKET) gives 50 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA. The crosswalk's two billable-unit columns disagree; FDA's strength settles it (see bill_units_per_package).","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"24208060203","name":"PROLENSA 0.07% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-602-03","proprietary_name":"Prolensa","nonproprietary_name":"Bromfenac Sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".7 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-602-03) / 3 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":115.55435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":13.24968,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prolensa|Bromfenac Sodium","basis":"brand"},"part_b":null}, {"ndc":"55513071001","name":"PROLIA 60 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-710-01","proprietary_name":"Prolia","nonproprietary_name":"denosumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/mL","labeler":"Amgen, Inc","package_description":"1 SYRINGE in 1 CARTON (55513-710-01) / 1 mL in 1 SYRINGE","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":1862.74398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prolia|Denosumab","basis":"brand"},"part_b":{"hcpcs":"J0897","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0897 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (55513-710-01) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55513071021","name":"PROLIA 60 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55513-710-21","proprietary_name":"Prolia","nonproprietary_name":"denosumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/mL","labeler":"Amgen, Inc","package_description":"1 SYRINGE in 1 CARTON (55513-710-21) / 1 mL in 1 SYRINGE","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":1862.74398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Prolia|Denosumab","basis":"brand"},"part_b":{"hcpcs":"J0897","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0897 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (55513-710-21) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"31722004031","name":"PROMETHAZINE 12.5 MG SUPPOS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-040-31","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (31722-040-31) / 6 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.85416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802075800","name":"PROMETHAZINE 12.5 MG SUPPOS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.85416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802075830","name":"PROMETHAZINE 12.5 MG SUPPOS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-758-30","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"12.5 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"12 BLISTER PACK in 1 CARTON (45802-758-30) / 1 SUPPOSITORY in 1 BLISTER PACK (45802-758-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.85416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746074501","name":"PROMETHAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-745-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-745-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.05434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687066001","name":"PROMETHAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-660-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-660-01) / 1 TABLET in 1 BLISTER PACK (60687-660-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.05434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687066011","name":"PROMETHAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162074510","name":"PROMETHAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-745-10","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-745-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.05434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001016100","name":"PROMETHAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-161-00","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-161-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.05434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382004001","name":"PROMETHAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-040-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-040-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.05434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722004131","name":"PROMETHAZINE 25 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-041-31","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (31722-041-31) / 6 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":2.03477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802075900","name":"PROMETHAZINE 25 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.03477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802075930","name":"PROMETHAZINE 25 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-759-30","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"25 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"12 BLISTER PACK in 1 CARTON (45802-759-30) / 1 SUPPOSITORY in 1 BLISTER PACK (45802-759-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":2.03477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591530701","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5307-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5307-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591530710","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5307-10","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-5307-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904730461","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7304-61","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7304-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000301","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-003-01","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"promethazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-003-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000310","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-003-10","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"promethazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"KVK-Tech, Inc.","package_description":"1000 TABLET in 1 BOTTLE (10702-003-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000350","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-003-50","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"promethazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"KVK-Tech, Inc.","package_description":"500 TABLET in 1 BOTTLE (10702-003-50)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746052101","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-521-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-521-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746052110","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-521-10","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 TABLET in 1 BOTTLE (53746-521-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162052110","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-521-10","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-521-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162052111","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-521-11","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-521-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001016200","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-162-00","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-162-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001016203","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-162-03","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-162-03)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084015501","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-155-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-155-01) / 1 TABLET in 1 BLISTER PACK (68084-155-11)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084015511","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382004101","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-041-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-041-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382004105","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-041-05","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-041-05)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382004110","name":"PROMETHAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-041-10","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-041-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641094835","name":"PROMETHAZINE 25 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0948-35","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 AMPULE in 1 CARTON (0641-0948-35) / 1 mL in 1 AMPULE (0641-0948-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.33454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 AMPULE in 1 CARTON (0641-0948-35) / 1 mL in 1 AMPULE (0641-0948-31)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641149535","name":"PROMETHAZINE 25 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-1495-35","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 AMPULE in 1 CARTON (0641-1495-35) / 1 mL in 1 AMPULE (0641-1495-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.33454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 AMPULE in 1 CARTON (0641-1495-35) / 1 mL in 1 AMPULE (0641-1495-31)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"39822552503","name":"PROMETHAZINE 25 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39822-5525-3","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"PROMETHAZINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"XGen Pharmaceuticals DJB, Inc.","package_description":"25 AMPULE in 1 CARTON (39822-5525-3) / 1 mL in 1 AMPULE (39822-5525-2)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.33454,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 AMPULE in 1 CARTON (39822-5525-3) / 1 mL in 1 AMPULE (39822-5525-2)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641092825","name":"PROMETHAZINE 25 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0928-25","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 PACKAGE (0641-0928-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-0928-21)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.74825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 PACKAGE (0641-0928-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0641-0928-21)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641095525","name":"PROMETHAZINE 25 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-0955-25","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-0955-25) / 1 mL in 1 VIAL (0641-0955-21)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.74825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-0955-25) / 1 mL in 1 VIAL (0641-0955-21)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641620825","name":"PROMETHAZINE 25 MG/ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6208-25","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"25 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6208-25) / 1 mL in 1 VIAL (0641-6208-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.74825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":13,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). BILLUNITS (0.5 per item) x PKG QTY is 12.5; CMS prints the whole number 13.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6208-25) / 1 mL in 1 VIAL (0641-6208-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00591531901","name":"PROMETHAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5319-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5319-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10702000401","name":"PROMETHAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-004-01","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"promethazine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 TABLET in 1 BOTTLE (10702-004-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746052201","name":"PROMETHAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-522-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-522-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162052210","name":"PROMETHAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-522-10","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-522-10)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001016300","name":"PROMETHAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-163-00","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-163-00)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382004201","name":"PROMETHAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-042-01","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-042-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.08196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00641094935","name":"PROMETHAZINE 50 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-0949-35","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 AMPULE in 1 CARTON (0641-0949-35) / 1 mL in 1 AMPULE (0641-0949-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":2.33887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 AMPULE in 1 CARTON (0641-0949-35) / 1 mL in 1 AMPULE (0641-0949-31)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00641149635","name":"PROMETHAZINE 50 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0641-1496-35","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"50 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 AMPULE in 1 PACKAGE (0641-1496-35) / 1 mL in 1 AMPULE (0641-1496-31)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":2.33887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 AMPULE in 1 PACKAGE (0641-1496-35) / 1 mL in 1 AMPULE (0641-1496-31)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"39822555006","name":"PROMETHAZINE 50 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"39822-5550-6","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"PROMETHAZINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"50 mg/mL","labeler":"XGen Pharmaceuticals DJB, Inc.","package_description":"25 AMPULE in 1 CARTON (39822-5550-6) / 1 mL in 1 AMPULE (39822-5550-5)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":2.33887,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2550","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2550 (50 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 AMPULE in 1 CARTON (39822-5550-6) / 1 mL in 1 AMPULE (39822-5550-5)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00121185416","name":"PROMETHAZINE 6.25 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1854-16","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-1854-16)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135077447","name":"PROMETHAZINE 6.25 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-774-47","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"PROMETHAZINE HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-774-47)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752013812","name":"PROMETHAZINE 6.25 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-138-12","proprietary_name":"Promethazine Hydrochloride","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70752-138-12)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00116402316","name":"PROMETHAZINE 6.25 MG/5 ML SYRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4023-16","proprietary_name":"PROMETHAZINE HYDROCHLORIDE","nonproprietary_name":"promethazine hydrochloride","dosage_form":"SYRUP","route":"ORAL","strength":"6.25 mg/5mL","labeler":"Xttrium Laboratories, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (0116-4023-16)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27808005102","name":"PROMETHAZINE 6.25 MG/5 ML SYRP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-051-02","proprietary_name":"promethazine hydrochloride","nonproprietary_name":"promethazine hydrochloride","dosage_form":"SYRUP","route":"ORAL","strength":"6.25 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (27808-051-02)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.04198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713082375","name":"PROMETHAZINE-CODEINE SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0823-75","proprietary_name":"Promethazine Hydrochloride and Codeine Phosphate","nonproprietary_name":"Promethazine Hydrochloride and Codeine Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 10 mg/5mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (0713-0823-75)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]","Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.06967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-Codeine|Promethazine HCl/Codeine","basis":"generic"},"part_b":null}, {"ndc":"27808006502","name":"PROMETHAZINE-CODEINE SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-065-02","proprietary_name":"Promethazine Hydrochloride and Codeine Phosphate","nonproprietary_name":"Promethazine Hydrochloride and Codeine Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 10 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (27808-065-02)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]","Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.06967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-Codeine|Promethazine HCl/Codeine","basis":"generic"},"part_b":null}, {"ndc":"70752013912","name":"PROMETHAZINE-CODEINE SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-139-12","proprietary_name":"Promethazine Hydrochloride and Codeine Phosphate","nonproprietary_name":"Promethazine Hydrochloride and Codeine Phosphate","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 10 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (70752-139-12)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]","Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.06967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-Codeine|Promethazine HCl/Codeine","basis":"generic"},"part_b":null}, {"ndc":"00121107016","name":"PROMETHAZINE-DM 6.25-15 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1070-16","proprietary_name":"Promethazine DM","nonproprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"15 mg/5mL; 6.25 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-1070-16)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.03904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-DM|Promethazine/Dextromethorphan","basis":"generic"},"part_b":null}, {"ndc":"00713078075","name":"PROMETHAZINE-DM 6.25-15 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0780-75","proprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 15 mg/5mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (0713-0780-75)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.03904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-DM|Promethazine/Dextromethorphan","basis":"generic"},"part_b":null}, {"ndc":"27808005701","name":"PROMETHAZINE-DM 6.25-15 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-057-01","proprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 15 mg/5mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE, PLASTIC (27808-057-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.03904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-DM|Promethazine/Dextromethorphan","basis":"generic"},"part_b":null}, {"ndc":"62559075816","name":"PROMETHAZINE-DM 6.25-15 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-758-16","proprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 15 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (62559-758-16)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.03904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-DM|Promethazine/Dextromethorphan","basis":"generic"},"part_b":null}, {"ndc":"65162068090","name":"PROMETHAZINE-DM 6.25-15 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-680-90","proprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SOLUTION","route":"ORAL","strength":"6.25 mg/5mL; 15 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE (65162-680-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.03904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-DM|Promethazine/Dextromethorphan","basis":"generic"},"part_b":null}, {"ndc":"00116402416","name":"PROMETHAZINE-DM 6.25-15 MG/5 ML SYRUP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0116-4024-16","proprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","nonproprietary_name":"Promethazine Hydrochloride and Dextromethorphan Hydrobromide","dosage_form":"SYRUP","route":"ORAL","strength":"6.25 mg/5mL; 15 mg/5mL","labeler":"Xttrium Laboratories, Inc","package_description":"473 mL in 1 BOTTLE, PLASTIC (0116-4024-16)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.03904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Promethazine-DM|Promethazine/Dextromethorphan","basis":"generic"},"part_b":null}, {"ndc":"00713053612","name":"PROMETHEGAN 12.5 MG SUPPOS","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0536-12","proprietary_name":"PROMETHEGAN","nonproprietary_name":"promethazine hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"12.5 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"12 SUPPOSITORY in 1 BOX (0713-0536-12)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.85416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Promethegan|Promethazine HCl","basis":"brand"},"part_b":null}, {"ndc":"00713052606","name":"PROMETHEGAN 25 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.03477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Promethegan|Promethazine HCl","basis":"brand"},"part_b":null}, {"ndc":"00713052612","name":"PROMETHEGAN 25 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0526-12","proprietary_name":"PROMETHEGAN","nonproprietary_name":"Promethazine Hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"25 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"12 SUPPOSITORY in 1 BOX (0713-0526-12)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":2.03477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Promethegan|Promethazine HCl","basis":"brand"},"part_b":null}, {"ndc":"00713013212","name":"PROMETHEGAN 50 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0132-12","proprietary_name":"PROMETHEGAN","nonproprietary_name":"promethazine hydrochloride","dosage_form":"SUPPOSITORY","route":"RECTAL","strength":"50 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"12 SUPPOSITORY in 1 BOX (0713-0132-12)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":26.69133,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Promethegan|Promethazine HCl","basis":"brand"},"part_b":null}, {"ndc":"72989037230","name":"PROMETRIUM 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72989-372-30","proprietary_name":"Prometrium","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Acertis Pharmaceuticals, LLC","package_description":"30 CAPSULE in 1 BOTTLE (72989-372-30)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":15.90949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22903,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prometrium|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"72989037330","name":"PROMETRIUM 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72989-373-30","proprietary_name":"Prometrium","nonproprietary_name":"Progesterone","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Acertis Pharmaceuticals, LLC","package_description":"30 CAPSULE in 1 BOTTLE (72989-373-30)","pharm_classes":["Progesterone [CS]","Progesterone [EPC]"]},"nadac":{"value":30.39475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.40405,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Prometrium|Progesterone, Micronized","basis":"brand"},"part_b":null}, {"ndc":"59651025601","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-256-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-256-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687070901","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-709-01","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-709-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-709-11)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687070911","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687093001","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-930-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-930-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-930-11)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687093011","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"62559023001","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-230-01","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (62559-230-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380016501","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-165-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Strides Pharma Science Limited","package_description":"300 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-165-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380016502","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-165-02","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-165-02)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380026901","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-269-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Strides Pharma Science Limited","package_description":"300 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-269-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380026902","name":"PROPAFENONE HCL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-269-02","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-269-02)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.11485,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651025701","name":"PROPAFENONE HCL 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-257-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"225 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-257-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"62559023101","name":"PROPAFENONE HCL 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-231-01","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"225 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (62559-231-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380016401","name":"PROPAFENONE HCL 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-164-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"225 mg/1","labeler":"Strides Pharma Science Limited","package_description":"300 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-164-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380016402","name":"PROPAFENONE HCL 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-164-02","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"225 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-164-02)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380026801","name":"PROPAFENONE HCL 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-268-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"225 mg/1","labeler":"Strides Pharma Science Limited","package_description":"300 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-268-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380026802","name":"PROPAFENONE HCL 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-268-02","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"225 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-268-02)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.20657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651025801","name":"PROPAFENONE HCL 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-258-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-258-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"62559023201","name":"PROPAFENONE HCL 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-232-01","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET, COATED in 1 BOTTLE (62559-232-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380016301","name":"PROPAFENONE HCL 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-163-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-163-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380024601","name":"PROPAFENONE HCL 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-246-01","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-246-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.38802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"00591228560","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"00832074060","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0740-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0832-0740-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"16571073606","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-736-06","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16571-736-06)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714082501","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-825-01","proprietary_name":"propafenone hydrochloride","nonproprietary_name":"propafenone hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Northstar Rx LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-825-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027660","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-276-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-276-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018401","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018402","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018404","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"68462040860","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-408-60","proprietary_name":"propafenone hydrochloride","nonproprietary_name":"propafenone hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-408-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"69680013060","name":"PROPAFENONE HCL ER 225 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-130-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"propafenone","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Vitruvias Therapeutics","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69680-130-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.29932,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"00591228660","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"00832074160","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0741-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0832-0741-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"16571073706","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-737-06","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16571-737-06)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714082601","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-826-01","proprietary_name":"propafenone hydrochloride","nonproprietary_name":"propafenone hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Northstar Rx LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-826-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027760","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-277-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-277-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018501","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018502","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018504","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"68462040960","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-409-60","proprietary_name":"propafenone hydrochloride","nonproprietary_name":"propafenone hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-409-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"69680013160","name":"PROPAFENONE HCL ER 325 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-131-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"propafenone","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Vitruvias Therapeutics","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (69680-131-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"00591228760","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"00832074260","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0742-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"425 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0832-0742-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"16571073806","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-738-06","proprietary_name":"PROPAFENONE HYDROCHLORIDE","nonproprietary_name":"PROPAFENONE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"425 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16571-738-06)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714082701","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-827-01","proprietary_name":"propafenone hydrochloride","nonproprietary_name":"propafenone hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"425 mg/1","labeler":"Northstar Rx LLC","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (16714-827-01)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"59651027860","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-278-60","proprietary_name":"Propafenone Hydrochloride","nonproprietary_name":"Propafenone Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"425 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (59651-278-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"64380018601","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"68462041060","name":"PROPAFENONE HCL ER 425 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-410-60","proprietary_name":"propafenone hydrochloride","nonproprietary_name":"propafenone hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"425 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-410-60)","pharm_classes":["Antiarrhythmic [EPC]"]},"nadac":{"value":0.57777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propafenone HCl ER|Propafenone HCl","basis":"generic"},"part_b":null}, {"ndc":"24208073006","name":"PROPARACAINE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-730-06","proprietary_name":"Proparacaine Hydrochloride","nonproprietary_name":"Proparacaine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-730-06) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Local Anesthesia [PE]","Local Anesthetic [EPC]"]},"nadac":{"value":1.46978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Proparacaine HCl|Proparacaine HCl","basis":"generic"},"part_b":null}, {"ndc":"42571049757","name":"PROPARACAINE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-497-57","proprietary_name":"Proparacaine hydrochloride","nonproprietary_name":"Proparacaine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Micro Labs Limited","package_description":"1 BOTTLE in 1 CARTON (42571-497-57) / 15 mL in 1 BOTTLE","pharm_classes":["Local Anesthesia [PE]","Local Anesthetic [EPC]"]},"nadac":{"value":1.46978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Proparacaine HCl|Proparacaine HCl","basis":"generic"},"part_b":null}, {"ndc":"61314001601","name":"PROPARACAINE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-016-01","proprietary_name":"Proparacaine Hydrochloride","nonproprietary_name":"Proparacaine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc.","package_description":"1 BOTTLE in 1 CARTON (61314-016-01) / 15 mL in 1 BOTTLE","pharm_classes":["Local Anesthesia [PE]","Local Anesthetic [EPC]"]},"nadac":{"value":1.46978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Proparacaine HCl|Proparacaine HCl","basis":"generic"},"part_b":null}, {"ndc":"70069060101","name":"PROPARACAINE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-601-01","proprietary_name":"Proparacaine Hydrochloride","nonproprietary_name":"Proparacaine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-601-01) / 15 mL in 1 BOTTLE","pharm_classes":["Local Anesthesia [PE]","Local Anesthetic [EPC]"]},"nadac":{"value":1.46978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Proparacaine HCl|Proparacaine HCl","basis":"generic"},"part_b":null}, {"ndc":"70756019335","name":"PROPARACAINE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-193-35","proprietary_name":"Proparacaine hydrochloride","nonproprietary_name":"Proparacaine hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-193-35) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Local Anesthesia [PE]","Local Anesthetic [EPC]"]},"nadac":{"value":1.46978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Proparacaine HCl|Proparacaine HCl","basis":"generic"},"part_b":null}, {"ndc":"78206015201","name":"PROPECIA 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-152-01","proprietary_name":"PROPECIA","nonproprietary_name":"finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-152-01)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":3.9692,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"78206015202","name":"PROPECIA 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-152-02","proprietary_name":"PROPECIA","nonproprietary_name":"finasteride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-152-02)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":3.58415,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04359,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409151198","name":"PROPOFOL 200 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-1511-98","proprietary_name":"PROPOFOL","nonproprietary_name":"PROPOFOL","dosage_form":"INJECTION, EMULSION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-1511-98) / 20 mL in 1 VIAL, SINGLE-DOSE (0409-1511-97)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.17094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409601025","name":"PROPOFOL 200 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-6010-25","proprietary_name":"PROPOFOL","nonproprietary_name":"PROPOFOL","dosage_form":"INJECTION, EMULSION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL in 1 TRAY (0409-6010-25) / 20 mL in 1 VIAL (0409-6010-02)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.17094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2704","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2704 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 TRAY (0409-6010-25) / 20 mL in 1 VIAL (0409-6010-02)) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021060820","name":"PROPOFOL 200 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"25021-608-20","proprietary_name":"propofol","nonproprietary_name":"propofol","dosage_form":"INJECTION, EMULSION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-608-20) / 20 mL in 1 VIAL","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.17094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2704","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2704 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-608-20) / 20 mL in 1 VIAL) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598026525","name":"PROPOFOL 200 MG/20 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-265-25","proprietary_name":"Propofol Injectable Emulsion","nonproprietary_name":"Propofol Injectable Emulsion","dosage_form":"INJECTION, EMULSION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"25 VIAL in 1 CARTON (43598-265-25) / 20 mL in 1 VIAL (43598-265-20)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.17094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2704","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2704 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":20,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (43598-265-25) / 20 mL in 1 VIAL (43598-265-20)) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288073051","name":"PROPOFOL 500 MG/50 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-730-51","proprietary_name":"propofol","nonproprietary_name":"propofol","dosage_form":"INJECTION, EMULSION","route":"INTRAVENOUS","strength":"10 mg/mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 VIAL in 1 CARTON (71288-730-51) / 50 mL in 1 VIAL (71288-730-50)","pharm_classes":["General Anesthesia [PE]","General Anesthetic [EPC]"]},"nadac":{"value":0.17094,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2704","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2704 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":50,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (71288-730-51) / 50 mL in 1 VIAL (71288-730-50)) gives 500 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00115165901","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115165903","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378018201","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0182-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0182-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00378018210","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0182-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0182-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00591555401","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591555410","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603548221","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5482-21","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0603-5482-21)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00603548232","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5482-32","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (0603-5482-32)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904746761","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7467-61","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7467-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268066211","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-662","inner_of":["50268-662-15"]},"part_b":null}, {"ndc":"50268066215","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-662-15","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-662-15) / 1 TABLET in 1 BLISTER PACK (50268-662-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687058701","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-587-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-587-01) / 1 TABLET in 1 BLISTER PACK (60687-587-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687058711","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-587","inner_of":["60687-587-01"]},"part_b":null}, {"ndc":"60687092601","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-926-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-926-01) / 1 TABLET in 1 BLISTER PACK (60687-926-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687092611","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-926","inner_of":["60687-926-01"]},"part_b":null}, {"ndc":"69238207701","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2077-1","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-2077-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69238207707","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2077-7","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE (69238-2077-7)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053001","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-530-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (69292-530-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053010","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-530-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE (69292-530-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756009411","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-094-11","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-094-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756009412","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-094-12","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-094-12)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000501","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-005-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-005-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000510","name":"PROPRANOLOL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-005-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-005-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00115166001","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115166003","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378018301","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0183-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0183-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00378018310","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0183-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0183-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00591555501","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591555510","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603548321","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5483-21","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0603-5483-21)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00603548332","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5483-32","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (0603-5483-32)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904746806","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7468-06","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7468-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904746861","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7468-61","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7468-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268066311","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-663","inner_of":["50268-663-15"]},"part_b":null}, {"ndc":"50268066315","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-663-15","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-663-15) / 1 TABLET in 1 BLISTER PACK (50268-663-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687059801","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-598-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-598-01) / 1 TABLET in 1 BLISTER PACK (60687-598-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687059811","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-598","inner_of":["60687-598-01"]},"part_b":null}, {"ndc":"60687093701","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-937-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-937-01) / 1 TABLET in 1 BLISTER PACK (60687-937-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687093711","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-937","inner_of":["60687-937-01"]},"part_b":null}, {"ndc":"69238207801","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2078-1","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-2078-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69238207807","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2078-7","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE (69238-2078-7)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053201","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-532-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (69292-532-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053210","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-532-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE (69292-532-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756009511","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-095-11","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-095-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756009512","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-095-12","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70756-095-12)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000601","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-006-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-006-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000610","name":"PROPRANOLOL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-006-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-006-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.0493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00054372763","name":"PROPRANOLOL 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-3727-63","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE, PLASTIC (0054-3727-63)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00121095816","name":"PROPRANOLOL 20 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0958-16","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"500 mL in 1 BOTTLE (0121-0958-16)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.09221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115166101","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115166103","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378018401","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0184-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0184-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00378018410","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0184-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0378-0184-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00591555601","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591555610","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603548421","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5484-21","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0603-5484-21)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00603548432","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5484-32","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (0603-5484-32)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268066411","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"50268-664","inner_of":["50268-664-15"]},"part_b":null}, {"ndc":"50268066415","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-664-15","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-664-15) / 1 TABLET in 1 BLISTER PACK (50268-664-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687060901","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-609-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-609-01) / 1 TABLET in 1 BLISTER PACK (60687-609-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687060911","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-609","inner_of":["60687-609-01"]},"part_b":null}, {"ndc":"60687094801","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-948-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-948-01) / 1 TABLET in 1 BLISTER PACK (60687-948-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687094811","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-948","inner_of":["60687-948-01"]},"part_b":null}, {"ndc":"69238207901","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2079-1","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-2079-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69238207907","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2079-7","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET in 1 BOTTLE (69238-2079-7)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053401","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-534-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (69292-534-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053410","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-534-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"1000 TABLET in 1 BOTTLE (69292-534-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756029611","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-296-11","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-296-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000701","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-007-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-007-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000710","name":"PROPRANOLOL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-007-10","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Ipca Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (83980-007-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.07658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00054373063","name":"PROPRANOLOL 40 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0054-3730-63","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"40 mg/5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 mL in 1 BOTTLE, PLASTIC (0054-3730-63)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00115169301","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378018701","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0187-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0187-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00603548521","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5485-21","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0603-5485-21)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69238208001","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2080-1","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-2080-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053601","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-536-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (69292-536-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756029711","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-297-11","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-297-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000801","name":"PROPRANOLOL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-008-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-008-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00115166201","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115166202","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378018501","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0185-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0185-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00378018505","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0185-05","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0185-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00591555701","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591555705","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00603548621","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5486-21","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (0603-5486-21)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00603548628","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0603-5486-28","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Par Health USA, LLC","package_description":"500 TABLET in 1 BOTTLE (0603-5486-28)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69238208101","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2081-1","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-2081-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69238208105","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2081-5","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET in 1 BOTTLE (69238-2081-5)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053801","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-538-01","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (69292-538-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"69292053850","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-538-50","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"AMICI PHARMACEUTICALS LLC","package_description":"500 TABLET in 1 BOTTLE (69292-538-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756029811","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-298-11","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Lifestar Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70756-298-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"70756029851","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-298-51","proprietary_name":"Propranolol hydrochloride","nonproprietary_name":"Propranolol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Lifestar Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (70756-298-51)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000901","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-009-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Ipca Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (83980-009-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"83980000905","name":"PROPRANOLOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83980-009-05","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Ipca Laboratories Limited","package_description":"500 TABLET in 1 BOTTLE (83980-009-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.15905,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl*|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00228278011","name":"PROPRANOLOL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2780-11","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2780-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00527411837","name":"PROPRANOLOL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4118-37","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4118-37)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991081901","name":"PROPRANOLOL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-819-01","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-819-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991081905","name":"PROPRANOLOL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-819-05","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-819-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00228278111","name":"PROPRANOLOL ER 160 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2781-11","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"160 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2781-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00527411937","name":"PROPRANOLOL ER 160 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4119-37","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"160 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4119-37)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991082001","name":"PROPRANOLOL ER 160 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-820-01","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"160 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-820-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991082005","name":"PROPRANOLOL ER 160 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-820-05","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"160 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-820-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00228277811","name":"PROPRANOLOL ER 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2778-11","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2778-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00527411637","name":"PROPRANOLOL ER 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4116-37","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4116-37)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991081701","name":"PROPRANOLOL ER 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-817-01","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-817-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991081705","name":"PROPRANOLOL ER 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-817-05","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-817-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687021501","name":"PROPRANOLOL ER 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-215-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-215-01) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-215-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.17007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687021511","name":"PROPRANOLOL ER 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00228277911","name":"PROPRANOLOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2779-11","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0228-2779-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00527411737","name":"PROPRANOLOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-4117-37","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4117-37)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991081801","name":"PROPRANOLOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-818-01","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-818-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"51991081805","name":"PROPRANOLOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-818-05","proprietary_name":"propranolol hydrochloride","nonproprietary_name":"propranolol hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (51991-818-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687022601","name":"PROPRANOLOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-226-01","proprietary_name":"Propranolol Hydrochloride","nonproprietary_name":"Propranolol Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"80 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-226-01) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-226-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.19078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687022611","name":"PROPRANOLOL ER 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propranolol HCl ER|Propranolol HCl","basis":"generic"},"part_b":null}, {"ndc":"00480924201","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-9242-01","proprietary_name":"Propylthiouracil","nonproprietary_name":"Propylthiouracil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (0480-9242-01)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"33342031411","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-314-11","proprietary_name":"Propylthiouracil","nonproprietary_name":"Propylthiouracil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-314-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"62135060690","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-606-90","proprietary_name":"Propylthiouracil","nonproprietary_name":"Propylthiouracil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-606-90)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"67253065110","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67253-651-10","proprietary_name":"Propylthiouracil","nonproprietary_name":"Propylthiouracil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET in 1 BOTTLE (67253-651-10)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"67253065111","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67253-651-11","proprietary_name":"Propylthiouracil","nonproprietary_name":"Propylthiouracil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"1000 TABLET in 1 BOTTLE (67253-651-11)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"68084096425","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-964-25","proprietary_name":"Propylthiouracil","nonproprietary_name":"Propylthiouracil","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-964-25) / 1 TABLET in 1 BLISTER PACK (68084-964-95)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"68084096495","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"70752017110","name":"PROPYLTHIOURACIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-171-10","proprietary_name":"PROPYLTHIOURACIL","nonproprietary_name":"PROPYLTHIOURACIL","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"100 TABLET in 1 BOTTLE (70752-171-10)","pharm_classes":["Thyroid Hormone Synthesis Inhibitor [EPC]","Thyroid Hormone Synthesis Inhibitors [MoA]"]},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Propylthiouracil|Propylthiouracil","basis":"generic"},"part_b":null}, {"ndc":"78206015301","name":"PROSCAR 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-153-01","proprietary_name":"PROSCAR","nonproprietary_name":"FINASTERIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-153-01)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":5.7018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Proscar|Finasteride","basis":"brand"},"part_b":null}, {"ndc":"78206015302","name":"PROSCAR 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-153-02","proprietary_name":"PROSCAR","nonproprietary_name":"FINASTERIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Organon LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (78206-153-02)","pharm_classes":["5-alpha Reductase Inhibitor [EPC]","5-alpha Reductase Inhibitors [MoA]"]},"nadac":{"value":5.7018,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06881,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Proscar|Finasteride","basis":"brand"},"part_b":null}, {"ndc":"00008084401","name":"PROTONIX 40 MG SUSPENSION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":14.06629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008084402","name":"PROTONIX 40 MG SUSPENSION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-0844-02","proprietary_name":"Protonix Delayed-Release","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"GRANULE, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"30 PACKET in 1 CARTON (0008-0844-02) / 1 GRANULE, DELAYED RELEASE in 1 PACKET (0008-0844-01)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":14.06629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.84903,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008084381","name":"PROTONIX DR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0008-0843-81","proprietary_name":"Protonix Delayed-Release","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (0008-0843-81)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":14.31343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04262,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00008084181","name":"PROTONIX DR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0008-0841-81","proprietary_name":"Protonix Delayed-Release","nonproprietary_name":"PANTOPRAZOLE SODIUM","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (0008-0841-81)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":14.23539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054021125","name":"PROTRIPTYLINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.71097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Protriptyline HCl|Protriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"42794000702","name":"PROTRIPTYLINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-007-02","proprietary_name":"Protriptyline Hydrochloride","nonproprietary_name":"Protriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42794-007-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":2.71097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Protriptyline HCl|Protriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"42806009730","name":"PROTRIPTYLINE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-097-30","proprietary_name":"Protriptyline Hydrochloride","nonproprietary_name":"Protriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Epic Pharma, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42806-097-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":2.71097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Protriptyline HCl|Protriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"00054021025","name":"PROTRIPTYLINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.6182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Protriptyline HCl|Protriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"42794000402","name":"PROTRIPTYLINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42794-004-02","proprietary_name":"Protriptyline Hydrochloride","nonproprietary_name":"Protriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sigmapharm Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42794-004-02)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":2.6182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Protriptyline HCl|Protriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"42806009630","name":"PROTRIPTYLINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-096-30","proprietary_name":"Protriptyline Hydrochloride","nonproprietary_name":"Protriptyline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Epic Pharma, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (42806-096-30)","pharm_classes":["Tricyclic Antidepressant [EPC]"]},"nadac":{"value":2.6182,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Protriptyline HCl|Protriptyline HCl","basis":"generic"},"part_b":null}, {"ndc":"52747050430","name":"PROVIDA OB CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.04142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505485103","name":"PROVIGIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4851-3","proprietary_name":"Provigil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET in 1 BOTTLE (60505-4851-3)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":53.1528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Provigil|Modafinil","basis":"brand"},"part_b":null}, {"ndc":"63459010130","name":"PROVIGIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":53.1528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24793,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Provigil|Modafinil","basis":"brand"},"part_b":null}, {"ndc":"60505485203","name":"PROVIGIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4852-3","proprietary_name":"Provigil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Apotex Corp","package_description":"30 TABLET in 1 BOTTLE (60505-4852-3)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":80.34944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Provigil|Modafinil","basis":"brand"},"part_b":null}, {"ndc":"63459020130","name":"PROVIGIL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63459-201-30","proprietary_name":"Provigil","nonproprietary_name":"Modafinil","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Cephalon, LLC","package_description":"30 TABLET in 1 BOTTLE (63459-201-30)","pharm_classes":["Central Nervous System Stimulation [PE]","Increased Sympathetic Activity [PE]","Sympathomimetic-like Agent [EPC]"]},"nadac":{"value":80.34944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.34362,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Provigil|Modafinil","basis":"brand"},"part_b":null}, {"ndc":"00054074913","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0749-13","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0054-0749-13)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406630103","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-6301-03","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0406-6301-03)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781815831","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8158-31","proprietary_name":"PRUCALOPRIDE","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-8158-31)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722039130","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-391-30","proprietary_name":"PRUCALOPRIDE","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-391-30)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505480603","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4806-3","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4806-3)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097021802","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-218-02","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-218-02)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238269801","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2698-1","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-2698-1)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069082101","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-821-01","proprietary_name":"Prucalopride succinate","nonproprietary_name":"Prucalopride succinate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 BOTTLE (70069-821-01) / 30 TABLET in 1 BOTTLE","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748038901","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-389-01","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70748-389-01)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954059610","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-596-10","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-596-10)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205021830","name":"PRUCALOPRIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-218-30","proprietary_name":"PRUCALOPRIDE","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-218-30)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.63933,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054075013","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0750-13","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0054-0750-13)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00406630203","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-6302-03","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"SpecGx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0406-6302-03)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781815931","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8159-31","proprietary_name":"PRUCALOPRIDE","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-8159-31)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722039230","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-392-30","proprietary_name":"PRUCALOPRIDE","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-392-30)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505480703","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4807-3","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4807-3)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69097021902","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-219-02","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-219-02)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238269901","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2699-1","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-2699-1)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069082201","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-822-01","proprietary_name":"Prucalopride succinate","nonproprietary_name":"Prucalopride succinate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 BOTTLE (70069-822-01) / 30 TABLET in 1 BOTTLE","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748039001","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-390-01","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70748-390-01)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954059710","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-597-10","proprietary_name":"Prucalopride","nonproprietary_name":"Prucalopride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (70954-597-10)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205021930","name":"PRUCALOPRIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-219-30","proprietary_name":"PRUCALOPRIDE","nonproprietary_name":"PRUCALOPRIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-219-30)","pharm_classes":["Serotonin 4 Receptor Agonists [MoA]","Serotonin-4 Receptor Agonist [EPC]"]},"nadac":{"value":0.61897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904699061","name":"PSEUDOEPHEDRINE 30 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6990-61","proprietary_name":"Pseudoephedrine HCl","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-6990-61) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802043262","name":"PSEUDOEPHEDRINE 30 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-432-62","proprietary_name":"pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"24 BLISTER PACK in 1 CARTON (45802-432-62) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904690706","name":"PSEUDOEPHEDRINE 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6907-06","proprietary_name":"Pseudoephedrine Hydrochloride","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"5 BLISTER PACK in 1 BOX (0904-6907-06) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904740915","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7409-15","proprietary_name":"Pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (0904-7409-15) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802010752","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-107-52","proprietary_name":"pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"10 BLISTER PACK in 1 CARTON (45802-107-52) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122016660","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660020421","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-204-21","proprietary_name":"Pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"20 TABLET, FILM COATED in 1 BLISTER PACK (51660-204-21)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660020469","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-204-69","proprietary_name":"Pseudoephedrine hydrochloride","nonproprietary_name":"Pseudoephedrine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"10 TABLET, FILM COATED in 1 BLISTER PACK (51660-204-69)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51660049221","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-492-21","proprietary_name":"Pseudoephedrine hydrochloride","nonproprietary_name":"pseudoephedrine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"20 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (51660-492-21)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000060101","name":"PSEUDOEPHEDRINE ER 120 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0601-1","proprietary_name":"Pseudoephedrine Hydrochloride","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"CARDINAL HEALTH 110, LLC DBA LEADER","package_description":"1 BLISTER PACK in 1 CARTON (70000-0601-1) / 20 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00186198904","name":"PULMICORT 0.5 MG/2 ML RESPULE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-1989-04","proprietary_name":"PULMICORT RESPULES","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":".5 mg/2mL","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"6 POUCH in 1 CARTON (0186-1989-04) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.9112,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.67608,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pulmicort|Budesonide","basis":"brand"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0186-1989-04) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00186199004","name":"PULMICORT 1 MG/2 ML RESPULE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0186-1990-04","proprietary_name":"PULMICORT RESPULES","nonproprietary_name":"Budesonide","dosage_form":"SUSPENSION","route":"RESPIRATORY (INHALATION)","strength":"1 mg/2mL","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"6 POUCH in 1 CARTON (0186-1990-04) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":9.8448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":3.42737,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pulmicort|Budesonide","basis":"brand"},"part_b":{"hcpcs":"J7626","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7626 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (6 POUCH in 1 CARTON (0186-1990-04) / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"61269051812","name":"PULMICORT 180 MCG FLEXHALER","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61269-518-12","proprietary_name":"PULMICORT FLEXHALER","nonproprietary_name":"Budesonide","dosage_form":"AEROSOL, POWDER","route":"RESPIRATORY (INHALATION)","strength":"180 ug/1","labeler":"H2-Pharma LLC","package_description":"1 INHALER in 1 CARTON (61269-518-12) / 120 AEROSOL, POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":253.49738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61269050906","name":"PULMICORT 90 MCG FLEXHALER","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61269-509-06","proprietary_name":"PULMICORT FLEXHALER","nonproprietary_name":"Budesonide","dosage_form":"AEROSOL, POWDER","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"H2-Pharma LLC","package_description":"1 INHALER in 1 CARTON (61269-509-06) / 60 AEROSOL, POWDER in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":188.51627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50242010040","name":"PULMOZYME 1 MG/ML AMPUL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50242-100-40","proprietary_name":"Pulmozyme","nonproprietary_name":"dornase alfa","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"1 mg/mL","labeler":"Genentech, Inc.","package_description":"5 POUCH in 1 CARTON (50242-100-40) / 6 AMPULE in 1 POUCH (50242-100-39) / 2.5 mL in 1 AMPULE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Deoxyribonuclease I [CS]","Recombinant Human Deoxyribonuclease 1 [EPC]","Recombinant Proteins [CS]"]},"nadac":{"value":53.15693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Pulmozyme|Dornase Alfa","basis":"brand"},"part_b":{"hcpcs":"J7639","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7639 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2.5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 POUCH in 1 CARTON (50242-100-40) / 6 AMPULE in 1 POUCH (50242-100-39) / 2.5 mL in 1 AMPULE) gives 75 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"59088011266","name":"PUREVIT DUALFE PLUS CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59088-112-66","proprietary_name":"PureVit DualFe Plus","nonproprietary_name":"Ferrous Fumarate, Polysaccharide Iron Complex","dosage_form":"CAPSULE","route":"ORAL","strength":".8 mg/1; 53 mg/1; 53 mg/1; 6 mg/1; 30 mg/1; 5 mg/1; 1 mg/1; 15 ug/1; 10 mg/1; 200 mg/1; 10 mg/1; 18.2 mg/1; 1.3 mg/1","labeler":"PureTek Corporation","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (59088-112-66)","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]","Iron [CS]","Magnetic Resonance Contrast Activity [MoA]","Paramagnetic Contrast Agent [EPC]","Parenteral Iron Replacement [EPC]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.3839,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68599350205","name":"PVP PREP 10% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.02034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61269038012","name":"PYLERA 140-125-125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-380-12","proprietary_name":"PYLERA","nonproprietary_name":"BISMUTH SUBCITRATE POTASSIUM, METRONIDAZOLE, and TETRACYCLINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"140 mg/1; 125 mg/1; 125 mg/1","labeler":"H2-Pharma, LLC","package_description":"10 BLISTER PACK in 1 BOX (61269-380-12) / 12 CAPSULE in 1 BLISTER PACK","pharm_classes":["Bismuth [CS]","Bismuth [EPC]","Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]","Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.42892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.40281,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pylera|Bismuth/Metronid/Tetracycline","basis":"brand"},"part_b":null}, {"ndc":"61269038112","name":"PYLERA 140-125-125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-381-12","proprietary_name":"PYLERA","nonproprietary_name":"BISMUTH SUBCITRATE POTASSIUM, METRONIDAZOLE, AND TETRACYCLINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"140 mg/1; 125 mg/1; 125 mg/1","labeler":"H2-Pharma, LLC","package_description":"10 BLISTER PACK in 1 BOX (61269-381-12) / 12 CAPSULE in 1 BLISTER PACK","pharm_classes":["Bismuth [CS]","Bismuth [EPC]","Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]","Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":2.42892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.40281,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pylera|Bismuth/Metronid/Tetracycline","basis":"brand"},"part_b":null}, {"ndc":"00054081221","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0812-21","proprietary_name":"pyrazinamide","nonproprietary_name":"pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"60 TABLET in 1 CONTAINER (0054-0812-21)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"00054081222","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0812-22","proprietary_name":"pyrazinamide","nonproprietary_name":"pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"90 TABLET in 1 CONTAINER (0054-0812-22)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"00054081225","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0812-25","proprietary_name":"pyrazinamide","nonproprietary_name":"pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"100 TABLET in 1 CONTAINER (0054-0812-25)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"00054081229","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0812-29","proprietary_name":"pyrazinamide","nonproprietary_name":"pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Hikma Pharmaceuticals USA Inc","package_description":"500 TABLET in 1 CONTAINER (0054-0812-29)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"33342044711","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-447-11","proprietary_name":"Pyrazinamide","nonproprietary_name":"Pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-447-11)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"33342044715","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-447-15","proprietary_name":"Pyrazinamide","nonproprietary_name":"Pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-447-15)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"60687078901","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-789-01","proprietary_name":"Pyrazinamide","nonproprietary_name":"Pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-789-01) / 1 TABLET in 1 BLISTER PACK (60687-789-11)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"60687078911","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"70954048410","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-484-10","proprietary_name":"Pyrazinamide","nonproprietary_name":"Pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (70954-484-10)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"70954048420","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-484-20","proprietary_name":"Pyrazinamide","nonproprietary_name":"Pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (70954-484-20)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"70954048430","name":"PYRAZINAMIDE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-484-30","proprietary_name":"Pyrazinamide","nonproprietary_name":"Pyrazinamide","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (70954-484-30)","pharm_classes":["Antimycobacterial [EPC]"]},"nadac":{"value":1.30807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrazinamide|Pyrazinamide","basis":"generic"},"part_b":null}, {"ndc":"60846050201","name":"PYRIDIUM 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-502-01","proprietary_name":"Pyridium","nonproprietary_name":"Phenazopyridine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60846-502-01)"},"nadac":{"value":5.463,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyridium|Phenazopyridine HCl","basis":"brand"},"part_b":null}, {"ndc":"16571083316","name":"PYRIDOSTIGMINE 60 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-833-16","proprietary_name":"Pryidostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"SOLUTION","route":"ORAL","strength":"60 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (16571-833-16)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.56484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192062616","name":"PYRIDOSTIGMINE 60 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-626-16","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"pyridostigmine bromide","dosage_form":"SOLUTION","route":"ORAL","strength":"60 mg/5mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (42192-626-16)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.56484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238173102","name":"PYRIDOSTIGMINE 60 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1731-2","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"SOLUTION","route":"ORAL","strength":"60 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"473 mL in 1 BOTTLE (69238-1731-2)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.56484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954014810","name":"PYRIDOSTIGMINE 60 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-148-10","proprietary_name":"Pyridostigmine","nonproprietary_name":"Pyridostigmine bromide oral","dosage_form":"SOLUTION","route":"ORAL","strength":"60 mg/5mL","labeler":"Novitium Pharma LLC","package_description":"473 mL in 1 BOTTLE (70954-148-10)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.56484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205009872","name":"PYRIDOSTIGMINE 60 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-098-72","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"SOLUTION","route":"ORAL","strength":"60 mg/5mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"473 mL in 1 BOTTLE (72205-098-72)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.56484,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657081021","name":"PYRIDOSTIGMINE BR 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-810-21","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"PYRIDOSTIGMINE BROMIDE","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"21 TABLET in 1 BOTTLE (58657-810-21)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":6.94704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115351101","name":"PYRIDOSTIGMINE BR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-3511-01","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"PYRIDOSTIGMINE BROMIDE","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-3511-01)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.24872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904662261","name":"PYRIDOSTIGMINE BR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6622-61","proprietary_name":"pyridostigmine bromide","nonproprietary_name":"pyridostigmine bromide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6622-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.24872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559047001","name":"PYRIDOSTIGMINE BR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-470-01","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-470-01)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.24872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084049401","name":"PYRIDOSTIGMINE BR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-494-01","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-494-01) / 1 TABLET in 1 BLISTER PACK (68084-494-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.24872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084049411","name":"PYRIDOSTIGMINE BR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382065906","name":"PYRIDOSTIGMINE BR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-659-06","proprietary_name":"pyridostigmine bromide","nonproprietary_name":"pyridostigmine bromide","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (68382-659-06)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.24872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00115140408","name":"PYRIDOSTIGMINE ER 180 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.99632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyridostigmine Bromide ER|Pyridostigmine Bromide","basis":"generic"},"part_b":null}, {"ndc":"47781033530","name":"PYRIDOSTIGMINE ER 180 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-335-30","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Alvogen, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (47781-335-30)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":3.99632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyridostigmine Bromide ER|Pyridostigmine Bromide","basis":"generic"},"part_b":null}, {"ndc":"64980022003","name":"PYRIDOSTIGMINE ER 180 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-220-03","proprietary_name":"Pyridostigmine Bromide","nonproprietary_name":"Pyridostigmine Bromide","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-220-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":3.99632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyridostigmine Bromide ER|Pyridostigmine Bromide","basis":"generic"},"part_b":null}, {"ndc":"00480372001","name":"PYRIMETHAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-3720-01","proprietary_name":"Pyrimethamine","nonproprietary_name":"Pyrimethamine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0480-3720-01)","pharm_classes":["Dihydrofolate Reductase Inhibitor Antimalarial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":137.00879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrimethamine|Pyrimethamine","basis":"generic"},"part_b":null}, {"ndc":"00480372056","name":"PYRIMETHAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-3720-56","proprietary_name":"Pyrimethamine","nonproprietary_name":"Pyrimethamine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0480-3720-56)","pharm_classes":["Dihydrofolate Reductase Inhibitor Antimalarial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":137.00879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrimethamine|Pyrimethamine","basis":"generic"},"part_b":null}, {"ndc":"43598067201","name":"PYRIMETHAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-672-01","proprietary_name":"Pyrimethamine","nonproprietary_name":"pyrimethamine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"DR.REDDYS LABORATORIES INC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (43598-672-01)","pharm_classes":["Dihydrofolate Reductase Inhibitor Antimalarial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":137.00879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrimethamine|Pyrimethamine","basis":"generic"},"part_b":null}, {"ndc":"43598067230","name":"PYRIMETHAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-672-30","proprietary_name":"Pyrimethamine","nonproprietary_name":"pyrimethamine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"DR.REDDYS LABORATORIES INC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (43598-672-30)","pharm_classes":["Dihydrofolate Reductase Inhibitor Antimalarial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":137.00879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrimethamine|Pyrimethamine","basis":"generic"},"part_b":null}, {"ndc":"59651059001","name":"PYRIMETHAMINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-590-01","proprietary_name":"Pyrimethamine","nonproprietary_name":"Pyrimethamine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-590-01)","pharm_classes":["Dihydrofolate Reductase Inhibitor Antimalarial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]"]},"nadac":{"value":137.00879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Pyrimethamine|Pyrimethamine","basis":"generic"},"part_b":null}, {"ndc":"52652300101","name":"QBRELIS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-3001-1","proprietary_name":"Qbrelis","nonproprietary_name":"lisinopril","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"150 mL in 1 BOTTLE (52652-3001-1)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":4.49739,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Qbrelis|Lisinopril","basis":"brand"},"part_b":null}, {"ndc":"83324008250","name":"QC 8 HOUR PAIN RLF ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-082-50","proprietary_name":"8 Hour Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-082-50) / 50 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008350","name":"QC 8HR ARTHRIT PAIN ER 650 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-083-50","proprietary_name":"8 Hour Arthritis Pain","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"650 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-083-50) / 50 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.06306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324007020","name":"QC ACETAMINOPHEN PM GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-070-20","proprietary_name":"Acetaminophen PM","nonproprietary_name":"Acetaminophen, Diphenhydramine HCl","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-070-20) / 20 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324002404","name":"QC ADULT TUSSIN 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-024-04","proprietary_name":"QCH Adult Tussin 541","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-024-04) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324015504","name":"QC ADULT TUSSIN CF LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-155-04","proprietary_name":"Tussin Multi Symptom Cold CF","nonproprietary_name":"Dextromethorphan HBr Guaifenesin Phenylephrine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/10mL; 200 mg/10mL; 10 mg/10mL","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-155-04) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324030501","name":"QC ALCOHOL 70% PREP PADS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-305-01","proprietary_name":"Chain Drug Marketing Association, Inc.","nonproprietary_name":"isopropyl alcohol","dosage_form":"CLOTH","route":"TOPICAL","strength":"70 mL/100mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"100 PACKET in 1 BOX (83324-305-01) / 1 APPLICATOR in 1 PACKET / 5 mL in 1 APPLICATOR"},"nadac":{"value":0.01362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324009114","name":"QC ALLERGY (CETRZN) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-091-14","proprietary_name":"Allergy Relief","nonproprietary_name":"Cetirizine hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-091-14) / 14 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.06128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324006824","name":"QC ALLERGY (CHLORPHEN) 4 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-068-24","proprietary_name":"Allergy Relief","nonproprietary_name":"Chlorpheniramine maleate","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-068-24) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008701","name":"QC ALLERGY (DIPHEN) 25 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-087-01","proprietary_name":"Allergy Relief","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-087-01) / 100 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011824","name":"QC ALLERGY (DIPHEN) 25 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-118-24","proprietary_name":"Quality Choice Allergy Relief","nonproprietary_name":"diphenhydramine hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Chain Drug Marketing Association","package_description":"2 BLISTER PACK in 1 CARTON (83324-118-24) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324028024","name":"QC ALLERGY (DIPHEN) 25 MG SFGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-280-24","proprietary_name":"Allergy Relief","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-280-24) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008801","name":"QC ALLERGY (DIPHEN) 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-088-01","proprietary_name":"Allergy Relief","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-088-01) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.03697,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324009515","name":"QC ALLERGY (FEXO) 180 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-095-15","proprietary_name":"Allergy Relief","nonproprietary_name":"Fexofenadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"3 BLISTER PACK in 1 CARTON (83324-095-15) / 5 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.2302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324014630","name":"QC ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-146-30","proprietary_name":"All Day Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-146-30) / 30 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324014710","name":"QC ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-147-10","proprietary_name":"All Day Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"10 BLISTER PACK in 1 CARTON (83324-147-10) / 1 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324015001","name":"QC ALLERGY (LORAT) 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-150-01","proprietary_name":"Allergy Relief","nonproprietary_name":"Loratadine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-150-01) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.05294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008624","name":"QC ALLERGY MULTI-SYMPTOM CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-086-24","proprietary_name":"Allergy Multi Symptom","nonproprietary_name":"ACETAMINOPHEN, CHLORPHENIRAMINE MALEATE, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 2 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-086-24) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324029401","name":"QC ALLERGY RELIEF 50 MCG SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-294-01","proprietary_name":"Fluticasone Propionate","nonproprietary_name":"Fluticasone Propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"50 ug/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (83324-294-01) / 144 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.67575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324000912","name":"QC ALLERGY RLF (FEXO) 60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-009-12","proprietary_name":"Allergy Relief","nonproprietary_name":"Fexofenadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (83324-009-12) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324000924","name":"QC ALLERGY RLF (FEXO) 60 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-009-24","proprietary_name":"Allergy Relief","nonproprietary_name":"Fexofenadine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-009-24) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.1529,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324031515","name":"QC ANTACID 500 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-315-15","proprietary_name":"QUALITY CHOICE Regular Strength","nonproprietary_name":"Antacid Tablets (Calcium Carbonate)","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"QUALITY CHOICE (Chain drug Marketing Assoiciation)","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (83324-315-15)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324031615","name":"QC ANTACID 500 MG CHEW TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-316-15","proprietary_name":"QUALITY CHOICE Regular Strength","nonproprietary_name":"Antacid Tablets (Calcium Carbonate)","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"QUALITY CHOICE (Chain drug Marketing Assoiciation)","package_description":"150 TABLET, CHEWABLE in 1 BOTTLE (83324-316-15)"},"nadac":{"value":0.01688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324031396","name":"QC ANTACID EX-STR 750 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-313-96","proprietary_name":"Quality Choice Extra Strength","nonproprietary_name":"Antacid Tablets (Calcium Carbonate)","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"QUALITY CHOICE (Chain drug Marketing Assoiciation)","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE (83324-313-96)"},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324031896","name":"QC ANTACID EX-STR 750 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-318-96","proprietary_name":"QUALITY CHOICE Extra Strength","nonproprietary_name":"Antacid Tablets (Calcium Carbonate)","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"QUALITY CHOICE (Chain drug Marketing Assoiciation)","package_description":"96 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (83324-318-96)"},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324031772","name":"QC ANTACID ULTRA 1,000 MG CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-317-72","proprietary_name":"QUALITY CHOICE Ultra Strength","nonproprietary_name":"Antacid Tablets (Calcium Carbonate)","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"1000 mg/1","labeler":"QUALITY CHOICE (Chain drug Marketing Assoiciation)","package_description":"72 TABLET, CHEWABLE in 1 BOTTLE (83324-317-72)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03701,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324012212","name":"QC ANTACID-ANTIGAS MAX STR LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-122-12","proprietary_name":"QCH Maximum Strength Antacid 516","nonproprietary_name":"aluminum hydroxide, magnesium hydroxide, simethicone","dosage_form":"LIQUID","route":"ORAL","strength":"800 mg/10mL; 800 mg/10mL; 80 mg/10mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"355 mL in 1 BOTTLE (83324-122-12)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Skin Barrier Activity [PE]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324006412","name":"QC ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-064-12","proprietary_name":"Anti Diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-064-12) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324006424","name":"QC ANTI-DIARRHEAL 2 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-064-24","proprietary_name":"Anti Diarrheal","nonproprietary_name":"Loperamide HCl","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (83324-064-24) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.1299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324020812","name":"QC ANTI-DIARRHEAL 2 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-208-12","proprietary_name":"Anti-Diarrheal","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION INC.","package_description":"1 BLISTER PACK in 1 CARTON (83324-208-12) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324020924","name":"QC ANTI-DIARRHEAL 2 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-209-24","proprietary_name":"Anti-Diarrheal","nonproprietary_name":"LOPERAMIDE HYDROCHLORIDE","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"2 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-209-24) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":0.13628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324021704","name":"QC ANTI-NAUSEA LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-217-04","proprietary_name":"QUALITY CHOICE Anti-Nausea","nonproprietary_name":"dextrose(glucose),Levulose(fructose),Phosphoric acid","dosage_form":"SOLUTION","route":"ORAL","strength":"1.87 g/5mL; 1.87 g/5mL; 21.5 mg/5mL","labeler":"QUALITY CHOICE (CHAIN DRUG MARKETING ASSOCIATION)","package_description":"1 BOTTLE in 1 CARTON (83324-217-04) / 118 mL in 1 BOTTLE"},"nadac":{"value":0.02351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324018914","name":"QC ARTIFICIAL TEARS DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-189-14","proprietary_name":"Quality Choice Artificial Tears Lubricant Eye Drops","nonproprietary_name":"Polyvinyl alcohol, Povidone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".5 g/100mL; .6 g/100mL","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, DROPPER in 1 BOX (83324-189-14) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.11327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324006601","name":"QC ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-066-01","proprietary_name":"Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (83324-066-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324020501","name":"QC ASPIRIN 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-205-01","proprietary_name":"Aspirin","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-205-01) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.0166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324007536","name":"QC ASPIRIN 81 MG CHEWABLE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-075-36","proprietary_name":"Chewable Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-075-36) / 36 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324005801","name":"QC ASPIRIN EC 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-058-01","proprietary_name":"Enteric Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"325 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-058-01) / 100 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02216,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008905","name":"QC ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-089-05","proprietary_name":"Aspirin 81 mg Low Dose","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"500 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (83324-089-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324009036","name":"QC ASPIRIN EC 81 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-090-36","proprietary_name":"Aspirin 81 mg Low dose","nonproprietary_name":"ASPIRIN","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"81 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-090-36) / 36 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.01418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324024806","name":"QC CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-248-06","proprietary_name":"Calamine","nonproprietary_name":"FERRIC OXIDE RED","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 80 mg/mL","labeler":"Chain Drug Marketing Association","package_description":"177 mL in 1 BOTTLE, PLASTIC (83324-248-06)"},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324005306","name":"QC CALAMINE MEDICATED LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-053-06","proprietary_name":"Calamine","nonproprietary_name":"Calamine, Pramoxine HCl","dosage_form":"LOTION","route":"TOPICAL","strength":"80 mg/mL; 10 mg/mL","labeler":"Chain Drug Marketing Association","package_description":"177 mL in 1 BOTTLE, PLASTIC (83324-053-06)"},"nadac":{"value":0.01668,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324024241","name":"QC CALAMINE PLUS 8%-1% SPRAY","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-242-41","proprietary_name":"Calamine Plus","nonproprietary_name":"Calamine Plus Pramoxine HCL","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":"5 mg/g; 10 mg/g; 79.5 mg/g","labeler":"Chain Drug Marketing Association Inc","package_description":"116 g in 1 CANISTER (83324-242-41)"},"nadac":{"value":0.04339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324001304","name":"QC CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-013-04","proprietary_name":"Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"100 mg/5mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-013-04) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324001404","name":"QC CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-014-04","proprietary_name":"Childrens Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"SUSPENSION/ DROPS","route":"ORAL","strength":"100 mg/5mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-014-04) / 120 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03013,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324003404","name":"QC CHILD PAIN RLF 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-034-04","proprietary_name":"Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-034-04) / 118 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324016104","name":"QC CHILD PAIN RLF 160 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-161-04","proprietary_name":"Pain Reliever","nonproprietary_name":"Acetaminophen","dosage_form":"SUSPENSION","route":"ORAL","strength":"160 mg/5mL","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-161-04) / 118 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324007124","name":"QC CHILD PAIN-FEVER 160 MG CHW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-071-24","proprietary_name":"Childrens Pain and Fever Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"160 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-071-24) / 24 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.11643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324015604","name":"QC CHILD'S DIBROMM COLD-ALLGY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-156-04","proprietary_name":"Dibromm Cold and Allergy","nonproprietary_name":"Brompheniramine maleate, Phenylephrine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"2 mg/10mL; 5 mg/10mL","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-156-04) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324024506","name":"QC CLEAR ANTI-ITCH LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-245-06","proprietary_name":"Clear Anti-Itch","nonproprietary_name":"Pramoxine HCl, Zinc acetate","dosage_form":"LOTION","route":"TOPICAL","strength":"10 mg/mL; 1 mg/mL","labeler":"Chain Drug Marketing Association","package_description":"177 mL in 1 BOTTLE, PLASTIC (83324-245-06)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324015415","name":"QC CLOTRIMAZOLE 1% VAG CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-154-15","proprietary_name":"Clotrimazole","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"10 mg/g","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 TUBE in 1 CARTON (83324-154-15) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.08945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324011424","name":"QC COLD HEAD CONGST SEVR CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-114-24","proprietary_name":"Cold plus Flu Congestion Severe","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-114-24) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011124","name":"QC COLD-FLU SEVERE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-111-24","proprietary_name":"Cold plus Flu Severe","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-111-24) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013404","name":"QC COUGH RELIEF 15 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-134-04","proprietary_name":"Adult Cough Relief","nonproprietary_name":"Dextromethorphan HBr","dosage_form":"LIQUID","route":"ORAL","strength":"15 mg/5mL","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-134-04) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324007224","name":"QC COUGH-COLD HBP TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-072-24","proprietary_name":"Cough and Cold HBP","nonproprietary_name":"Chlorpheniramine maleate, Dextromethorphan HBr","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1; 30 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (83324-072-24) / 8 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324030601","name":"QC DICLOFENAC SODIUM 1% GEL","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-306-01","proprietary_name":"Arthritis Pain Reliever","nonproprietary_name":"Diclofenac Sodium","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 TUBE in 1 CARTON (83324-306-01) / 100 g in 1 TUBE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.08134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324014936","name":"QC DUAL ACTION PAIN 250-125 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-149-36","proprietary_name":"dual action pain reliever","nonproprietary_name":"Acetaminophen and Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"125 mg/1; 250 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION INC.","package_description":"1 BOTTLE in 1 CARTON (83324-149-36) / 36 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.10711,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324029245","name":"QC ENEMA READY TO USE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-292-45","proprietary_name":"Quality Choice Laxative","nonproprietary_name":"SODIUM PHOSPHATE, DIBASIC, UNSPECIFIED FORM and SODIUM PHOSPHATE, MONOBASIC, UNSPECIFIED FORM","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"Chain Drug Marketing Association","package_description":"1 BOTTLE in 1 CARTON (83324-292-45) / 133 mL in 1 BOTTLE"},"nadac":{"value":0.0067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324029390","name":"QC ENEMA READY TO USE TWIN PAK","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-293-90","proprietary_name":"Quality Choice Laxative","nonproprietary_name":"SODIUM PHOSPHATE, DIBASIC, UNSPECIFIED FORM and SODIUM PHOSPHATE, MONOBASIC, UNSPECIFIED FORM","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"Chain Drug Marketing Association","package_description":"2 BOTTLE in 1 CARTON (83324-293-90) / 133 mL in 1 BOTTLE"},"nadac":{"value":0.0067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324017516","name":"QC EPSOM SALT GRANULES","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-175-16","proprietary_name":"Epsom Salt","nonproprietary_name":"Magnesium sulfate","dosage_form":"GRANULE, FOR SOLUTION","route":"ORAL; TOPICAL","strength":"1 g/g","labeler":"Chain Drug Marketing Association","package_description":"454 g in 1 POUCH (83324-175-16)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.00389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324034015","name":"QC EYE DROPS 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83324-340-15","proprietary_name":"Quality Choice Eye Drops Redness Relief","nonproprietary_name":"Tetrahydrozoline HCl","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".05 g/100mL","labeler":"Chain Drug Marketing Assoc., Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (83324-340-15) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.09689,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324019114","name":"QC EYE DROPS MOISTURIZING RLF","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83324-191-14","proprietary_name":"Quality Choice Moisturizing Relief Eye Drops","nonproprietary_name":"Dextran 70, Polyethylene glycol 400, Povidone, Tetrahydrozoline HCl","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".1 g/100mL; .05 g/100mL; 1 g/100mL; 1 g/100mL","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, DROPPER in 1 BOX (83324-191-14) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Increased Intravascular Volume [PE]","Osmotic Activity [MoA]","Plasma Volume Expander [EPC]"]},"nadac":{"value":0.152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324019204","name":"QC EYE WASH IRRIGATING SOLN","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-192-04","proprietary_name":"Quality Choice Eye Wash","nonproprietary_name":"Water","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"99.05 g/100mL","labeler":"Chain Drug Marketing Assoc., Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 BOX (83324-192-04) / 118 mL in 1 BOTTLE, WITH APPLICATOR"},"nadac":{"value":0.02879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324001506","name":"QC EZZ NITE SLEEP 50 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83324-015-06","proprietary_name":"Nighttime Sleep-Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"50 mg/30mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"177 mL in 1 BOTTLE (83324-015-06)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324000850","name":"QC FAMOTIDINE 20 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-008-50","proprietary_name":"famotidine","nonproprietary_name":"famotidine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 CONTAINER in 1 CARTON (83324-008-50) / 50 TABLET, FILM COATED in 1 CONTAINER","pharm_classes":["Histamine H2 Receptor Antagonists [MoA]","Histamine-2 Receptor Antagonist [EPC]"]},"nadac":{"value":0.13819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013190","name":"QC FIBER 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-131-90","proprietary_name":"Fiber caplets 147","nonproprietary_name":"Calcium polycarbophil","dosage_form":"TABLET","route":"ORAL","strength":"625 mg/1","labeler":"Chain Drug Marketing Association Inc.","package_description":"90 TABLET in 1 BOTTLE (83324-131-90)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324027690","name":"QC FIBER 625 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-276-90","proprietary_name":"Quality Choice Fiber Caplets","nonproprietary_name":"Calcium Polycarbophil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"625 mg/1","labeler":"QUALITY CHOICE (CHAIN DRUG MARKETING ASSOCIATION)","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (83324-276-90)"},"nadac":{"value":0.05908,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324003330","name":"QC GENTLE LAXATIVE EC 5 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-033-30","proprietary_name":"Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-033-30) / 15 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011224","name":"QC HEAD CONGEST-MUCUS PE CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-112-24","proprietary_name":"Head Congestion plus Mucus PE","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-112-24) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324020648","name":"QC IBUPROFEN 200 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-206-48","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-206-48) / 48 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.07623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324005624","name":"QC IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-056-24","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-056-24) / 24 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324005924","name":"QC IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-059-24","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-059-24) / 24 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010050","name":"QC IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-100-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-100-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010250","name":"QC IBUPROFEN 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-102-50","proprietary_name":"Ibuprofen","nonproprietary_name":"Ibuprofen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-102-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013301","name":"QC INFANT GAS RLF 20 MG/0.3 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-133-01","proprietary_name":"Quality Choice Infants Non-staining Gas relief","nonproprietary_name":"Simethicone","dosage_form":"SOLUTION/ DROPS","route":"ORAL","strength":"20 mg/.3mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (83324-133-01) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.10234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324000114","name":"QC LANSOPRAZOLE DR 15 MG CAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-001-14","proprietary_name":"Lansoprazole","nonproprietary_name":"Lansoprazole","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"Chain Drug Marketing Association","package_description":"1 BOTTLE in 1 CARTON (83324-001-14) / 14 CAPSULE, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Inhibition Gastric Acid Secretion [PE]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.40674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324000401","name":"QC LAXATIVE 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-004-01","proprietary_name":"Senna","nonproprietary_name":"Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-004-01) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324006130","name":"QC LAXATIVE EC 5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-061-30","proprietary_name":"Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (83324-061-30) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324000208","name":"QC LAXATIVE PEG 3350 POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-002-08","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"238 g in 1 BOTTLE (83324-002-08)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324000216","name":"QC LAXATIVE PEG 3350 POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-002-16","proprietary_name":"Polyethylene Glycol 3350","nonproprietary_name":"Polyethylene Glycol 3350","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"17 g/17g","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"510 g in 1 BOTTLE (83324-002-16)","pharm_classes":["Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.02037,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324025705","name":"QC LIDOCAINE PAIN RLF 4% PATCH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-257-05","proprietary_name":"Quality Choice Lidocaine Pain Relief Patch","nonproprietary_name":"LIDOCAINE","dosage_form":"PATCH","route":"TOPICAL","strength":"4 g/100g","labeler":"Quality Choice (CHAIN DRUG MARKETING ASSOCIATION)","package_description":"5 PATCH in 1 CARTON (83324-257-05) / 9 g in 1 PATCH","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.10004,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324030320","name":"QC LONG ACT COUGH 15 MG SOFTGL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-303-20","proprietary_name":"QUALITY CHOICE Long Acting Cough Softgel","nonproprietary_name":"Dextromethorphan hydrobromide","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"15 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-303-20) / 20 CAPSULE, LIQUID FILLED in 1 BOTTLE","pharm_classes":["Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.1217,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324002915","name":"QC LUBRICANT 0.4-0.3% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"83324-029-15","proprietary_name":"Quality Choice Lubricant Eye Drops High Performance","nonproprietary_name":"Polyethylene glycol 400, Propylene glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".4 g/100mL; .3 g/100mL","labeler":"Chain Drug Marketing Assoc., Inc.","package_description":"1 BOTTLE, DROPPER in 1 BOX (83324-029-15) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.36253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324002815","name":"QC LUBRICANT 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.21406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324031101","name":"QC MEDICATED COOLING 50% PADS","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-311-01","proprietary_name":"QC Medicated Cooling","nonproprietary_name":"Witch Hazel","dosage_form":"CLOTH","route":"TOPICAL","strength":"500 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 JAR in 1 CARTON (83324-311-01) / 100 CLOTH in 1 JAR"},"nadac":{"value":0.04352,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324005720","name":"QC MENSTRUAL PAIN RELIEF CAPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-057-20","proprietary_name":"Menstrual Pain Relief","nonproprietary_name":"Acetaminophen, Pamabrom, Pyrilamine Maleate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1; 15 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-057-20) / 20 TABLET, FILM COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.09261,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324016015","name":"QC MICONAZOLE 7 CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-160-15","proprietary_name":"Miconazole 7","nonproprietary_name":"Miconazole Nitrate","dosage_form":"CREAM","route":"VAGINAL","strength":"20 mg/g","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 TUBE in 1 CARTON (83324-160-15) / 45 g in 1 TUBE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.1188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324003212","name":"QC MOTION SICKNESS 50 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-032-12","proprietary_name":"Motion Sickness Relief","nonproprietary_name":"Dimenhydrinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-032-12) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013714","name":"QC MUCUS DM MAX ER 1200-60 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-137-14","proprietary_name":"Mucus Relief DM","nonproprietary_name":"Guaifenesin Dextromethorphan HBr","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1; 1200 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"14 BLISTER PACK in 1 CARTON (83324-137-14) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.54461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010520","name":"QC MUCUS RELIEF COLD-FLU CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-105-20","proprietary_name":"Mucus Relief Cold and Flu All in One","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-105-20) / 10 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324009614","name":"QC MUCUS RELIEF ER 1,200 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-096-14","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1200 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BLISTER PACK in 1 CARTON (83324-096-14) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.43164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324009720","name":"QC MUCUS RELIEF ER 600 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-097-20","proprietary_name":"Mucus Relief","nonproprietary_name":"Guaifenesin","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BLISTER PACK in 1 CARTON (83324-097-20) / 20 TABLET, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.28398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010420","name":"QC MUCUS RLF COLD-FLU-THRT CPT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-104-20","proprietary_name":"Mucus Relief Cold Flu and Sore Throat","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 PACKAGE in 1 CARTON (83324-104-20) / 10 TABLET, COATED in 1 PACKAGE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324019550","name":"QC MUCUS RLF DM 20-400 MG CPLT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-195-50","proprietary_name":"Quality Choice Mucus Relief DM DM","nonproprietary_name":"Dextromethorphan Hydrobromide / Guaifenesin","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 400 mg/1","labeler":"Chain Drug Marketing Association","package_description":"1 BOTTLE in 1 CARTON (83324-195-50) / 50 TABLET in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.08191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324002606","name":"QC MUCUS RLF MAX 400-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-026-06","proprietary_name":"QCH Maximum Strength Mucus Relief DM 628","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"177 mL in 1 BOTTLE (83324-026-06)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02122,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324010720","name":"QC MUCUS RLF SINUS CONG PAIN","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-107-20","proprietary_name":"Mucus Relief Sinus Severe Congestion and Pain","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-107-20) / 10 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010620","name":"QC MUCUS RLF SINUS PAIN COUGH","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-106-20","proprietary_name":"Mucus Relief Sinus Pressure Pain and Cough","nonproprietary_name":"ACETAMINOPHEN, DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 PACKAGE in 1 PACKAGE (83324-106-20) / 10 TABLET, COATED in 1 PACKAGE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010850","name":"QC NAPROXEN SOD 220 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-108-50","proprietary_name":"Naproxen Sodium","nonproprietary_name":"NAPROXEN SODIUM","dosage_form":"TABLET, COATED","route":"ORAL","strength":"220 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-108-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324010950","name":"QC NAPROXEN SOD 220 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-109-50","proprietary_name":"Naproxen Sodium","nonproprietary_name":"NAPROXEN SODIUM","dosage_form":"TABLET, COATED","route":"ORAL","strength":"220 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-109-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.06732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324023801","name":"QC NASAL SPRAY 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-238-01","proprietary_name":"Quality Choice Nasal","nonproprietary_name":"oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"CHAIN DRUG MARKETING ASSOCIATION","package_description":"1 BOTTLE, SPRAY in 1 CARTON (83324-238-01) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.07516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324021501","name":"QC NASAL SPRAY 1%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-215-01","proprietary_name":"QUALITY CHOICE","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"NASAL","strength":"1 g/100mL","labeler":"CHAIN DRUG MARKETING ASSOCIATION","package_description":"1 BOTTLE, DROPPER in 1 CARTON (83324-215-01) / 30 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324014824","name":"QC NIGHTTIME COLD-FLU SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-148-24","proprietary_name":"Nighttime Cold and Flu Relief","nonproprietary_name":"Acetaminophen Dextromethorphan HBr Doxylamine Succinate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"325 mg/1; 15 mg/1; 6.25 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"24 BLISTER PACK in 1 CARTON (83324-148-24) / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.11915,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011032","name":"QC NIGHTTIME SLEEP 25 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-110-32","proprietary_name":"Nighttime Sleep Aid","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"4 BLISTER PACK in 1 CARTON (83324-110-32) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324021101","name":"QC NO DRIP NASAL MIST 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-211-01","proprietary_name":"Quality Choicel Nasal Mist Extra Moisturizing","nonproprietary_name":"Oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"CHAIN DRUG MARKETING ASSOCIATION","package_description":"1 BOTTLE, SPRAY in 1 CARTON (83324-211-01) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.09967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324027401","name":"QC NO DRIP NASAL MIST 0.05%","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-274-01","proprietary_name":"Quality Choice Nasal Mist Severe Congestion","nonproprietary_name":"Oxymetazoline hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":".05 g/100mL","labeler":"CHAIN DRUG MARKETING ASSOCIATION","package_description":"1 BOTTLE, SPRAY in 1 CARTON (83324-274-01) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":0.09967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324007601","name":"QC PAIN RELIEF 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-076-01","proprietary_name":"Pain Relief Regular Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION INC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-076-01) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324007801","name":"QC PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-078-01","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-078-01) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324007950","name":"QC PAIN RELIEF 500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-079-50","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-079-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013850","name":"QC PAIN RELIEF 500 MG GELCAP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-138-50","proprietary_name":"Pain Relief","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-138-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008001","name":"QC PAIN RELIEF 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-080-01","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-080-01) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008101","name":"QC PAIN RELIEF 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-081-01","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chain Drug Marketing Association","package_description":"1 PACKAGE in 1 CARTON (83324-081-01) / 100 TABLET in 1 PACKAGE"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008110","name":"QC PAIN RELIEF 500 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-081-10","proprietary_name":"Pain Relief Extra Strength","nonproprietary_name":"Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chain Drug Marketing Association","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (83324-081-10)"},"nadac":{"value":0.03394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324008501","name":"QC PAIN RLF PM 25-500 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-085-01","proprietary_name":"Pain Relief PM Extra Strength","nonproprietary_name":"Acetaminophen and Diphenhydramine Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-085-01) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324016650","name":"QC PAIN RLF PM 25-500 MG GELTAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-166-50","proprietary_name":"Pain Reliever PM","nonproprietary_name":"Acetaminophen Diphenhydramine HCl","dosage_form":"TABLET, COATED","route":"ORAL","strength":"500 mg/1; 25 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-166-50) / 50 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.04392,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011301","name":"QC REST SIMPLY 25 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-113-01","proprietary_name":"Rest Simply","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-113-01) / 100 TABLET, COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324007336","name":"QC SINUS CONGEST PE 10 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-073-36","proprietary_name":"Sinus Congestion","nonproprietary_name":"Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-073-36) / 18 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324011524","name":"QC SINUS SEVERE 325-200-5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-115-24","proprietary_name":"Sinus Severe","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-115-24) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324009424","name":"QC SINUS-HEADACHE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-094-24","proprietary_name":"Sinus plus Headache","nonproprietary_name":"ACETAMINOPHEN and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 5 mg/1","labeler":"CHAIN DRUG MARKETING ASSOCIATION, INC.","package_description":"2 BLISTER PACK in 1 CARTON (83324-094-24) / 12 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324015132","name":"QC SLEEP AID 50 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-151-32","proprietary_name":"Sleep Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-151-32) / 32 CAPSULE in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324027506","name":"QC SORE THROAT 1.4% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-275-06","proprietary_name":"QUALITY CHOICE Sore Throat","nonproprietary_name":"Phenol","dosage_form":"SPRAY","route":"ORAL","strength":"1.4 g/100mL","labeler":"CHAIN DRUG MARKETING ASSOCIATION","package_description":"177 mL in 1 BOTTLE, SPRAY (83324-275-06)"},"nadac":{"value":0.01244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324007416","name":"QC STAY AWAKE 200 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-074-16","proprietary_name":"Stay Awake","nonproprietary_name":"Caffeine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-074-16) / 8 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.08299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324002108","name":"QC STOMACH RELIEF 525 MG/15 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-021-08","proprietary_name":"Quality Choice Stomach Relief 528","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/15mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"236 mL in 1 BOTTLE (83324-021-08)"},"nadac":{"value":0.01212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324002008","name":"QC STOMACH RELIEF 525 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-020-08","proprietary_name":"Quality Choice Regular Strength Stomach Relief","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/30mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"236 mL in 1 BOTTLE (83324-020-08)"},"nadac":{"value":0.01263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324002208","name":"QC STOMACH RELIEF 525 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-022-08","proprietary_name":"QCH Stomach Relief 535","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/30mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"236 mL in 1 BOTTLE (83324-022-08)"},"nadac":{"value":0.01263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324006040","name":"QC STOMACH RLF 262 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-060-40","proprietary_name":"Stomach Relief","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"TABLET","route":"ORAL","strength":"262 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (83324-060-40) / 40 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.09302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013030","name":"QC STOMACH RLF 262 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-130-30","proprietary_name":"Stomach Relief","nonproprietary_name":"Stomach Relief","dosage_form":"TABLET","route":"ORAL","strength":"262 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"1 CELLO PACK in 1 CARTON (83324-130-30) / 30 TABLET in 1 CELLO PACK","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.08166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013560","name":"QC STOOL SOFTENER-LAXATIVE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-135-60","proprietary_name":"Senna S","nonproprietary_name":"Docusate Sodium Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"1 BOTTLE, PLASTIC in 1 BOX (83324-135-60) / 60 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324013601","name":"QC STOOL SOFTENER-STIM LAX TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-136-01","proprietary_name":"Stool Softener","nonproprietary_name":"Docusate Sodium Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"QUALITY CHOICE (Chain Drug Marketing Association)","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (83324-136-01)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324002716","name":"QC TRAVEL EASE 25 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-027-16","proprietary_name":"Travel ease","nonproprietary_name":"Meclizine HCl","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"25 mg/1","labeler":"Chain Drug Marketing Association, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (83324-027-16) / 8 TABLET, CHEWABLE in 1 BLISTER PACK","pharm_classes":["Antiemetic [EPC]","Emesis Suppression [PE]"]},"nadac":{"value":0.03334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"83324005005","name":"QC TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-050-05","proprietary_name":"QC Triple Antibiotic","nonproprietary_name":"Bacitracin zinc, Neomycin sulfate , Polymyxin B sulfate.","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"Chain Drug Marketing Association","package_description":"1 TUBE in 1 BOX (83324-050-05) / 14.2 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.13907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"83324002304","name":"QC TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-023-04","proprietary_name":"QCH Adult Tussin DM 542","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-023-04) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324002308","name":"QC TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-023-08","proprietary_name":"QCH Adult Tussin DM 542","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-023-08) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83324002504","name":"QC TUSSIN DM 200-20 MG/20 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83324-025-04","proprietary_name":"QCH Adult Tussin DM Sugar free 545","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Chain Drug Marketing Association Inc.","package_description":"1 BOTTLE in 1 CARTON (83324-025-04) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"17772013130","name":"QELBREE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-131-30","proprietary_name":"QELBREE","nonproprietary_name":"viloxazine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Supernus Pharmaceuticals, Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-131-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":12.73257,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"17772013230","name":"QELBREE ER 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-132-30","proprietary_name":"QELBREE","nonproprietary_name":"viloxazine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Supernus Pharmaceuticals, Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-132-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":12.731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"17772013330","name":"QELBREE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-133-30","proprietary_name":"QELBREE","nonproprietary_name":"viloxazine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Supernus Pharmaceuticals, Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-133-30)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":12.73799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"17772013360","name":"QELBREE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"17772-133-60","proprietary_name":"QELBREE","nonproprietary_name":"viloxazine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Supernus Pharmaceuticals, Inc","package_description":"60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-133-60)","pharm_classes":["Cytochrome P450 1A2 Inhibitors [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":12.73799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59310041012","name":"QNASL 80 MCG NASAL SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59310-410-12","proprietary_name":"QNASL","nonproprietary_name":"Beclomethasone dipropionate","dosage_form":"AEROSOL, METERED","route":"NASAL","strength":"80 ug/1","labeler":"Teva Respiratory, LLC","package_description":"1 INHALER in 1 CARTON (59310-410-12) / 120 AEROSOL, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":30.22549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Qnasl|Beclomethasone Dipropionate","basis":"brand"},"part_b":null}, {"ndc":"59310040606","name":"QNASL CHILDREN'S 40 MCG SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59310-406-06","proprietary_name":"QNASL","nonproprietary_name":"Beclomethasone Dipropionate","dosage_form":"AEROSOL, METERED","route":"NASAL","strength":"40 ug/1","labeler":"Teva Respiratory, LLC","package_description":"1 INHALER in 1 CARTON (59310-406-06) / 60 AEROSOL, METERED in 1 INHALER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":47.07776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Qnasl Children|Beclomethasone Dipropionate","basis":"brand"},"part_b":null}, {"ndc":"16571080901","name":"QUETIAPINE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-809-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-809-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.23864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904680261","name":"QUETIAPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6802-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6802-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.18361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300030916","name":"QUETIAPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-309-16","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-309-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.18361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"33342013409","name":"QUETIAPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-134-09","proprietary_name":"QUETIAPINE","nonproprietary_name":"QUETIAPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-134-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.18361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50228038160","name":"QUETIAPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-381-60","proprietary_name":"Quetiapine Extended Release","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-381-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.18361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001059906","name":"QUETIAPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-599-06","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-599-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.18361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180061307","name":"QUETIAPINE ER 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-613-07","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-613-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.18361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904680361","name":"QUETIAPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6803-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6803-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.21991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300031016","name":"QUETIAPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-310-16","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-310-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.21991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"33342013509","name":"QUETIAPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-135-09","proprietary_name":"QUETIAPINE","nonproprietary_name":"QUETIAPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-135-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.21991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50228038260","name":"QUETIAPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-382-60","proprietary_name":"Quetiapine Extended Release","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-382-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.21991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001060006","name":"QUETIAPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-600-06","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-600-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.21991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180061407","name":"QUETIAPINE ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-614-07","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-614-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.21991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904680461","name":"QUETIAPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6804-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6804-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300031116","name":"QUETIAPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-311-16","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-311-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"33342013609","name":"QUETIAPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-136-09","proprietary_name":"QUETIAPINE","nonproprietary_name":"QUETIAPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-136-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50228038360","name":"QUETIAPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-383-60","proprietary_name":"Quetiapine Extended Release","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-383-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001060106","name":"QUETIAPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-601-06","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-601-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180061507","name":"QUETIAPINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-615-07","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-615-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27174,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904680561","name":"QUETIAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6805-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6805-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300031216","name":"QUETIAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-312-16","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-312-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"33342013709","name":"QUETIAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-137-09","proprietary_name":"QUETIAPINE","nonproprietary_name":"QUETIAPINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (33342-137-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50228038460","name":"QUETIAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-384-60","proprietary_name":"Quetiapine Extended Release","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-384-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001060206","name":"QUETIAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-602-06","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-602-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180061607","name":"QUETIAPINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-616-07","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-616-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904680161","name":"QUETIAPINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6801-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6801-61) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16729013212","name":"QUETIAPINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-132-12","proprietary_name":"QUETIAPINE FUMARATE","nonproprietary_name":"QUETIAPINE FUMARATE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Accord Healthcare Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (16729-132-12)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300030816","name":"QUETIAPINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-308-16","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (29300-308-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50228038060","name":"QUETIAPINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-380-60","proprietary_name":"Quetiapine Extended Release","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (50228-380-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001059806","name":"QUETIAPINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-598-06","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-598-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180061207","name":"QUETIAPINE ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-612-07","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68180-612-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.11917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate ER|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093816201","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8162-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8162-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904664061","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6640-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6640-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571071901","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-719-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-719-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571071910","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-719-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-719-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037701","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-377-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-377-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037702","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-377-02","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-377-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300014901","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-149-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-149-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076601","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-766-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-766-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547052010","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-520-10","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-520-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547052011","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-520-11","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-520-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"47335090418","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-904-18","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (47335-904-18)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063211","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063215","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-632-15","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-632-15) / 1 TABLET in 1 BLISTER PACK (50268-632-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687034901","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-349-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-349-01) / 1 TABLET in 1 BLISTER PACK (60687-349-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687034911","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862049101","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-491-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-491-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877025001","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-250-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-250-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877025010","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-250-10","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-250-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018400","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-184-00","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-184-00)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018408","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-184-08","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-184-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044701","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-447-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-447-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044703","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-447-03","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-447-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"82009009710","name":"QUETIAPINE FUMARATE 100 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-097-10","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-097-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.0483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093816301","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8163-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8163-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904664161","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6641-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6641-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072001","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-720-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-720-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072010","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-720-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-720-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037801","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-378-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-378-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300015001","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-150-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-150-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076701","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-767-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-767-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547052110","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-521-10","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-521-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547052111","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-521-11","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-521-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063311","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063315","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-633-15","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-633-15) / 1 TABLET in 1 BLISTER PACK (50268-633-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687036001","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-360-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-360-01) / 1 TABLET in 1 BLISTER PACK (60687-360-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687036011","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862049301","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-493-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-493-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024601","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-246-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-246-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024610","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-246-10","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-246-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018200","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-182-00","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-182-00)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018203","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-182-03","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-182-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044801","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-448-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-448-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044802","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-448-02","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-448-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"82009009801","name":"QUETIAPINE FUMARATE 200 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-098-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 TABLET in 1 BOTTLE (82009-098-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093206301","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2063-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-2063-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904663861","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6638-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6638-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571071701","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-717-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-717-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571071710","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-717-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-717-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037501","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-375-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-375-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037502","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-375-02","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-375-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300014701","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-147-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-147-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300014710","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-147-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-147-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076401","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-764-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-764-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547051810","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-518-10","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-518-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547051811","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-518-11","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-518-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063011","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063015","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-630-15","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-630-15) / 1 TABLET in 1 BLISTER PACK (50268-630-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687032701","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-327-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-327-01) / 1 TABLET in 1 BLISTER PACK (60687-327-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687032711","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862048901","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-489-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-489-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024201","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-242-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-242-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024210","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-242-10","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-242-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018500","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-185-00","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-185-00)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018508","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-185-08","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-185-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044501","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-445-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-445-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044503","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-445-03","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-445-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"82009009501","name":"QUETIAPINE FUMARATE 25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-095-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 TABLET in 1 BOTTLE (82009-095-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093816401","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8164-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8164-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904664261","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6642-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6642-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072101","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-721-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-721-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072106","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-721-06","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (16571-721-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072110","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-721-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-721-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300015101","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-151-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-151-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300015116","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-151-16","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-151-16)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076801","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-768-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-768-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076860","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-768-60","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-768-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547052206","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-522-06","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-522-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"47335090686","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-906-86","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-906-86)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063411","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063415","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-634-15","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-634-15) / 1 TABLET in 1 BLISTER PACK (50268-634-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687037101","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-371-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-371-01) / 1 TABLET in 1 BLISTER PACK (60687-371-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687037111","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862049460","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-494-60","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-494-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024710","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-247-10","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-247-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024760","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-247-60","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-247-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018300","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-183-00","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-183-00)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018303","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-183-03","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-183-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018306","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-183-06","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"BluePoint Laboratories","package_description":"60 TABLET in 1 BOTTLE (68001-183-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044901","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-449-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-449-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044902","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-449-02","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-449-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044907","name":"QUETIAPINE FUMARATE 300 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-449-07","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (68180-449-07)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.12747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093816501","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8165-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8165-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904664361","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6643-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6643-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072201","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-722-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-722-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571072250","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-722-50","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-722-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714038001","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-380-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-380-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300015201","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-152-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-152-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076901","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-769-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-769-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076905","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-769-05","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-769-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547052310","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-523-10","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-523-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063511","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063515","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-635-15","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-635-15) / 1 TABLET in 1 BLISTER PACK (50268-635-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687038201","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-382-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-382-01) / 1 TABLET in 1 BLISTER PACK (60687-382-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687038211","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862049501","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-495-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-495-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024801","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-248-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-248-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024810","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-248-10","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-248-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018100","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-181-00","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-181-00)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018103","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-181-03","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-181-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180045001","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-450-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-450-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180045002","name":"QUETIAPINE FUMARATE 400 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-450-02","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (68180-450-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.16163,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00093816601","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8166-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-8166-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"00904663961","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6639-61","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6639-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571071801","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-718-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-718-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16571071810","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-718-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-718-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037601","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-376-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-376-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714037602","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-376-02","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-376-02)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300014801","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-148-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-148-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"29300014810","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-148-10","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-148-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722076501","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-765-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-765-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547051910","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-519-10","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-519-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"43547051911","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-519-11","proprietary_name":"QUETIAPINE","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-519-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"47335090388","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-903-88","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (47335-903-88)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063111","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268063115","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-631-15","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-631-15) / 1 TABLET in 1 BLISTER PACK (50268-631-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687033801","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-338-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"Quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-338-01) / 1 TABLET in 1 BLISTER PACK (60687-338-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"60687033811","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862049001","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-490-01","proprietary_name":"Quetiapine Fumarate","nonproprietary_name":"Quetiapine Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-490-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024901","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-249-01","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-249-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"67877024910","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-249-10","proprietary_name":"Quetiapine","nonproprietary_name":"Quetiapine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (67877-249-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018000","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-180-00","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-180-00)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68001018008","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-180-08","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"1000 TABLET in 1 BOTTLE (68001-180-08)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044601","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-446-01","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-446-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"68180044603","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-446-03","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET in 1 BOTTLE (68180-446-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"82009009610","name":"QUETIAPINE FUMARATE 50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-096-10","proprietary_name":"Quetiapine fumarate","nonproprietary_name":"quetiapine fumarate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET in 1 BOTTLE (82009-096-10)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.02817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quetiapine Fumarate|Quetiapine Fumarate","basis":"generic"},"part_b":null}, {"ndc":"24478007401","name":"QUILLICHEW ER 20 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-074-01","proprietary_name":"QuilliChew ER","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, CHEWABLE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"100 TABLET, CHEWABLE, EXTENDED RELEASE in 1 BOTTLE (24478-074-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.90025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quillichew ER|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"24478007501","name":"QUILLICHEW ER 30 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-075-01","proprietary_name":"QuilliChew ER","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, CHEWABLE, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"100 TABLET, CHEWABLE, EXTENDED RELEASE in 1 BOTTLE (24478-075-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.88441,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quillichew ER|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"24478007601","name":"QUILLICHEW ER 40 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-076-01","proprietary_name":"QuilliChew ER","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, CHEWABLE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"NextWave Pharmaceuticals, Inc","package_description":"100 TABLET, CHEWABLE, EXTENDED RELEASE in 1 BOTTLE (24478-076-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.87202,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quillichew ER|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"24478032102","name":"QUILLIVANT XR 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-321-02","proprietary_name":"Quillivant XR","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/60mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (24478-321-02) / 60 mL in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":5.39619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Quillivant XR|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"24478032204","name":"QUILLIVANT XR 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-322-04","proprietary_name":"Quillivant XR","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/120mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (24478-322-04) / 120 mL in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.7009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Quillivant XR|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"24478032305","name":"QUILLIVANT XR 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-323-05","proprietary_name":"Quillivant XR","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"750 mg/150mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (24478-323-05) / 150 mL in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":2.16116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Quillivant XR|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"24478032406","name":"QUILLIVANT XR 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24478-324-06","proprietary_name":"Quillivant XR","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"SUSPENSION, EXTENDED RELEASE","route":"ORAL","strength":"900 mg/180mL","labeler":"NextWave Pharmaceuticals, Inc","package_description":"1 BOTTLE in 1 CARTON (24478-324-06) / 180 mL in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.80061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Quillivant XR|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"53489014101","name":"QUINIDINE GLUC ER 324 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-141-01","proprietary_name":"Quinidine Gluconate","nonproprietary_name":"Quinidine Gluconate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"324 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (53489-141-01)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 2D6 Inhibitor [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":4.92197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quinidine Gluconate|Quinidine Gluconate","basis":"generic"},"part_b":null}, {"ndc":"71930001612","name":"QUINIDINE GLUC ER 324 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71930-016-12","proprietary_name":"Quinidine gluconate","nonproprietary_name":"Quinidine gluonate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"324 mg/1","labeler":"Eywa Pharma Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (71930-016-12)","pharm_classes":["Antiarrhythmic [EPC]","Cytochrome P450 2D6 Inhibitor [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]"]},"nadac":{"value":4.92197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quinidine Gluconate|Quinidine Gluconate","basis":"generic"},"part_b":null}, {"ndc":"00093300256","name":"QUININE SULFATE 324 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3002-56","proprietary_name":"Quinine Sulfate","nonproprietary_name":"Quinine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"324 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (0093-3002-56)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":0.69802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quinine Sulfate|Quinine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"50742023830","name":"QUININE SULFATE 324 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-238-30","proprietary_name":"QUININE SULFATE","nonproprietary_name":"QUININE SULFATE","dosage_form":"CAPSULE","route":"ORAL","strength":"324 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (50742-238-30)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":0.69802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quinine Sulfate|Quinine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"68180056006","name":"QUININE SULFATE 324 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-560-06","proprietary_name":"QUININE SULFATE","nonproprietary_name":"QUININE SULFATE","dosage_form":"CAPSULE","route":"ORAL","strength":"324 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-560-06)","pharm_classes":["Antimalarial [EPC]"]},"nadac":{"value":0.69802,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quinine Sulfate|Quinine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00074709530","name":"QULIPTA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7095-30","proprietary_name":"Qulipta","nonproprietary_name":"Atogepant","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AbbVie Inc.","package_description":"30 TABLET in 1 BOTTLE (0074-7095-30)","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":38.35832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Qulipta|Atogepant","basis":"brand"},"part_b":null}, {"ndc":"00074709630","name":"QULIPTA 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7096-30","proprietary_name":"Qulipta","nonproprietary_name":"Atogepant","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"AbbVie Inc.","package_description":"30 TABLET in 1 BOTTLE (0074-7096-30)","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":38.37771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Qulipta|Atogepant","basis":"brand"},"part_b":null}, {"ndc":"00074709430","name":"QULIPTA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7094-30","proprietary_name":"Qulipta","nonproprietary_name":"Atogepant","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"AbbVie Inc.","package_description":"30 TABLET in 1 BOTTLE (0074-7094-30)","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":38.44941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Qulipta|Atogepant","basis":"brand"},"part_b":null}, {"ndc":"80491782503","name":"QUVIVIQ 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80491-7825-3","proprietary_name":"QUVIVIQ","nonproprietary_name":"Daridorexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Idorsia Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (80491-7825-3) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]"]},"nadac":{"value":16.70464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quviviq|Daridorexant HCl","basis":"brand"},"part_b":null}, {"ndc":"80491785003","name":"QUVIVIQ 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80491-7850-3","proprietary_name":"QUVIVIQ","nonproprietary_name":"Daridorexant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Idorsia Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (80491-7850-3) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Orexin Receptor Antagonist [EPC]","Orexin Receptor Antagonists [MoA]"]},"nadac":{"value":16.70464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Quviviq|Daridorexant HCl","basis":"brand"},"part_b":null}, {"ndc":"59310030240","name":"QVAR REDIHALER 40 MCG","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59310-302-40","proprietary_name":"QVAR REDIHALER","nonproprietary_name":"Beclomethasone Dipropionate HFA","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"40 ug/1","labeler":"Teva Respiratory, LLC","package_description":"1 INHALER in 1 CARTON (59310-302-40) / 1 CANISTER in 1 INHALER / 120 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":20.56589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Qvar Redihaler|Beclomethasone Dipropionate","basis":"brand"},"part_b":null}, {"ndc":"59310030480","name":"QVAR REDIHALER 80 MCG","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59310-304-80","proprietary_name":"QVAR REDIHALER","nonproprietary_name":"Beclomethasone Dipropionate HFA","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1","labeler":"Teva Respiratory, LLC","package_description":"1 INHALER in 1 CARTON (59310-304-80) / 1 CANISTER in 1 INHALER / 120 AEROSOL, METERED in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":27.56579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Qvar Redihaler|Beclomethasone Dipropionate","basis":"brand"},"part_b":null}, {"ndc":"13668010730","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-107-30","proprietary_name":"Rabeprazole sodium","nonproprietary_name":"Rabeprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-107-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"13668010790","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-107-90","proprietary_name":"Rabeprazole sodium","nonproprietary_name":"Rabeprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (13668-107-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"62135050330","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-503-30","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (62135-503-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"62175030232","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-302-32","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (62175-302-32)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"62175030246","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62175-302-46","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (62175-302-46)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862072130","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-721-30","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (65862-721-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862072190","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-721-90","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (65862-721-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"67877044330","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-443-30","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-443-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"67877044390","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-443-90","proprietary_name":"Rabeprazole Sodium","nonproprietary_name":"Rabeprazole Sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (67877-443-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"72888005930","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-059-30","proprietary_name":"RABEPRAZOLE SODIUM","nonproprietary_name":"rabeprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Limited","package_description":"30 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-059-30)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"72888005990","name":"RABEPRAZOLE SOD DR 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-059-90","proprietary_name":"RABEPRAZOLE SODIUM","nonproprietary_name":"rabeprazole sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Limited","package_description":"90 TABLET, DELAYED RELEASE in 1 BOTTLE (72888-059-90)","pharm_classes":["Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]"]},"nadac":{"value":0.22385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rabeprazole Sodium|Rabeprazole Sodium","basis":"generic"},"part_b":null}, {"ndc":"52709160101","name":"RAGWITEK SUBLINGUAL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.7396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52709160103","name":"RAGWITEK SUBLINGUAL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":11.7396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"30698045501","name":"RALDESY 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-455-01","proprietary_name":"RALDESY TM","nonproprietary_name":"TRAZODONE HYDROCHLORIDE ORAL","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Validus Pharmaceuticals LLC","package_description":"300 mL in 1 BOTTLE (30698-455-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":1.54111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"30698045502","name":"RALDESY 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"30698-455-02","proprietary_name":"RALDESY TM","nonproprietary_name":"TRAZODONE HYDROCHLORIDE ORAL","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"Validus Pharmaceuticals LLC","package_description":"150 mL in 1 BOTTLE (30698-455-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":2.45747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093729001","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7290-01","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-7290-01)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"00093729056","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7290-56","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7290-56)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"00904690204","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6902-04","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6902-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"16714021301","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-213-01","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-213-01)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"16714021302","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-213-02","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-213-02)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"16714021303","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-213-03","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-213-03)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"43598050501","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-505-01","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (43598-505-01)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"43598050510","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-505-10","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (43598-505-10)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"43598050530","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-505-30","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Dr.Reddy’s Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-505-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"50268069411","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"50268069415","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-694-15","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-694-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-694-11)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"60687026611","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"60687026621","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-266-21","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-266-21) / 1 TABLET in 1 BLISTER PACK (60687-266-11)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"65162005703","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-057-03","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65162-057-03)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"65162005710","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-057-10","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65162-057-10)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"65862070901","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-709-01","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-709-01)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"65862070930","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-709-30","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-709-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"69097082502","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-825-02","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-825-02)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"69097082507","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-825-07","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-825-07)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"69097082515","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-825-15","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-825-15)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"72241001005","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-010-05","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"60 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (72241-010-05)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"72241001011","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-010-11","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"60 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (72241-010-11)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"72241001022","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-010-22","proprietary_name":"Raloxifene hydrochloride","nonproprietary_name":"Raloxifene hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"60 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (72241-010-22)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"76282025605","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-256-05","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (76282-256-05)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"76282025630","name":"RALOXIFENE HCL 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-256-30","proprietary_name":"Raloxifene Hydrochloride","nonproprietary_name":"Raloxifene Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-256-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.22348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Raloxifene HCl|Raloxifene HCl","basis":"generic"},"part_b":null}, {"ndc":"00591219101","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2191-01","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (0591-2191-01)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"00591219130","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2191-30","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (0591-2191-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"00832125011","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1250-11","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0832-1250-11)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"00832125030","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1250-30","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0832-1250-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"00904749406","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7494-06","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7494-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"42571037501","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-375-01","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Micro Labs Limited","package_description":"100 TABLET in 1 BOTTLE (42571-375-01)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"42571037530","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-375-30","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-375-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"50268082211","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"50268082215","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-822-15","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-822-15) / 1 TABLET in 1 BLISTER PACK (50268-822-11)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"52817023510","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-235-10","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"TruPharma, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (52817-235-10)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"52817023530","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-235-30","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"TruPharma, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (52817-235-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"59651050501","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-505-01","proprietary_name":"RAMELTEON","nonproprietary_name":"RAMELTEON","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59651-505-01)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"59651050530","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-505-30","proprietary_name":"RAMELTEON","nonproprietary_name":"RAMELTEON","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-505-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"60687069211","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"60687069265","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-692-65","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-692-65) / 1 TABLET in 1 BLISTER PACK (60687-692-11)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"70010002803","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-028-03","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (70010-028-03)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"70700027205","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-272-05","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Xiromed, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70700-272-05)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"70700027210","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-272-10","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Xiromed, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (70700-272-10)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"70700027230","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-272-30","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Xiromed, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70700-272-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"70710134401","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1344-1","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1344-1)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"70710134403","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1344-3","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET","route":"ORAL","strength":"8 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1344-3)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"85742002322","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85742-023-22","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Kanchan Healthcare Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (85742-023-22)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"85742002323","name":"RAMELTEON 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85742-023-23","proprietary_name":"Ramelteon","nonproprietary_name":"Ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Kanchan Healthcare Inc","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (85742-023-23)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramelteon|Ramelteon","basis":"generic"},"part_b":null}, {"ndc":"57237022201","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-222-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-222-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022230","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-222-30","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (57237-222-30)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"62135027190","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-271-90","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-271-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047401","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-474-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-474-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68001042800","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-428-00","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-428-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68382014406","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-144-06","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68382-144-06)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067001","name":"RAMIPRIL 1.25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-670-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-670-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.08041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022501","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-225-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-225-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022505","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-225-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-225-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"62135027401","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-274-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 CAPSULE in 1 BOTTLE (62135-274-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"62135027490","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-274-90","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-274-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047701","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-477-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-477-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047705","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-477-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-477-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68001043100","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-431-00","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-431-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68001043103","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-431-03","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE in 1 BOTTLE (68001-431-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059101","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-591-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-591-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059102","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-591-02","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (68180-591-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059109","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-591-09","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-591-09)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059110","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-591-10","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-591-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68382014701","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-147-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-147-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067301","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-673-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-673-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067305","name":"RAMIPRIL 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-673-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (76282-673-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.07071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022301","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-223-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-223-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022305","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-223-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-223-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"62135027290","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-272-90","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-272-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047501","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-475-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-475-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047505","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-475-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-475-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68001042900","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-429-00","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-429-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180058901","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-589-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-589-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180058902","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-589-02","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (68180-589-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180058909","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-589-09","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-589-09)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180058910","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-589-10","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-589-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68382014501","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-145-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-145-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067101","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-671-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-671-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067105","name":"RAMIPRIL 2.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-671-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (76282-671-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.0473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022401","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-224-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-224-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"57237022405","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-224-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-224-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"62135027301","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-273-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 CAPSULE in 1 BOTTLE (62135-273-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"62135027390","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-273-90","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 CAPSULE in 1 BOTTLE (62135-273-90)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047601","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-476-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-476-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"65862047605","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-476-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-476-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68001043000","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-430-00","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-430-00)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68001043003","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-430-03","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE in 1 BOTTLE (68001-430-03)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059001","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-590-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68180-590-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059002","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-590-02","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (68180-590-02)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059009","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-590-09","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-590-09)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68180059010","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-590-10","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-590-10)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"68382014601","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-146-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-146-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067201","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-672-01","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-672-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"76282067205","name":"RAMIPRIL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-672-05","proprietary_name":"Ramipril","nonproprietary_name":"Ramipril","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (76282-672-05)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.05141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ramipril|Ramipril","basis":"generic"},"part_b":null}, {"ndc":"27241012602","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-126-02","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-126-02)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"27241012605","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-126-05","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-126-05)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"31722066960","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-669-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-669-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"50228042460","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-424-60","proprietary_name":"RANOLAZINE","nonproprietary_name":"RANOLAZINE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 PACKAGE (50228-424-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"50268072311","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"50268072313","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-723-13","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-723-13) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-723-11)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"59651001060","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-010-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-010-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"67877052660","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-526-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-526-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"68462032060","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-320-60","proprietary_name":"Ranolazine","nonproprietary_name":"RANOLAZINE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-320-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"69367029460","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-294-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69367-294-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"70756070460","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-704-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Lifestar Pharma LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70756-704-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"72319002202","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-022-02","proprietary_name":"RANOLAZINE","nonproprietary_name":"RANOLAZINE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (72319-022-02)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"72578006514","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-065-14","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (72578-065-14)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"90096015260","name":"RANOLAZINE ER 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"90096-152-60","proprietary_name":"Ranolazine","nonproprietary_name":"ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"1000 mg/1","labeler":"Zameer Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (90096-152-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.27428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"00904750604","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7506-04","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7506-04) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"27241012502","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-125-02","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-125-02)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"27241012505","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-125-05","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-125-05)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"31722066860","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-668-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-668-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"42385096360","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"50228042360","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-423-60","proprietary_name":"RANOLAZINE","nonproprietary_name":"RANOLAZINE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"ScieGen Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 PACKAGE (50228-423-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"50268072211","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"50268072215","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-722-15","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-722-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK (50268-722-11)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"59651000960","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-009-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (59651-009-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"60687054911","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"60687054921","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-549-21","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-549-21) / 1 TABLET, EXTENDED RELEASE in 1 BLISTER PACK (60687-549-11)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"67877052560","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-525-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (67877-525-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"68462031960","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-319-60","proprietary_name":"Ranolazine","nonproprietary_name":"RANOLAZINE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-319-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"69367029360","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-293-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (69367-293-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"70756070360","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-703-60","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Lifestar Pharma LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70756-703-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"72319002102","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-021-02","proprietary_name":"RANOLAZINE","nonproprietary_name":"RANOLAZINE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (72319-021-02)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"72578006414","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-064-14","proprietary_name":"Ranolazine","nonproprietary_name":"Ranolazine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (72578-064-14)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"90096015160","name":"RANOLAZINE ER 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"90096-151-60","proprietary_name":"Ranolazine","nonproprietary_name":"ranolazine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Zameer Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (90096-151-60)","pharm_classes":["Anti-anginal [EPC]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.16493,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ranolazine ER|Ranolazine","basis":"generic"},"part_b":null}, {"ndc":"00093306056","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3060-56","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-3060-56)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"13668044730","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-447-30","proprietary_name":"RASAGILINE","nonproprietary_name":"RASAGILINE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 CONTAINER (13668-447-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"16714077001","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-770-01","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-770-01)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"23155074603","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"33342030807","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-308-07","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-308-07)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"42571022030","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-220-30","proprietary_name":"RASAGILINE","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-220-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"47781068330","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-683-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Alvogen, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (47781-683-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135067630","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-676-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-676-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"64980071130","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-711-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-711-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"67877025930","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-259-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-259-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"71921040733","name":"RASAGILINE MESYLATE 0.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-407-33","proprietary_name":"Rasagiline mesylate","nonproprietary_name":"Rasagiline mesylate","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"30 TABLET in 1 BOTTLE (71921-407-33)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.52085,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"00093306156","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3061-56","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET in 1 BOTTLE (0093-3061-56)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"13668044630","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-446-30","proprietary_name":"RASAGILINE","nonproprietary_name":"RASAGILINE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 CONTAINER (13668-446-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"16714077101","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-771-01","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 BOTTLE (16714-771-01)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"23155074703","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"33342030907","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-309-07","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-309-07)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"42571022130","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-221-30","proprietary_name":"RASAGILINE","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-221-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"47781069030","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-690-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Alvogen, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (47781-690-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"62135067730","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-677-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-677-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"64980071230","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-712-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE (64980-712-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"67877026030","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-260-30","proprietary_name":"Rasagiline","nonproprietary_name":"Rasagiline","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-260-30)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"71921040833","name":"RASAGILINE MESYLATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-408-33","proprietary_name":"Rasagiline mesylate","nonproprietary_name":"Rasagiline mesylate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"30 TABLET in 1 BOTTLE (71921-408-33)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.92551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rasagiline Mesylate|Rasagiline Mesylate","basis":"generic"},"part_b":null}, {"ndc":"59137051004","name":"RASUVO 10 MG/0.2 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59137-510-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"10 mg/.2mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-510-04) / .2 mL in 1 PACKAGE (59137-510-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":721.8144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"59137051504","name":"RASUVO 12.5 MG/0.25 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59137-515-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"12.5 mg/.25mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-515-04) / .25 mL in 1 PACKAGE (59137-515-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":574.86795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"59137052004","name":"RASUVO 15 MG/0.3 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59137-520-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"15 mg/.3mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-520-04) / .3 mL in 1 PACKAGE (59137-520-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":480.00227,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"59137052504","name":"RASUVO 17.5 MG/0.35 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59137-525-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"17.5 mg/.35mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-525-04) / .35 mL in 1 PACKAGE (59137-525-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":409.92919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"59137053004","name":"RASUVO 20 MG/0.4 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59137-530-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20 mg/.4mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-530-04) / .4 mL in 1 PACKAGE (59137-530-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":362.2851,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"59137054004","name":"RASUVO 25 MG/0.5 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59137-540-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"25 mg/.5mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-540-04) / .5 mL in 1 PACKAGE (59137-540-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":289.365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"59137050504","name":"RASUVO 7.5 MG/0.15 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59137-505-04","proprietary_name":"Rasuvo","nonproprietary_name":"methotrexate","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.15mL","labeler":"Medexus Pharma Inc.","package_description":"4 PACKAGE in 1 CARTON (59137-505-04) / .15 mL in 1 PACKAGE (59137-505-00)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":960.29324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rasuvo|Methotrexate/PF","basis":"brand"},"part_b":null}, {"ndc":"70301100201","name":"RAYALDEE ER 30 MCG CAP (HARD)","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70301-1002-1","proprietary_name":"Rayaldee","nonproprietary_name":"calcifediol","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"30 ug/1","labeler":"OPKO Pharmaceuticals LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70301-1002-1)","pharm_classes":["Cholecalciferol [CS]","Vitamin D3 Analog [EPC]"]},"nadac":{"value":41.25971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"44087334401","name":"REBIF REBIDOSE 44 MCG/0.5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"44087-3344-1","proprietary_name":"REBIF REBIDOSE","nonproprietary_name":"INTERFERON BETA-1A","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"44 ug/.5mL","labeler":"EMD Serono, Inc.","package_description":"12 PACKAGE in 1 CARTON (44087-3344-1) / .5 mL in 1 PACKAGE (44087-3344-9)","pharm_classes":["Interferon beta [EPC]","Interferon-beta [CS]"]},"nadac":{"value":1848.67278,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-03","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rebif Rebidose|Interferon Beta-1a/Albumin","basis":"brand"},"part_b":null}, {"ndc":"00093330416","name":"RECLIPSEN 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3304-16","proprietary_name":"Reclipsen 28 Day","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0093-3304-16) / 1 BLISTER PACK in 1 POUCH (0093-3304-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Reclipsen|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093330428","name":"RECLIPSEN 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Reclipsen|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"58914030180","name":"RECTIV 0.4% OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58914-301-80","proprietary_name":"Rectiv","nonproprietary_name":"nitroglycerin","dosage_form":"OINTMENT","route":"RECTAL","strength":"4 mg/g","labeler":"Allergan, Inc.","package_description":"1 TUBE in 1 CARTON (58914-301-80) / 30 g in 1 TUBE","pharm_classes":["Nitrate Vasodilator [EPC]","Nitrates [CS]","Vasodilation [PE]"]},"nadac":{"value":20.58573,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":8.3149,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Rectiv|Nitroglycerin","basis":"brand"},"part_b":null}, {"ndc":"70000001001","name":"REDNESS RELIEF EYE DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0010-1","proprietary_name":"Leader Eye Drops Redness Relief","nonproprietary_name":"Glycerin, Naphazoline hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".25 g/100mL; .012 g/100mL","labeler":"Cardinal Health","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0010-1) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.10358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023455430","name":"REFRESH CELLUVISC 1% EYE GEL","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-4554-30","proprietary_name":"REFRESH CELLUVISC","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"GEL","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (0023-4554-30) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.36652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023050601","name":"REFRESH CLASSIC EYE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0506-01","proprietary_name":"REFRESH Classic","nonproprietary_name":"Polyvinyl Alcohol, Povidone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"14 mg/mL; 6 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (0023-0506-01) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.30611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023050650","name":"REFRESH CLASSIC EYE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0506-50","proprietary_name":"REFRESH Classic","nonproprietary_name":"Polyvinyl Alcohol, Povidone","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"14 mg/mL; 6 mg/mL","labeler":"Allergan, Inc.","package_description":"50 VIAL, SINGLE-USE in 1 CARTON (0023-0506-50) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.27972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023695210","name":"REFRESH DIGITAL EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-6952-10","proprietary_name":"Refresh Digital","nonproprietary_name":"Carboxymethylcellulose sodium, Glycerin, Polysorbate 80","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 10 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-6952-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.03229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023695430","name":"REFRESH DIGITAL PF EYE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-6954-30","proprietary_name":"Refresh Digital PF","nonproprietary_name":"Carboxymethylcellulose sodium, Glycerin and Polysorbate 80","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 10 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, PLASTIC in 1 CARTON (0023-6954-30) / .4 mL in 1 VIAL, PLASTIC","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.44482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023031204","name":"REFRESH LACRI-LUBE OINTMENT","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0312-04","proprietary_name":"REFRESH LACRI-LUBE","nonproprietary_name":"mineral oil, petrolatum","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"425 mg/g; 568 mg/g","labeler":"Allergan, Inc.","package_description":"1 TUBE in 1 CARTON (0023-0312-04) / 3.5 g in 1 TUBE"},"nadac":{"value":2.78813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00023920515","name":"REFRESH LIQUIGEL 1% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-9205-15","proprietary_name":"REFRESH LIQUIGEL","nonproprietary_name":"Carboxymethylcellulose sodium","dosage_form":"GEL","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-9205-15) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.57805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023430710","name":"REFRESH OPTIVE ADVANCED DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-4307-10","proprietary_name":"REFRESH OPTIVE Advanced","nonproprietary_name":"carboxymethylcellulose sodium, glycerin, and polysorbate 80","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 10 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-4307-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.03229,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023449130","name":"REFRESH OPTIVE ADVANCED DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-4491-30","proprietary_name":"REFRESH OPTIVE Advanced","nonproprietary_name":"carboxymethylcellulose sodium, glycerin, polysorbate 80","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 10 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (0023-4491-30) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.44482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023324015","name":"REFRESH OPTIVE EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-3240-15","proprietary_name":"REFRESH OPTIVE","nonproprietary_name":"carboxymethylcellulose sodium and glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3240-15) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.65911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023545910","name":"REFRESH OPTIVE GEL EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-5459-10","proprietary_name":"REFRESH OPTIVE Drops","nonproprietary_name":"carboxymethylcellulose sodium and glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-5459-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.09895,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023577330","name":"REFRESH OPTIVE MEGA-3 PF DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-5773-30","proprietary_name":"REFRESH Optive Mega-3","nonproprietary_name":"Carboxymethylcellulose sodium, Glycerin and Polysorbate 80","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 10 mg/mL; 5 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 BOX (0023-5773-30) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.44482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023341630","name":"REFRESH OPTIVE SENSITIVE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-3416-30","proprietary_name":"Refresh Optive","nonproprietary_name":"Carboxymethylcellulose Sodium, Glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (0023-3416-30) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.34199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023024004","name":"REFRESH P.M. OINTMENT","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":null,"nadac":{"value":2.44857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":1.48809,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00023066704","name":"REFRESH P.M. OINTMENT","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0667-04","proprietary_name":"REFRESH P.M.","nonproprietary_name":"mineral oil, petrolatum","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"425 mg/g; 573 mg/g","labeler":"Allergan, Inc.","package_description":"1 TUBE in 1 CARTON (0023-0667-04) / 3.5 g in 1 TUBE"},"nadac":{"value":2.44857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":1.48809,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00023040330","name":"REFRESH PLUS 0.5% EYE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0403-30","proprietary_name":"REFRESH PLUS","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (0023-0403-30) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.29683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22679,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023040350","name":"REFRESH PLUS 0.5% EYE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0403-50","proprietary_name":"REFRESH PLUS","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Allergan, Inc.","package_description":"50 VIAL, SINGLE-USE in 1 CARTON (0023-0403-50) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.27639,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.2548,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023040370","name":"REFRESH PLUS 0.5% EYE DROPS","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0403-70","proprietary_name":"REFRESH PLUS","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Allergan, Inc.","package_description":"70 VIAL, SINGLE-USE in 1 CARTON (0023-0403-70) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.25955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16275,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023663010","name":"REFRESH RELIEVA 0.5-0.9% DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-6630-10","proprietary_name":"Refresh Relieva","nonproprietary_name":"Carboxymethylcellulose sodium, Glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-6630-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.08866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023663410","name":"REFRESH RELIEVA PF 0.5-0.9% DP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6634-10","proprietary_name":"Refresh Relieva Preservative Free","nonproprietary_name":"Carboxymethylcellulose sodium and Glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-6634-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.2541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023451530","name":"REFRESH RELIEVA PF 0.5-1% DROP","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-4515-30","proprietary_name":"Refresh RELIEVA PF","nonproprietary_name":"Carboxymethylcellulose sodium and Glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 10 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 CARTON (0023-4515-30) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.45293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023378210","name":"REFRESH RELIEVA PF XTRA DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3782-10","proprietary_name":"Refresh Relieva PF Xtra","nonproprietary_name":"Carboxymethylcellulose Sodium and Glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3782-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.2541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023079801","name":"REFRESH TEARS 0.5% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0798-01","proprietary_name":"REFRESH TEARS","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Allergan, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0023-0798-01) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.41169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.28017,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023079815","name":"REFRESH TEARS 0.5% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0023-0798-15","proprietary_name":"REFRESH TEARS","nonproprietary_name":"carboxymethylcellulose sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-0798-15) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.55781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.32365,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00023311010","name":"REFRESH TEARS PF 0.5-0.9% DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-3110-10","proprietary_name":"REFRESH TEARS PF","nonproprietary_name":"carboxymethylcellulose sodium, Glycerin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 9 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0023-3110-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Glycerol [CS]","Increased Histamine Release [PE]","Increased IgG Production [PE]","Non-Standardized Chemical Allergen [EPC]"]},"nadac":{"value":1.2541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"15370017030","name":"RELAFEN DS 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"15370-170-30","proprietary_name":"RELAFEN DS","nonproprietary_name":"NABUMETONE","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (15370-170-30)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":31.66667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relafen Ds|Nabumetone","basis":"brand"},"part_b":null}, {"ndc":"15370017060","name":"RELAFEN DS 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"15370-170-60","proprietary_name":"RELAFEN DS","nonproprietary_name":"NABUMETONE","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Carwin Pharmaceutical Associates, LLC","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (15370-170-60)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":31.66667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relafen Ds|Nabumetone","basis":"brand"},"part_b":null}, {"ndc":"68025009510","name":"RELEXXII ER 18 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-095-10","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-095-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.94478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009530","name":"RELEXXII ER 18 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-095-30","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"18 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-095-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.94478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009610","name":"RELEXXII ER 27 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-096-10","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-096-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.32467,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009630","name":"RELEXXII ER 27 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-096-30","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"27 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-096-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.32467,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009710","name":"RELEXXII ER 36 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-097-10","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-097-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.74277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009730","name":"RELEXXII ER 36 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-097-30","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"36 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-097-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":11.74277,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009810","name":"RELEXXII ER 54 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68025-098-10","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-098-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.77792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025009830","name":"RELEXXII ER 54 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68025-098-30","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"54 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-098-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.77792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025008930","name":"RELEXXII ER 63 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-089-30","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"63 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-089-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":21.35259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":18.87437,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68025008430","name":"RELEXXII ER 72 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68025-084-30","proprietary_name":"RELEXXII","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"72 mg/1","labeler":"Vertical Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68025-084-30)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":22.0992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657023301","name":"RELGAABI 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-233-01","proprietary_name":"RELGAABI","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (58657-233-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"58657023401","name":"RELGAABI 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-234-01","proprietary_name":"RELGAABI","nonproprietary_name":"Gabapentin","dosage_form":"CAPSULE","route":"ORAL","strength":"400 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (58657-234-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.04222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Gabapentin|Gabapentin","basis":"generic"},"part_b":null}, {"ndc":"58151036732","name":"RELPAX 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":77.37047,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relpax|Eletriptan Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"58151036756","name":"RELPAX 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-367-56","proprietary_name":"Relpax","nonproprietary_name":"eletriptan hydrobromide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Viatris Specialty LLC","package_description":"6 BLISTER PACK in 1 CARTON (58151-367-56) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":77.37047,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.72929,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relpax|Eletriptan Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"58151036832","name":"RELPAX 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":77.04869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relpax|Eletriptan Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"58151036856","name":"RELPAX 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-368-56","proprietary_name":"Relpax","nonproprietary_name":"eletriptan hydrobromide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Viatris Specialty LLC","package_description":"6 BLISTER PACK in 1 CARTON (58151-368-56) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":77.04869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relpax|Eletriptan Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"58151036896","name":"RELPAX 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-368-96","proprietary_name":"Relpax","nonproprietary_name":"eletriptan hydrobromide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Viatris Specialty LLC","package_description":"12 BLISTER PACK in 1 CARTON (58151-368-96) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":77.04869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.74515,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Relpax|Eletriptan Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"78206016001","name":"REMERON 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-160-01","proprietary_name":"REMERON","nonproprietary_name":"MIRTAZAPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-160-01)"},"nadac":{"value":6.36287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06299,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Remeron|Mirtazapine","basis":"brand"},"part_b":null}, {"ndc":"78206016101","name":"REMERON 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-161-01","proprietary_name":"REMERON","nonproprietary_name":"MIRTAZAPINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-161-01)"},"nadac":{"value":6.67309,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08852,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Remeron|Mirtazapine","basis":"brand"},"part_b":null}, {"ndc":"58468013301","name":"RENVELA 800 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58468-0133-1","proprietary_name":"Renvela","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Genzyme Corporation","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (58468-0133-1)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":5.68515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Renvela|Sevelamer Carbonate","basis":"brand"},"part_b":null}, {"ndc":"33342024811","name":"REPAGLINIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-248-11","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-248-11)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.07724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"57237015701","name":"REPAGLINIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-157-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-157-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.07724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"62135094690","name":"REPAGLINIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-946-90","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-946-90)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.07724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"65862067001","name":"REPAGLINIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-670-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-670-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.07724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"72603081001","name":"REPAGLINIDE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-810-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (72603-810-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.07724,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"33342024911","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-249-11","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-249-11)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"57237015801","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-158-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-158-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"60687056011","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"60687056021","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-560-21","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-560-21) / 1 TABLET in 1 BLISTER PACK (60687-560-11)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"62135094790","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-947-90","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-947-90)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"65862067101","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-671-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-671-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"72603081101","name":"REPAGLINIDE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-811-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (72603-811-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"33342025011","name":"REPAGLINIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-250-11","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (33342-250-11)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"57237015901","name":"REPAGLINIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-159-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-159-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"62135094890","name":"REPAGLINIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-948-90","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-948-90)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"65862067201","name":"REPAGLINIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-672-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-672-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"72603081201","name":"REPAGLINIDE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-812-01","proprietary_name":"Repaglinide","nonproprietary_name":"Repaglinide","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar RxLLC","package_description":"100 TABLET in 1 BOTTLE (72603-812-01)","pharm_classes":["Glinide [EPC]","Potassium Channel Antagonists [MoA]"]},"nadac":{"value":0.09249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Repaglinide|Repaglinide","basis":"generic"},"part_b":null}, {"ndc":"72511039302","name":"REPATHA 140 MG/ML SURECLICK","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72511-393-02","proprietary_name":"REPATHA","nonproprietary_name":"Evolocumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"140 mg/mL","labeler":"Amgen USA Inc.","package_description":"2 SYRINGE in 1 CARTON (72511-393-02) / 1 mL in 1 SYRINGE","pharm_classes":["Antibodies, Monoclonal [CS]","PCSK9 Inhibitor [EPC]","PCSK9 Inhibitors [MoA]"]},"nadac":{"value":281.96114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Repatha Sureclick|Evolocumab","basis":"brand"},"part_b":null}, {"ndc":"72511076002","name":"REPATHA 140 MG/ML SURECLICK","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72511-760-02","proprietary_name":"REPATHA","nonproprietary_name":"Evolocumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"140 mg/mL","labeler":"Amgen USA Inc.","package_description":"2 SYRINGE in 1 CARTON (72511-760-02) / 1 mL in 1 SYRINGE (72511-760-01)","pharm_classes":["Antibodies, Monoclonal [CS]","PCSK9 Inhibitor [EPC]","PCSK9 Inhibitors [MoA]"]},"nadac":{"value":281.96114,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Repatha Sureclick|Evolocumab","basis":"brand"},"part_b":null}, {"ndc":"72511050101","name":"REPATHA 140 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72511-501-01","proprietary_name":"REPATHA","nonproprietary_name":"Evolocumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"140 mg/mL","labeler":"Amgen USA Inc.","package_description":"1 SYRINGE in 1 CARTON (72511-501-01) / 1 mL in 1 SYRINGE","pharm_classes":["Antibodies, Monoclonal [CS]","PCSK9 Inhibitor [EPC]","PCSK9 Inhibitors [MoA]"]},"nadac":{"value":281.80579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Repatha Syringe|Evolocumab","basis":"brand"},"part_b":null}, {"ndc":"72511075001","name":"REPATHA 140 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72511-750-01","proprietary_name":"REPATHA","nonproprietary_name":"Evolocumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"140 mg/mL","labeler":"Amgen USA Inc.","package_description":"1 SYRINGE in 1 CARTON (72511-750-01) / 1 mL in 1 SYRINGE","pharm_classes":["Antibodies, Monoclonal [CS]","PCSK9 Inhibitor [EPC]","PCSK9 Inhibitors [MoA]"]},"nadac":{"value":281.80579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Repatha Syringe|Evolocumab","basis":"brand"},"part_b":null}, {"ndc":"00023916330","name":"RESTASIS 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9163-30","proprietary_name":"RESTASIS","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Allergan, Inc.","package_description":"30 VIAL, SINGLE-USE in 1 TRAY (0023-9163-30) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":10.31333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.18033,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Restasis|Cyclosporine","basis":"brand"},"part_b":null}, {"ndc":"00023916360","name":"RESTASIS 0.05% EYE EMULSION","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-9163-60","proprietary_name":"RESTASIS","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Allergan, Inc.","package_description":"60 VIAL, SINGLE-USE in 1 TRAY (0023-9163-60) / .4 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":10.31247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.90945,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Restasis|Cyclosporine","basis":"brand"},"part_b":null}, {"ndc":"00023530105","name":"RESTASIS MULTIDOSE 0.05% EYE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-5301-05","proprietary_name":"Restasis MultiDose","nonproprietary_name":"cyclosporine","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".5 mg/mL","labeler":"Allergan, Inc.","package_description":"1 BOTTLE in 1 CARTON (0023-5301-05) / 5.5 mL in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":112.32159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Restasis Multidose|Cyclosporine","basis":"brand"},"part_b":null}, {"ndc":"52747020730","name":"RESTORA RX CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.56858,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00069130810","name":"RETACRIT 10,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0069-1308-10","proprietary_name":"RETACRIT","nonproprietary_name":"epoetin alfa-epbx","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"10000 [iU]/mL","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0069-1308-10) / 1 mL in 1 VIAL, SINGLE-DOSE (0069-1308-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":112.68282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Retacrit|Epoetin Alfa-Epbx","basis":"brand"},"part_b":null}, {"ndc":"00069130510","name":"RETACRIT 2,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0069-1305-10","proprietary_name":"RETACRIT","nonproprietary_name":"epoetin alfa-epbx","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"2000 [iU]/mL","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (0069-1305-10) / 1 mL in 1 VIAL, SINGLE-DOSE (0069-1305-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":22.52274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Retacrit|Epoetin Alfa-Epbx","basis":"brand"},"part_b":null}, {"ndc":"00069131110","name":"RETACRIT 20,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0069-1311-10","proprietary_name":"RETACRIT","nonproprietary_name":"epoetin alfa-epbx","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"20000 [iU]/mL","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (0069-1311-10) / 1 mL in 1 VIAL, MULTI-DOSE (0069-1311-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":224.78764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Retacrit|Epoetin Alfa-Epbx","basis":"brand"},"part_b":null}, {"ndc":"00069130904","name":"RETACRIT 40,000 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0069-1309-04","proprietary_name":"RETACRIT","nonproprietary_name":"epoetin alfa-epbx","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"40000 [iU]/mL","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"4 VIAL, SINGLE-DOSE in 1 CARTON (0069-1309-04) / 1 mL in 1 VIAL, SINGLE-DOSE (0069-1309-01)","pharm_classes":["Erythropoiesis-stimulating Agent [EPC]","Erythropoietin [CS]","Increased Erythroid Cell Production [PE]"]},"nadac":{"value":448.00738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Retacrit|Epoetin Alfa-Epbx","basis":"brand"},"part_b":null}, {"ndc":"59148003513","name":"REXULTI 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-035-13","proprietary_name":"Rexulti","nonproprietary_name":"brexpiprazole","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (59148-035-13) / 30 TABLET in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.49708,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rexulti|Brexpiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148003613","name":"REXULTI 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-036-13","proprietary_name":"Rexulti","nonproprietary_name":"brexpiprazole","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (59148-036-13) / 30 TABLET in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.48616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rexulti|Brexpiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148003713","name":"REXULTI 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-037-13","proprietary_name":"Rexulti","nonproprietary_name":"brexpiprazole","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (59148-037-13) / 30 TABLET in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.55969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rexulti|Brexpiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148003813","name":"REXULTI 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-038-13","proprietary_name":"Rexulti","nonproprietary_name":"brexpiprazole","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (59148-038-13) / 30 TABLET in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.52525,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rexulti|Brexpiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148003913","name":"REXULTI 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-039-13","proprietary_name":"Rexulti","nonproprietary_name":"brexpiprazole","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (59148-039-13) / 30 TABLET in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.50907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rexulti|Brexpiprazole","basis":"brand"},"part_b":null}, {"ndc":"59148004013","name":"REXULTI 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59148-040-13","proprietary_name":"Rexulti","nonproprietary_name":"brexpiprazole","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Otsuka America Pharmaceutical, Inc.","package_description":"1 BOTTLE in 1 CARTON (59148-040-13) / 30 TABLET in 1 BOTTLE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.46742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rexulti|Brexpiprazole","basis":"brand"},"part_b":null}, {"ndc":"00002449108","name":"REYVOW 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-4491-08","proprietary_name":"Reyvow","nonproprietary_name":"lasmiditan","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Eli Lilly and Company","package_description":"2 BLISTER PACK in 1 CARTON (0002-4491-08) / 4 TABLET in 1 BLISTER PACK"},"nadac":{"value":88.77148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Reyvow|Lasmiditan Succinate","basis":"brand"},"part_b":null}, {"ndc":"00002431208","name":"REYVOW 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-4312-08","proprietary_name":"Reyvow","nonproprietary_name":"lasmiditan","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Eli Lilly and Company","package_description":"2 BLISTER PACK in 1 CARTON (0002-4312-08) / 4 TABLET in 1 BLISTER PACK"},"nadac":{"value":88.69728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Reyvow|Lasmiditan Succinate","basis":"brand"},"part_b":null}, {"ndc":"00002898005","name":"REZVOGLAR 100 UNIT/ML KWIKPEN","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-8980-05","proprietary_name":"Rezvoglar KwikPen","nonproprietary_name":"Insulin glargine-aglr","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Eli Lilly and Company","package_description":"5 SYRINGE in 1 CARTON (0002-8980-05) / 3 mL in 1 SYRINGE (0002-8980-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":5.92161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rezvoglar Kwikpen|Insulin Glargine-Aglr","basis":"brand"},"part_b":null}, {"ndc":"00078148320","name":"RHAPSIDO 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-1483-20","proprietary_name":"RHAPSIDO","nonproprietary_name":"remibrutinib","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"60 TABLET in 1 BOTTLE (0078-1483-20)","pharm_classes":["Bruton's Tyrosine Kinase Inhibitors [MoA]","Kinase Inhibitor [EPC]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":72.46221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51862076530","name":"RHOFADE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51862-765-30","proprietary_name":"Rhofade","nonproprietary_name":"oxymetazoline hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mayne Pharma","package_description":"1 TUBE in 1 CARTON (51862-765-30) / 30 g in 1 TUBE","pharm_classes":["Imidazolines [CS]","Increased Sympathetic Activity [PE]","Vasoconstriction [PE]","Vasoconstrictor [EPC]"]},"nadac":{"value":23.47434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Rhofade|Oxymetazoline HCl","basis":"brand"},"part_b":null}, {"ndc":"70727049725","name":"RHOPRESSA 0.02% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70727-497-25","proprietary_name":"Rhopressa","nonproprietary_name":"netarsudil","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC; TOPICAL","strength":".2 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE in 1 CARTON (70727-497-25) / 2.5 mL in 1 BOTTLE","pharm_classes":["Rho Kinase Inhibitor [EPC]","Rho Kinase Inhibitors [MoA]"]},"nadac":{"value":131.67612,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rhopressa|Netarsudil Mesylate","basis":"brand"},"part_b":null}, {"ndc":"65862020768","name":"RIBAVIRIN 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-207-68","proprietary_name":"Ribavirin","nonproprietary_name":"Ribavirin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"168 TABLET, FILM COATED in 1 BOTTLE (65862-207-68)","pharm_classes":["Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.45069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ribavirin*|Ribavirin","basis":"generic"},"part_b":null}, {"ndc":"54766009306","name":"RIDAURA 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"54766-093-06","proprietary_name":"RIDAURA","nonproprietary_name":"auranofin","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Sebela Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (54766-093-06)"},"nadac":{"value":24.84543,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ridaura|Auranofin","basis":"brand"},"part_b":null}, {"ndc":"59762135001","name":"RIFABUTIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1350-1","proprietary_name":"Rifabutin","nonproprietary_name":"rifabutin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59762-1350-1)","pharm_classes":["Rifamycin Antimycobacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":8.13629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifabutin|Rifabutin","basis":"generic"},"part_b":null}, {"ndc":"70954004110","name":"RIFABUTIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-041-10","proprietary_name":"Rifabutin","nonproprietary_name":"Rifabutin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-041-10)","pharm_classes":["Rifamycin Antimycobacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":8.13629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifabutin|Rifabutin","basis":"generic"},"part_b":null}, {"ndc":"72319001004","name":"RIFABUTIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-010-04","proprietary_name":"Rifabutin","nonproprietary_name":"Rifabutin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (72319-010-04)","pharm_classes":["Rifamycin Antimycobacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":8.13629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifabutin|Rifabutin","basis":"generic"},"part_b":null}, {"ndc":"24658080130","name":"RIFAMPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-801-30","proprietary_name":"RIFAMPIN","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"30 CAPSULE in 1 BOTTLE (24658-801-30)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.89776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"42806080130","name":"RIFAMPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-801-30","proprietary_name":"RIFAMPIN","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"30 CAPSULE in 1 BOTTLE (42806-801-30)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.89776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"60687057511","name":"RIFAMPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.89776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-575","inner_of":["60687-575-21"]},"part_b":null}, {"ndc":"60687057521","name":"RIFAMPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-575-21","proprietary_name":"Rifampin","nonproprietary_name":"Rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-575-21) / 1 CAPSULE in 1 BLISTER PACK (60687-575-11)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.89776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"68180065806","name":"RIFAMPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-658-06","proprietary_name":"rifampin","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-658-06)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.89776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"70954089210","name":"RIFAMPIN 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-892-10","proprietary_name":"Rifampin","nonproprietary_name":"Rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70954-892-10)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.89776,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"00904731561","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7315-61","proprietary_name":"rifampin","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7315-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"24658080260","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-802-60","proprietary_name":"RIFAMPIN","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"60 CAPSULE in 1 BOTTLE (24658-802-60)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"42806079960","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-799-60","proprietary_name":"RIFAMPIN","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"60 CAPSULE in 1 BOTTLE (42806-799-60)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"60687058601","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-586-01","proprietary_name":"Rifampin","nonproprietary_name":"Rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-586-01) / 1 CAPSULE in 1 BLISTER PACK (60687-586-11)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"60687058611","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-586","inner_of":["60687-586-01"]},"part_b":null}, {"ndc":"68180065906","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-659-06","proprietary_name":"rifampin","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-659-06)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"68180065907","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-659-07","proprietary_name":"rifampin","nonproprietary_name":"rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (68180-659-07)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"70954089310","name":"RIFAMPIN 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-893-10","proprietary_name":"Rifampin","nonproprietary_name":"Rifampin","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70954-893-10)","pharm_classes":["Rifamycin Antibacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":0.67892,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rifampin*|Rifampin","basis":"generic"},"part_b":null}, {"ndc":"67877028660","name":"RILUZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-286-60","proprietary_name":"Riluzole","nonproprietary_name":"Riluzole","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET in 1 BOTTLE (67877-286-60)","pharm_classes":["Benzothiazole [EPC]","Benzothiazoles [CS]"]},"nadac":{"value":0.29336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Riluzole|Riluzole","basis":"generic"},"part_b":null}, {"ndc":"68462038160","name":"RILUZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-381-60","proprietary_name":"riluzole","nonproprietary_name":"riluzole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-381-60)","pharm_classes":["Benzothiazole [EPC]","Benzothiazoles [CS]"]},"nadac":{"value":0.29336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Riluzole|Riluzole","basis":"generic"},"part_b":null}, {"ndc":"69076020060","name":"RILUZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69076-200-60","proprietary_name":"RILUZOLE","nonproprietary_name":"RILUZOLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69076-200-60)","pharm_classes":["Benzothiazole [EPC]","Benzothiazoles [CS]"]},"nadac":{"value":0.29336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Riluzole|Riluzole","basis":"generic"},"part_b":null}, {"ndc":"00074230630","name":"RINVOQ ER 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2306-30","proprietary_name":"Rinvoq","nonproprietary_name":"Upadacitinib","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"15 mg/1","labeler":"AbbVie Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0074-2306-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":229.30897,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074231030","name":"RINVOQ ER 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2310-30","proprietary_name":"Rinvoq","nonproprietary_name":"Upadacitinib","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"30 mg/1","labeler":"AbbVie Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0074-2310-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":229.2939,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00074104328","name":"RINVOQ ER 45 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-1043-28","proprietary_name":"Rinvoq","nonproprietary_name":"Upadacitinib","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"45 mg/1","labeler":"AbbVie Inc.","package_description":"28 TABLET, EXTENDED RELEASE in 1 BOTTLE (0074-1043-28)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":459.6225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762040704","name":"RISEDRONATE SOD DR 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0407-4","proprietary_name":"Risedronate Sodium","nonproprietary_name":"risedronate sodium","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"30.1 mg/1; 4.9 mg/1","labeler":"Mylan Pharmaceuticals, Inc.","package_description":"4 TABLET, DELAYED RELEASE in 1 DOSE PACK (59762-0407-4)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":30.67721,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium Dr|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093777113","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093777119","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093777179","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"47335092860","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-928-60","proprietary_name":"risedronate sodium","nonproprietary_name":"risedronate sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (47335-928-60) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"47335092867","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-928-67","proprietary_name":"risedronate sodium","nonproprietary_name":"risedronate sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (47335-928-67) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"59762040601","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0406-1","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"129 mg/1; 21 mg/1","labeler":"Mylan Pharmaceuticals, Inc.","package_description":"1 TABLET, FILM COATED in 1 DOSE PACK (59762-0406-1)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505309702","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3097-2","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"1 BLISTER PACK in 1 CARTON (60505-3097-2) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505309704","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3097-4","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp.","package_description":"1 BLISTER PACK in 1 CARTON (60505-3097-4) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862087003","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-870-03","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-870-03) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"65862087011","name":"RISEDRONATE SODIUM 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-870-11","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-870-11) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":12.90725,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093309819","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093309829","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3098-29","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"12 BLISTER PACK in 1 CARTON (0093-3098-29) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0093-3098-19)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093309844","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3098-44","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (0093-3098-44) / 1 TABLET, FILM COATED in 1 BLISTER PACK (0093-3098-19)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342010937","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-109-37","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-109-37) / 4 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342010950","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-109-50","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"3 BLISTER PACK in 1 CARTON (33342-109-50) / 4 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"47335066862","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-668-62","proprietary_name":"risedronate sodium","nonproprietary_name":"risedronate sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (47335-668-62) / 4 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"47335066868","name":"RISEDRONATE SODIUM 35 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-668-68","proprietary_name":"risedronate sodium","nonproprietary_name":"risedronate sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (47335-668-68) / 4 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"59762040504","name":"RISEDRONATE SODIUM 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0405-4","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30.1 mg/1; 4.9 mg/1","labeler":"Mylan Pharmaceuticals, Inc.","package_description":"4 TABLET, FILM COATED in 1 DOSE PACK (59762-0405-4)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"60505316500","name":"RISEDRONATE SODIUM 35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3165-0","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"35 mg/1","labeler":"Apotex Corp.","package_description":"1 BLISTER PACK in 1 CARTON (60505-3165-0) / 4 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.59807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093309956","name":"RISEDRONATE SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3099-56","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-3099-56)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.51515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"33342010707","name":"RISEDRONATE SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-107-07","proprietary_name":"Risedronate Sodium","nonproprietary_name":"Risedronate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 CONTAINER (33342-107-07)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":1.51515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risedronate Sodium|Risedronate Sodium","basis":"generic"},"part_b":null}, {"ndc":"50458030206","name":"RISPERDAL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-302-06","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (50458-302-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.38113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458030001","name":"RISPERDAL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-300-01","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (50458-300-01) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.69073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458030006","name":"RISPERDAL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-300-06","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (50458-300-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":4.69073,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458030503","name":"RISPERDAL 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-305-03","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 mL in 1 BOTTLE (50458-305-03)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":5.28293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.47238,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50458032001","name":"RISPERDAL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-320-01","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (50458-320-01) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":7.86404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458032006","name":"RISPERDAL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-320-06","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (50458-320-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":7.86404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458033006","name":"RISPERDAL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-330-06","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (50458-330-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":9.20606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458035001","name":"RISPERDAL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-350-01","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (50458-350-01) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":12.35264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458035006","name":"RISPERDAL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-350-06","proprietary_name":"RISPERDAL","nonproprietary_name":"risperidone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (50458-350-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":12.35264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458030911","name":"RISPERDAL CONSTA 12.5 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-309-11","proprietary_name":"RISPERDAL CONSTA","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (50458-309-11) * 2 mL in 1 VIAL * 2 mL in 1 SYRINGE (50458-309-01)"},"nadac":{"value":317.93143,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperdal Consta|Risperidone Microspheres","basis":"brand"},"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (50458-309-11) * 2 mL in 1 VIAL * 2 mL in 1 SYRINGE (50458-309-01)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"50458030611","name":"RISPERDAL CONSTA 25 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-306-11","proprietary_name":"RISPERDAL CONSTA","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (50458-306-11) * 2 mL in 1 SYRINGE (50458-306-01) * 2 mL in 1 VIAL"},"nadac":{"value":636.878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperdal Consta|Risperidone Microspheres","basis":"brand"},"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (50458-306-11) * 2 mL in 1 SYRINGE (50458-306-01) * 2 mL in 1 VIAL) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"50458030711","name":"RISPERDAL CONSTA 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-307-11","proprietary_name":"RISPERDAL CONSTA","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (50458-307-11) * 2 mL in 1 VIAL * 2 mL in 1 SYRINGE (50458-307-01)"},"nadac":{"value":949.93769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperdal Consta|Risperidone Microspheres","basis":"brand"},"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (75 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (50458-307-11) * 2 mL in 1 VIAL * 2 mL in 1 SYRINGE (50458-307-01)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"50458030811","name":"RISPERDAL CONSTA 50 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-308-11","proprietary_name":"RISPERDAL CONSTA","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (50458-308-11) * 2 mL in 1 VIAL * 2 mL in 1 SYRINGE (50458-308-01)"},"nadac":{"value":1273.39195,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperdal Consta|Risperidone Microspheres","basis":"brand"},"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (50458-308-11) * 2 mL in 1 VIAL * 2 mL in 1 SYRINGE (50458-308-01)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"49884021252","name":"RISPERIDONE 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.55281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884021255","name":"RISPERIDONE 0.25 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-212-55","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".25 mg/1","labeler":"Par Health USA, LLC","package_description":"5 BLISTER PACK in 1 CARTON (49884-212-55) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-212-52)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":2.55281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00904736061","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7360-61","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7360-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003560","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-035-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-035-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000206","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-002-06","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-002-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000250","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-002-50","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-002-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547033906","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-339-06","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-339-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547033950","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-339-50","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-339-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"62135060060","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-600-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-600-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027001","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-270-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-270-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-270-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027011","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011205","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-112-05","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-112-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011214","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-112-14","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-112-14)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367036805","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-368-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-368-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367036860","name":"RISPERIDONE 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-368-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-368-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884031152","name":"RISPERIDONE 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.00228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884031155","name":"RISPERIDONE 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-311-55","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"5 BLISTER PACK in 1 CARTON (49884-311-55) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.00228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884031191","name":"RISPERIDONE 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-311-91","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"7 BLISTER PACK in 1 CARTON (49884-311-91) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-311-52)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.00228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"59746001032","name":"RISPERIDONE 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-010-32","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"3 BLISTER PACK in 1 CARTON (59746-010-32) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.00228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69292057106","name":"RISPERIDONE 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.00228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69292057130","name":"RISPERIDONE 0.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-571-30","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":".5 mg/1","labeler":"Amici Pharma, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (69292-571-30) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.00228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00904736161","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7361-61","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7361-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003605","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-036-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-036-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003660","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-036-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-036-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000306","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-003-06","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-003-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000350","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-003-50","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-003-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034006","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-340-06","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-340-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034050","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-340-50","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-340-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"62135060160","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-601-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-601-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027101","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-271-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-271-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-271-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027111","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011305","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-113-05","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-113-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011314","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-113-14","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-113-14)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367036905","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-369-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-369-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367036960","name":"RISPERIDONE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-369-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-369-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884031552","name":"RISPERIDONE 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.15235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884031555","name":"RISPERIDONE 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-315-55","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"5 BLISTER PACK in 1 CARTON (49884-315-55) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.15235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884031591","name":"RISPERIDONE 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-315-91","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"7 BLISTER PACK in 1 CARTON (49884-315-91) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-315-52)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.15235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"59746002022","name":"RISPERIDONE 1 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-020-22","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"1 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"7 BLISTER PACK in 1 CARTON (59746-020-22) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.15235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00904736261","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7362-61","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7362-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003705","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-037-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-037-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003760","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-037-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-037-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000106","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-001-06","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-001-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000150","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-001-50","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-001-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034106","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-341-06","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-341-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034150","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-341-50","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-341-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"62135060260","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-602-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-602-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027201","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-272-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-272-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-272-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027211","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011405","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-114-05","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-114-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011414","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-114-14","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-114-14)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037005","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-370-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-370-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037060","name":"RISPERIDONE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-370-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-370-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.03661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27808000201","name":"RISPERIDONE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-002-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"30 mL in 1 BOTTLE, UNIT-DOSE (27808-002-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.47238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50458059601","name":"RISPERIDONE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-596-01","proprietary_name":"Risperidone","nonproprietary_name":"risperidone","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 mL in 1 BOTTLE (50458-596-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.47238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135092943","name":"RISPERIDONE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-929-43","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Chartwell RX, LLC","package_description":"30 mL in 1 BOTTLE (62135-929-43)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.47238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559098130","name":"RISPERIDONE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-981-30","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 mL in 1 BOTTLE (62559-981-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.47238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162067384","name":"RISPERIDONE 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-673-84","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 mL in 1 BOTTLE (65162-673-84)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.47238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49884040152","name":"RISPERIDONE 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.21992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884040191","name":"RISPERIDONE 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-401-91","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2 mg/1","labeler":"Par Health USA, LLC","package_description":"7 BLISTER PACK in 1 CARTON (49884-401-91) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-401-52)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.21992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"59746003022","name":"RISPERIDONE 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-030-22","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"7 BLISTER PACK in 1 CARTON (59746-030-22) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.21992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69292057304","name":"RISPERIDONE 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.21992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69292057328","name":"RISPERIDONE 2 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-573-28","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2 mg/1","labeler":"Amici Pharma, Inc.","package_description":"7 BLISTER PACK in 1 CARTON (69292-573-28) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.21992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00904736361","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7363-61","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7363-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003805","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-038-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-038-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003860","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-038-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-038-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000406","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-004-06","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-004-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000450","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-004-50","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-004-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034206","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-342-06","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-342-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034250","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-342-50","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-342-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"62135060360","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-603-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-603-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027301","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-273-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-273-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-273-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027311","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011505","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-115-05","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-115-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011514","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-115-14","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-115-14)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037105","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-371-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-371-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037160","name":"RISPERIDONE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-371-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-371-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.05444,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884040252","name":"RISPERIDONE 3 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.31722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884040291","name":"RISPERIDONE 3 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-402-91","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"3 mg/1","labeler":"Par Health USA, LLC","package_description":"7 BLISTER PACK in 1 CARTON (49884-402-91) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-402-52)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.31722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"59746004022","name":"RISPERIDONE 3 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-040-22","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"3 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"7 BLISTER PACK in 1 CARTON (59746-040-22) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.31722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00904736461","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7364-61","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7364-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003905","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-039-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-039-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668003960","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-039-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-039-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000506","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-005-06","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-005-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000550","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-005-50","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-005-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034306","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-343-06","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-343-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034350","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-343-50","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-343-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"62135060460","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-604-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-604-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027401","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-274-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-274-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-274-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027411","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011605","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-116-05","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-116-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011614","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-116-14","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-116-14)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037205","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-372-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-372-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037260","name":"RISPERIDONE 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-372-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-372-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.06863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884040352","name":"RISPERIDONE 4 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.52769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"49884040391","name":"RISPERIDONE 4 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-403-91","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Par Health USA, LLC","package_description":"7 BLISTER PACK in 1 CARTON (49884-403-91) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (49884-403-52)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.52769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"59746005022","name":"RISPERIDONE 4 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-050-22","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"4 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"7 BLISTER PACK in 1 CARTON (59746-050-22) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":1.52769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone ODT|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00904736561","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7365-61","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7365-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668004005","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-040-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-040-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"13668004060","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-040-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-040-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000606","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-006-06","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-006-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"27241000650","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-006-50","proprietary_name":"RISPERIDONE","nonproprietary_name":"RISPERIDONE","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-006-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034406","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-344-06","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-344-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"43547034450","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-344-50","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-344-50)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"62135060560","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-605-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-605-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027701","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-277-01","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-277-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-277-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68084027711","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011705","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-117-05","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-117-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"68382011714","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-117-14","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-117-14)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037305","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-373-05","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-373-05)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"69367037360","name":"RISPERIDONE 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-373-60","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69367-373-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.08179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Risperidone|Risperidone","basis":"generic"},"part_b":null}, {"ndc":"00480123208","name":"RISPERIDONE ER 25 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-1232-08","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (0480-1232-08) * 2 mL in 1 VIAL (0480-9733-01) * 2 mL in 1 SYRINGE (0480-1200-21)"},"nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (0480-1232-08) * 2 mL in 1 VIAL (0480-9733-01) * 2 mL in 1 SYRINGE (0480-1200-21)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480973301","name":"RISPERIDONE ER 25 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70121135101","name":"RISPERIDONE ER 25 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70121262605","name":"RISPERIDONE ER 25 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-2626-5","proprietary_name":"Risperidone","nonproprietary_name":"risperidone","dosage_form":"KIT","route":"INTRAMUSCULAR","strength":null,"labeler":"Amneal Pharmaceuticals LLC","package_description":"1 KIT in 1 CARTON (70121-2626-5) * 2 mL in 1 SYRINGE (70121-2624-2) * 2 mL in 1 VIAL (70121-1351-1)"},"nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (70121-2626-5) * 2 mL in 1 SYRINGE (70121-2624-2) * 2 mL in 1 VIAL (70121-1351-1)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70748027011","name":"RISPERIDONE ER 25 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748027013","name":"RISPERIDONE ER 25 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-270-13","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (70748-270-13) * 2 mL in 1 VIAL (70748-449-11) * 2 mL in 1 SYRINGE (70748-448-01)"},"nadac":{"value":355.23159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (70748-270-13) * 2 mL in 1 VIAL (70748-449-11) * 2 mL in 1 SYRINGE (70748-448-01)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480134208","name":"RISPERIDONE ER 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-1342-08","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (0480-1342-08) * 2 mL in 1 VIAL (0480-9734-01) * 2 mL in 1 SYRINGE (0480-1200-21)"},"nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (75 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (0480-1342-08) * 2 mL in 1 VIAL (0480-9734-01) * 2 mL in 1 SYRINGE (0480-1200-21)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480973401","name":"RISPERIDONE ER 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70121135201","name":"RISPERIDONE ER 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70121262705","name":"RISPERIDONE ER 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-2627-5","proprietary_name":"Risperidone","nonproprietary_name":"risperidone","dosage_form":"KIT","route":"INTRAMUSCULAR","strength":null,"labeler":"Amneal Pharmaceuticals LLC","package_description":"1 KIT in 1 CARTON (70121-2627-5) * 2 mL in 1 VIAL (70121-1352-1) * 2 mL in 1 SYRINGE (70121-2624-2)"},"nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (75 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (70121-2627-5) * 2 mL in 1 VIAL (70121-1352-1) * 2 mL in 1 SYRINGE (70121-2624-2)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70748027111","name":"RISPERIDONE ER 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748027113","name":"RISPERIDONE ER 37.5 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-271-13","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (70748-271-13) * 2 mL in 1 VIAL (70748-450-11) * 2 mL in 1 SYRINGE (70748-448-01)"},"nadac":{"value":566.40385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (75 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (70748-271-13) * 2 mL in 1 VIAL (70748-450-11) * 2 mL in 1 SYRINGE (70748-448-01)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480145308","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-1453-08","proprietary_name":"Risperidone","nonproprietary_name":"Risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (0480-1453-08) * 2 mL in 1 VIAL (0480-9735-01) * 2 mL in 1 SYRINGE (0480-1200-21)"},"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (0480-1453-08) * 2 mL in 1 VIAL (0480-9735-01) * 2 mL in 1 SYRINGE (0480-1200-21)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480973501","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70121135301","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70121262805","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-2628-5","proprietary_name":"Risperidone","nonproprietary_name":"risperidone","dosage_form":"KIT","route":"INTRAMUSCULAR","strength":null,"labeler":"Amneal Pharmaceuticals LLC","package_description":"1 KIT in 1 CARTON (70121-2628-5) * 2 mL in 1 VIAL (70121-1353-1) * 2 mL in 1 SYRINGE (70121-2624-2)"},"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (70121-2628-5) * 2 mL in 1 VIAL (70121-1353-1) * 2 mL in 1 SYRINGE (70121-2624-2)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70748027211","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748027213","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-272-13","proprietary_name":"risperidone","nonproprietary_name":"risperidone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 KIT in 1 BOX (70748-272-13) * 2 mL in 1 VIAL (70748-451-11) * 2 mL in 1 SYRINGE (70748-448-01)"},"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2794","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2794 (0.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 BOX (70748-272-13) * 2 mL in 1 VIAL (70748-451-11) * 2 mL in 1 SYRINGE (70748-448-01)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70748045111","name":"RISPERIDONE ER 50 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":760.21785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66758027401","name":"RITALIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-274-01","proprietary_name":"Ritalin","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (66758-274-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.13437,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.15796,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritalin|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758027501","name":"RITALIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-275-01","proprietary_name":"Ritalin","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (66758-275-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":1.6333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.20139,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritalin|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"66758027301","name":"RITALIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-273-01","proprietary_name":"Ritalin","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET in 1 BOTTLE (66758-273-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":0.79354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.12682,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritalin|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"00078037005","name":"RITALIN LA 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0370-05","proprietary_name":"Ritalin LA","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"20 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0078-0370-05)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.10231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.69545,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritalin La|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"00078037205","name":"RITALIN LA 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0372-05","proprietary_name":"Ritalin LA","nonproprietary_name":"methylphenidate hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"40 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0078-0372-05)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.72548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.85373,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritalin La|Methylphenidate HCl","basis":"brand"},"part_b":null}, {"ndc":"31722059730","name":"RITONAVIR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-597-30","proprietary_name":"Ritonavir","nonproprietary_name":"Ritonavir","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-597-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":0.60659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritonavir|Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"60687042025","name":"RITONAVIR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-420-25","proprietary_name":"Ritonavir","nonproprietary_name":"Ritonavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-420-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-420-95)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":0.60659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritonavir|Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"60687042095","name":"RITONAVIR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.60659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritonavir|Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"65862068730","name":"RITONAVIR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-687-30","proprietary_name":"Ritonavir","nonproprietary_name":"Ritonavir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-687-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":0.60659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritonavir|Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"69097065502","name":"RITONAVIR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-655-02","proprietary_name":"Ritonavir film coated","nonproprietary_name":"ritonavir 100 mg","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 CONTAINER (69097-655-02)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inducers [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]","UDP Glucuronosyltransferases Inducers [MoA]"]},"nadac":{"value":0.60659,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ritonavir|Ritonavir","basis":"generic"},"part_b":null}, {"ndc":"67877088271","name":"RIVAROXABAN 1 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-882-71","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"155 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (67877-882-71) / 1 GRANULE, FOR SUSPENSION in 1 BOTTLE","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":1.78883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70748035501","name":"RIVAROXABAN 1 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-355-01","proprietary_name":"rivaroxaban granule","nonproprietary_name":"rivaroxaban granule","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"155 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70748-355-01) / 1 FOR SUSPENSION in 1 BOTTLE","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":1.78883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"33342048809","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-488-09","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-488-09)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342048857","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-488-57","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (33342-488-57)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598098118","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-981-18","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Dr.Reddy's Laboratories, Inc.","package_description":"180 TABLET in 1 BOTTLE (43598-981-18)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598098160","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-981-60","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Dr.Reddy's Laboratories, Inc.","package_description":"60 TABLET in 1 BOTTLE (43598-981-60)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228051318","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-513-18","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"ScieGen pharmaceuticals,Inc","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (50228-513-18)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228051360","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-513-60","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"ScieGen pharmaceuticals,Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50228-513-60)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672422804","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4228-4","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (51672-4228-4)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51672422809","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4228-9","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"180 TABLET, COATED in 1 BOTTLE (51672-4228-9)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084918","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-849-18","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (59651-849-18)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651084960","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-849-60","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59651-849-60)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505625606","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6256-6","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-6256-6)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332068345","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-683-45","proprietary_name":"RIVAROXABAN","nonproprietary_name":"RIVAROXABAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (62332-683-45)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332068360","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-683-60","proprietary_name":"RIVAROXABAN","nonproprietary_name":"RIVAROXABAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-683-60)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180070906","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-709-06","proprietary_name":"RIVAROXABAN","nonproprietary_name":"RIVAROXABAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-709-06)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180070909","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-709-09","proprietary_name":"RIVAROXABAN","nonproprietary_name":"RIVAROXABAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-709-09)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71921040506","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-405-06","proprietary_name":"rivaroxaban","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"60 TABLET in 1 BOTTLE (71921-405-06)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71921040521","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-405-21","proprietary_name":"rivaroxaban","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"180 TABLET in 1 BOTTLE (71921-405-21)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205041602","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-416-02","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"10 BLISTER PACK in 1 CARTON (72205-416-02) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205041604","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-416-04","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-416-04)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205041605","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-416-05","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (72205-416-05)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282077418","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-774-18","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan pharmaceuticals,Inc","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (76282-774-18)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282077460","name":"RIVAROXABAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-774-60","proprietary_name":"Rivaroxaban","nonproprietary_name":"Rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan pharmaceuticals,Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-774-60)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904710761","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7107-61","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7107-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342008909","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-089-09","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-089-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342008915","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-089-15","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-089-15)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035205","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-352-05","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-352-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035260","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-352-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-352-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687077701","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-777-01","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-777-01) / 1 CAPSULE in 1 BLISTER PACK (60687-777-11)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687077711","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135090060","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-900-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-900-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332006360","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-063-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-063-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064860","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-648-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-648-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72241001103","name":"RIVASTIGMINE 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-011-03","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"1.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72241-011-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.16428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378907216","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378907293","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9072-93","proprietary_name":"Rivastigmine","nonproprietary_name":"rivastigmine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"13.3 mg/24h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9072-93) / 1 PATCH in 1 POUCH (0378-9072-16) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781731331","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7313-31","proprietary_name":"Rivastigmine","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"13.3 mg/24h","labeler":"Sandoz Inc","package_description":"30 PATCH in 1 CARTON (0781-7313-31) / 24 h in 1 PATCH (0781-7313-58)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781731358","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714011701","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714011702","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-117-02","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"13.3 mg/24h","labeler":"Northstar Rx LLC.","package_description":"30 POUCH in 1 CARTON (16714-117-02) / 24 h in 1 POUCH (16714-117-01)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991089930","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-899-30","proprietary_name":"Rivastigmine Transdermal System","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"13.3 mg/24h","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 POUCH in 1 CARTON (51991-899-30) / 1 PATCH in 1 POUCH (51991-899-99) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991089999","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162074934","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-749-34","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"13.3 mg/24h","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 PATCH in 1 CARTON (65162-749-34) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119801","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119807","name":"RIVASTIGMINE 13.3 MG/24HR PTCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1198-7","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"13.3 mg/24h","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 POUCH in 1 CARTON (70710-1198-7) / 24 h in 1 POUCH (70710-1198-1)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.79594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009009","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-090-09","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-090-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009015","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-090-15","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-090-15)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035305","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-353-05","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-353-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035360","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-353-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-353-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135090160","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-901-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-901-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332006460","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-064-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-064-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862064960","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-649-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-649-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72241001203","name":"RIVASTIGMINE 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-012-03","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"3 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72241-012-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.14581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009109","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-091-09","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-091-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009115","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-091-15","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-091-15)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035405","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-354-05","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-354-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035460","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-354-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-354-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135090260","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-902-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-902-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332006560","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-065-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-065-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862065060","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-650-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-650-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72241001303","name":"RIVASTIGMINE 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-013-03","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"4.5 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72241-013-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.17435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378907016","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378907093","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9070-93","proprietary_name":"Rivastigmine","nonproprietary_name":"rivastigmine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9070-93) / 1 PATCH in 1 POUCH (0378-9070-16) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781730431","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7304-31","proprietary_name":"Rivastigmine","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Sandoz Inc","package_description":"30 PATCH in 1 CARTON (0781-7304-31) / 24 h in 1 PATCH (0781-7304-58)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781730458","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991089730","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-897-30","proprietary_name":"Rivastigmine Transdermal System","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 POUCH in 1 CARTON (51991-897-30) / 1 PATCH in 1 POUCH (51991-897-99) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991089799","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162082534","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-825-34","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 PATCH in 1 CARTON (65162-825-34) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119601","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119607","name":"RIVASTIGMINE 4.6 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1196-7","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4.6 mg/24h","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 POUCH in 1 CARTON (70710-1196-7) / 24 h in 1 POUCH (70710-1196-1)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.75167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009209","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-092-09","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-092-09)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009215","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-092-15","proprietary_name":"RIVASTIGMINE TARTRATE","nonproprietary_name":"RIVASTIGMINE TARTRATE","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-092-15)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035505","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-355-05","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"500 CAPSULE in 1 BOTTLE (55111-355-05)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111035560","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-355-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-355-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135090360","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-903-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-903-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332006660","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-066-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 CAPSULE in 1 BOTTLE (62332-066-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862065160","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-651-60","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-651-60)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72241001403","name":"RIVASTIGMINE 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-014-03","proprietary_name":"Rivastigmine Tartrate","nonproprietary_name":"Rivastigmine Tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"60 CAPSULE in 1 BOTTLE (72241-014-03)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":0.15637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378907116","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378907193","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9071-93","proprietary_name":"Rivastigmine","nonproprietary_name":"rivastigmine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (0378-9071-93) / 1 PATCH in 1 POUCH (0378-9071-16) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781730931","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-7309-31","proprietary_name":"Rivastigmine","nonproprietary_name":"rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Sandoz Inc","package_description":"30 PATCH in 1 CARTON (0781-7309-31) / 24 h in 1 PATCH (0781-7309-58)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781730958","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714011601","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714011602","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-116-02","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Northstar Rx LLC.","package_description":"30 POUCH in 1 CARTON (16714-116-02) / 24 h in 1 POUCH (16714-116-01)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991089830","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-898-30","proprietary_name":"Rivastigmine Transdermal System","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"30 POUCH in 1 CARTON (51991-898-30) / 1 PATCH in 1 POUCH (51991-898-99) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991089899","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162082634","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-826-34","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 PATCH in 1 CARTON (65162-826-34) / 24 h in 1 PATCH","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119701","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710119707","name":"RIVASTIGMINE 9.5 MG/24HR PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1197-7","proprietary_name":"Rivastigmine","nonproprietary_name":"Rivastigmine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9.5 mg/24h","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 POUCH in 1 CARTON (70710-1197-7) / 24 h in 1 POUCH (70710-1197-1)","pharm_classes":["Cholinesterase Inhibitor [EPC]","Cholinesterase Inhibitors [MoA]"]},"nadac":{"value":1.78226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093603182","name":"RIVELSA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-6031-82","proprietary_name":"Rivelsa","nonproprietary_name":"Levonorgestrel/Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 POUCH in 1 CARTON (0093-6031-82) / 1 KIT in 1 POUCH (0093-6031-91)"},"nadac":{"value":1.37118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rivelsa|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"00093603191","name":"RIVELSA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":1.37118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rivelsa|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"33342009402","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009441","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-094-41","proprietary_name":"rizatriptan benzoate","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"3 BLISTER PACK in 1 CARTON (33342-094-41) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009452","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-094-52","proprietary_name":"rizatriptan benzoate","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-094-52) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237008663","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-086-63","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-086-63) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862062603","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862062612","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-626-12","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"4 BLISTER PACK in 1 CARTON (65862-626-12) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-626-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862062690","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-626-90","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-626-90) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-626-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452015773","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-157-73","proprietary_name":"RIZATRIPTAN BENZOATE","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.,","package_description":"6 BLISTER PACK in 1 CARTON (69452-157-73) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (69452-157-74)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452015774","name":"RIZATRIPTAN 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.50969,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093747219","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"00093747243","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7472-43","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"18 BLISTER PACK in 1 BOX (0093-7472-43) / 1 TABLET in 1 BLISTER PACK (0093-7472-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008802","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008841","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-088-41","proprietary_name":"Rizatriptan","nonproprietary_name":"Rizatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"3 BLISTER PACK in 1 CARTON (33342-088-41) / 6 TABLET, FILM COATED in 1 BLISTER PACK (33342-088-02)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008845","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-088-45","proprietary_name":"Rizatriptan","nonproprietary_name":"Rizatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"2 BLISTER PACK in 1 CARTON (33342-088-45) / 6 TABLET, FILM COATED in 1 BLISTER PACK (33342-088-02)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008852","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"57237008834","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-088-34","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (57237-088-34) / 3 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"57237008863","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-088-63","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-088-63) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"65862060003","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"65862060012","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-600-12","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"4 BLISTER PACK in 1 CARTON (65862-600-12) / 3 TABLET in 1 BLISTER PACK (65862-600-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"67877026206","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"67877026218","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-262-18","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"3 BLISTER PACK in 1 CARTON (67877-262-18) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"76282046306","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"76282046318","name":"RIZATRIPTAN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33545,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342009302","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009341","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-093-41","proprietary_name":"rizatriptan benzoate","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"3 BLISTER PACK in 1 CARTON (33342-093-41) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009345","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-093-45","proprietary_name":"rizatriptan benzoate","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"2 BLISTER PACK in 1 CARTON (33342-093-45) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342009352","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-093-52","proprietary_name":"rizatriptan benzoate","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-093-52) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237008563","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-085-63","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-085-63) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862062503","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862062512","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-625-12","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"4 BLISTER PACK in 1 CARTON (65862-625-12) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-625-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862062590","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-625-90","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-625-90) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-625-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452015673","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-156-73","proprietary_name":"RIZATRIPTAN BENZOATE","nonproprietary_name":"rizatriptan benzoate","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.,","package_description":"6 BLISTER PACK in 1 CARTON (69452-156-73) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (69452-156-74)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452015674","name":"RIZATRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.54459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093747119","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"00093747143","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7471-43","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"18 BLISTER PACK in 1 BOX (0093-7471-43) / 1 TABLET in 1 BLISTER PACK (0093-7471-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008702","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008741","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-087-41","proprietary_name":"Rizatriptan","nonproprietary_name":"Rizatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"3 BLISTER PACK in 1 CARTON (33342-087-41) / 6 TABLET, FILM COATED in 1 BLISTER PACK (33342-087-02)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008745","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-087-45","proprietary_name":"Rizatriptan","nonproprietary_name":"Rizatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"2 BLISTER PACK in 1 CARTON (33342-087-45) / 6 TABLET, FILM COATED in 1 BLISTER PACK (33342-087-02)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"33342008752","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"57237008734","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-087-34","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (57237-087-34) / 3 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"57237008763","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-087-63","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (57237-087-63) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"65862059903","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"65862059912","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-599-12","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"4 BLISTER PACK in 1 CARTON (65862-599-12) / 3 TABLET in 1 BLISTER PACK (65862-599-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"67877026106","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"67877026118","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-261-18","proprietary_name":"Rizatriptan Benzoate","nonproprietary_name":"Rizatriptan Benzoate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"3 BLISTER PACK in 1 CARTON (67877-261-18) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"76282046206","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"76282046218","name":"RIZATRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rizatriptan|Rizatriptan Benzoate","basis":"generic"},"part_b":null}, {"ndc":"00904653720","name":"ROBAFEN CF LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6537-20","proprietary_name":"Tussin Multi Symptom Cold CF Adult","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin, Phenylephrine","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/10mL; 200 mg/10mL; 10 mg/10mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 BOX (0904-6537-20) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.02093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904722320","name":"ROBAFEN DM 200-20 MG/20 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7223-20","proprietary_name":"robafen dm","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7223-20) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904722359","name":"ROBAFEN DM 200-20 MG/20 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7223-59","proprietary_name":"robafen dm","nonproprietary_name":"dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-7223-59) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904744120","name":"ROBAFEN DM 200-20 MG/20 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7441-20","proprietary_name":"Robafen DM Cough","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-7441-20) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70727052925","name":"ROCKLATAN 0.02%-0.005% EYE DRP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70727-529-25","proprietary_name":"Rocklatan","nonproprietary_name":"netarsudil and latanoprost ophthalmic solution, 0.02%/0.005%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC; TOPICAL","strength":".2 mg/mL; .05 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70727-529-25) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Rho Kinase Inhibitor [EPC]","Rho Kinase Inhibitors [MoA]"]},"nadac":{"value":139.40317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Rocklatan|Netarsudil Mesylat/Latanoprost","basis":"brand"},"part_b":null}, {"ndc":"00904749371","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7493-71","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"28 TABLET in 1 BOTTLE (0904-7493-71)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"31722067631","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"31722067632","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-676-32","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (31722-676-32) / 10 TABLET in 1 BLISTER PACK (31722-676-31)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"31722067636","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-676-36","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (31722-676-36) / 28 TABLET in 1 BLISTER PACK (31722-676-35)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"42571036983","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-369-83","proprietary_name":"ROFLUMILAST","nonproprietary_name":"ROFLUMILAST","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Micro Labs Limited","package_description":"28 TABLET in 1 BOTTLE (42571-369-83)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59651080120","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-801-20","proprietary_name":"ROFLUMILAST","nonproprietary_name":"ROFLUMILAST","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (59651-801-20) / 20 TABLET in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59651080128","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-801-28","proprietary_name":"ROFLUMILAST","nonproprietary_name":"ROFLUMILAST","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (59651-801-28) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59746080170","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-801-70","proprietary_name":"Roflumilast","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"28 TABLET in 1 BLISTER PACK (59746-801-70)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"67877073032","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"67877073093","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-730-93","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Ascend Laboratories, LLC","package_description":"4 BLISTER PACK in 1 CARTON (67877-730-93) / 7 TABLET in 1 BLISTER PACK (67877-730-32)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"68382062430","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"68382062431","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-624-31","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68382-624-31) / 28 TABLET in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"68382062483","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-624-83","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"2 BLISTER PACK in 1 CARTON (68382-624-83) / 10 TABLET in 1 BLISTER PACK (68382-624-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"72205020111","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"72205020113","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"72205020124","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-201-24","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"2 BLISTER PACK in 1 CARTON (72205-201-24) / 10 TABLET in 1 BLISTER PACK (72205-201-11)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"72205020132","name":"ROFLUMILAST 250 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-201-32","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"250 ug/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"2 BLISTER PACK in 1 CARTON (72205-201-32) / 14 TABLET in 1 BLISTER PACK (72205-201-13)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":1.98132,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"00904739946","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7399-46","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"MAJOR PHARMACEUTICALS","package_description":"30 TABLET in 1 BOTTLE (0904-7399-46)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"00904748303","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7483-03","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Major Pharmaceuticals","package_description":"30 TABLET in 1 BOTTLE (0904-7483-03)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"00904748389","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7483-89","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Major Pharmaceuticals","package_description":"90 TABLET in 1 BOTTLE (0904-7483-89)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"31722062330","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-623-30","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-623-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"31722062390","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-623-90","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-623-90)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"42571025930","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-259-30","proprietary_name":"ROFLUMILAST","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Micro Labs Limited","package_description":"30 TABLET in 1 BOTTLE (42571-259-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"43547000503","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-005-03","proprietary_name":"ROFLUMILAST","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Solco Healthcare US, LLC.","package_description":"30 TABLET in 1 BOTTLE (43547-005-03)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"43547000509","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-005-09","proprietary_name":"ROFLUMILAST","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Solco Healthcare US, LLC.","package_description":"90 TABLET in 1 BOTTLE (43547-005-09)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59651027530","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-275-30","proprietary_name":"ROFLUMILAST","nonproprietary_name":"ROFLUMILAST","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-275-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59651027590","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-275-90","proprietary_name":"ROFLUMILAST","nonproprietary_name":"ROFLUMILAST","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET in 1 BOTTLE (59651-275-90)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59746080230","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-802-30","proprietary_name":"Roflumilast","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-802-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"59746080290","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-802-90","proprietary_name":"Roflumilast","nonproprietary_name":"roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59746-802-90)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"60687078611","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"60687078621","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-786-21","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-786-21) / 1 TABLET in 1 BLISTER PACK (60687-786-11)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"67877048090","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-480-90","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (67877-480-90)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"68382096906","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-969-06","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET in 1 BOTTLE (68382-969-06)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"68382096916","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-969-16","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET in 1 BOTTLE (68382-969-16)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"72205020030","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-200-30","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-200-30)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"72205020090","name":"ROFLUMILAST 500 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-200-90","proprietary_name":"Roflumilast","nonproprietary_name":"Roflumilast","dosage_form":"TABLET","route":"ORAL","strength":"500 ug/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72205-200-90)","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":0.31126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roflumilast|Roflumilast","basis":"generic"},"part_b":null}, {"ndc":"00904637361","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6373-61","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6373-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547026810","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-268-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-268-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547026850","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-268-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-268-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074111","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074115","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-741-15","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-741-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-741-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"60687057701","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-577-01","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-577-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-577-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"60687057711","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003031","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-030-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-030-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025301","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-253-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-253-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452035620","name":"ROPINIROLE HCL 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-356-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".25 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-356-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04599,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547026910","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-269-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-269-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547026950","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-269-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-269-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074211","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074215","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-742-15","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-742-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-742-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003131","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-031-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-031-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025401","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-254-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-254-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452035720","name":"ROPINIROLE HCL 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-357-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-357-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04297,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00904637461","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6374-61","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6374-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027010","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-270-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-270-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027050","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-270-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-270-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074311","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074315","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-743-15","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-743-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-743-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"60687058801","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-588-01","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-588-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-588-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"60687058811","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003231","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-032-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-032-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025501","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-255-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-255-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452035820","name":"ROPINIROLE HCL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-358-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-358-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.04774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027110","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-271-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-271-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027150","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-271-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-271-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074411","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074415","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-744-15","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-744-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-744-11)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003331","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-033-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-033-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025601","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-256-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-256-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452035920","name":"ROPINIROLE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-359-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-359-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027210","name":"ROPINIROLE HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-272-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-272-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027250","name":"ROPINIROLE HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-272-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-272-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003431","name":"ROPINIROLE HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-034-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-034-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025701","name":"ROPINIROLE HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-257-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-257-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452036020","name":"ROPINIROLE HCL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-360-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"3 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-360-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.0768,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027310","name":"ROPINIROLE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-273-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-273-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027350","name":"ROPINIROLE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-273-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-273-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003531","name":"ROPINIROLE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-035-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-035-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025801","name":"ROPINIROLE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-258-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-258-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452036120","name":"ROPINIROLE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-361-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-361-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027410","name":"ROPINIROLE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-274-10","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-274-10)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547027450","name":"ROPINIROLE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-274-50","proprietary_name":"ropinirole hydrochloride","nonproprietary_name":"ropinirole hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"SOLCO HEALTHCARE US, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43547-274-50)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332003631","name":"ROPINIROLE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-036-31","proprietary_name":"ROPINIROLE","nonproprietary_name":"ROPINIROLE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (62332-036-31)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"68462025901","name":"ROPINIROLE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-259-01","proprietary_name":"ropinirole","nonproprietary_name":"ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-259-01)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"69452036220","name":"ROPINIROLE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-362-20","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (69452-362-20)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.08434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole HCl|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228366103","name":"ROPINIROLE HCL ER 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3661-03","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3661-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.81115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055803","name":"ROPINIROLE HCL ER 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-558-03","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-558-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.81115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111072830","name":"ROPINIROLE HCL ER 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-728-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-728-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.81115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332011130","name":"ROPINIROLE HCL ER 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-111-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-111-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.81115,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228365803","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3658-03","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3658-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228365809","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3658-09","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3658-09)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055403","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-554-03","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-554-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055409","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111065930","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-659-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-659-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111065990","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-659-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-659-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332010730","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-107-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-107-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332010790","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-107-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-107-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"64850025030","name":"ROPINIROLE HCL ER 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-250-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64850-250-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.3487,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228365903","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3659-03","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3659-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228365909","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3659-09","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3659-09)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055503","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-555-03","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-555-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055509","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-555-09","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-555-09)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111066130","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-661-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-661-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111066190","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-661-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-661-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332010830","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-108-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-108-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332010890","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-108-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-108-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"64850025130","name":"ROPINIROLE HCL ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-251-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64850-251-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.4617,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228364003","name":"ROPINIROLE HCL ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3640-03","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3640-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.34089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055603","name":"ROPINIROLE HCL ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-556-03","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-556-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.34089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111072730","name":"ROPINIROLE HCL ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-727-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-727-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.34089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111072790","name":"ROPINIROLE HCL ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-727-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-727-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.34089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332010930","name":"ROPINIROLE HCL ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-109-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-109-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.34089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"64850025230","name":"ROPINIROLE HCL ER 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-252-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64850-252-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":1.34089,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228366003","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3660-03","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3660-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"00228366009","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-3660-09","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0228-3660-09)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055703","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-557-03","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-557-03)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"43547055709","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-557-09","proprietary_name":"ROPINIROLE","nonproprietary_name":"ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (43547-557-09)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111066230","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-662-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-662-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"55111066290","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-662-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (55111-662-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332011030","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-110-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-110-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"62332011090","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-110-90","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (62332-110-90)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"64850025330","name":"ROPINIROLE HCL ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64850-253-30","proprietary_name":"Ropinirole","nonproprietary_name":"Ropinirole","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Elite Laboratories, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64850-253-30)","pharm_classes":["Dopamine Agonists [MoA]","Nonergot Dopamine Agonist [EPC]"]},"nadac":{"value":0.9066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ropinirole ER|Ropinirole HCl","basis":"generic"},"part_b":null}, {"ndc":"11788013105","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-131-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (11788-131-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013110","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-131-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (11788-131-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013190","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-131-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (11788-131-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018005","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-180-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, COATED in 1 BOTTLE (13668-180-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018030","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-180-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (13668-180-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018090","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-180-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, COATED in 1 BOTTLE (13668-180-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072105","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-721-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"500 TABLET in 1 BOTTLE (13668-721-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072190","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-721-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"90 TABLET in 1 BOTTLE (13668-721-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714098901","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-989-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-989-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026245","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-262-45","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"45 TABLET in 1 BOTTLE (24658-262-45)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026290","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-262-90","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"90 TABLET in 1 BOTTLE (24658-262-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015601","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-156-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (27808-156-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015603","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-156-03","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27808-156-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722088390","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-883-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-883-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059209","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059250","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011705","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-117-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-117-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011710","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-117-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-117-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011790","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-117-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-117-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268070911","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268070915","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-709-15","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-709-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-709-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237016990","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-169-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-169-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237016999","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-169-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-169-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687024501","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-245-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-245-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-245-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687024511","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687024565","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-245-65","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (60687-245-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-245-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029490","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-294-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-294-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029499","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-294-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-294-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877044005","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-440-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-440-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877044090","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-440-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-440-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026210","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-262-10","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-262-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026290","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-262-90","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-262-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036005","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-360-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-360-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036009","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-360-09","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-360-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036010","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-360-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-360-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000712","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-007-12","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-007-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000713","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-007-13","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-007-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000390","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-003-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-003-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000399","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-003-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-003-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036501","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-365-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx, LLC","package_description":"90 TABLET in 1 BOTTLE (72603-365-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036502","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-365-02","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx, LLC","package_description":"1000 TABLET in 1 BOTTLE (72603-365-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009001810","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-018-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-018-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009001890","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-018-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-018-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009018905","name":"ROSUVASTATIN CALCIUM 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-189-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-189-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013205","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-132-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (11788-132-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013210","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-132-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (11788-132-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013290","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-132-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (11788-132-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018105","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-181-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, COATED in 1 BOTTLE (13668-181-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018130","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-181-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (13668-181-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018190","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-181-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, COATED in 1 BOTTLE (13668-181-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072205","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-722-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"500 TABLET in 1 BOTTLE (13668-722-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072290","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-722-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"90 TABLET in 1 BOTTLE (13668-722-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714099001","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-990-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-990-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026345","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-263-45","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"45 TABLET in 1 BOTTLE (24658-263-45)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026390","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-263-90","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"90 TABLET in 1 BOTTLE (24658-263-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015701","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-157-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (27808-157-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015703","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-157-03","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27808-157-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722088490","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-884-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-884-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059309","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059350","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011805","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-118-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-118-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011810","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-118-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-118-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011890","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-118-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-118-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268071011","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268071015","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-710-15","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-710-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-710-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237017090","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-170-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-170-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237017099","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-170-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (57237-170-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60290004502","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-045-02","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"90 TABLET in 1 BOTTLE (60290-045-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687025601","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-256-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-256-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-256-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687025611","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029590","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-295-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-295-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029599","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-295-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-295-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877044105","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-441-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (67877-441-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877044190","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-441-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-441-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026310","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-263-10","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-263-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026390","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-263-90","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-263-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036105","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-361-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-361-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036109","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-361-09","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-361-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036110","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-361-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-361-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000812","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-008-12","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-008-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000813","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-008-13","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-008-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000490","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-004-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-004-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000499","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-004-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-004-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036601","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-366-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx, LLC","package_description":"90 TABLET in 1 BOTTLE (72603-366-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036602","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-366-02","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx, LLC","package_description":"500 TABLET in 1 BOTTLE (72603-366-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036603","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-366-03","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx, LLC","package_description":"1000 TABLET in 1 BOTTLE (72603-366-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009001910","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-019-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-019-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009001990","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-019-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-019-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009019005","name":"ROSUVASTATIN CALCIUM 20 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-190-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-190-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.04539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013305","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-133-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (11788-133-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013310","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-133-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (11788-133-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013390","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-133-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (11788-133-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018205","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-182-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, COATED in 1 BOTTLE (13668-182-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668018230","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-182-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"40 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (13668-182-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072305","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-723-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"500 TABLET in 1 BOTTLE (13668-723-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072330","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-723-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"30 TABLET in 1 BOTTLE (13668-723-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714099101","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-991-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-991-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026430","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-264-30","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"30 TABLET in 1 BOTTLE (24658-264-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026445","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-264-45","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"45 TABLET in 1 BOTTLE (24658-264-45)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026490","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-264-90","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"90 TABLET in 1 BOTTLE (24658-264-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015801","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-158-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (27808-158-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015803","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-158-03","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27808-158-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722088530","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-885-30","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-885-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059403","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059450","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011905","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-119-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-119-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011910","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-119-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-119-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011930","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-119-30","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-119-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011990","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-119-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-119-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268071111","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50268071115","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-711-15","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-711-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-711-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237017105","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-171-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-171-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237017130","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-171-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-171-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237017190","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-171-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-171-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"62135069330","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-693-30","proprietary_name":"Rosuvastain Calcium","nonproprietary_name":"Rosuvastain Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-693-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862029630","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-296-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-296-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029690","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-296-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-296-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029699","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-296-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-296-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877044230","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-442-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-442-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877044290","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-442-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-442-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026405","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-264-05","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-264-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026410","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-264-10","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-264-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026430","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-264-30","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-264-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036205","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-362-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-362-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036209","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-362-09","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-362-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367036230","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-362-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69367-362-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000911","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-009-11","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-009-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000912","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-009-12","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-009-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000913","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-009-13","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-009-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000530","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-005-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72205-005-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000590","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-005-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-005-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205000599","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-005-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-005-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036701","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-367-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx, LLC","package_description":"30 TABLET in 1 BOTTLE (72603-367-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036702","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-367-02","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx, LLC","package_description":"90 TABLET in 1 BOTTLE (72603-367-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036703","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-367-03","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx, LLC","package_description":"500 TABLET in 1 BOTTLE (72603-367-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036704","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-367-04","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx, LLC","package_description":"1000 TABLET in 1 BOTTLE (72603-367-04)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009002010","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-020-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-020-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009002030","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-020-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (82009-020-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009019105","name":"ROSUVASTATIN CALCIUM 40 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-191-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-191-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.06919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013005","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-130-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"500 TABLET, COATED in 1 BOTTLE (11788-130-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013010","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-130-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (11788-130-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"11788013090","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-130-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (11788-130-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668017905","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-179-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET, COATED in 1 BOTTLE (13668-179-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668017930","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-179-30","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (13668-179-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668017990","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-179-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, COATED in 1 BOTTLE (13668-179-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072005","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-720-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"500 TABLET in 1 BOTTLE (13668-720-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"13668072090","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-720-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"TORRENT PHARMACEUTICALS LIMITED","package_description":"90 TABLET in 1 BOTTLE (13668-720-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"16714098801","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-988-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-988-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"24658026190","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-261-90","proprietary_name":"ROSUVASTATIN CALCIUM","nonproprietary_name":"ROSUVASTATIN CALCIUM","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"PURACAP LABORATORIES LLC DBA BLU PHARMACEUTICALS","package_description":"90 TABLET in 1 BOTTLE (24658-261-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015501","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-155-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (27808-155-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"27808015503","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27808-155-03","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27808-155-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"31722088290","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-882-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-882-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059109","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"43547059150","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011605","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-116-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (50228-116-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011610","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-116-10","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50228-116-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"50228011690","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-116-90","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-116-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237016805","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-168-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (57237-168-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"57237016890","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-168-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-168-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687023401","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-234-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-234-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-234-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"60687023411","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029390","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-293-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-293-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"65862029399","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-293-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-293-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"67877043990","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-439-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-439-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026110","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-261-10","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-261-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"68462026190","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-261-90","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceutials Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-261-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367035905","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-359-05","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (69367-359-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367035909","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-359-09","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-359-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"69367035910","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-359-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-359-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000612","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-006-12","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-006-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70377000613","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-006-13","proprietary_name":"Rosuvastatin calcium","nonproprietary_name":"Rosuvastatin calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70377-006-13)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002790","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-027-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72205-027-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72205002799","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-027-99","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72205-027-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036401","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-364-01","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx, LLC","package_description":"90 TABLET in 1 BOTTLE (72603-364-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"72603036402","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-364-02","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx, LLC","package_description":"1000 TABLET in 1 BOTTLE (72603-364-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009001710","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-017-10","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-017-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009001790","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-017-90","proprietary_name":"Rosuvastatin Calcium","nonproprietary_name":"Rosuvastatin Calcium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-017-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"82009018805","name":"ROSUVASTATIN CALCIUM 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-188-05","proprietary_name":"Rosuvastatin","nonproprietary_name":"Rosuvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-188-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rosuvastatin Calcium|Rosuvastatin Calcium","basis":"generic"},"part_b":null}, {"ndc":"70700031287","name":"ROSYRAH TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-312-87","proprietary_name":"Rosyrah","nonproprietary_name":"levonorgestrel and ethinyl estradiol and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Xiromed, LLC","package_description":"1 POUCH in 1 CARTON (70700-312-87) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":1.37118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69102010501","name":"ROWEEPRA 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69102-105-01","proprietary_name":"Levetiracetam","nonproprietary_name":"Levetiracetam","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"OWP Pharmaceuticals, Inc.","package_description":"120 TABLET in 1 BOTTLE (69102-105-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.07362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23635058110","name":"ROXICODONE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23635-581-10","proprietary_name":"Roxicodone","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23635-581-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":5.46804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.19655,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roxicodone|Oxycodone HCl","basis":"brand"},"part_b":null}, {"ndc":"23635058210","name":"ROXICODONE 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23635-582-10","proprietary_name":"Roxicodone","nonproprietary_name":"oxycodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (23635-582-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":10.70102,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.35692,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Roxicodone|Oxycodone HCl","basis":"brand"},"part_b":null}, {"ndc":"64764080510","name":"ROZEREM 8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-805-10","proprietary_name":"Rozerem","nonproprietary_name":"ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64764-805-10)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":12.41691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rozerem|Ramelteon","basis":"brand"},"part_b":null}, {"ndc":"64764080530","name":"ROZEREM 8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-805-30","proprietary_name":"Rozerem","nonproprietary_name":"ramelteon","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64764-805-30)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":12.41691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.65983,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rozerem|Ramelteon","basis":"brand"},"part_b":null}, {"ndc":"00054042523","name":"RUFINAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0425-23","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (0054-0425-23)"},"nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722059812","name":"RUFINAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-598-12","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-598-12)"},"nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571039112","name":"RUFINAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-391-12","proprietary_name":"RUFINAMIDE","nonproprietary_name":"RUFINAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Micro Labs Limited","package_description":"120 TABLET in 1 BOTTLE (42571-391-12)"},"nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651061608","name":"RUFINAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-616-08","proprietary_name":"Rufinamide","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (59651-616-08)"},"nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180080316","name":"RUFINAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-803-16","proprietary_name":"RUFINAMIDE","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68180-803-16)"},"nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462071308","name":"RUFINAMIDE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-713-08","proprietary_name":"rufinamide","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68462-713-08)"},"nadac":{"value":0.881,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054052863","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0528-63","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 BOTTLE in 1 CARTON (0054-0528-63) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722068846","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-688-46","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-688-46) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651056360","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-563-60","proprietary_name":"RUFINAMIDE","nonproprietary_name":"RUFINAMIDE","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-563-60) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877067362","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-673-62","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (67877-673-62) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180079701","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-797-01","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (68180-797-01) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452022384","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-223-84","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Bionpharma Inc.","package_description":"1 BOTTLE in 1 CARTON (69452-223-84) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205003877","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-038-77","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-038-77) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603026101","name":"RUFINAMIDE 40 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-261-01","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-261-01) / 460 mL in 1 BOTTLE"},"nadac":{"value":0.20341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00054042623","name":"RUFINAMIDE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0426-23","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (0054-0426-23)"},"nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722059912","name":"RUFINAMIDE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-599-12","proprietary_name":"Rufinamide","nonproprietary_name":"Rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (31722-599-12)"},"nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571039212","name":"RUFINAMIDE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-392-12","proprietary_name":"RUFINAMIDE","nonproprietary_name":"RUFINAMIDE","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1","labeler":"Micro Labs Limited","package_description":"120 TABLET in 1 BOTTLE (42571-392-12)"},"nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651061708","name":"RUFINAMIDE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-617-08","proprietary_name":"Rufinamide","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (59651-617-08)"},"nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180080416","name":"RUFINAMIDE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-804-16","proprietary_name":"RUFINAMIDE","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68180-804-16)"},"nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462071408","name":"RUFINAMIDE 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-714-08","proprietary_name":"rufinamide","nonproprietary_name":"rufinamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"400 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (68462-714-08)"},"nadac":{"value":1.39131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49702025018","name":"RUKOBIA ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49702-250-18","proprietary_name":"Rukobia","nonproprietary_name":"fostemsavir tromethamine","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"ViiV Healthcare Company","package_description":"1 BOTTLE in 1 CARTON (49702-250-18) / 60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE"},"nadac":{"value":156.83623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59467070027","name":"RYALTRIS 665-25 MCG SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59467-700-27","proprietary_name":"Ryaltris","nonproprietary_name":"olopatadine hydrochloride and mometasone furoate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"665 ug/1; 25 ug/1","labeler":"HIKMA SPECIALTY USA INC.","package_description":"12 CARTON in 1 BOX (59467-700-27) / 1 BOTTLE, SPRAY in 1 CARTON / 240 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":7.67149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ryaltris|Olopatadine HCl/Mometasone","basis":"brand"},"part_b":null}, {"ndc":"68462065927","name":"RYALTRIS 665-25 MCG SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-659-27","proprietary_name":"Ryaltris","nonproprietary_name":"olopatadine hydrochloride and mometasone furoate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"665 ug/1; 25 ug/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"12 CARTON in 1 BOX (68462-659-27) / 1 BOTTLE, SPRAY in 1 CARTON / 240 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Decreased Histamine Release [PE]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","Histamine-1 Receptor Inhibitor [EPC]","Mast Cell Stabilizer [EPC]"]},"nadac":{"value":7.67149,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ryaltris|Olopatadine HCl/Mometasone","basis":"brand"},"part_b":null}, {"ndc":"00169431430","name":"RYBELSUS 14 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4314-30","proprietary_name":"RYBELSUS","nonproprietary_name":"oral semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"14 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4314-30)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":33.18852,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rybelsus|Semaglutide","basis":"brand"},"part_b":null}, {"ndc":"00169430330","name":"RYBELSUS 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4303-30","proprietary_name":"RYBELSUS","nonproprietary_name":"oral semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4303-30)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":33.19015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rybelsus|Semaglutide","basis":"brand"},"part_b":null}, {"ndc":"00169430730","name":"RYBELSUS 7 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4307-30","proprietary_name":"RYBELSUS","nonproprietary_name":"oral semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"7 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4307-30)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":33.19336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Rybelsus|Semaglutide","basis":"brand"},"part_b":null}, {"ndc":"15370015004","name":"RYCLORA 2 MG/5 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"15370-150-04","proprietary_name":"RYCLORA","nonproprietary_name":"Dexchlorpheniramine Maleate","dosage_form":"LIQUID","route":"ORAL","strength":"2 mg/5mL","labeler":"CARWIN PHARMACEUTICAL ASSOCIATES, LLC","package_description":"118 mL in 1 BOTTLE, PLASTIC (15370-150-04)"},"nadac":{"value":2.90212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Ryclora|Dexchlorpheniramine Maleate","basis":"brand"},"part_b":null}, {"ndc":"00485008001","name":"RYMED TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0485-0080-01","proprietary_name":"RYMED","nonproprietary_name":"DEXCHLORPHENIRAMINE MALEATE and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2 mg/1; 10 mg/1","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (0485-0080-01)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.22396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00485020404","name":"RYNEX DM LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0204-04","proprietary_name":"Rynex DM","nonproprietary_name":"Brompheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"2.5 mg/5mL; 1 mg/5mL; 5 mg/5mL","labeler":"Edwards Pharmaceuticals, Inc","package_description":"118 mL in 1 BOTTLE, PLASTIC (0485-0204-04)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07504,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00485020416","name":"RYNEX DM LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0204-16","proprietary_name":"Rynex DM","nonproprietary_name":"Brompheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride","dosage_form":"LIQUID","route":"ORAL","strength":"2.5 mg/5mL; 1 mg/5mL; 5 mg/5mL","labeler":"Edwards Pharmaceuticals, Inc","package_description":"473 mL in 1 BOTTLE (0485-0204-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05121,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00485020216","name":"RYNEX PE LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0202-16","proprietary_name":"RYNEX PE","nonproprietary_name":"BROMPHENIRAMINE MALEATE and Phenylephrine HCL","dosage_form":"LIQUID","route":"ORAL","strength":"1 mg/5mL; 2.5 mg/5mL","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"473 mL in 1 BOTTLE, PLASTIC (0485-0202-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.04656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64896066101","name":"RYTARY ER 23.75 MG-95 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64896-661-01","proprietary_name":"RYTARY","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"95 mg/1; 23.75 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64896-661-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.98069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.15323,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896066201","name":"RYTARY ER 36.25 MG-145 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64896-662-01","proprietary_name":"RYTARY","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"145 mg/1; 36.25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64896-662-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.9763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.3941,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896066301","name":"RYTARY ER 48.75 MG-195 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64896-663-01","proprietary_name":"RYTARY","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"195 mg/1; 48.75 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64896-663-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":3.98378,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.18794,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896066401","name":"RYTARY ER 61.25 MG-245 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64896-664-01","proprietary_name":"RYTARY","nonproprietary_name":"Carbidopa and Levodopa","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"245 mg/1; 61.25 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (64896-664-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":4.99716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.92786,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904758004","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7580-04","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7580-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668063433","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-634-33","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (13668-634-33)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668063460","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-634-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-634-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067318","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-673-18","proprietary_name":"Sacubitril and valsartan","nonproprietary_name":"Sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (31722-673-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067360","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-673-60","proprietary_name":"Sacubitril and valsartan","nonproprietary_name":"Sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-673-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342057009","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-570-09","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-570-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342057057","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-570-57","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (33342-570-57)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598064318","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-643-18","proprietary_name":"Sacubitril and Valsartan Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (43598-643-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598064360","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-643-60","proprietary_name":"Sacubitril and Valsartan Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (43598-643-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268060611","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268060615","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-606-15","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-606-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-606-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687095511","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687095557","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-955-57","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-955-57) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-955-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055645","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-556-45","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (62332-556-45)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055660","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-556-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-556-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877070751","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-707-51","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (67877-707-51)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877070760","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-707-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-707-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238273101","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2731-1","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69238-2731-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238273102","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2731-2","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (69238-2731-2)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003112","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-031-12","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70377-031-12)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003113","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-031-13","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Biocon Pharma Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70377-031-13)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710127206","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1272-6","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (70710-1272-6)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748019507","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-195-07","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70748-195-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954097520","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-975-20","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70954-975-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954097530","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-975-30","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70954-975-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205028018","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-280-18","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (72205-280-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205028060","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-280-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-280-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82293002710","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-027-10","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (82293-027-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82293002720","name":"SACUBITRIL-VALSARTAN 24-26 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-027-20","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"24 mg/1; 26 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (82293-027-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.49855,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904758204","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7582-04","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7582-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668063533","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-635-33","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (13668-635-33)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668063560","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-635-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-635-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668074633","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-746-33","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (13668-746-33)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668074660","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-746-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-746-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067418","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-674-18","proprietary_name":"Sacubitril and valsartan","nonproprietary_name":"Sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (31722-674-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067460","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-674-60","proprietary_name":"Sacubitril and valsartan","nonproprietary_name":"Sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-674-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342057109","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-571-09","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-571-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342057157","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-571-57","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (33342-571-57)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598064418","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-644-18","proprietary_name":"Sacubitril and Valsartan Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (43598-644-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598064460","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-644-60","proprietary_name":"Sacubitril and Valsartan Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (43598-644-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268060711","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268060715","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-607-15","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-607-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-607-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687096611","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687096657","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-966-57","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-966-57) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-966-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055745","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-557-45","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (62332-557-45)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055760","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-557-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-557-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877070860","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-708-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-708-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877094951","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-949-51","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (67877-949-51)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877094960","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-949-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-949-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238273201","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2732-1","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69238-2732-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238273202","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2732-2","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (69238-2732-2)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003212","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-032-12","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70377-032-12)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003213","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-032-13","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Biocon Pharma Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70377-032-13)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710127306","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1273-6","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (70710-1273-6)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748019607","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-196-07","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70748-196-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954097620","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-976-20","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70954-976-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954097630","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-976-30","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70954-976-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205028118","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-281-18","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (72205-281-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205028160","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-281-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-281-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82293002810","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-028-10","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (82293-028-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82293002820","name":"SACUBITRIL-VALSARTAN 49-51 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-028-20","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"49 mg/1; 51 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (82293-028-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.53337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904758104","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7581-04","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7581-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668063633","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-636-33","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (13668-636-33)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668063660","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-636-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-636-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668074733","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-747-33","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (13668-747-33)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"13668074760","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-747-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (13668-747-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067518","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-675-18","proprietary_name":"Sacubitril and valsartan","nonproprietary_name":"Sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (31722-675-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722067560","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-675-60","proprietary_name":"Sacubitril and valsartan","nonproprietary_name":"Sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-675-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342057209","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-572-09","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-572-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342057257","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-572-57","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET in 1 BOTTLE (33342-572-57)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598064518","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-645-18","proprietary_name":"Sacubitril and Valsartan Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (43598-645-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598064560","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-645-60","proprietary_name":"Sacubitril and Valsartan Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (43598-645-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268060811","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268060813","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-608-13","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-608-13) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-608-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687097711","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687097757","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-977-57","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-977-57) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-977-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055845","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-558-45","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (62332-558-45)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332055860","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-558-60","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-558-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877070960","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-709-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-709-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877095051","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-950-51","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (67877-950-51)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877095060","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-950-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-950-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238273301","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2733-1","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69238-2733-1)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238273302","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2733-2","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (69238-2733-2)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003312","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-033-12","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Biocon Pharma Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70377-033-12)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377003313","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-033-13","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Biocon Pharma Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70377-033-13)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710127406","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1274-6","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET in 1 BOTTLE (70710-1274-6)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70748019707","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-197-07","proprietary_name":"sacubitril and valsartan","nonproprietary_name":"sacubitril and valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70748-197-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954097720","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-977-20","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70954-977-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954097730","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-977-30","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70954-977-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205028218","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-282-18","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (72205-282-18)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205028260","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-282-60","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-282-60)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82293002910","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-029-10","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (82293-029-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82293002920","name":"SACUBITRIL-VALSARTAN 97-103 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82293-029-20","proprietary_name":"Sacubitril and Valsartan","nonproprietary_name":"Sacubitril and Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"97 mg/1; 103 mg/1","labeler":"Novugen Pharma (USA) LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (82293-029-20)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Neprilysin Inhibitor [EPC]","Neprilysin Inhibitors [MoA]"]},"nadac":{"value":0.59213,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42192036510","name":"SALSALATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"65162051210","name":"SALSALATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-512-10","proprietary_name":"Salsalate","nonproprietary_name":"Salsalate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-512-10)"},"nadac":{"value":0.22636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"65162051250","name":"SALSALATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-512-50","proprietary_name":"Salsalate","nonproprietary_name":"Salsalate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-512-50)"},"nadac":{"value":0.22636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"69367061501","name":"SALSALATE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-615-01","proprietary_name":"Salsalate","nonproprietary_name":"Salsalate","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-615-01)"},"nadac":{"value":0.22636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"65162051310","name":"SALSALATE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-513-10","proprietary_name":"Salsalate","nonproprietary_name":"Salsalate","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-513-10)"},"nadac":{"value":0.224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"65162051350","name":"SALSALATE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-513-50","proprietary_name":"Salsalate","nonproprietary_name":"Salsalate","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-513-50)"},"nadac":{"value":0.224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"69367061601","name":"SALSALATE 750 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-616-01","proprietary_name":"Salsalate","nonproprietary_name":"Salsalate","dosage_form":"TABLET","route":"ORAL","strength":"750 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69367-616-01)"},"nadac":{"value":0.224,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Salsalate|Salsalate","basis":"generic"},"part_b":null}, {"ndc":"66220063731","name":"SANCUSO 3.1 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66220-637-31","proprietary_name":"SANCUSO","nonproprietary_name":"granisetron","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"3.1 mg/24h","labeler":"Cumberland Pharmaceuticals Inc.","package_description":"168 h in 1 POUCH (66220-637-31)","pharm_classes":["Serotonin 3 Receptor Antagonists [MoA]","Serotonin-3 Receptor Antagonist [EPC]"]},"nadac":{"value":685.85231,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sancuso|Granisetron","basis":"brand"},"part_b":null}, {"ndc":"00078081181","name":"SANDOSTATIN LAR DEPOT 10 MG KT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0811-81","proprietary_name":"Sandostatin LAR Depot","nonproprietary_name":"octreotide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 KIT in 1 KIT (0078-0811-81) * 6 mL in 1 VIAL (0078-0790-61) * 2 mL in 1 SYRINGE"},"nadac":{"value":3523.02912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres","basis":"brand"},"part_b":{"hcpcs":"J2353","bill_units_per_package":{"value":10,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2353 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (10 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 KIT (0078-0811-81) * 6 mL in 1 VIAL (0078-0790-61) * 2 mL in 1 SYRINGE) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00078079061","name":"SANDOSTATIN LAR DEPOT 10 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":3523.02912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres","basis":"brand"},"part_b":null}, {"ndc":"00078081881","name":"SANDOSTATIN LAR DEPOT 20 MG KT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0818-81","proprietary_name":"Sandostatin LAR Depot","nonproprietary_name":"octreotide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 KIT in 1 KIT (0078-0818-81) * 6 mL in 1 VIAL (0078-0797-61) * 2 mL in 1 SYRINGE"},"nadac":{"value":4588.54686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres","basis":"brand"},"part_b":{"hcpcs":"J2353","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2353 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 KIT (0078-0818-81) * 6 mL in 1 VIAL (0078-0797-61) * 2 mL in 1 SYRINGE) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00078079761","name":"SANDOSTATIN LAR DEPOT 20 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":4588.54686,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres","basis":"brand"},"part_b":null}, {"ndc":"00078082581","name":"SANDOSTATIN LAR DEPOT 30 MG KT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0825-81","proprietary_name":"Sandostatin LAR Depot","nonproprietary_name":"octreotide acetate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Novartis Pharmaceuticals Corporation","package_description":"1 KIT in 1 KIT (0078-0825-81) * 2 mL in 1 SYRINGE * 6 mL in 1 VIAL (0078-0804-61)"},"nadac":{"value":6948.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres","basis":"brand"},"part_b":{"hcpcs":"J2353","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2353 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 KIT (0078-0825-81) * 2 mL in 1 SYRINGE * 6 mL in 1 VIAL (0078-0804-61)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00078080461","name":"SANDOSTATIN LAR DEPOT 30 MG VL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":6948.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-08","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sandostatin Lar Depot|Octreotide Acetate,Mi-Spheres","basis":"brand"},"part_b":null}, {"ndc":"00456241006","name":"SAPHRIS 10 MG TAB SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.15928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saphris|Asenapine Maleate","basis":"brand"},"part_b":null}, {"ndc":"00456241060","name":"SAPHRIS 10 MG TAB SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2410-60","proprietary_name":"SAPHRIS","nonproprietary_name":"Asenapine Maleate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"10 mg/1","labeler":"Allergan, Inc.","package_description":"6 CASE in 1 CARTON (0456-2410-60) / 1 BLISTER PACK in 1 CASE (0456-2410-06) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.15928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.62719,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saphris|Asenapine Maleate","basis":"brand"},"part_b":null}, {"ndc":"00456240206","name":"SAPHRIS 2.5 MG TAB SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":20.99436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.08807,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saphris|Asenapine Maleate","basis":"brand"},"part_b":null}, {"ndc":"00456240260","name":"SAPHRIS 2.5 MG TAB SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2402-60","proprietary_name":"SAPHRIS","nonproprietary_name":"Asenapine Maleate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"2.5 mg/1","labeler":"Allergan, Inc.","package_description":"6 CASE in 1 CARTON (0456-2402-60) / 1 BLISTER PACK in 1 CASE (0456-2402-06) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":20.99436,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.08807,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saphris|Asenapine Maleate","basis":"brand"},"part_b":null}, {"ndc":"00456240506","name":"SAPHRIS 5 MG TAB SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":21.16056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saphris|Asenapine Maleate","basis":"brand"},"part_b":null}, {"ndc":"00456240560","name":"SAPHRIS 5 MG TAB SUBLINGUAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-2405-60","proprietary_name":"SAPHRIS","nonproprietary_name":"Asenapine Maleate","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"5 mg/1","labeler":"Allergan, Inc.","package_description":"6 CASE in 1 CARTON (0456-2405-60) / 1 BLISTER PACK in 1 CASE (0456-2405-06) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.16056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.03247,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saphris|Asenapine Maleate","basis":"brand"},"part_b":null}, {"ndc":"65597020230","name":"SAVAYSA 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65597-202-30","proprietary_name":"SAVAYSA","nonproprietary_name":"EDOXABAN TOSYLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Daiichi Sankyo Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65597-202-30)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":15.4815,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savaysa|Edoxaban Tosylate","basis":"brand"},"part_b":null}, {"ndc":"65597020330","name":"SAVAYSA 60 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65597-203-30","proprietary_name":"SAVAYSA","nonproprietary_name":"EDOXABAN TOSYLATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Daiichi Sankyo Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65597-203-30)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":15.51152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savaysa|Edoxaban Tosylate","basis":"brand"},"part_b":null}, {"ndc":"00456151060","name":"SAVELLA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1510-60","proprietary_name":"Savella","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Allergan, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0456-1510-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":8.15054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.81889,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savella|Milnacipran HCl","basis":"brand"},"part_b":null}, {"ndc":"00456151260","name":"SAVELLA 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1512-60","proprietary_name":"Savella","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Allergan, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0456-1512-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":8.16401,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.78243,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savella|Milnacipran HCl","basis":"brand"},"part_b":null}, {"ndc":"00456152560","name":"SAVELLA 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1525-60","proprietary_name":"Savella","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Allergan, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0456-1525-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":8.15605,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.52611,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savella|Milnacipran HCl","basis":"brand"},"part_b":null}, {"ndc":"00456155060","name":"SAVELLA 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1550-60","proprietary_name":"Savella","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Allergan, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0456-1550-60)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":8.15866,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.80179,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savella|Milnacipran HCl","basis":"brand"},"part_b":null}, {"ndc":"00456150055","name":"SAVELLA TITRATION PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1500-55","proprietary_name":"Savella","nonproprietary_name":"milnacipran hydrochloride","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Allergan, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0456-1500-55) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":8.14138,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Savella|Milnacipran HCl","basis":"brand"},"part_b":null}, {"ndc":"00378470577","name":"SAXAGLIPTIN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4705-77","proprietary_name":"Saxagliptin","nonproprietary_name":"saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4705-77)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.14446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378470593","name":"SAXAGLIPTIN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4705-93","proprietary_name":"Saxagliptin","nonproprietary_name":"saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4705-93)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.14446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862082530","name":"SAXAGLIPTIN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-825-30","proprietary_name":"Saxagliptin","nonproprietary_name":"Saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-825-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.14446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862082590","name":"SAXAGLIPTIN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-825-90","proprietary_name":"Saxagliptin","nonproprietary_name":"Saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-825-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.14446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462072630","name":"SAXAGLIPTIN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-726-30","proprietary_name":"SAXAGLIPTIN","nonproprietary_name":"SAXAGLIPTIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-726-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.14446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462072690","name":"SAXAGLIPTIN HCL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-726-90","proprietary_name":"SAXAGLIPTIN","nonproprietary_name":"SAXAGLIPTIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-726-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.14446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378470677","name":"SAXAGLIPTIN HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4706-77","proprietary_name":"Saxagliptin","nonproprietary_name":"saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4706-77)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.03871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378470693","name":"SAXAGLIPTIN HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4706-93","proprietary_name":"Saxagliptin","nonproprietary_name":"saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4706-93)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.03871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862082630","name":"SAXAGLIPTIN HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-826-30","proprietary_name":"Saxagliptin","nonproprietary_name":"Saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-826-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.03871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862082690","name":"SAXAGLIPTIN HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-826-90","proprietary_name":"Saxagliptin","nonproprietary_name":"Saxagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-826-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.03871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462072730","name":"SAXAGLIPTIN HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-727-30","proprietary_name":"SAXAGLIPTIN","nonproprietary_name":"SAXAGLIPTIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-727-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.03871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"68462072790","name":"SAXAGLIPTIN HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-727-90","proprietary_name":"SAXAGLIPTIN","nonproprietary_name":"SAXAGLIPTIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-727-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.03871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin HCl|Saxagliptin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378817691","name":"SAXAGLIPTIN-METFORMIN ER 2.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8176-91","proprietary_name":"Saxagliptin and Metformin","nonproprietary_name":"saxagliptin and metformin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-8176-91)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.00702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin-Metformin ER|Saxagliptin HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43598061860","name":"SAXAGLIPTIN-METFORMIN ER 2.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-618-60","proprietary_name":"Saxagliptin and Metformin Hydrochloride","nonproprietary_name":"Saxagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43598-618-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.00702,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin-Metformin ER|Saxagliptin HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00378817793","name":"SAXAGLIPTIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8177-93","proprietary_name":"Saxagliptin and Metformin","nonproprietary_name":"saxagliptin and metformin","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-8177-93)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":9.647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin-Metformin ER|Saxagliptin HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"43598061930","name":"SAXAGLIPTIN-METFORMIN ER 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-619-30","proprietary_name":"Saxagliptin and Metformin Hydrochloride","nonproprietary_name":"Saxagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (43598-619-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":9.647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Saxagliptin-Metformin ER|Saxagliptin HCl/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00169280015","name":"SAXENDA 18 MG/3 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-2800-15","proprietary_name":"Saxenda","nonproprietary_name":"liraglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-2800-15) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":87.12596,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":49.24809,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378647016","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00378647044","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6470-44","proprietary_name":"Scopolamine","nonproprietary_name":"scopolamine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"24 POUCH in 1 CARTON (0378-6470-44) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00378647097","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6470-97","proprietary_name":"Scopolamine","nonproprietary_name":"scopolamine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"10 POUCH in 1 CARTON (0378-6470-97) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00378647099","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6470-99","proprietary_name":"Scopolamine","nonproprietary_name":"scopolamine","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"4 POUCH in 1 CARTON (0378-6470-99) / 1 PATCH in 1 POUCH (0378-6470-16) / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00591225804","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2258-04","proprietary_name":"scopolamine","nonproprietary_name":"scopolamine","dosage_form":"SYSTEM","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Actavis Pharma, Inc.","package_description":"4 POUCH in 1 CARTON (0591-2258-04) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00591225823","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2258-23","proprietary_name":"scopolamine","nonproprietary_name":"scopolamine","dosage_form":"SYSTEM","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Actavis Pharma, Inc.","package_description":"24 POUCH in 1 CARTON (0591-2258-23) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00591225854","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"00591225879","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2258-79","proprietary_name":"scopolamine","nonproprietary_name":"scopolamine","dosage_form":"SYSTEM","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Actavis Pharma, Inc.","package_description":"10 POUCH in 1 CARTON (0591-2258-79) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Scopolamine|Scopolamine","basis":"generic"},"part_b":null}, {"ndc":"42858015014","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-150-14","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Rhodes Pharmaceuticals LLC","package_description":"10 POUCH in 1 BOX (42858-150-14) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858015040","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-150-40","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Rhodes Pharmaceuticals LLC","package_description":"4 POUCH in 1 BOX (42858-150-40) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858015070","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42858-150-70","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Rhodes Pharmaceuticals LLC","package_description":"24 POUCH in 1 BOX (42858-150-70) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42858015091","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802058001","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802058046","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-580-46","proprietary_name":"Scopolamine Transdermal System","nonproprietary_name":"scopolamine transdermal system","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"10 POUCH in 1 CARTON (45802-580-46) / 1 PATCH, EXTENDED RELEASE in 1 POUCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802058062","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-580-62","proprietary_name":"Scopolamine Transdermal System","nonproprietary_name":"scopolamine transdermal system","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"24 POUCH in 1 CARTON (45802-580-62) / 1 PATCH, EXTENDED RELEASE in 1 POUCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802058084","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-580-84","proprietary_name":"Scopolamine Transdermal System","nonproprietary_name":"scopolamine transdermal system","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"4 POUCH in 1 CARTON (45802-580-84) / 1 PATCH, EXTENDED RELEASE in 1 POUCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742050501","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742050504","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-505-04","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"4 POUCH in 1 CARTON (50742-505-04) / 1 PATCH, EXTENDED RELEASE in 1 POUCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742050510","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-505-10","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"10 POUCH in 1 CARTON (50742-505-10) / 1 PATCH, EXTENDED RELEASE in 1 POUCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742050524","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-505-24","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1.5 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"24 POUCH in 1 CARTON (50742-505-24) / 1 PATCH, EXTENDED RELEASE in 1 POUCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238166201","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238166202","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1662-2","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"10 PATCH in 1 CARTON (69238-1662-2) / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238166204","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1662-4","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"24 PATCH in 1 CARTON (69238-1662-4) / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238166209","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1662-9","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"4 PATCH in 1 CARTON (69238-1662-9) / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710184601","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710184602","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1846-2","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"10 POUCH in 1 CARTON (70710-1846-2) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710184604","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1846-4","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"4 POUCH in 1 CARTON (70710-1846-4) / 1 PATCH in 1 POUCH (70710-1846-1) / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710184607","name":"SCOPOLAMINE 1 MG/3 DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1846-7","proprietary_name":"Scopolamine","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"24 POUCH in 1 CARTON (70710-1846-7) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536196297","name":"SEBEX SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1962-97","proprietary_name":"Sebex Antidandruff, anti-seborrheic dermatitis, anti-psoriasis","nonproprietary_name":"Salicylic Acid, Sulfur","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"20 mg/1000mL; 20 mg/1000mL","labeler":"Rugby Laboratories","package_description":"118 mL in 1 BOTTLE (0536-1962-97)"},"nadac":{"value":0.02249,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68968017201","name":"SECUADO 3.8 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":49.0677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Secuado|Asenapine","basis":"brand"},"part_b":null}, {"ndc":"68968017203","name":"SECUADO 3.8 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0172-3","proprietary_name":"SECUADO","nonproprietary_name":"ASENAPINE","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"3.8 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0172-3) / 1 d in 1 POUCH","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.0677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Secuado|Asenapine","basis":"brand"},"part_b":null}, {"ndc":"68968017301","name":"SECUADO 5.7 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":49.04924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Secuado|Asenapine","basis":"brand"},"part_b":null}, {"ndc":"68968017303","name":"SECUADO 5.7 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0173-3","proprietary_name":"SECUADO","nonproprietary_name":"ASENAPINE","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"5.7 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0173-3) / 1 d in 1 POUCH","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.04924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Secuado|Asenapine","basis":"brand"},"part_b":null}, {"ndc":"68968017401","name":"SECUADO 7.6 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":48.83104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Secuado|Asenapine","basis":"brand"},"part_b":null}, {"ndc":"68968017403","name":"SECUADO 7.6 MG/24 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0174-3","proprietary_name":"SECUADO","nonproprietary_name":"ASENAPINE","dosage_form":"FILM, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"7.6 mg/d","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0174-3) / 1 d in 1 POUCH","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":48.83104,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Secuado|Asenapine","basis":"brand"},"part_b":null}, {"ndc":"00006537303","name":"SEGLUROMET 2.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5373-03","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-5373-03)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.7555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006537306","name":"SEGLUROMET 2.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5373-06","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0006-5373-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.7555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006536903","name":"SEGLUROMET 2.5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0006-5369-03","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-5369-03)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.70117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006536906","name":"SEGLUROMET 2.5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0006-5369-06","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0006-5369-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.70117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006537403","name":"SEGLUROMET 7.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5374-03","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-5374-03)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.71171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006537406","name":"SEGLUROMET 7.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5374-06","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1; 1000 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0006-5374-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.71171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006537003","name":"SEGLUROMET 7.5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5370-03","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0006-5370-03)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.73631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00006537006","name":"SEGLUROMET 7.5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5370-06","proprietary_name":"SEGLUROMET","nonproprietary_name":"ertugliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1; 500 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0006-5370-06)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]"]},"nadac":{"value":5.73631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Segluromet|Ertugliflozin/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00642007530","name":"SELECT-OB + DHA PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-0075-30","proprietary_name":"Select-OB Plus DHA Prenatal Supplement Plus DHA","nonproprietary_name":".BETA.-CAROTENE, VITAMIN A ACETATE, ASCORBIC ACID, CHOLECALCIFEROL, .ALPHA.-TOCOPHEROL ACETATE, DL-, Thiamine Mononitrate, Riboflavin, NIACINAMIDE, Pyridoxine Hydrochloride, Folic Acid, LEVOMEFOLATE CALCIUM, Cobalamin, Iron, MAGNESIUM OXIDE, ZINC OXIDE, and DOCONEXANT","dosage_form":"KIT","route":null,"strength":null,"labeler":"Exeltis USA, Inc.","package_description":"1 KIT in 1 CARTON (0642-0075-30) * 30 TABLET, COATED in 1 BOX * 30 CAPSULE in 1 BOX"},"nadac":{"value":2.23386,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571065906","name":"SELEGILINE HCL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-659-06","proprietary_name":"Selegiline Hydrochloride","nonproprietary_name":"Selegiline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 CAPSULE in 1 BOTTLE (16571-659-06)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":0.75631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selegiline HCl|Selegiline HCl","basis":"generic"},"part_b":null}, {"ndc":"60505005501","name":"SELEGILINE HCL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0055-1","proprietary_name":"SELEGILINE HYDROCHLORIDE","nonproprietary_name":"SELEGILINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-0055-1)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":0.75631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selegiline HCl|Selegiline HCl","basis":"generic"},"part_b":null}, {"ndc":"70954050410","name":"SELEGILINE HCL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-504-10","proprietary_name":"Selegiline Hydrochloride","nonproprietary_name":"Selegiline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Novitium Pharma LLC","package_description":"60 CAPSULE in 1 BOTTLE (70954-504-10)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":0.75631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selegiline HCl|Selegiline HCl","basis":"generic"},"part_b":null}, {"ndc":"70954050420","name":"SELEGILINE HCL 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-504-20","proprietary_name":"Selegiline Hydrochloride","nonproprietary_name":"Selegiline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Novitium Pharma LLC","package_description":"1000 CAPSULE in 1 BOTTLE (70954-504-20)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":0.75631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selegiline HCl|Selegiline HCl","basis":"generic"},"part_b":null}, {"ndc":"60505343803","name":"SELEGILINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3438-3","proprietary_name":"Selegiline Hydrochloride","nonproprietary_name":"Selegiline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-3438-3)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":0.76567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selegiline HCl|Selegiline HCl","basis":"generic"},"part_b":null}, {"ndc":"72319000602","name":"SELEGILINE HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72319-006-02","proprietary_name":"Selegiline Hydrochloride","nonproprietary_name":"Selegiline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"i3 Pharmaceuticals, LLC","package_description":"60 TABLET in 1 BOTTLE (72319-006-02)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":0.76567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selegiline HCl|Selegiline HCl","basis":"generic"},"part_b":null}, {"ndc":"69367022918","name":"SELENIUM SULFIDE 2.25% SHAMPOO","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-229-18","proprietary_name":"Selenium Sulfide","nonproprietary_name":"Selenium Sulfide","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"22.5 mg/mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"180 mL in 1 BOTTLE (69367-229-18)"},"nadac":{"value":0.16978,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Selenium Sulfide|Selenium Sulfide","basis":"generic"},"part_b":null}, {"ndc":"45802004064","name":"SELENIUM SULFIDE 2.5% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-040-64","proprietary_name":"SELENIUM SULFIDE","nonproprietary_name":"SELENIUM SULFIDE","dosage_form":"LOTION","route":"TOPICAL","strength":"2.5 mg/100mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"118 mL in 1 BOTTLE (45802-040-64)"},"nadac":{"value":0.07813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Selenium Sulfide|Selenium Sulfide","basis":"generic"},"part_b":null}, {"ndc":"49702022318","name":"SELZENTRY 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"49702-223-18","proprietary_name":"SELZENTRY","nonproprietary_name":"maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"ViiV Healthcare Company","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (49702-223-18)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":28.0158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":9.14963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selzentry|Maraviroc","basis":"brand"},"part_b":null}, {"ndc":"49702022418","name":"SELZENTRY 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"49702-224-18","proprietary_name":"SELZENTRY","nonproprietary_name":"maraviroc","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"ViiV Healthcare Company","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (49702-224-18)","pharm_classes":["CCR5 Co-receptor Antagonist [EPC]","Chemokine Co-receptor 5 Antagonists [MoA]"]},"nadac":{"value":28.13113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.33913,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Selzentry|Maraviroc","basis":"brand"},"part_b":null}, {"ndc":"83257001233","name":"SEMGLEE (YFGN) 100 UNIT/ML PEN","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-012-33","proprietary_name":"SEMGLEE","nonproprietary_name":"insulin glargine-yfgn","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Biocon Biologics Inc.","package_description":"5 SYRINGE in 1 CARTON (83257-012-33) / 3 mL in 1 SYRINGE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":25.75456,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83257001111","name":"SEMGLEE (YFGN) 100 UNIT/ML VL","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-011-11","proprietary_name":"SEMGLEE","nonproprietary_name":"insulin glargine-yfgn","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL","labeler":"Biocon Biologics Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (83257-011-11) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":26.0674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536124701","name":"SENEXON-S 50-8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1247-01","proprietary_name":"Senexon-S","nonproprietary_name":"Docusate Sodium 50mg and Sennosides 8.6mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"RUGBY LABORATORIES","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0536-1247-01)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536124710","name":"SENEXON-S 50-8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1247-10","proprietary_name":"Senexon-S","nonproprietary_name":"Docusate Sodium 50mg and Sennosides 8.6mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"RUGBY LABORATORIES","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0536-1247-10)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904725260","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904725280","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000061001","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0610-1","proprietary_name":"Sennosides","nonproprietary_name":"Sennosides","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"50 TABLET, FILM COATED in 1 BOTTLE (70000-0610-1)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000061002","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0610-2","proprietary_name":"Sennosides","nonproprietary_name":"Sennosides","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0610-2) / 100 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000061003","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0610-3","proprietary_name":"Sennosides","nonproprietary_name":"Sennosides","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"250 TABLET, FILM COATED in 1 BOTTLE (70000-0610-3)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000601","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0006-1","proprietary_name":"SENNA","nonproprietary_name":"SENNOSIDES","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"AARNA USA INC.","package_description":"100 TABLET in 1 BOTTLE (82568-0006-1)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000602","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0006-2","proprietary_name":"SENNA","nonproprietary_name":"SENNOSIDES","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"AARNA USA INC.","package_description":"1000 TABLET in 1 BOTTLE (82568-0006-2)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82568000603","name":"SENNA 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0006-3","proprietary_name":"SENNA","nonproprietary_name":"SENNOSIDES","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"AARNA USA INC.","package_description":"100 PACKET in 1 PACKAGE (82568-0006-3) / 1 TABLET in 1 PACKET"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536126659","name":"SENNA 8.8 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1266-59","proprietary_name":"Senna Liquid","nonproprietary_name":"Sennosides","dosage_form":"LIQUID","route":"ORAL","strength":"8.8 mg/5mL","labeler":"RUGBY LABORATORIES","package_description":"237 mL in 1 BOTTLE (0536-1266-59)"},"nadac":{"value":0.03693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"39328002008","name":"SENNA 8.8 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-020-08","proprietary_name":"Senna","nonproprietary_name":"Sennosides","dosage_form":"SYRUP","route":"ORAL","strength":"8.8 mg/5mL","labeler":"Patrin Pharma, Inc.","package_description":"237 mL in 1 BOTTLE, PLASTIC (39328-020-08)"},"nadac":{"value":0.03693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54859080808","name":"SENNA 8.8 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-808-08","proprietary_name":"Senna Syrup","nonproprietary_name":"Sennosides","dosage_form":"LIQUID","route":"ORAL","strength":"8.8 mg/5mL","labeler":"Llorens Pharmaceutical International Division, Inc.","package_description":"237 mL in 1 BOTTLE (54859-808-08)"},"nadac":{"value":0.03693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237030124","name":"SENNA 8.8 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-301-24","proprietary_name":"Senna Syrup","nonproprietary_name":"Sennosides","dosage_form":"LIQUID","route":"ORAL","strength":"8.8 mg/5mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"237 mL in 1 BOTTLE (57237-301-24)"},"nadac":{"value":0.03693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657051808","name":"SENNA 8.8 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-518-08","proprietary_name":"Senna Syrup","nonproprietary_name":"Natural Vegetable Laxative","dosage_form":"LIQUID","route":"ORAL","strength":"8.8 mg/5mL","labeler":"Method Pharmaceuticals","package_description":"237 mL in 1 BOTTLE (58657-518-08)"},"nadac":{"value":0.03693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568002408","name":"SENNA 8.8 MG/5 ML SYRUP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0024-8","proprietary_name":"Senna","nonproprietary_name":"Sennosides","dosage_form":"SYRUP","route":"ORAL","strength":"8.8 mg/5mL","labeler":"AARNA USA INC.","package_description":"237 mL in 1 BOTTLE (82568-0024-8)"},"nadac":{"value":0.03693,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000052001","name":"SENNA PLUS 8.6-50 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0520-1","proprietary_name":"Senna Plus","nonproprietary_name":"Docusate Sodium 50 mg and Sennosides 8.6 mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"CARDINAL HEALTH, 110 DBA LEADER","package_description":"30 BOTTLE, PLASTIC in 1 CARTON (70000-0520-1) / 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904725261","name":"SENNA-LAX 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483008001","name":"SENNA-TIME 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-080-01","proprietary_name":"SENNA TIME","nonproprietary_name":"SENNOSIDES","dosage_form":"TABLET, COATED","route":"ORAL","strength":"8.6 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-080-01)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483008010","name":"SENNA-TIME 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-080-10","proprietary_name":"SENNA TIME","nonproprietary_name":"SENNOSIDES","dosage_form":"TABLET, COATED","route":"ORAL","strength":"8.6 mg/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, COATED in 1 BOTTLE, PLASTIC (49483-080-10)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483008101","name":"SENNA-TIME S TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-081-01","proprietary_name":"SENNA TIME S","nonproprietary_name":"DOCUSATE SODIUM-SENNOSIDES","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 8.6 min/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-081-01)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49483008110","name":"SENNA-TIME S TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49483-081-10","proprietary_name":"SENNA TIME S","nonproprietary_name":"DOCUSATE SODIUM-SENNOSIDES","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 8.6 min/1","labeler":"TIME CAP LABORATORIES, INC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (49483-081-10)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62993000102","name":"SENNOSIDES 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62993-0001-2","proprietary_name":"Sennosides","nonproprietary_name":"Sennosides","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"Morepen Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (62993-0001-2)"},"nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904744061","name":"SENNOSIDES-DOCUSATE SODIUM TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7440-61","proprietary_name":"Sennosides, Docusate Sodium","nonproprietary_name":"Sennosides, Docusate Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 8.6 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-7440-61) / 10 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062201","name":"SENNOSIDES-DOCUSATE SODIUM TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-622-01","proprietary_name":"Sennosides and Docusate Sodium","nonproprietary_name":"Sennosides and Docusate Sodium","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-622-01) / 1 TABLET in 1 BLISTER PACK (60687-622-11)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687062211","name":"SENNOSIDES-DOCUSATE SODIUM TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618030010","name":"SENOKOT 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-300-10","proprietary_name":"Senokot","nonproprietary_name":"standardized senna concentrate","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-300-10) / 100 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.24706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618030020","name":"SENOKOT 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-300-20","proprietary_name":"Senokot","nonproprietary_name":"standardized senna concentrate","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (67618-300-20) / 10 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.24706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618030050","name":"SENOKOT 8.6 MG TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-300-50","proprietary_name":"Senokot","nonproprietary_name":"standardized senna concentrate","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-300-50) / 50 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.24706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0258,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618012012","name":"SENOKOT EXTRA STR 17.2 MG TAB","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67618-120-12","proprietary_name":"Senokot","nonproprietary_name":"standardized senna concentrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"17.2 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (67618-120-12) / 12 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.41634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618031001","name":"SENOKOT-S TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-310-01","proprietary_name":"Senokot-S","nonproprietary_name":"standardized senna concentrate and docusate sodium","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (67618-310-01) / 10 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.41197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618031030","name":"SENOKOT-S TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-310-30","proprietary_name":"Senokot-S","nonproprietary_name":"standardized senna concentrate and docusate sodium","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-310-30) / 30 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.41197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67618031060","name":"SENOKOT-S TABLET","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67618-310-60","proprietary_name":"Senokot-S","nonproprietary_name":"standardized senna concentrate and docusate sodium","dosage_form":"TABLET","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"Atlantis Consumer Healthcare, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (67618-310-60) / 60 TABLET in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.41197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00173052100","name":"SEREVENT DISKUS 50 MCG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0521-00","proprietary_name":"SEREVENT DISKUS","nonproprietary_name":"salmeterol xinafoate","dosage_form":"POWDER, METERED","route":"ORAL; RESPIRATORY (INHALATION)","strength":"50 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0521-00) / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":6.74459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Serevent Diskus|Salmeterol Xinafoate","basis":"brand"},"part_b":null}, {"ndc":"61269027460","name":"SEROQUEL XR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-274-60","proprietary_name":"SEROQUEL XR","nonproprietary_name":"quetiapine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"H2-Pharma, LLC","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (61269-274-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":26.35797,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31743,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Seroquel XR|Quetiapine Fumarate","basis":"brand"},"part_b":null}, {"ndc":"44087000501","name":"SEROSTIM 5 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":278.604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Serostim|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"47781095130","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-951-30","proprietary_name":"sertraline hydrochloride","nonproprietary_name":"sertraline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Alvogen, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (47781-951-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"52427066430","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-664-30","proprietary_name":"sertraline HCl","nonproprietary_name":"sertraline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE in 1 BOTTLE (52427-664-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097043802","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-438-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Cipla USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (69097-438-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70377012811","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-128-11","proprietary_name":"Sertraline HCl","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70377-128-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710194803","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1948-3","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70710-1948-3)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70954089910","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-899-10","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70954-899-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907031030","name":"SERTRALINE 150 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-310-30","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 CAPSULE in 1 BOTTLE (75907-310-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.2507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714060102","name":"SERTRALINE 20 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-601-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (16714-601-02) / 60 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.36502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762006701","name":"SERTRALINE 20 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0067-1","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"20 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (59762-0067-1) / 60 mL in 1 BOTTLE, DROPPER","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.36502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980040906","name":"SERTRALINE 20 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-409-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"20 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (64980-409-06) / 60 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.36502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71093014311","name":"SERTRALINE 20 MG/ML ORAL CONC","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.36502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"47781096230","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-962-30","proprietary_name":"sertraline hydrochloride","nonproprietary_name":"sertraline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Alvogen, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (47781-962-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"52427067230","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-672-30","proprietary_name":"sertraline HCl","nonproprietary_name":"sertraline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE in 1 BOTTLE (52427-672-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097045102","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-451-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (69097-451-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70377012911","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-129-11","proprietary_name":"Sertraline HCl","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70377-129-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70710194903","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1949-3","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70710-1949-3)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70954090010","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-900-10","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (70954-900-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"75907031130","name":"SERTRALINE 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-311-30","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 CAPSULE in 1 BOTTLE (75907-311-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":1.73616,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"00904692661","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6926-61","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6926-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061301","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-613-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-613-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061304","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-613-04","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-613-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061305","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-613-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-613-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061306","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-613-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-613-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075905","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-759-05","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (23155-759-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075909","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-759-09","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (23155-759-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014705","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-147-05","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-147-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014730","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-147-30","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-147-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014790","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-147-90","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-147-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268077011","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268077015","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-770-15","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-770-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-770-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268082511","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268082515","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-825-15","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-825-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-825-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687025301","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-253-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-253-01) / 1 TABLET in 1 BLISTER PACK (60687-253-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687025311","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001301","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-013-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-013-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001305","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-013-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-013-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001330","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-013-30","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-013-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035302","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-353-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-353-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035305","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-353-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET, FILM COATED in 1 BOTTLE (68180-353-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035306","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-353-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-353-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035309","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-353-09","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-353-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180099201","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-992-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-992-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180099202","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-992-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-992-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180099203","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-992-03","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-992-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180099204","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-992-04","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET, FILM COATED in 1 BOTTLE (68180-992-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68645052354","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-523-54","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-523-54)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083502","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-835-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-835-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083512","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-835-12","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-835-12)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020503","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-205-03","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70010-205-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020505","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-205-05","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-205-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020509","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-205-09","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70010-205-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020510","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-205-10","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70010-205-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021401","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021405","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021418","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021430","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021460","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021490","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"82009005005","name":"SERTRALINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-050-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-050-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"00904692461","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6924-61","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6924-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061101","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-611-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-611-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061104","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-611-04","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-611-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061105","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-611-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-611-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061106","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-611-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-611-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075703","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-757-03","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (23155-757-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075705","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-757-05","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (23155-757-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075709","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-757-09","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (23155-757-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014505","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-145-05","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-145-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014530","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-145-30","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-145-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014590","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-145-90","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-145-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076811","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076815","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-768-15","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-768-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-768-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268082311","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268082315","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-823-15","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-823-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-823-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687023101","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-231-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-231-01) / 1 TABLET in 1 BLISTER PACK (60687-231-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687023111","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001101","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-011-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-011-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001105","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-011-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-011-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001130","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-011-30","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-011-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035103","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-351-03","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68180-351-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035106","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-351-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-351-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035109","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-351-09","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-351-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180097801","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-978-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-978-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180097802","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-978-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-978-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180097803","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-978-03","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68180-978-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68645052154","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-521-54","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-521-54)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083302","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-833-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-833-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083305","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-833-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"90 TABLET in 1 BOTTLE (69097-833-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083312","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-833-12","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-833-12)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020303","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-203-03","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70010-203-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020305","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-203-05","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-203-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020309","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-203-09","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70010-203-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020310","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-203-10","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70010-203-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021201","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021205","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021218","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021230","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021260","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021290","name":"SERTRALINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"00904692561","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6925-61","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6925-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061201","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-612-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-612-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061204","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-612-04","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-612-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061205","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-612-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-612-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714061206","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-612-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-612-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075805","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-758-05","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (23155-758-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155075809","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-758-09","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (23155-758-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014605","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-146-05","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (31722-146-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014630","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-146-30","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-146-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"31722014690","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-146-90","proprietary_name":"SERTRALINE HYDROCHLORIDE","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET in 1 BOTTLE (31722-146-90)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076911","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076915","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-769-15","proprietary_name":"Sertraline","nonproprietary_name":"Sertraline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-769-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-769-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268082411","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"50268082415","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-824-15","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-824-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-824-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687024201","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-242-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-242-01) / 1 TABLET in 1 BLISTER PACK (60687-242-11)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"60687024211","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001201","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-012-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-012-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001205","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-012-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-012-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"65862001230","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-012-30","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-012-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035202","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-352-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-352-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035205","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-352-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET, FILM COATED in 1 BOTTLE (68180-352-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035206","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-352-06","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-352-06)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180035209","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-352-09","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-352-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180098601","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-986-01","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-986-01)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180098602","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-986-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-986-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180098603","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-986-03","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68180-986-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68180098604","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-986-04","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"5000 TABLET, FILM COATED in 1 BOTTLE (68180-986-04)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"68645052254","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68645-522-54","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Legacy Pharmaceutical Packaging, LLC","package_description":"30 TABLET in 1 BOTTLE (68645-522-54)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083402","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-834-02","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-834-02)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"69097083412","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-834-12","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-834-12)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020403","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-204-03","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70010-204-03)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020405","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-204-05","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (70010-204-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020409","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-204-09","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70010-204-09)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"70010020410","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-204-10","proprietary_name":"Sertraline hydrochloride","nonproprietary_name":"Sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70010-204-10)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021301","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021305","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021318","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021330","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021360","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"76282021390","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"82009004905","name":"SERTRALINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-049-05","proprietary_name":"Sertraline Hydrochloride","nonproprietary_name":"Sertraline Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-049-05)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sertraline HCl|Sertraline HCl","basis":"generic"},"part_b":null}, {"ndc":"16714036601","name":"SETLAKIN 0.15 MG-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Setlakin|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714036603","name":"SETLAKIN 0.15 MG-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-366-03","proprietary_name":"SETLAKIN","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"3 POUCH in 1 CARTON (16714-366-03) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.22674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Setlakin|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00115136529","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1365-29","proprietary_name":"sevelamer carbonate","nonproprietary_name":"sevelamer carbonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 PACKET in 1 CARTON (0115-1365-29) / 1 POWDER, FOR SUSPENSION in 1 PACKET (0115-1365-30)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00115136530","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"33342028868","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-288-68","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":".8 g/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 PACKET in 1 CARTON (33342-288-68) / 1 POWDER, FOR SUSPENSION in 1 PACKET","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"43598047801","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598047890","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-478-90","proprietary_name":"Sevelamer Carbonate for Oral Suspension","nonproprietary_name":"Sevelamer Carbonate for Oral Suspension","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"800 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"90 PACKET in 1 CARTON (43598-478-90) / 1 POWDER, FOR SUSPENSION in 1 PACKET (43598-478-01)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380088080","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-880-80","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"sevelamer carbonate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"800 mg/930mg","labeler":"Strides Pharma Science Limited","package_description":"90 PACKET in 1 CARTON (64380-880-80) / 800 mg in 1 PACKET (64380-880-00)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"65862093008","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"65862093090","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-930-90","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 POUCH in 1 CARTON (65862-930-90) / 1 POWDER, FOR SUSPENSION in 1 POUCH (65862-930-08)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69452012619","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-126-19","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"800 mg/1","labeler":"Bionpharma Inc.","package_description":"90 PACKET in 1 CARTON (69452-126-19) / 1 POWDER, FOR SUSPENSION in 1 PACKET (69452-126-60)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69452012660","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"72603039801","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"72603039802","name":"SEVELAMER 0.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-398-02","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":".8 g/1","labeler":"NorthStar RxLLC","package_description":"90 PACKET in 1 CARTON (72603-398-02) / 1 POWDER, FOR SUSPENSION in 1 PACKET (72603-398-01)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.91959,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00115136629","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-1366-29","proprietary_name":"sevelamer carbonate","nonproprietary_name":"sevelamer carbonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"2400 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"90 PACKET in 1 CARTON (0115-1366-29) / 1 POWDER, FOR SUSPENSION in 1 PACKET (0115-1366-30)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00115136630","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"33342028968","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-289-68","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"2.4 g/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 PACKET in 1 CARTON (33342-289-68) / 1 POWDER, FOR SUSPENSION in 1 PACKET","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"43598047901","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598047990","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-479-90","proprietary_name":"Sevelamer Carbonate for Oral Suspension","nonproprietary_name":"Sevelamer Carbonate for Oral Suspension","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"2400 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"90 PACKET in 1 CARTON (43598-479-90) / 1 POWDER, FOR SUSPENSION in 1 PACKET (43598-479-01)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380088180","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-881-80","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"sevelamer carbonate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"2400 mg/2790mg","labeler":"Strides Pharma Science Limited","package_description":"90 PACKET in 1 CARTON (64380-881-80) / 2400 mg in 1 PACKET (64380-881-00)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"65862093108","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"65862093190","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-931-90","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"2400 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 POUCH in 1 CARTON (65862-931-90) / 1 POWDER, FOR SUSPENSION in 1 POUCH (65862-931-08)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69452012719","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-127-19","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"2400 mg/1","labeler":"Bionpharma Inc.","package_description":"90 PACKET in 1 CARTON (69452-127-19) / 1 POWDER, FOR SUSPENSION in 1 PACKET (69452-127-60)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69452012760","name":"SEVELAMER 2.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.00501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00904670706","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6707-06","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6707-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00904670782","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6707-82","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6707-82) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"11788011607","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-116-07","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"270 TABLET in 1 BOTTLE (11788-116-07)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"16714081401","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-814-01","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"NorthStar Rx LLC","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (16714-814-01)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"24979018646","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-186-46","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"TWi Pharmaceuticals, Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (24979-186-46)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"33342021558","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-215-58","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (33342-215-58)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"50268072011","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"50268072015","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-720-15","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-720-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-720-11)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"55111078911","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-789-11","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"DR. REDDY'S LABORATORIES LIMITED","package_description":"25 BLISTER PACK in 1 CARTON (55111-789-11) / 4 TABLET, FILM COATED in 1 BLISTER PACK (55111-789-48)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"55111078927","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-789-27","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"DR. REDDY'S LABORATORIES LIMITED","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (55111-789-27)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"55111078948","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687032811","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687032831","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-328-31","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-328-31) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-328-33)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687032833","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"60687032865","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-328-65","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-328-65) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-328-11)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"64380087267","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-872-67","proprietary_name":"SEVELAMER CARBONATE","nonproprietary_name":"sevelamer carbonate","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Strides Pharma Science Limited","package_description":"270 TABLET in 1 BOTTLE (64380-872-67)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"65162005827","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-058-27","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (65162-058-27)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"65862092127","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-921-27","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (65862-921-27)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68094003459","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"68094003464","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-034-64","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Precision Dose, Inc.","package_description":"9 BLISTER PACK in 1 CARTON (68094-034-64) / 10 TABLET, FILM COATED in 1 BLISTER PACK (68094-034-59)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69097096793","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-967-93","proprietary_name":"Sevelamer carbonate","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Cipla USA Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (69097-967-93)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"69367042327","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-423-27","proprietary_name":"Sevelamer Carbonate","nonproprietary_name":"Sevelamer Carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (69367-423-27)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"70710217007","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2170-7","proprietary_name":"Sevelamer carbonate","nonproprietary_name":"Sevelamer carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70710-2170-7)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"70710217008","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2170-8","proprietary_name":"Sevelamer carbonate","nonproprietary_name":"Sevelamer carbonate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (70710-2170-8)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"76282040727","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-407-27","proprietary_name":"Sevelamer carbonate","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (76282-407-27)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"76282066427","name":"SEVELAMER CARBONATE 800 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-664-27","proprietary_name":"Sevelamer carbonate","nonproprietary_name":"SEVELAMER CARBONATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"270 TABLET, FILM COATED in 1 BOTTLE (76282-664-27)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer Carbonate|Sevelamer Carbonate","basis":"generic"},"part_b":null}, {"ndc":"00904720906","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7209-06","proprietary_name":"sevelamer hydrochloride","nonproprietary_name":"sevelamer hydrochloride","dosage_form":"TABLET, FILM COATED","route":"PARENTERAL","strength":"800 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7209-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"33342024257","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-242-57","proprietary_name":"Sevelamer Hydrochloride","nonproprietary_name":"Sevelamer Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (33342-242-57)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"59651008818","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-088-18","proprietary_name":"SEVELAMER HYDROCHLORIDE","nonproprietary_name":"SEVELAMER HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (59651-088-18)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044901","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-449-01","proprietary_name":"Sevelamer Hydrochloride","nonproprietary_name":"Sevelamer Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-449-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-449-11)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044911","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"68462044718","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-447-18","proprietary_name":"sevelamer hydrochloride","nonproprietary_name":"sevelamer hydrochloride","dosage_form":"TABLET, FILM COATED","route":"PARENTERAL","strength":"800 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (68462-447-18)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"70710205808","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-2058-8","proprietary_name":"Sevelamer Hydrochloride","nonproprietary_name":"Sevelamer Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (70710-2058-8)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"70748017326","name":"SEVELAMER HCL 800 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-173-26","proprietary_name":"Sevelamer hydrochloride","nonproprietary_name":"Sevelamer hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"180 TABLET in 1 BOTTLE (70748-173-26)","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.69517,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sevelamer HCl|Sevelamer HCl","basis":"generic"},"part_b":null}, {"ndc":"70000052501","name":"SEVERE COLD-FLU CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0525-1","proprietary_name":"Severe Cold and Flu","nonproprietary_name":"Acetaminophen, Dextromethorphan HBr, Guaifenesin, Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 10 mg/1; 200 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0525-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.13211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714044101","name":"SHAROBEL 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-441-01","proprietary_name":"SHAROBEL","nonproprietary_name":"Norethindrone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-441-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sharobel|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"16714044104","name":"SHAROBEL 0.35 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-441-04","proprietary_name":"SHAROBEL","nonproprietary_name":"Norethindrone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-441-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.09243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sharobel|Norethindrone","basis":"brand"},"part_b":null}, {"ndc":"71770012030","name":"SIKLOS 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71770-120-30","proprietary_name":"Siklos","nonproprietary_name":"hydroxyurea","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Medunik","package_description":"1 BOTTLE in 1 CARTON (71770-120-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":61.99589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Siklos|Hydroxyurea","basis":"brand"},"part_b":null}, {"ndc":"71770010560","name":"SIKLOS 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71770-105-60","proprietary_name":"Siklos","nonproprietary_name":"hydroxyurea","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Medunik","package_description":"1 BOTTLE in 1 CARTON (71770-105-60) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":6.23183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Siklos|Hydroxyurea","basis":"brand"},"part_b":null}, {"ndc":"00591405094","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4050-94","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE in 1 CARTON (0591-4050-94) / 112 mL in 1 BOTTLE","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27241017529","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-175-29","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Ajanta Pharma USA Inc.","package_description":"1 POUCH in 1 CARTON (27241-175-29) / 1 BOTTLE in 1 POUCH / 112 mL in 1 BOTTLE","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722013631","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-136-31","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil Powder,","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (31722-136-31) / 112 mL in 1 BOTTLE, GLASS","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651042011","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-420-11","proprietary_name":"sildenafil CITRATE","nonproprietary_name":"sildenafil CITRATE","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE in 1 CARTON (59651-420-11) / 112 mL in 1 BOTTLE","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60219265101","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2651-1","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (60219-2651-1) / 112 mL in 1 BOTTLE, GLASS","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238157401","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1574-1","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (69238-1574-1) / 112 mL in 1 BOTTLE, GLASS","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70710171604","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1716-4","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil Citrate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (70710-1716-4) / 112 mL in 1 BOTTLE, GLASS","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954016810","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-168-10","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil citrate","dosage_form":"FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (70954-168-10) / 112 mL in 1 BOTTLE","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205005976","name":"SILDENAFIL 10 MG/ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-059-76","proprietary_name":"sildenafil citrate","nonproprietary_name":"sildenafil citrate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-059-76) / 112 mL in 1 BOTTLE","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.26026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093534301","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5343-01","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5343-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"00093534356","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5343-56","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5343-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"13668018801","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-188-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-188-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"13668018830","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-188-30","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-188-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006903","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-069-03","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (27241-069-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006905","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-069-05","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27241-069-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006910","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-069-10","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (27241-069-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722071101","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-711-01","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-711-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722071105","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-711-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-711-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722071130","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-711-30","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-711-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004307","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-043-07","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-043-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004311","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-043-11","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (33342-043-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004344","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-043-44","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-043-44)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"59762003602","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0036-2","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59762-0036-2)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60219175303","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1753-3","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60219-1753-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290000301","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-003-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-003-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290000302","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-003-02","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (60290-003-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290000303","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-003-03","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60290-003-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862069101","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-691-01","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-691-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862069105","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-691-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-691-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862069130","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-691-30","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-691-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241007105","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-071-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72241-071-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241007111","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-071-11","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72241-071-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241007122","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-071-22","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72241-071-22)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72603088501","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-885-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (72603-885-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72603088502","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-885-02","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Northstar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-885-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888001700","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-017-00","proprietary_name":"SILDENAFIL","nonproprietary_name":"sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-017-00)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834024100","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-241-00","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-241-00)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834024101","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-241-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"100 TABLET in 1 BOTTLE (75834-241-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834024130","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-241-30","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"30 TABLET in 1 BOTTLE (75834-241-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"76282064501","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-645-01","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-645-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"76282064530","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-645-30","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (76282-645-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"82009009301","name":"SILDENAFIL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-093-01","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (82009-093-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"00904667104","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6671-04","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6671-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"00904667106","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6671-06","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6671-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"13668018590","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-185-90","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (13668-185-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241012403","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-124-03","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 TABLET in 1 BOTTLE (27241-124-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241012405","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-124-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-124-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722077605","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-776-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-776-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722077690","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-776-90","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-776-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342012110","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-121-10","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-121-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342053610","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-536-10","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-536-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"50268071711","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"50268071715","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-717-15","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-717-15) / 1 TABLET in 1 BLISTER PACK (50268-717-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"52817029590","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-295-90","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"TruPharma LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (52817-295-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60687078811","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60687078821","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-788-21","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-788-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-788-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"62135037290","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-372-90","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-372-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65162035109","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-351-09","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-351-09)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65162035111","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-351-11","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-351-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862068890","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-688-90","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-688-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862068899","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-688-99","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-688-99)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"68001059705","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-597-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68001-597-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888001800","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-018-00","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-018-00)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888001890","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-018-90","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Advagen Pharma Ltd","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72888-018-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"82009009490","name":"SILDENAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-094-90","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET in 1 BOTTLE (82009-094-90)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.05105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"00093534156","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5341-56","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5341-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"13668018630","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-186-30","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-186-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006703","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-067-03","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (27241-067-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006705","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-067-05","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27241-067-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722070930","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-709-30","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-709-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004107","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-041-07","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-041-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004144","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-041-44","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-041-44)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"59762003401","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0034-1","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59762-0034-1)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60219175103","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1751-3","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60219-1751-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290007901","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-079-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-079-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290007903","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-079-03","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60290-079-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862068930","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-689-30","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-689-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862068999","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-689-99","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-689-99)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241006911","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-069-11","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72241-069-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241006922","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-069-22","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72241-069-22)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72603088301","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-883-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (72603-883-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888001505","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-015-05","proprietary_name":"SILDENAFIL","nonproprietary_name":"sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (72888-015-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834027200","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-272-00","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-272-00)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"76282064330","name":"SILDENAFIL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-643-30","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (76282-643-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.12199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"00093534201","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5342-01","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-5342-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"00093534256","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5342-56","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5342-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"13668018701","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-187-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (13668-187-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"13668018730","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-187-30","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (13668-187-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006803","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-068-03","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (27241-068-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241006805","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-068-05","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (27241-068-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722071001","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-710-01","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-710-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"31722071030","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-710-30","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-710-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004207","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-042-07","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-042-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004211","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-042-11","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (33342-042-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"33342004244","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-042-44","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (33342-042-44)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"59762003501","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0035-1","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59762-0035-1)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"59762003502","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0035-2","proprietary_name":"Sildenafil Citrate","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59762-0035-2)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60219175203","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1752-3","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60219-1752-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290000201","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-002-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-002-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"60290000203","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-002-03","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60290-002-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862069001","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-690-01","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-690-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862069030","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-690-30","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-690-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"65862069099","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-690-99","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-690-99)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241007005","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-070-05","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (72241-070-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241007011","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-070-11","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72241-070-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72241007022","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-070-22","proprietary_name":"Sildenafil","nonproprietary_name":"Sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72241-070-22)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72603088401","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-884-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (72603-884-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"72888001600","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-016-00","proprietary_name":"SILDENAFIL","nonproprietary_name":"sildenafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (72888-016-00)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834024000","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-240-00","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET in 1 BOTTLE (75834-240-00)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834024001","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-240-01","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"100 TABLET in 1 BOTTLE (75834-240-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"75834024030","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-240-30","proprietary_name":"SILDENAFIL CITRATE","nonproprietary_name":"SILDENAFIL CITRATE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"30 TABLET in 1 BOTTLE (75834-240-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"76282064401","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-644-01","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-644-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"76282064430","name":"SILDENAFIL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-644-30","proprietary_name":"SILDENAFIL","nonproprietary_name":"SILDENAFIL","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (76282-644-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sildenafil Citrate|Sildenafil Citrate","basis":"generic"},"part_b":null}, {"ndc":"27241014401","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-144-01","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (27241-144-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"31722063530","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-635-30","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-635-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"33342038407","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-384-07","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 CAPSULE in 1 BOTTLE (33342-384-07)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"59651009530","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-095-30","proprietary_name":"SILODOSIN","nonproprietary_name":"SILODOSIN","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-095-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"68180074006","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-740-06","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-740-06)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"69238142103","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1421-3","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 CAPSULE in 1 BOTTLE (69238-1421-3)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"72205000930","name":"SILODOSIN 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-009-30","proprietary_name":"SILODOSIN","nonproprietary_name":"SILODOSIN","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 CAPSULE in 1 BOTTLE (72205-009-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.26502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"27241014501","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-145-01","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE in 1 BOTTLE (27241-145-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"27241014503","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-145-03","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (27241-145-03)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"31722063630","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-636-30","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (31722-636-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"31722063690","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-636-90","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (31722-636-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"33342038507","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-385-07","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 CAPSULE in 1 BOTTLE (33342-385-07)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"33342038510","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-385-10","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 CAPSULE in 1 BOTTLE (33342-385-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"59651009630","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-096-30","proprietary_name":"SILODOSIN","nonproprietary_name":"SILODOSIN","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE in 1 BOTTLE (59651-096-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"59651009690","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-096-90","proprietary_name":"SILODOSIN","nonproprietary_name":"SILODOSIN","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE in 1 BOTTLE (59651-096-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"68180074106","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-741-06","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (68180-741-06)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"68180074109","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-741-09","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68180-741-09)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"69238142003","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1420-3","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 CAPSULE in 1 BOTTLE (69238-1420-3)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"69238142009","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1420-9","proprietary_name":"Silodosin","nonproprietary_name":"Silodosin","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"90 CAPSULE in 1 BOTTLE (69238-1420-9)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"72205001030","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-010-30","proprietary_name":"SILODOSIN","nonproprietary_name":"SILODOSIN","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 CAPSULE in 1 BOTTLE (72205-010-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"72205001090","name":"SILODOSIN 8 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-010-90","proprietary_name":"SILODOSIN","nonproprietary_name":"SILODOSIN","dosage_form":"CAPSULE","route":"ORAL","strength":"8 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 CAPSULE in 1 BOTTLE (72205-010-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.31867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Silodosin|Silodosin","basis":"generic"},"part_b":null}, {"ndc":"61570013120","name":"SILVADENE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61570-131-20","proprietary_name":"SILVADENE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 TUBE in 1 CARTON (61570-131-20) / 20 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.43283,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.40717,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silvadene|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"61570013125","name":"SILVADENE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61570-131-25","proprietary_name":"SILVADENE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 TUBE in 1 CARTON (61570-131-25) / 25 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.28856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.31774,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silvadene|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"61570013140","name":"SILVADENE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61570-131-40","proprietary_name":"SILVADENE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"400 g in 1 JAR (61570-131-40)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.12469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.12781,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silvadene|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"61570013150","name":"SILVADENE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61570-131-50","proprietary_name":"SILVADENE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"50 g in 1 JAR (61570-131-50)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.23076,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silvadene|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"61570013155","name":"SILVADENE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61570-131-55","proprietary_name":"SILVADENE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 TUBE in 1 CARTON (61570-131-55) / 50 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.23076,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silvadene|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"61570013185","name":"SILVADENE 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61570-131-85","proprietary_name":"SILVADENE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"1 TUBE in 1 CARTON (61570-131-85) / 85 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.27318,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.2609,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silvadene|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"59762013100","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0131-0","proprietary_name":"SILVER SULFADIAZINE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-0131-0) / 20 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.40717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"59762013102","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0131-2","proprietary_name":"SILVER SULFADIAZINE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-0131-2) / 25 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.31774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"59762013104","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0131-4","proprietary_name":"SILVER SULFADIAZINE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"400 g in 1 JAR (59762-0131-4)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.12781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"59762013105","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0131-5","proprietary_name":"SILVER SULFADIAZINE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-0131-5) / 50 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"59762013106","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0131-6","proprietary_name":"SILVER SULFADIAZINE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"50 g in 1 JAR (59762-0131-6)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"59762013108","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0131-8","proprietary_name":"SILVER SULFADIAZINE","nonproprietary_name":"silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (59762-0131-8) / 85 g in 1 TUBE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.2609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"67877012405","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-124-05","proprietary_name":"Silver sulfadiazine","nonproprietary_name":"Silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"50 g in 1 TUBE (67877-124-05)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"67877012420","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-124-20","proprietary_name":"Silver sulfadiazine","nonproprietary_name":"Silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"20 g in 1 TUBE (67877-124-20)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.40717,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"67877012425","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-124-25","proprietary_name":"Silver sulfadiazine","nonproprietary_name":"Silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"25 g in 1 TUBE (67877-124-25)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.31774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"67877012440","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-124-40","proprietary_name":"Silver sulfadiazine","nonproprietary_name":"Silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"400 g in 1 JAR (67877-124-40)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.12781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"67877012450","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-124-50","proprietary_name":"Silver sulfadiazine","nonproprietary_name":"Silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"50 g in 1 JAR (67877-124-50)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"67877012485","name":"SILVER SULFADIAZINE 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-124-85","proprietary_name":"Silver sulfadiazine","nonproprietary_name":"Silver sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"85 g in 1 TUBE (67877-124-85)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.2609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Silver Sulfadiazine|Silver Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"00065414727","name":"SIMBRINZA 1%-0.2% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-4147-27","proprietary_name":"SIMBRINZA","nonproprietary_name":"brinzolamide/brimonidine tartrate","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL; 2 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-4147-27) / 8 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Carbonic Anhydrase Inhibitor [EPC]","Carbonic Anhydrase Inhibitors [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":26.03918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Simbrinza|Brinzolamide/Brimonidine Tart","basis":"brand"},"part_b":null}, {"ndc":"00536130608","name":"SIMETHICONE 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1306-08","proprietary_name":"Gas Relief Ultra Strength","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"180 mg/1","labeler":"Rugby Laboratories, Inc.","package_description":"60 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0536-1306-08)","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536142108","name":"SIMETHICONE 180 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1421-08","proprietary_name":"Gas Relief","nonproprietary_name":"Simethicone","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"180 mg/1","labeler":"Rugby Laboratories","package_description":"60 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (0536-1421-08)","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.05412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904720660","name":"SIMETHICONE 80 MG TAB CHEW","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7206-60","proprietary_name":"Antiflatulent","nonproprietary_name":"Simethicone","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (0904-7206-60)","pharm_classes":["Skin Barrier Activity [PE]"]},"nadac":{"value":0.0322,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51759040202","name":"SIMLANDI(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"B-BIO","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-402-02","proprietary_name":"Simlandi","nonproprietary_name":"adalimumab-ryvk","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 KIT in 1 CARTON (51759-402-02) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE (51759-513-21) * .4 mL in 1 POUCH (65517-0002-1)"},"nadac":{"value":499.11944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51759040217","name":"SIMLANDI(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"B-BIO","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-402-17","proprietary_name":"Simlandi","nonproprietary_name":"adalimumab-ryvk","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 KIT in 1 CARTON (51759-402-17) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE (51759-513-21) * .4 mL in 1 POUCH (65517-0002-1)"},"nadac":{"value":499.11944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51759051321","name":"SIMLANDI(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"B-BIO","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":499.11944,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51759041222","name":"SIMLANDI(CF) 40 MG/0.4 ML SYRINGE","unit":"EA","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51759-412-22","proprietary_name":"Simlandi","nonproprietary_name":"adalimumab-ryvk","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"2 KIT in 1 CARTON (51759-412-22) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE (51759-624-31) * .4 mL in 1 POUCH"},"nadac":{"value":478.649,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862088628","name":"SIMLIYA 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862086494","name":"SIMPESSE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simpesse|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"65862086495","name":"SIMPESSE 0.15-0.03-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-864-95","proprietary_name":"Simpesse","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"2 POUCH in 1 CARTON (65862-864-95) / 1 BLISTER PACK in 1 POUCH (65862-864-94) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12477,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simpesse|L-Norgest/E.Estradiol-E.Estrad","basis":"brand"},"part_b":null}, {"ndc":"57894007002","name":"SIMPONI 50 MG/0.5 ML PEN INJEC","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-070-02","proprietary_name":"Simponi","nonproprietary_name":"golimumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"50 mg/.5mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-070-02) / .5 mL in 1 SYRINGE","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":12890.31636,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Simponi|Golimumab","basis":"brand"},"part_b":null}, {"ndc":"57894007001","name":"SIMPONI 50 MG/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"57894-070-01","proprietary_name":"Simponi","nonproprietary_name":"golimumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"50 mg/.5mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (57894-070-01) / .5 mL in 1 SYRINGE, GLASS","pharm_classes":["Tumor Necrosis Factor Blocker [EPC]","Tumor Necrosis Factor Receptor Blocking Activity [MoA]"]},"nadac":{"value":12977.244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Simponi|Golimumab","basis":"brand"},"part_b":null}, {"ndc":"16714068201","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-682-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-682-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068202","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-682-02","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-682-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068203","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-682-03","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-682-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050110","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050130","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050145","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050190","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005130","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-051-30","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-051-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005190","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-051-90","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-051-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005199","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-051-99","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-051-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68084051101","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-511-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-511-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-511-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68084051111","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180047801","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-478-01","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-478-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180047802","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-478-02","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-478-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180047803","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-478-03","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68180-478-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037409","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-374-09","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-374-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037410","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-374-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-374-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000212","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-002-12","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc,","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-002-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000214","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-002-14","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc,","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-002-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000215","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-002-15","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Biocon Pharma Inc,","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-002-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"82009001310","name":"SIMVASTATIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-013-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-013-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.02807,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068301","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-683-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-683-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068302","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-683-02","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-683-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068303","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-683-03","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-683-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050210","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050230","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050245","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050290","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005226","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-052-26","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"2500 TABLET, FILM COATED in 1 BOTTLE (65862-052-26)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005230","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-052-30","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-052-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005290","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-052-90","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-052-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005299","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-052-99","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-052-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68084051201","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-512-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-512-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-512-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68084051211","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180047901","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-479-01","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-479-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180047902","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-479-02","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-479-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180047903","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-479-03","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68180-479-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68645047054","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037509","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-375-09","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-375-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037510","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-375-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-375-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000312","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-003-12","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc,","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-003-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000314","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-003-14","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc,","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-003-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000315","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-003-15","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Biocon Pharma Inc,","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-003-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"82009001410","name":"SIMVASTATIN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-014-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-014-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068401","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-684-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-684-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068402","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-684-02","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-684-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068403","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-684-03","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-684-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050310","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050330","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050345","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050390","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"60687021001","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-210-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-210-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-210-11)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"60687021011","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005322","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-053-22","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"2000 TABLET, FILM COATED in 1 BOTTLE (65862-053-22)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005330","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-053-30","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-053-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005390","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-053-90","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-053-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005399","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-053-99","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-053-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046403","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-464-03","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68180-464-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046406","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-464-06","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-464-06)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046409","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-464-09","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-464-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68645052754","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037609","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-376-09","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-376-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037610","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-376-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-376-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000412","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-004-12","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc,","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-004-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000414","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-004-14","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc,","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-004-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000415","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-004-15","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Biocon Pharma Inc,","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-004-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"82009001510","name":"SIMVASTATIN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-015-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-015-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068101","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-681-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-681-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068102","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-681-02","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-681-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050010","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050030","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050090","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"31722051010","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-510-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-510-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005090","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-050-90","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-050-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000112","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-001-12","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc,","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-001-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000114","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-001-14","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc,","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-001-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000115","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-001-15","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc,","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-001-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"82009001210","name":"SIMVASTATIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-012-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (82009-012-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.03136,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068501","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-685-01","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-685-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068502","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-685-02","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-685-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"16714068503","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-685-03","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16714-685-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050410","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050430","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050445","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"24658050490","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"31722051490","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-514-90","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-514-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005430","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-054-30","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-054-30)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005490","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-054-90","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-054-90)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"65862005499","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-054-99","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-054-99)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046503","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-465-03","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68180-465-03)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046506","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-465-06","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68180-465-06)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"68180046509","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-465-09","proprietary_name":"SIMVASTATIN","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68180-465-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037709","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-377-09","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (69367-377-09)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"69367037710","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-377-10","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (69367-377-10)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000512","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-005-12","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc,","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-005-12)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000514","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-005-14","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc,","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (70377-005-14)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"70377000515","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-005-15","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Biocon Pharma Inc,","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (70377-005-15)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"82009001605","name":"SIMVASTATIN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-016-05","proprietary_name":"Simvastatin","nonproprietary_name":"Simvastatin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-016-05)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":0.09376,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Simvastatin|Simvastatin","basis":"generic"},"part_b":null}, {"ndc":"78206019001","name":"SINEMET 25-100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-190-01","proprietary_name":"SINEMET","nonproprietary_name":"carbidopa and levodopa","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 100 mg/1","labeler":"Organon LLC","package_description":"100 TABLET in 1 BOTTLE (78206-190-01)","pharm_classes":["Amino Acids, Aromatic [CS]","Aromatic Amino Acid [EPC]"]},"nadac":{"value":1.42358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07589,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sinemet|Carbidopa/Levodopa","basis":"brand"},"part_b":null}, {"ndc":"78206017201","name":"SINGULAIR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-172-01","proprietary_name":"SINGULAIR","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-172-01)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":9.21312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Singulair|Montelukast Sodium","basis":"brand"},"part_b":null}, {"ndc":"78206017202","name":"SINGULAIR 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-172-02","proprietary_name":"SINGULAIR","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-172-02)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":9.21312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04191,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Singulair|Montelukast Sodium","basis":"brand"},"part_b":null}, {"ndc":"78206017301","name":"SINGULAIR 5 MG TABLET CHEW","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-173-01","proprietary_name":"SINGULAIR","nonproprietary_name":"montelukast sodium","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"5 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, CHEWABLE in 1 BOTTLE (78206-173-01)","pharm_classes":["Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":9.2741,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07045,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Singulair|Montelukast Sodium","basis":"brand"},"part_b":null}, {"ndc":"00113201760","name":"SINUS 12 HOUR 120 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-2017-60","proprietary_name":"sinus 12 hour","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"L. Perrigo Company","package_description":"20 BLISTER PACK in 1 CARTON (0113-2017-60) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536128935","name":"SINUS CONGESTION-PAIN CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1289-35","proprietary_name":"Sinus Congestion and Pain Maximum Strength","nonproprietary_name":"Acetaminophen, Phenylephrine HCl","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1; 5 mg/1","labeler":"Rugby Laboratories","package_description":"2 BLISTER PACK in 1 CARTON (0536-1289-35) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000008001","name":"SINUS CONGST-PAIN 325-200-5 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0080-1","proprietary_name":"Sinus Relief Severe Congestion and Pain","nonproprietary_name":"ACETAMINOPHEN, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"325 mg/1; 200 mg/1; 5 mg/1","labeler":"CARDINAL HEALTH","package_description":"2 BLISTER PACK in 1 CARTON (70000-0080-1) / 10 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.11111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000016101","name":"SINUS PRESSURE-PAIN CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0161-1","proprietary_name":"Sinus Pressure and Pain Maximum Strength","nonproprietary_name":"Acetaminophen, Phenylephrine HCl","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0161-1) / 12 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000013201","name":"SINUS RELIEF 1% NASAL SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0132-1","proprietary_name":"Extra Strength Sinus Relief Nasal Decongestant","nonproprietary_name":"Phenylephrine Hydrochloride","dosage_form":"SPRAY","route":"NASAL","strength":"1 g/100mL","labeler":"CARDINAL HEALTH","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70000-0132-1) / 30 mL in 1 BOTTLE, SPRAY","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000056801","name":"SINUS-HEADACHE 5-325 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0568-1","proprietary_name":"Sinus and Headache","nonproprietary_name":"Acetaminophen and Phenylephrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"325 mg/1; 5 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"2 BLISTER PACK in 1 CARTON (70000-0568-1) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.08531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714018701","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-187-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-187-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (16714-187-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59762100101","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1001-1","proprietary_name":"Sirolimus","nonproprietary_name":"SIROLIMUS","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1001-1)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1001-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"60687090211","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687090221","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-902-21","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-902-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-902-11)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877074601","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-746-01","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-746-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (67877-746-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68382052001","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-520-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-520-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068201","name":"SIROLIMUS 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-682-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-682-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.84147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (68462-682-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904724804","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7248-04","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7248-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714018801","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-188-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-188-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (16714-188-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"50268071811","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268071813","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-718-13","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-718-13) / 1 TABLET in 1 BLISTER PACK (50268-718-11)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 BOX (50268-718-13) / 1 TABLET in 1 BLISTER PACK (50268-718-11)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55111065301","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-653-01","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-653-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (55111-653-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59762100201","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1002-1","proprietary_name":"Sirolimus","nonproprietary_name":"SIROLIMUS","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1002-1)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1002-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877074701","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-747-01","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-747-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (67877-747-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084091525","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-915-25","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-915-25) / 1 TABLET in 1 BLISTER PACK (68084-915-95)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":30,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (30 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-915-25) / 1 TABLET in 1 BLISTER PACK (68084-915-95)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084091595","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382035101","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-351-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-351-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068301","name":"SIROLIMUS 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-683-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-683-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":0.72296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (68462-683-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16571080606","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-806-06","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 CARTON in 1 KIT (16571-806-06) / 1 BOTTLE, GLASS in 1 CARTON / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722031631","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-316-31","proprietary_name":"SIROLIMUS","nonproprietary_name":"Sirolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 CARTON in 1 KIT (31722-316-31) / 1 BOTTLE, GLASS in 1 CARTON (31722-316-60) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762120504","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762120506","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1205-6","proprietary_name":"Sirolimus","nonproprietary_name":"sirolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 CARTON in 1 KIT (59762-1205-6) / 1 BOTTLE, GLASS in 1 CARTON (59762-1205-4) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 CARTON in 1 KIT (59762-1205-6) / 1 BOTTLE, GLASS in 1 CARTON (59762-1205-4) / 60 mL in 1 BOTTLE, GLASS) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"60505619702","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6197-2","proprietary_name":"Sirolimus","nonproprietary_name":"SIROLIMUS","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Apotex Corp","package_description":"1 BOTTLE, GLASS in 1 CARTON (60505-6197-2) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (60505-6197-2) / 60 mL in 1 BOTTLE, GLASS) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"66689034702","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-347-02","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"VistaPharm, LLC","package_description":"1 CARTON in 1 KIT (66689-347-02) / 1 BOTTLE in 1 CARTON / 60 mL in 1 BOTTLE","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238159403","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1594-3","proprietary_name":"Sirolimus","nonproprietary_name":"SIrolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 CARTON in 1 KIT (69238-1594-3) / 1 BOTTLE, GLASS in 1 CARTON (69238-1594-6) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 CARTON in 1 KIT (69238-1594-3) / 1 BOTTLE, GLASS in 1 CARTON (69238-1594-6) / 60 mL in 1 BOTTLE, GLASS) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69238159406","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205009978","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-099-78","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (72205-099-78) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (72205-099-78) / 60 mL in 1 BOTTLE, GLASS) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603040901","name":"SIROLIMUS 1 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-409-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"SOLUTION","route":"ORAL","strength":"1 mg/mL","labeler":"Northstar Rx LLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (72603-409-01) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":4.39032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (72603-409-01) / 60 mL in 1 BOTTLE, GLASS) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714018901","name":"SIROLIMUS 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-189-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-189-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":2.5288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (16714-189-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"55111065401","name":"SIROLIMUS 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-654-01","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"100 TABLET in 1 BOTTLE (55111-654-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":2.5288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET in 1 BOTTLE (55111-654-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59762100301","name":"SIROLIMUS 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-1003-1","proprietary_name":"Sirolimus","nonproprietary_name":"SIROLIMUS","dosage_form":"TABLET, SUGAR COATED","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1003-1)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":2.5288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1003-1)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877074801","name":"SIROLIMUS 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-748-01","proprietary_name":"Sirolimus","nonproprietary_name":"Sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (67877-748-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":2.5288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (67877-748-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68382035201","name":"SIROLIMUS 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-352-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-352-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":2.5288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068401","name":"SIROLIMUS 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-684-01","proprietary_name":"sirolimus","nonproprietary_name":"sirolimus","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68462-684-01)","pharm_classes":["Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":2.5288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7520","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7520 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 TABLET, FILM COATED in 1 BOTTLE (68462-684-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00480260910","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2609-10","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0480-2609-10)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00480260956","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2609-56","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2609-56)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00480260998","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2609-98","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-2609-98)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781577010","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5770-10","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (0781-5770-10)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781577031","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5770-31","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-5770-31)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781577092","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5770-92","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sandoz Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0781-5770-92)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"60505364503","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3645-3","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-3645-3)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"60505364509","name":"SITAGLIPTIN PHOSPHATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3645-9","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-3645-9)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.77084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00480260756","name":"SITAGLIPTIN PHOSPHATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2607-56","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2607-56)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00480260798","name":"SITAGLIPTIN PHOSPHATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2607-98","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-2607-98)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781576631","name":"SITAGLIPTIN PHOSPHATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5766-31","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-5766-31)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781576692","name":"SITAGLIPTIN PHOSPHATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5766-92","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sandoz Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0781-5766-92)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"60505364303","name":"SITAGLIPTIN PHOSPHATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3643-3","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-3643-3)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"60505364309","name":"SITAGLIPTIN PHOSPHATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3643-9","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-3643-9)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.46931,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00480260856","name":"SITAGLIPTIN PHOSPHATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2608-56","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2608-56)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00480260898","name":"SITAGLIPTIN PHOSPHATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0480-2608-98","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0480-2608-98)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781576831","name":"SITAGLIPTIN PHOSPHATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5768-31","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-5768-31)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781576892","name":"SITAGLIPTIN PHOSPHATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5768-92","proprietary_name":"Sitagliptin Phosphate","nonproprietary_name":"Sitagliptin Phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0781-5768-92)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"60505364403","name":"SITAGLIPTIN PHOSPHATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3644-3","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-3644-3)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"60505364409","name":"SITAGLIPTIN PHOSPHATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3644-9","proprietary_name":"Sitagliptin","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (60505-3644-9)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":3.6838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin|Sitagliptin","basis":"generic"},"part_b":null}, {"ndc":"00781580260","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5802-60","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Sandoz Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0781-5802-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00781580271","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5802-71","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Sandoz Inc","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0781-5802-71)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60505365906","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3659-6","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-3659-6)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60505365907","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3659-7","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Apotex Corp.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (60505-3659-7)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.75986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00781580160","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5801-60","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Sandoz Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0781-5801-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"00781580171","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0781-5801-71","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Sandoz Inc","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (0781-5801-71)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60505365806","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3658-6","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-3658-6)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"60505365807","name":"SITAGLIPTIN PHOSPHATE-METFORMIN 50 MG-500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-3658-7","proprietary_name":"Sitagliptin and Metformin Hydrochloride","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Apotex Corp.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (60505-3658-7)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":1.92131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sitagliptin-Metformin|Sitagliptin/Metformin HCl","basis":"generic"},"part_b":null}, {"ndc":"67919004104","name":"SIVEXTRO 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67919-041-04","proprietary_name":"SIVEXTRO","nonproprietary_name":"tedizolid phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67919-041-04)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":475.79029,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sivextro*|Tedizolid Phosphate","basis":"brand"},"part_b":null}, {"ndc":"67919004105","name":"SIVEXTRO 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67919-041-05","proprietary_name":"SIVEXTRO","nonproprietary_name":"tedizolid phosphate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"1 BLISTER PACK in 1 CARTON (67919-041-05) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Oxazolidinone Antibacterial [EPC]","Oxazolidinones [CS]"]},"nadac":{"value":475.79029,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sivextro*|Tedizolid Phosphate","basis":"brand"},"part_b":null}, {"ndc":"67919004199","name":"SIVEXTRO 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":475.79029,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sivextro*|Tedizolid Phosphate","basis":"brand","route_from":"fda_product","route":"ORAL","product_ndc":"67919-041","inner_of":[]},"part_b":null}, {"ndc":"24338018504","name":"SKLICE 0.5% LOTION","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-185-04","proprietary_name":"Sklice","nonproprietary_name":"ivermectin","dosage_form":"LOTION","route":"TOPICAL","strength":"5 mg/g","labeler":"Azurity Pharmaceuticals","package_description":"1 TUBE in 1 CARTON (24338-185-04) / 117 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":0.28538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":1.23937,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00074210001","name":"SKYRIZI 150 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-2100-01","proprietary_name":"Skyrizi","nonproprietary_name":"risankizumab-rzaa","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"AbbVie Inc.","package_description":"1 SYRINGE in 1 CARTON (0074-2100-01) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":22774.36091,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00074105001","name":"SKYRIZI 150 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-1050-01","proprietary_name":"Skyrizi","nonproprietary_name":"risankizumab-rzaa","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"150 mg/mL","labeler":"AbbVie Inc.","package_description":"1 SYRINGE in 1 CARTON (0074-1050-01) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":22887.43857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00074106901","name":"SKYRIZI 360 MG/2.4 ML ON-BODY","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":9572.665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00074107001","name":"SKYRIZI 360 MG/2.4 ML ON-BODY","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-1070-01","proprietary_name":"Skyrizi","nonproprietary_name":"Risankizumab-rzaa","dosage_form":"KIT","route":"INTRAVENOUS","strength":null,"labeler":"AbbVie Inc.","package_description":"1 KIT in 1 CARTON (0074-1070-01) * 2.4 mL in 1 CARTRIDGE (0074-1069-02) * 2.4 mL in 1 CARTRIDGE (0074-1069-01)"},"nadac":{"value":9572.665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000058401","name":"SLEEP AID 25 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0584-1","proprietary_name":"Sleep-Aid Diphenhydramine HCl","nonproprietary_name":"Diphenhydramine Hydrochloride","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BLISTER PACK in 1 CARTON (70000-0584-1) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.21549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000056701","name":"SLEEP AID 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0567-1","proprietary_name":"Sleep-Aid","nonproprietary_name":"Doxylamine succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"3 BLISTER PACK in 1 CARTON (70000-0567-1) / 16 TABLET in 1 BLISTER PACK","pharm_classes":["Antihistamine [EPC]","Histamine Receptor Antagonists [MoA]"]},"nadac":{"value":0.11579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000061601","name":"SLEEP AID 50 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0616-1","proprietary_name":"Nighttime Sleep Aid","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Cardinal Health (Leader) 70000","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (70000-0616-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.11141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000017401","name":"SLEEP AID 50 MG/30 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0174-1","proprietary_name":"LEADER Nighttime Sleep-Aid","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"50 mg/30mL","labeler":"CARDINAL HEALTH","package_description":"354 mL in 1 BOTTLE, PLASTIC (70000-0174-1)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.00972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000017402","name":"SLEEP AID 50 MG/30 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0174-2","proprietary_name":"LEADER Nighttime Sleep-Aid","nonproprietary_name":"DIPHENHYDRAMINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"50 mg/30mL","labeler":"CARDINAL HEALTH","package_description":"177 mL in 1 BOTTLE, PLASTIC (70000-0174-2)","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.01363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904427451","name":"SLEEP TABS 25 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-4274-51","proprietary_name":"Sleep Tabs","nonproprietary_name":"Diphenhydramine HCl","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-4274-51) / 50 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":0.05997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00642747001","name":"SLYND 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-7470-01","proprietary_name":"SLYND","nonproprietary_name":"Drospirenone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Exeltis USA, Inc.","package_description":"1 KIT in 1 CARTON (0642-7470-01) * 24 TABLET, FILM COATED in 1 BLISTER PACK * 4 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":6.61253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Slynd|Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"00642747002","name":"SLYND 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-7470-02","proprietary_name":"SLYND","nonproprietary_name":"Drospirenone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Exeltis USA, Inc.","package_description":"1 KIT in 1 CARTON (0642-7470-02) * 24 TABLET, FILM COATED in 1 BLISTER PACK * 4 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":6.61253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Slynd|Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"49348037954","name":"SM 3-DAY VAGINAL CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-379-54","proprietary_name":"sunmark Clotrimazole 3","nonproprietary_name":"Clotrimazole","dosage_form":"CREAM","route":"VAGINAL","strength":"2 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (49348-379-54) / 21 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.3124,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49348015529","name":"SM ANTIFUNGAL 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-155-29","proprietary_name":"sunmark antifungal","nonproprietary_name":"Tolnaftate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (49348-155-29) / 15 g in 1 TUBE"},"nadac":{"value":0.15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49348075707","name":"SM ASPIRIN 81 MG CHEWABLE TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-757-07","proprietary_name":"Sunmark Aspirin","nonproprietary_name":"Aspirin","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"81 mg/1","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (49348-757-07) / 36 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","Decreased Prostaglandin Production [PE]","Nonsteroidal Anti-inflammatory Drug [EPC]","Platelet Aggregation Inhibitor [EPC]"]},"nadac":{"value":0.02571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49348001134","name":"SM CALAMINE LOTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-011-34","proprietary_name":"Sunmark Calamine","nonproprietary_name":"Calamine 8% and Zinc Oxide 8%","dosage_form":"LOTION","route":"TOPICAL","strength":"160 mg/mL","labeler":"Strategic Sourcing Services LLC","package_description":"177 mL in 1 BOTTLE, PLASTIC (49348-011-34)","pharm_classes":["Copper Absorption Inhibitor [EPC]","Decreased Copper Ion Absorption [PE]"]},"nadac":{"value":0.01098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677002901","name":"SM CHILD ALLERGY 5 MG/5 ML SOL","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.04139,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677015301","name":"SM CHILD IBUPROFEN 100 MG/5 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70677-0153-1","proprietary_name":"Ibuprofen Oral","nonproprietary_name":"Ibuprofen Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Strategic Sourcing Services","package_description":"1 BOTTLE in 1 CARTON (70677-0153-1) / 118 mL in 1 BOTTLE","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.03324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49348027472","name":"SM DOUBLE ANTIBIOTIC OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-274-72","proprietary_name":"sunmark double antibiotic","nonproprietary_name":"Bacitracin zinc and Polymyxin B sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g; 10000 [USP'U]/g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (49348-274-72) / 28.4 g in 1 TUBE","pharm_classes":["Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.1148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"49348018620","name":"SM ENEMA READY TO USE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-186-20","proprietary_name":"Sunmark Saline Single Laxative","nonproprietary_name":"Sodium Phosphate, Dibasic and Sodium Phosphate, Monobasic, Unspecified Form","dosage_form":"ENEMA","route":"RECTAL","strength":"7 g/118mL; 19 g/118mL","labeler":"Strategic Sourcing Services LLC","package_description":"1 BOTTLE in 1 CARTON (49348-186-20) / 133 mL in 1 BOTTLE"},"nadac":{"value":0.0067,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49348052272","name":"SM HYDROCORTISONE 1% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-522-72","proprietary_name":"sunmark Hydrocortisone","nonproprietary_name":"Hydrocortisone","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 g/100g","labeler":"Strategic Sourcing Services LLC","package_description":"1 TUBE in 1 CARTON (49348-522-72) / 28.4 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70677007201","name":"SM IBUPROFEN IB 100 MG CHEW TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1544,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49348071130","name":"SM IODIDES TINCTURE","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49348-711-30","proprietary_name":"Sunmark Iodides Tincture","nonproprietary_name":"Ethyl Alcohol","dosage_form":"LIQUID","route":"TOPICAL","strength":".45 mL/mL","labeler":"Strategic Sourcing Services LLC","package_description":"59 mL in 1 BOTTLE (49348-711-30)"},"nadac":{"value":0.0722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70677000101","name":"SM NASAL DECONGEST ER 120 MG","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000059301","name":"SMOOTH ANTACID 750 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0593-1","proprietary_name":"Cardinal Extra Strength Smooth Antacid Assorted Fruits","nonproprietary_name":"Calcium carbonate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"750 mg/1","labeler":"CARDINAL HEALTH","package_description":"60 TABLET, CHEWABLE in 1 BOTTLE (70000-0593-1)","pharm_classes":["Blood Coagulation Factor [EPC]","Calcium [CS]","Cations, Divalent [CS]","Increased Coagulation Factor Activity [PE]","Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":0.03154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121059516","name":"SOD CITRATE-CITRIC ACID SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0595-16","proprietary_name":"Sodium Citrate and Citric Acid","nonproprietary_name":"SODIUM CITRATE and CITRIC ACID MONOHYDRATE","dosage_form":"SOLUTION","route":"ORAL","strength":"500 mg/5mL; 334 mg/5mL","labeler":"Pharmaceutical Associates, Inc.","package_description":"473 mL in 1 BOTTLE (0121-0595-16)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.02289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Citrate-Citric Acid|Citric Acid/Sodium Citrate","basis":"generic"},"part_b":null}, {"ndc":"58657031016","name":"SOD CITRATE-CITRIC ACID SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.02289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Citrate-Citric Acid|Citric Acid/Sodium Citrate","basis":"generic"},"part_b":null}, {"ndc":"62135043447","name":"SOD CITRATE-CITRIC ACID SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-434-47","proprietary_name":"Sodium Citrate and Citric Acid","nonproprietary_name":"Sodium Citrate and Citric Acid","dosage_form":"SOLUTION","route":"ORAL","strength":"500 mg/5mL; 334 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-434-47)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.02289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Citrate-Citric Acid|Citric Acid/Sodium Citrate","basis":"generic"},"part_b":null}, {"ndc":"11527074534","name":"SOD FLUORIDE ENAM PROT 5000PPM","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-745-34","proprietary_name":"Sodium Fluoride 5000 ppm Enamel Protect","nonproprietary_name":"Sodium Fluoride1.1%, Potassium Nitrate 5%","dosage_form":"GEL, DENTIFRICE","route":"DENTAL","strength":"57.5 mg/mL; 5.8 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-745-34) / 100 mL in 1 TUBE"},"nadac":{"value":0.11606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"10572001201","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10572-012-01","proprietary_name":"SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE","nonproprietary_name":"sodium sulfate, potassium sulfate, magnesium sulfate","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"17.5 g/mL; 3.13 g/mL; 1.6 g/mL","labeler":"Affordable Pharmaceuticals, LLC","package_description":"2 BOTTLE, PLASTIC in 1 CARTON (10572-012-01) / 177.4 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722009831","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-098-31","proprietary_name":"Sodium sulfate, potassium sulfate and magnesium sulfate","nonproprietary_name":"Sodium sulfate, potassium sulfate and magnesium sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"2 BOTTLE, PLASTIC in 1 CARTON (31722-098-31) / 177 mL in 1 BOTTLE, PLASTIC (31722-098-17)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43386070083","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43386-700-83","proprietary_name":"SODIUM SULFATE, POTASSIUM SULFATE, MAGNESIUM SULFATE","nonproprietary_name":"sodium sulfate, potassium sulfate, magnesium sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"2 BOTTLE in 1 CARTON (43386-700-83) / 177 mL in 1 BOTTLE","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"51672417005","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4170-5","proprietary_name":"Sodium Sulfate, Potassium Sulfate, and Magnesium Sulfate Bowel Prep kit","nonproprietary_name":"sodium sulfate anhydrous, potassium sulfate, and magnesium sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"2 BOTTLE in 1 CARTON (51672-4170-5) / 177 mL in 1 BOTTLE","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536017501","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-175-01","proprietary_name":"SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE","nonproprietary_name":"sodium sulfate, potassium sulfate, magnesium sulfate","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"17.5 g/mL; 3.13 g/mL; 1.6 g/mL","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"2 BOTTLE, PLASTIC in 1 CARTON (52536-175-01) / 177.4 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380011601","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-116-01","proprietary_name":"Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral","nonproprietary_name":"Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"Strides Pharma Science Limited","package_description":"2 BOTTLE in 1 CARTON (64380-116-01) / 177 mL in 1 BOTTLE (64380-116-02)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877072592","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-725-92","proprietary_name":"Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate","nonproprietary_name":"Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"Ascend Laboratories, LLC","package_description":"2 BOTTLE, PLASTIC in 1 CARTON (67877-725-92) / 177 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69452042862","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-428-62","proprietary_name":"sodium sulfate, potassium sulfate, and magnesium sulfate","nonproprietary_name":"sodium sulfate, potassium sulfate, and magnesium sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"Bionpharma Inc.,","package_description":"2 BOTTLE, PLASTIC in 1 KIT (69452-428-62) / 177 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603027802","name":"SOD SUL-POTASS SUL-MAG SUL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-278-02","proprietary_name":"Sodium sulfate, potassium sulfate and magnesium sulfate","nonproprietary_name":"Sodium sulfate, potassium sulfate and magnesium sulfate","dosage_form":"SOLUTION","route":"ORAL","strength":"17.5 g/177mL; 3.13 g/177mL; 1.6 g/177mL","labeler":"NorthStar RxLLC","package_description":"2 BOTTLE, PLASTIC in 1 CARTON (72603-278-02) / 177 mL in 1 BOTTLE, PLASTIC (72603-278-01)","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192015610","name":"SOD SULFACE-SULF 9.8-4.8% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-156-10","proprietary_name":"Sodium Sulfacetamide 9.8% and Sulfur 4.8% Cleanser","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"98 mg/g; 48 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"285 g in 1 BOTTLE, PLASTIC (42192-156-10)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.13064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367024410","name":"SOD SULFACE-SULF 9.8-4.8% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-244-10","proprietary_name":"SODIUM SULFACETAMIDE, SULFUR","nonproprietary_name":"sulfacetamide sodium and sulfur","dosage_form":"LIQUID","route":"TOPICAL","strength":"98 mg/g; 48 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"285 g in 1 BOTTLE (69367-244-10)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.13064,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42192014416","name":"SOD SULFACE-SULFUR 9-4.5% WASH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-144-16","proprietary_name":"Sodium Sulfacetamide 9 Sulfur 4.5 Wash","nonproprietary_name":"Sulfacetamide Sodium and Sulfur","dosage_form":"RINSE","route":"TOPICAL","strength":"90 mg/g; 45 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (42192-144-16) / 454 g in 1 BOTTLE","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.07128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657047416","name":"SOD SULFACE-SULFUR 9-4.5% WASH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-474-16","proprietary_name":"Sodium Sulfacetamide 9% and Sulfur 4.5% Cleanser","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"90 mg/g; 45 mg/g","labeler":"Method Pharmaceuticals","package_description":"454 g in 1 BOTTLE, PLASTIC (58657-474-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.07128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42192013606","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-136-06","proprietary_name":"Sodium Sulfacetamide 10 Sulfur 5 Cleanser","nonproprietary_name":"Sulfacetamide Sodium and Sulfur","dosage_form":"RINSE","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"170.3 g in 1 BOTTLE (42192-136-06)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.15342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42192013608","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-136-08","proprietary_name":"Sodium Sulfacetamide 10 Sulfur 5 Cleanser","nonproprietary_name":"Sulfacetamide Sodium and Sulfur","dosage_form":"RINSE","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"227 g in 1 BOTTLE (42192-136-08)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.39059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42192013612","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-136-12","proprietary_name":"Sodium Sulfacetamide 10 Sulfur 5 Cleanser","nonproprietary_name":"Sulfacetamide Sodium and Sulfur","dosage_form":"RINSE","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"340.2 g in 1 BOTTLE (42192-136-12)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657047207","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-472-07","proprietary_name":"Sodium Sulfacetamide and Sulfur","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"170.3 g in 1 BOTTLE, PLASTIC (58657-472-07)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.15342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657047208","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-472-08","proprietary_name":"Sodium Sulfacetamide and Sulfur","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"227 g in 1 BOTTLE, PLASTIC (58657-472-08)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.39059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657047213","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-472-13","proprietary_name":"Sodium Sulfacetamide and Sulfur","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"340.2 g in 1 BOTTLE, PLASTIC (58657-472-13)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367024706","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-247-06","proprietary_name":"SODIUM SULFACETAMIDE, SULFUR","nonproprietary_name":"sulfacetamide sodium and sulfur","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"170.3 g in 1 BOTTLE (69367-247-06)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.15342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367024708","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-247-08","proprietary_name":"SODIUM SULFACETAMIDE, SULFUR","nonproprietary_name":"sulfacetamide sodium and sulfur","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"227 g in 1 BOTTLE (69367-247-08)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.39059,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367024712","name":"SOD SULFACET-SULFUR 10-5% CLSR","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-247-12","proprietary_name":"SODIUM SULFACETAMIDE, SULFUR","nonproprietary_name":"sulfacetamide sodium and sulfur","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"340.2 g in 1 BOTTLE (69367-247-12)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.14643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536104610","name":"SODIUM BICARB 325 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1046-10","proprietary_name":"Sodium Bicarbonate Antacid","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"TABLET","route":"ORAL","strength":"325 mg/1","labeler":"Rugby Laboratories","package_description":"1000 TABLET in 1 BOTTLE (0536-1046-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.01468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536104710","name":"SODIUM BICARB 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1047-10","proprietary_name":"Sodium Bicarbonate Antacid","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Rugby Laboratories","package_description":"1000 TABLET in 1 BOTTLE (0536-1047-10)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.01279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904726161","name":"SODIUM BICARB 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7261-61","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-7261-61) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.01279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24689013701","name":"SODIUM BICARB 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24689-137-01","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"APNAR PHARMA LP","package_description":"1000 TABLET in 1 BOTTLE (24689-137-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.01279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980052810","name":"SODIUM BICARB 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-528-10","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-528-10)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.01279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367025810","name":"SODIUM BICARB 650 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-258-10","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (69367-258-10)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.01279,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00409662514","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-6625-14","proprietary_name":"SODIUM BICARBONATE","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6625-14) / 50 mL in 1 VIAL, SINGLE-DOSE (0409-6625-22)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"00409662535","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-6625-35","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-6625-35) / 50 mL in 1 VIAL, SINGLE-DOSE (0409-6625-30)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"51754500104","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51754-5001-4","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Exela Pharma Sciences, LLC","package_description":"25 VIAL in 1 CARTON (51754-5001-4) / 50 mL in 1 VIAL","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"51754500105","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51754-5001-5","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Exela Pharma Sciences, LLC","package_description":"20 VIAL in 1 CARTON (51754-5001-5) / 50 mL in 1 VIAL","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.15869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"51754888804","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51754-8888-4","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Exela Pharma Sciences, LLC","package_description":"25 VIAL in 1 CARTON (51754-8888-4) / 50 mL in 1 VIAL","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-12","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"63323008950","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-089-50","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"Sodium Bicarbonate","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-089-50) / 50 mL in 1 VIAL, SINGLE-DOSE (63323-089-25)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"68462095165","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68462-951-65","proprietary_name":"SODIUM BICARBONATE","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"25 VIAL in 1 CARTON (68462-951-65) / 50 mL in 1 VIAL (68462-951-50)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"70095005003","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70095-050-03","proprietary_name":"SODIUM BICARBONATE","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"25 VIAL in 1 CARTON (70095-050-03) / 50 mL in 1 VIAL (70095-050-01)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"72572074020","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.15869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"72572074025","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72572-740-25","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Civica","package_description":"25 VIAL in 1 CARTON (72572-740-25) / 50 mL in 1 VIAL","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"81298762003","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81298-7620-3","proprietary_name":"SODIUM BICARBONATE","nonproprietary_name":"sodium bicarbonate injection,","dosage_form":"SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"Long Grove Pharmaceuticals, LLC","package_description":"20 VIAL in 1 CARTON (81298-7620-3) / 50 mL in 1 VIAL (81298-7620-1)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.15869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"81665020005","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81665-200-05","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"20 VIAL in 1 CARTON (81665-200-05) / 50 mL in 1 VIAL (81665-200-01)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.15869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"81665020025","name":"SODIUM BICARBONATE 8.4% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"81665-200-25","proprietary_name":"Sodium Bicarbonate","nonproprietary_name":"SODIUM BICARBONATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"84 mg/mL","labeler":"OMNIVIUM PHARMACEUTICALS LLC.","package_description":"25 VIAL in 1 CARTON (81665-200-25) / 50 mL in 1 VIAL (81665-200-01)","pharm_classes":["Alkalinizing Activity [MoA]"]},"nadac":{"value":0.154,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sodium Bicarbonate|Sodium Bicarbonate","basis":"generic"},"part_b":null}, {"ndc":"00338004904","name":"SODIUM CHLORIDE 0.9% SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0338-0049-04","proprietary_name":"Sodium Chloride","nonproprietary_name":"Sodium Chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"9 g/1000mL","labeler":"Baxter Healthcare Corporation","package_description":"1000 mL in 1 BAG (0338-0049-04)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.00208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409488810","name":"SODIUM CHLORIDE 0.9% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4888-10","proprietary_name":"Sodium Chloride","nonproprietary_name":"Sodium Chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"9 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-4888-10) / 10 mL in 1 VIAL, SINGLE-DOSE (0409-4888-02)"},"nadac":{"value":0.08875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409488812","name":"SODIUM CHLORIDE 0.9% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4888-12","proprietary_name":"Sodium Chloride","nonproprietary_name":"Sodium Chloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"9 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-4888-12) / 10 mL in 1 VIAL, SINGLE-DOSE (0409-4888-01)"},"nadac":{"value":0.08875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"14789013305","name":"SODIUM CHLORIDE 0.9% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.08875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63323018610","name":"SODIUM CHLORIDE 0.9% VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-186-10","proprietary_name":"Sodium Chloride","nonproprietary_name":"SODIUM CHLORIDE","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"9 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (63323-186-10) / 10 mL in 1 VIAL, SINGLE-DOSE (63323-186-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.08875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57237036101","name":"SODIUM CHLORIDE 1 GM TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-361-01","proprietary_name":"Sodium Chloride","nonproprietary_name":"Sodium Chloride","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-361-01)"},"nadac":{"value":0.06817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657011801","name":"SODIUM CHLORIDE 1 GM TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-118-01","proprietary_name":"Sodium Chloride Normal Salt","nonproprietary_name":"sodium chloride","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Method Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (58657-118-01)"},"nadac":{"value":0.06817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"81033002801","name":"SODIUM CHLORIDE 1 GM TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81033-028-01","proprietary_name":"Sodium Chloride","nonproprietary_name":"Sodium Chloride Tablets","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Kesin Pharma Corporation","package_description":"100 TABLET in 1 BOTTLE (81033-028-01)"},"nadac":{"value":0.06817,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536125494","name":"SODIUM CHLORIDE 5% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1254-94","proprietary_name":"Sodium Chlorode Hypertonicity Ophthalmic Solution","nonproprietary_name":"sodium chloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"50 mg/mL","labeler":"Rugby Laboratories","package_description":"1 BOTTLE in 1 CARTON (0536-1254-94) / 15 mL in 1 BOTTLE","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":0.32865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536125391","name":"SODIUM CHLORIDE 5% EYE OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1253-91","proprietary_name":"Sodium Chloride Hypertonicity Ophthalmic","nonproprietary_name":"sodium chloride","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"50 mg/g","labeler":"Rugby Laboratories","package_description":"1 TUBE in 1 CARTON (0536-1253-91) / 3.5 g in 1 TUBE","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]"]},"nadac":{"value":2.99016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"11527073516","name":"SODIUM FLUORIDE 0.2% RINSE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-735-16","proprietary_name":"Wentworth Alcohol Free","nonproprietary_name":"Sodium Fluoride","dosage_form":"MOUTHWASH","route":"DENTAL","strength":".9 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (11527-735-16) / 473 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.02527,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657016012","name":"SODIUM FLUORIDE 0.25 (0.55) MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-160-12","proprietary_name":"Sodium Fluoride Chewable","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (58657-160-12)"},"nadac":{"value":0.0774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657016110","name":"SODIUM FLUORIDE 0.5 MG(1.1 MG)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-161-10","proprietary_name":"Sodium Fluoride Chewable","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"1000 TABLET in 1 BOTTLE (58657-161-10)"},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657016112","name":"SODIUM FLUORIDE 0.5 MG(1.1 MG)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-161-12","proprietary_name":"Sodium Fluoride Chewable","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (58657-161-12)"},"nadac":{"value":0.07335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657032250","name":"SODIUM FLUORIDE 0.5 MG/ML DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-322-50","proprietary_name":"Sodium Fluoride","nonproprietary_name":"Sodium Fluoride","dosage_form":"SOLUTION/ DROPS","route":"ORAL","strength":".5 mg/mL","labeler":"Method Pharmaceuticals, LLC","package_description":"50 mL in 1 BOTTLE, DROPPER (58657-322-50)"},"nadac":{"value":0.15562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61269016550","name":"SODIUM FLUORIDE 0.5 MG/ML DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.15562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657016212","name":"SODIUM FLUORIDE 1 MG (2.2 MG)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-162-12","proprietary_name":"Sodium Fluoride Chewable","nonproprietary_name":"Sodium Fluoride","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"120 TABLET in 1 BOTTLE (58657-162-12)"},"nadac":{"value":0.07223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"35573043556","name":"SODIUM FLUORIDE 1.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-435-56","proprietary_name":"Sodium Fluoride 1.1%","nonproprietary_name":"Sodium Fluoride","dosage_form":"GEL, DENTIFRICE","route":"DENTAL","strength":"5 mg/g","labeler":"Burel Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (35573-435-56) / 56 g in 1 TUBE"},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"50268073356","name":"SODIUM FLUORIDE 1.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-733-56","proprietary_name":"Sodium Fluoride Gel","nonproprietary_name":"Sodium Fluoride","dosage_form":"GEL, DENTIFRICE","route":"DENTAL","strength":"5 mg/g","labeler":"AvPAK","package_description":"1 TUBE in 1 CARTON (50268-733-56) / 56 g in 1 TUBE"},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367031056","name":"SODIUM FLUORIDE 1.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-310-56","proprietary_name":"Sodium Fluoride 1.1% Gel","nonproprietary_name":"Sodium Fluoride","dosage_form":"GEL","route":"DENTAL","strength":"5 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-310-56) / 56 g in 1 TUBE"},"nadac":{"value":0.10844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367031801","name":"SODIUM FLUORIDE 1.1%-POTASSIUM NITRATE 5% SENSITIVE PASTE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-318-01","proprietary_name":"Sodium Fluoride and Potassium Nitrate","nonproprietary_name":"Sodium Fluoride and Potassium Nitrate","dosage_form":"GEL","route":"DENTAL","strength":"5.8 mg/mL; 57.5 mg/mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-318-01) / 100 mL in 1 TUBE"},"nadac":{"value":0.11606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11527075534","name":"SODIUM FLUORIDE 5000 DRY MOUTH","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-755-34","proprietary_name":"Sodium Fluoride 5000 ppm Dry Mouth","nonproprietary_name":"Sodium Fluoride","dosage_form":"GEL, DENTIFRICE","route":"DENTAL","strength":"6.1 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-755-34) / 100 mL in 1 TUBE"},"nadac":{"value":0.09748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367030951","name":"SODIUM FLUORIDE 5000 PLUS CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-309-51","proprietary_name":"Sodium Fluoride 5000 Plus","nonproprietary_name":"Sodium Fluoride","dosage_form":"CREAM","route":"DENTAL","strength":"5 mg/g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (69367-309-51) / 51 g in 1 TUBE"},"nadac":{"value":0.06333,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"11527073044","name":"SODIUM FLUORIDE 5000 PPM PASTE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-730-44","proprietary_name":"Sodium Fluoride 5000 ppm Fruit","nonproprietary_name":"Sodium Fluoride","dosage_form":"PASTE, DENTIFRICE","route":"DENTAL","strength":"6 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-730-44) / 100 mL in 1 TUBE"},"nadac":{"value":0.09748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11527075043","name":"SODIUM FLUORIDE 5000 PPM PASTE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-750-43","proprietary_name":"Sodium Fluoride 5000 ppm Spearmint","nonproprietary_name":"Sodium Fluoride","dosage_form":"PASTE, DENTIFRICE","route":"DENTAL","strength":"6 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-750-43) / 100 mL in 1 TUBE"},"nadac":{"value":0.09748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367031101","name":"SODIUM FLUORIDE 5000 PPM PASTE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-311-01","proprietary_name":"Sodium Fluoride 5000 PPM","nonproprietary_name":"Sodium Fluoride","dosage_form":"PASTE","route":"DENTAL","strength":"6 mg/mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 mL in 1 TUBE (69367-311-01)"},"nadac":{"value":0.09748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367031201","name":"SODIUM FLUORIDE 5000 PPM PASTE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-312-01","proprietary_name":"Sodium Fluoride 5000 PPM","nonproprietary_name":"Sodium Fluoride","dosage_form":"PASTE","route":"DENTAL","strength":"6 mg/mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 mL in 1 TUBE (69367-312-01)"},"nadac":{"value":0.09748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"11527070442","name":"SODIUM FLUORIDE SENSTV 5000PPM","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-704-42","proprietary_name":"Sodium Fluoride 5000 ppm Sensitive","nonproprietary_name":"Sodium Fluoride1.1%, Potassium Nitrate 5%","dosage_form":"GEL, DENTIFRICE","route":"DENTAL","strength":"5.8 mg/mL; 57.5 mg/mL","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-704-42) / 100 mL in 1 TUBE"},"nadac":{"value":0.11606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"10702003615","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-036-15","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER","route":"ORAL; RECTAL","strength":"1 g/g","labeler":"KVK-Tech, Inc.","package_description":"15 g in 1 BOTTLE (10702-036-15)"},"nadac":{"value":0.47405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"10702003645","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-036-45","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER","route":"ORAL; RECTAL","strength":"1 g/g","labeler":"KVK-Tech, Inc.","package_description":"454 g in 1 JAR (10702-036-45)"},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"11534016616","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-166-16","proprietary_name":"SODIUM POLYSTYRENE SULFONATE","nonproprietary_name":"sodium polystyrene sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL; RECTAL","strength":"4.1 meq/g","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"15 g in 1 BOTTLE (11534-166-16)"},"nadac":{"value":0.47405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"11534016644","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-166-44","proprietary_name":"SODIUM POLYSTYRENE SULFONATE","nonproprietary_name":"sodium polystyrene sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL; RECTAL","strength":"4.1 meq/g","labeler":"SUNRISE PHARMACEUTICAL, INC.","package_description":"454 g in 1 JAR (11534-166-44)"},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"24658076016","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-760-16","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4.1 meq/g","labeler":"PuraCap Laboratories, LLC","package_description":"453.6 g in 1 JAR (24658-760-16)"},"nadac":{"value":0.15518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"42806001394","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-013-94","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4.1 meq/g","labeler":"Epic Pharma, LLC","package_description":"15 g in 1 BOTTLE (42806-013-94)"},"nadac":{"value":0.47405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"42806001396","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-013-96","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"4.1 meq/g","labeler":"Epic Pharma, LLC","package_description":"453.6 g in 1 JAR (42806-013-96)"},"nadac":{"value":0.15518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"46287001216","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-012-16","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL; RECTAL","strength":"1 g/g","labeler":"CMP Pharma, Inc.","package_description":"454 g in 1 JAR (46287-012-16)"},"nadac":{"value":0.0924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"62135034053","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-340-53","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL; RECTAL","strength":"4.1 meq/g","labeler":"Chartwell RX, LLC","package_description":"453.6 g in 1 BOTTLE (62135-340-53)"},"nadac":{"value":0.15518,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"62135034062","name":"SODIUM POLYSTYRENE SULF POWDER","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-340-62","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"Sodium Polystyrene Sulfonate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL; RECTAL","strength":"4.1 meq/g","labeler":"Chartwell RX, LLC","package_description":"15 g in 1 BOTTLE (62135-340-62)"},"nadac":{"value":0.47405,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sodium Polystyrene Sulfonate*|Sodium Polystyrene Sulfonate","basis":"generic"},"part_b":null}, {"ndc":"42192012916","name":"SODIUM SULFACETAMIDE 10% WASH","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42192-129-16","proprietary_name":"SODIUM SULFACETAMIDE","nonproprietary_name":"SODIUM SULFACETAMIDE","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"480 mL in 1 BOTTLE (42192-129-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.23985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657047706","name":"SODIUM SULFACETAMIDE 10% WASH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-477-06","proprietary_name":"Sodium Sulfacetamide","nonproprietary_name":"Sodium Sulfacetamide","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"177 g in 1 BOTTLE (58657-477-06)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.11351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657047712","name":"SODIUM SULFACETAMIDE 10% WASH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58657-477-12","proprietary_name":"Sodium Sulfacetamide","nonproprietary_name":"Sodium Sulfacetamide","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"355 g in 1 BOTTLE (58657-477-12)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.10577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657047716","name":"SODIUM SULFACETAMIDE 10% WASH","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-477-16","proprietary_name":"Sodium Sulfacetamide","nonproprietary_name":"Sodium Sulfacetamide","dosage_form":"LIQUID","route":"TOPICAL","strength":"100 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"480 g in 1 BOTTLE (58657-477-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.0849,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72626270101","name":"SOFOSBUVIR-VELPATASVIR 400-100","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72626-2701-1","proprietary_name":"Sofosbuvir and Velpatasvir","nonproprietary_name":"Velpatasvir and Sofosbuvir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1; 400 mg/1","labeler":"Asegua Therapeutics LLC","package_description":"2 BLISTER PACK in 1 CARTON (72626-2701-1) / 14 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Hepatitis C Virus NS5A Inhibitor [EPC]","Hepatitis C Virus Nucleotide Analog NS5B Polymerase Inhibitor [EPC]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 2B1 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","RNA Replicase Inhibitors [MoA]"]},"nadac":{"value":278.02579,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sofosbuvir-Velpatasvir|Sofosbuvir/Velpatasvir","basis":"generic"},"part_b":null}, {"ndc":"00591379619","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3796-19","proprietary_name":"Solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0591-3796-19)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591379630","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3796-30","proprietary_name":"Solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0591-3796-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"29300032913","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-329-13","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (29300-329-13)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"29300032919","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-329-19","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (29300-329-19)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722002830","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-028-30","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-028-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722002890","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-028-90","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-028-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"33342014907","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-149-07","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 CONTAINER (33342-149-07)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"33342014910","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-149-10","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, COATED in 1 CONTAINER (33342-149-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"50228042830","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-428-30","proprietary_name":"SOLIFENACIN SUCCINATE","nonproprietary_name":"SOLIFENACIN SUCCINATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-428-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"50228042890","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-428-90","proprietary_name":"SOLIFENACIN SUCCINATE","nonproprietary_name":"SOLIFENACIN SUCCINATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-428-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"60505470303","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4703-3","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4703-3)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"62332019330","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-193-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-193-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"62332019390","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-193-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (62332-193-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"65862087930","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-879-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-879-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"65862087990","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-879-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-879-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877052830","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-528-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-528-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877052890","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-528-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-528-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"68462038730","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-387-30","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-387-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462038790","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-387-90","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-387-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205002130","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-021-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-021-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"72205002190","name":"SOLIFENACIN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-021-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72205-021-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.16167,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591379519","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3795-19","proprietary_name":"Solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0591-3795-19)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"00591379530","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3795-30","proprietary_name":"Solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0591-3795-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"29300032813","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-328-13","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (29300-328-13)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"29300032819","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-328-19","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (29300-328-19)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722002730","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-027-30","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-027-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"31722002790","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-027-90","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-027-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"33342014807","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-148-07","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, COATED in 1 CONTAINER (33342-148-07)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"33342014810","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-148-10","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, COATED in 1 CONTAINER (33342-148-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"50228042730","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-427-30","proprietary_name":"SOLIFENACIN SUCCINATE","nonproprietary_name":"SOLIFENACIN SUCCINATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50228-427-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"50228042790","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-427-90","proprietary_name":"SOLIFENACIN SUCCINATE","nonproprietary_name":"SOLIFENACIN SUCCINATE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"ScieGen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50228-427-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"60505470203","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4702-3","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60505-4702-3)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"62332019230","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-192-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-192-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"62332019290","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-192-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, COATED in 1 BOTTLE (62332-192-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"65862087830","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-878-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-878-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"65862087890","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-878-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-878-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877052730","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-527-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-527-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"67877052790","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-527-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-527-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"68462038630","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-386-30","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-386-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"68462038690","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-386-90","proprietary_name":"solifenacin succinate","nonproprietary_name":"solifenacin succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (68462-386-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"72205002030","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-020-30","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-020-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"72205002090","name":"SOLIFENACIN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-020-90","proprietary_name":"Solifenacin Succinate","nonproprietary_name":"Solifenacin Succinate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72205-020-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.14134,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solifenacin Succinate|Solifenacin Succinate","basis":"generic"},"part_b":null}, {"ndc":"00024576105","name":"SOLIQUA 100 UNIT-33 MCG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5761-05","proprietary_name":"Soliqua 100/33","nonproprietary_name":"insulin glargine and lixisenatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 U/mL; 33 ug/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"5 SYRINGE in 1 CARTON (0024-5761-05) / 3 mL in 1 SYRINGE (0024-5761-02)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":57.06155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Soliqua 100-33|Insulin Glargine/Lixisenatide","basis":"brand"},"part_b":null}, {"ndc":"27437005101","name":"SOLOSEC 2 GM GRANULE PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":281.9575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solosec|Secnidazole","basis":"brand"},"part_b":null}, {"ndc":"69751040001","name":"SOLOSEC 2 GM GRANULE PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69751-400-01","proprietary_name":"Solosec","nonproprietary_name":"secnidazole","dosage_form":"GRANULE","route":"ORAL","strength":"2 g/4.8g","labeler":"Evofem Inc.","package_description":"1 PACKET in 1 CARTON (69751-400-01) / 2 g in 1 PACKET","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":281.9575,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Solosec|Secnidazole","basis":"brand"},"part_b":null}, {"ndc":"00009001103","name":"SOLU-CORTEF 100 MG ACT-O-VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0011-03","proprietary_name":"Solu-Cortef","nonproprietary_name":"hydrocortisone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/2mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0009-0011-03) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":25.52679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0009-0011-03) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009001104","name":"SOLU-CORTEF 100 MG ACT-O-VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0011-04","proprietary_name":"Solu-Cortef","nonproprietary_name":"hydrocortisone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/2mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-0011-04) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":24.68317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 PACKAGE (0009-0011-04) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009082501","name":"SOLU-CORTEF 100 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["3","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0825-01","proprietary_name":"Solu-Cortef","nonproprietary_name":"hydrocortisone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/2mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL in 1 CARTON (0009-0825-01) / 2 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":25.72673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":14.61713,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":1,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0009-0825-01) / 2 mL in 1 VIAL) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009001305","name":"SOLU-CORTEF 250 MG ACT-O-VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0013-05","proprietary_name":"Solu-Cortef","nonproprietary_name":"hydrocortisone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"250 mg/2mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0009-0013-05) / 2 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":51.43208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J1720","bill_units_per_package":{"value":3,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1720 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (3 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0009-0013-05) / 2 mL in 1 VIAL, SINGLE-DOSE) gives 1 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009004722","name":"SOLU-MEDROL 125 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0047-22","proprietary_name":"SOLU-MEDROL","nonproprietary_name":"methylprednisolone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"125 mg/2mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"25 VIAL in 1 CARTON (0009-0047-22) / 2 mL in 1 VIAL (0009-0047-25)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":10.03574,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":625,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (25 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0009-0047-22) / 2 mL in 1 VIAL (0009-0047-25)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009003906","name":"SOLU-MEDROL 40 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0039-06","proprietary_name":"SOLU-MEDROL","nonproprietary_name":"methylprednisolone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"25 VIAL in 1 CARTON (0009-0039-06) / 1 mL in 1 VIAL (0009-0039-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.28128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0009-0039-06) / 1 mL in 1 VIAL (0009-0039-05)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009003928","name":"SOLU-MEDROL 40 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0039-28","proprietary_name":"SOLU-MEDROL","nonproprietary_name":"methylprednisolone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"25 VIAL in 1 CARTON (0009-0039-28) / 1 mL in 1 VIAL (0009-0039-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.28128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0009-0039-28) / 1 mL in 1 VIAL (0009-0039-30)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00009003932","name":"SOLU-MEDROL 40 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0009-0039-32","proprietary_name":"SOLU-MEDROL","nonproprietary_name":"methylprednisolone sodium succinate","dosage_form":"INJECTION, POWDER, FOR SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Pharmacia & Upjohn Company LLC","package_description":"25 VIAL in 1 CARTON (0009-0039-32) / 1 mL in 1 VIAL (0009-0039-33)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.28128,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J2919","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2919 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (8 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0009-0039-32) / 1 mL in 1 VIAL (0009-0039-33)) gives 25 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00037200101","name":"SOMA 350 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0037-2001-01","proprietary_name":"Soma","nonproprietary_name":"Carisoprodol","dosage_form":"TABLET","route":"ORAL","strength":"350 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0037-2001-01)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":11.29746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07059,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Soma|Carisoprodol","basis":"brand"},"part_b":null}, {"ndc":"00299382345","name":"SOOLANTRA 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0299-3823-45","proprietary_name":"SOOLANTRA","nonproprietary_name":"IVERMECTIN","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Galderma Laboratories, L.P.","package_description":"1 TUBE in 1 CARTON (0299-3823-45) / 45 g in 1 TUBE","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":15.5092,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":2.74609,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Soolantra|IVermectin","basis":"brand"},"part_b":null}, {"ndc":"00904630521","name":"SORE THROAT 1.4% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6305-21","proprietary_name":"Sore Throat Cherry","nonproprietary_name":"Phenol","dosage_form":"LIQUID","route":"ORAL","strength":"1.5 g/100mL","labeler":"Major Pharmaceuticals","package_description":"177 mL in 1 BOTTLE, SPRAY (0904-6305-21)"},"nadac":{"value":0.01244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000045801","name":"SORE THROAT 1.4% SPRAY","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0458-1","proprietary_name":"Sore Throat Relief Cherry Flavor","nonproprietary_name":"Phenol","dosage_form":"SPRAY","route":"ORAL","strength":"1.4 g/100mL","labeler":"Cardinal Health","package_description":"177 mL in 1 BOTTLE, SPRAY (70000-0458-1)"},"nadac":{"value":0.01244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904625549","name":"SORE THROAT 15-3.6 MG LOZENGE","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6255-49","proprietary_name":"Sore Throat Logenzes Sore Throat","nonproprietary_name":"Benzocaine and Menthol","dosage_form":"LOZENGE","route":"ORAL","strength":"15 mg/1; 3.6 mg/1","labeler":"Major Pharmaceuticals","package_description":"18 BLISTER PACK in 1 CARTON (0904-6255-49) / 18 LOZENGE in 1 BLISTER PACK","pharm_classes":["Allergens [CS]","Cell-mediated Immunity [PE]","Increased Histamine Release [PE]","Standardized Chemical Allergen [EPC]"]},"nadac":{"value":0.14495,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093106001","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1060-01","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1060-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005201","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-052-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-052-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268072511","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268072515","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-725-15","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-725-15) / 1 TABLET in 1 BLISTER PACK (50268-725-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505015900","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0159-0","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0159-0)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"69584084210","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-842-10","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-842-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"69584084230","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-842-30","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"300 TABLET in 1 BOTTLE (69584-842-30)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"76385011501","name":"SOTALOL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-115-01","proprietary_name":"Sotalol","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-115-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"00093106201","name":"SOTALOL 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1062-01","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1062-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005301","name":"SOTALOL 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-053-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-053-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008100","name":"SOTALOL 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0081-0","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0081-0)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"69584084310","name":"SOTALOL 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-843-10","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-843-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"76385011601","name":"SOTALOL 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-116-01","proprietary_name":"Sotalol","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-116-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"00093106301","name":"SOTALOL 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1063-01","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1063-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.20056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005401","name":"SOTALOL 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-054-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-054-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.20056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008200","name":"SOTALOL 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0082-0","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0082-0)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.20056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"69584084410","name":"SOTALOL 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-844-10","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-844-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.20056,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"00093106101","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1061-01","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1061-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904714361","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7143-61","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7143-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"11788005101","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-051-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"AiPing Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11788-051-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268072411","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268072415","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-724-15","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-724-15) / 1 TABLET in 1 BLISTER PACK (50268-724-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505008000","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0080-0","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-0080-0)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"68084065401","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-654-01","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-654-01) / 1 TABLET in 1 BLISTER PACK (68084-654-11)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"68084065411","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"69584084110","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-841-10","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE (69584-841-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"69584084150","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-841-50","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET in 1 BOTTLE (69584-841-50)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"76385011401","name":"SOTALOL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-114-01","proprietary_name":"Sotalol","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-114-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"42806012201","name":"SOTALOL AF 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-122-01","proprietary_name":"Sotalol hydrochloride","nonproprietary_name":"sotalol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-122-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651077601","name":"SOTALOL AF 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-776-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-776-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505022301","name":"SOTALOL AF 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0223-1","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60505-0223-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"76385012601","name":"SOTALOL AF 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-126-01","proprietary_name":"Sotalol Hydrochloride AF","nonproprietary_name":"Sotalol Hydrochloride Tables AF","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-126-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.11009,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806012301","name":"SOTALOL AF 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-123-01","proprietary_name":"Sotalol hydrochloride","nonproprietary_name":"sotalol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-123-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651077701","name":"SOTALOL AF 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-777-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-777-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505022401","name":"SOTALOL AF 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0224-1","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60505-0224-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"76385012701","name":"SOTALOL AF 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-127-01","proprietary_name":"Sotalol Hydrochloride AF","nonproprietary_name":"Sotalol Hydrochloride Tablets AF","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-127-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.12996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806012101","name":"SOTALOL AF 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-121-01","proprietary_name":"Sotalol hydrochloride","nonproprietary_name":"sotalol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-121-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"59651077501","name":"SOTALOL AF 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-775-01","proprietary_name":"SOTALOL HYDROCHLORIDE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-775-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"60505022201","name":"SOTALOL AF 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0222-1","proprietary_name":"Sotalol Hydrochloride","nonproprietary_name":"Sotalol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (60505-0222-1)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sotalol Af|Sotalol HCl","basis":"generic"},"part_b":null}, {"ndc":"76385012501","name":"SOTALOL AF 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76385-125-01","proprietary_name":"Sotalol Hydrochloride AF","nonproprietary_name":"Sotalol Hydrochloride Tables AF","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"UNICHEM PHARMACEUTICALS (USA), INC.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (76385-125-01)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":0.07066,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24338053025","name":"SOTYLIZE 5 MG/ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-530-25","proprietary_name":"SOTYLIZE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"250 mL in 1 BOTTLE (24338-530-25)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":2.31744,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sotylize|Sotalol HCl","basis":"brand"},"part_b":null}, {"ndc":"24338053048","name":"SOTYLIZE 5 MG/ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24338-530-48","proprietary_name":"SOTYLIZE","nonproprietary_name":"SOTALOL HYDROCHLORIDE","dosage_form":"SOLUTION","route":"ORAL","strength":"5 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"480 mL in 1 BOTTLE (24338-530-48)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","Antiarrhythmic [EPC]","Cardiac Rhythm Alteration [PE]"]},"nadac":{"value":2.32452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Sotylize|Sotalol HCl","basis":"brand"},"part_b":null}, {"ndc":"28595057004","name":"SPINOSAD 0.9% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"28595-570-04","proprietary_name":"Spinosad","nonproprietary_name":"spinosad","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"9 mg/mL","labeler":"Allegis Pharmaceuticals, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (28595-570-04) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Pediculicide [EPC]"]},"nadac":{"value":2.0169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Spinosad|Spinosad","basis":"generic"},"part_b":null}, {"ndc":"52246057004","name":"SPINOSAD 0.9% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52246-570-04","proprietary_name":"Spinosad","nonproprietary_name":"spinosad","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"9 mg/mL","labeler":"ParaPRO LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (52246-570-04) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Pediculicide [EPC]"]},"nadac":{"value":2.0169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Spinosad|Spinosad","basis":"generic"},"part_b":null}, {"ndc":"84635057004","name":"SPINOSAD 0.9% TOPICAL SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"84635-570-04","proprietary_name":"Spinosad","nonproprietary_name":"spinosad","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"9 mg/mL","labeler":"Cipher Pharmaceuticals Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (84635-570-04) / 120 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Pediculicide [EPC]"]},"nadac":{"value":2.0169,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Spinosad|Spinosad","basis":"generic"},"part_b":null}, {"ndc":"00597007541","name":"SPIRIVA HANDIHALER 18 MCG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0075-41","proprietary_name":"Spiriva HandiHaler","nonproprietary_name":"TIOTROPIUM BROMIDE","dosage_form":"CAPSULE","route":"ORAL; RESPIRATORY (INHALATION)","strength":"18 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0597-0075-41) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":10.60481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":11.81093,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spiriva Handihaler|Tiotropium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00597007547","name":"SPIRIVA HANDIHALER 18 MCG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0075-47","proprietary_name":"Spiriva HandiHaler","nonproprietary_name":"TIOTROPIUM BROMIDE","dosage_form":"CAPSULE","route":"ORAL; RESPIRATORY (INHALATION)","strength":"18 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"9 BLISTER PACK in 1 CARTON (0597-0075-47) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":10.61989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spiriva Handihaler|Tiotropium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00597007575","name":"SPIRIVA HANDIHALER 18 MCG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0075-75","proprietary_name":"Spiriva HandiHaler","nonproprietary_name":"TIOTROPIUM BROMIDE","dosage_form":"CAPSULE","route":"ORAL; RESPIRATORY (INHALATION)","strength":"18 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0597-0075-75) / 5 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":11.679,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spiriva Handihaler|Tiotropium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00597016061","name":"SPIRIVA RESPIMAT 1.25 MCG INH","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0160-61","proprietary_name":"Spiriva Respimat","nonproprietary_name":"tiotropium bromide inhalation spray","dosage_form":"SPRAY, METERED","route":"RESPIRATORY (INHALATION)","strength":"1.562 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 CARTRIDGE in 1 CARTON (0597-0160-61) / 60 SPRAY, METERED in 1 CARTRIDGE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":126.07565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Spiriva Respimat|Tiotropium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00597010061","name":"SPIRIVA RESPIMAT 2.5 MCG INH","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0100-61","proprietary_name":"Spiriva Respimat","nonproprietary_name":"tiotropium bromide inhalation spray","dosage_form":"SPRAY, METERED","route":"RESPIRATORY (INHALATION)","strength":"3.124 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 CARTRIDGE in 1 CARTON (0597-0100-61) / 60 SPRAY, METERED in 1 CARTRIDGE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":126.12032,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Spiriva Respimat|Tiotropium Bromide","basis":"brand"},"part_b":null}, {"ndc":"00378043701","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0437-01","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0437-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009601","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-096-01","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-096-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009605","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-096-05","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-096-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"51079098001","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"51079098008","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-980-08","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"80 BLISTER PACK in 1 CARTON (51079-980-08) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-980-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489032901","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489032905","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-329-05","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (53489-329-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051501","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-515-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-515-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051505","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-515-05","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-515-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59651042801","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-428-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-428-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021801","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-218-01","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-218-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021806","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-218-06","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-218-06)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"60687048701","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-487-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-487-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-487-11)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"60687048711","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"64980070801","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-708-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-708-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"64980070850","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-708-50","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-708-50)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066201","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-662-01","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-662-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066205","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-662-05","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-662-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085410","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-854-10","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69584-854-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085450","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-854-50","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (69584-854-50)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085490","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-854-90","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69584-854-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013601","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-136-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-136-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013602","name":"SPIRONOLACTONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-136-02","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-136-02)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.16783,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"00378214601","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2146-01","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2146-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"00378214605","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2146-05","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2146-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"00904692761","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6927-61","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6927-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009401","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-094-01","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-094-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009405","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-094-05","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-094-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009410","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-094-10","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (31722-094-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"51079010301","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"51079010320","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-103-20","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-103-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-103-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489014301","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-143-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-143-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489014305","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-143-05","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (53489-143-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489014310","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-143-10","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (53489-143-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051101","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-511-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-511-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051105","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-511-05","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-511-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051110","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-511-10","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 TABLET in 1 BOTTLE (53746-511-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59651042601","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-426-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-426-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59651042605","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-426-05","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-426-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59651042699","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-426-99","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET in 1 BOTTLE (59651-426-99)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021605","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-216-05","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59746-216-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021606","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-216-06","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-216-06)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021609","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-216-09","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (59746-216-09)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"60687046501","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-465-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-465-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-465-11)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"60687046511","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"64980070601","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-706-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-706-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"64980070650","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-706-50","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-706-50)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066001","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-660-01","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-660-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066005","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-660-05","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-660-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066010","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-660-10","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-660-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085210","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-852-10","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69584-852-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085250","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-852-50","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (69584-852-50)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085290","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-852-90","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69584-852-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085292","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-852-92","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"2500 TABLET, COATED in 1 BOTTLE (69584-852-92)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013401","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-134-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-134-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013402","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-134-02","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-134-02)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013403","name":"SPIRONOLACTONE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-134-03","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET in 1 BOTTLE (72603-134-03)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.04264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"00574113304","name":"SPIRONOLACTONE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-1133-04","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"spironolactone","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Padagis US LLC","package_description":"118 mL in 1 BOTTLE (0574-1133-04)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":1.61922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00574113316","name":"SPIRONOLACTONE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-1133-16","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"spironolactone","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Padagis US LLC","package_description":"473 mL in 1 BOTTLE (0574-1133-16)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":1.81187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722069111","name":"SPIRONOLACTONE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-691-11","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"118 mL in 1 BOTTLE (31722-691-11)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":1.61922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722069147","name":"SPIRONOLACTONE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-691-47","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (31722-691-47)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":1.81187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238202702","name":"SPIRONOLACTONE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2027-2","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"473 mL in 1 BOTTLE (69238-2027-2)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":1.81187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238202708","name":"SPIRONOLACTONE 25 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2027-8","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"SUSPENSION","route":"ORAL","strength":"25 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"118 mL in 1 BOTTLE (69238-2027-8)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":1.61922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378024301","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0243-01","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0243-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"00378024305","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0243-05","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0243-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009501","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-095-01","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (31722-095-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"31722009505","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-095-05","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-095-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"51079097901","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"51079097920","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-979-20","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-979-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-979-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489032801","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-328-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (53489-328-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53489032805","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-328-05","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (53489-328-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051401","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-514-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-514-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"53746051405","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-514-05","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-514-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59651042701","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-427-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (59651-427-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59651042705","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-427-05","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (59651-427-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021701","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-217-01","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-217-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"59746021706","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-217-06","proprietary_name":"Spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (59746-217-06)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"60687047601","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-476-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-476-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-476-11)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"60687047611","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"64980070701","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-707-01","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-707-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"64980070750","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-707-50","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-707-50)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066101","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-661-01","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (68382-661-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"68382066105","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-661-05","proprietary_name":"spironolactone","nonproprietary_name":"spironolactone","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-661-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085310","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-853-10","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (69584-853-10)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085350","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-853-50","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (69584-853-50)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"69584085390","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69584-853-90","proprietary_name":"Spironolactone","nonproprietary_name":"Spironolactone","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Oxford Pharmaceuticals, LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (69584-853-90)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013501","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-135-01","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (72603-135-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"72603013502","name":"SPIRONOLACTONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-135-02","proprietary_name":"SPIRONOLACTONE","nonproprietary_name":"SPIRONOLACTONE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET in 1 BOTTLE (72603-135-02)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]"]},"nadac":{"value":0.08319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spironolactone|Spironolactone","basis":"generic"},"part_b":null}, {"ndc":"00378040301","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0403-01","proprietary_name":"Spironolactone and Hydrochlorothiazide","nonproprietary_name":"spironolactone and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0378-0403-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378040305","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0403-05","proprietary_name":"Spironolactone and Hydrochlorothiazide","nonproprietary_name":"spironolactone and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0378-0403-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42292001701","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42292001720","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42292-017-20","proprietary_name":"Spironolactone and Hydrochlorothiazide","nonproprietary_name":"spironolactone and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (42292-017-20) / 1 TABLET in 1 BLISTER PACK (42292-017-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53489014401","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-144-01","proprietary_name":"Spironolactone and Hydrochlorothiazide","nonproprietary_name":"Spironolactone and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-144-01)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53489014405","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-144-05","proprietary_name":"Spironolactone and Hydrochlorothiazide","nonproprietary_name":"Spironolactone and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1; 25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (53489-144-05)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993018802","name":"SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-188-02","proprietary_name":"Spironolactone and Hydrochlorothiazide","nonproprietary_name":"spironolactone and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1; 25 mg/1","labeler":"Prasco Laboratories","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (66993-188-02)","pharm_classes":["Aldosterone Antagonist [EPC]","Aldosterone Antagonists [MoA]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.48325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458029001","name":"SPORANOX 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50458-290-01","proprietary_name":"SPORANOX","nonproprietary_name":"ITRACONAZOLE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (50458-290-01) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":28.35676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sporanox|Itraconazole","basis":"brand"},"part_b":null}, {"ndc":"50458029004","name":"SPORANOX 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50458-290-04","proprietary_name":"SPORANOX","nonproprietary_name":"ITRACONAZOLE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 CAPSULE in 1 BOTTLE (50458-290-04)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":28.35676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.91018,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sporanox|Itraconazole","basis":"brand"},"part_b":null}, {"ndc":"50458002802","name":"SPRAVATO 56 MG DOSE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50458-028-02","proprietary_name":"Spravato","nonproprietary_name":"Esketamine Hydrochloride","dosage_form":"SOLUTION","route":"NASAL","strength":"28 mg/.2mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 KIT (50458-028-02) / 1 VIAL, SINGLE-USE in 1 BLISTER PACK / .2 mL in 1 VIAL, SINGLE-USE (50458-028-00)"},"nadac":{"value":426.299,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-29","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spravato|Esketamine HCl","basis":"brand"},"part_b":null}, {"ndc":"50458002803","name":"SPRAVATO 84 MG DOSE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-028-03","proprietary_name":"Spravato","nonproprietary_name":"Esketamine Hydrochloride","dosage_form":"SOLUTION","route":"NASAL","strength":"28 mg/.2mL","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 KIT (50458-028-03) / 1 VIAL, SINGLE-USE in 1 BLISTER PACK / .2 mL in 1 VIAL, SINGLE-USE (50458-028-00)"},"nadac":{"value":429.97909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spravato|Esketamine HCl","basis":"brand"},"part_b":null}, {"ndc":"00555901658","name":"SPRINTEC 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9016-58","proprietary_name":"Sprintec","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9016-58) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sprintec|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"43485010401","name":"SPRITAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":10.199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spritam|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"43485010460","name":"SPRITAM 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43485-104-60","proprietary_name":"Spritam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FOR SUSPENSION","route":"ORAL","strength":"1000 mg/1","labeler":"Aprecia Pharmaceuticals, LLC","package_description":"60 BLISTER PACK in 1 CARTON (43485-104-60) / 1 TABLET, FOR SUSPENSION in 1 BLISTER PACK (43485-104-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spritam|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"43485010101","name":"SPRITAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":10.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spritam|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"43485010160","name":"SPRITAM 250 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43485-101-60","proprietary_name":"Spritam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FOR SUSPENSION","route":"ORAL","strength":"250 mg/1","labeler":"Aprecia Pharmaceuticals, LLC","package_description":"60 BLISTER PACK in 1 CARTON (43485-101-60) / 1 TABLET, FOR SUSPENSION in 1 BLISTER PACK (43485-101-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spritam|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"43485010201","name":"SPRITAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":10.2412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spritam|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"43485010260","name":"SPRITAM 500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43485-102-60","proprietary_name":"Spritam","nonproprietary_name":"levetiracetam","dosage_form":"TABLET, FOR SUSPENSION","route":"ORAL","strength":"500 mg/1","labeler":"Aprecia Pharmaceuticals, LLC","package_description":"60 BLISTER PACK in 1 CARTON (43485-102-60) / 1 TABLET, FOR SUSPENSION in 1 BLISTER PACK (43485-102-01)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.2412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Spritam|Levetiracetam","basis":"brand"},"part_b":null}, {"ndc":"00003085222","name":"SPRYCEL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0003-0852-22","proprietary_name":"SPRYCEL","nonproprietary_name":"dasatinib","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"E.R. Squibb & Sons, L.L.C.","package_description":"1 BOTTLE in 1 CARTON (0003-0852-22) / 30 TABLET in 1 BOTTLE","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]"]},"nadac":{"value":591.1812,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":26.45683,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sprycel|Dasatinib","basis":"brand"},"part_b":null}, {"ndc":"46287000601","name":"SPS 15 GM/60 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-006-01","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"sodium polystyrene sulfonate","dosage_form":"SUSPENSION","route":"ORAL; RECTAL","strength":"15 g/60mL","labeler":"CMP Pharma, Inc.","package_description":"473 mL in 1 BOTTLE (46287-006-01)"},"nadac":{"value":0.43798,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"46287000660","name":"SPS 15 GM/60 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"46287-006-60","proprietary_name":"Sodium Polystyrene Sulfonate","nonproprietary_name":"sodium polystyrene sulfonate","dosage_form":"SUSPENSION","route":"ORAL; RECTAL","strength":"15 g/60mL","labeler":"CMP Pharma, Inc.","package_description":"10 BOTTLE, UNIT-DOSE in 1 CARTON (46287-006-60) / 60 mL in 1 BOTTLE, UNIT-DOSE"},"nadac":{"value":0.38512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598021025","name":"SSD 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-210-25","proprietary_name":"SSD Cream","nonproprietary_name":"Silver Sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 g/1000g","labeler":"Dr Reddys Laboratories Inc","package_description":"25 g in 1 TUBE (43598-210-25)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.31774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ssd|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"43598021040","name":"SSD 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-210-40","proprietary_name":"SSD Cream","nonproprietary_name":"Silver Sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 g/1000g","labeler":"Dr Reddys Laboratories Inc","package_description":"400 g in 1 JAR (43598-210-40)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.12781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ssd|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"43598021050","name":"SSD 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-210-50","proprietary_name":"SSD Cream","nonproprietary_name":"Silver Sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 g/1000g","labeler":"Dr Reddys Laboratories Inc","package_description":"50 g in 1 TUBE (43598-210-50)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ssd|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"43598021055","name":"SSD 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-210-55","proprietary_name":"SSD Cream","nonproprietary_name":"Silver Sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 g/1000g","labeler":"Dr Reddys Laboratories Inc","package_description":"50 g in 1 JAR (43598-210-55)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.25963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ssd|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"43598021085","name":"SSD 1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-210-85","proprietary_name":"SSD Cream","nonproprietary_name":"Silver Sulfadiazine","dosage_form":"CREAM","route":"TOPICAL","strength":"10 g/1000g","labeler":"Dr Reddys Laboratories Inc","package_description":"85 g in 1 TUBE (43598-210-85)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.2609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ssd|Silver Sulfadiazine","basis":"brand"},"part_b":null}, {"ndc":"42192013901","name":"SSS 10-5 CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42192-139-01","proprietary_name":"SODIUM SULFACETAMIDE, SULFUR","nonproprietary_name":"Sodium Sulfacetamide and Sulfur","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"28 g in 1 TUBE (42192-139-01)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":1.55559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00006536403","name":"STEGLATRO 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5364-03","proprietary_name":"STEGLATRO","nonproprietary_name":"ertugliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5364-03)"},"nadac":{"value":11.4425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Steglatro|Ertugliflozin Pidolate","basis":"brand"},"part_b":null}, {"ndc":"00006536406","name":"STEGLATRO 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5364-06","proprietary_name":"STEGLATRO","nonproprietary_name":"ertugliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-5364-06)"},"nadac":{"value":11.4425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Steglatro|Ertugliflozin Pidolate","basis":"brand"},"part_b":null}, {"ndc":"00006536303","name":"STEGLATRO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5363-03","proprietary_name":"STEGLATRO","nonproprietary_name":"ertugliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5363-03)"},"nadac":{"value":11.43622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Steglatro|Ertugliflozin Pidolate","basis":"brand"},"part_b":null}, {"ndc":"00006536306","name":"STEGLATRO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5363-06","proprietary_name":"STEGLATRO","nonproprietary_name":"ertugliflozin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-5363-06)"},"nadac":{"value":11.43622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Steglatro|Ertugliflozin Pidolate","basis":"brand"},"part_b":null}, {"ndc":"00006536803","name":"STEGLUJAN 15-100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5368-03","proprietary_name":"STEGLUJAN","nonproprietary_name":"ertugliflozin and sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5368-03)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":17.58643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Steglujan|Ertugliflozin/Sitagliptin Phos","basis":"brand"},"part_b":null}, {"ndc":"00006536806","name":"STEGLUJAN 15-100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5368-06","proprietary_name":"STEGLUJAN","nonproprietary_name":"ertugliflozin and sitagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1; 100 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-5368-06)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":17.58643,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Steglujan|Ertugliflozin/Sitagliptin Phos","basis":"brand"},"part_b":null}, {"ndc":"57894006003","name":"STELARA 45 MG/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-060-03","proprietary_name":"STELARA","nonproprietary_name":"ustekinumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"45 mg/.5mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-060-03) / .5 mL in 1 SYRINGE","pharm_classes":["Interleukin-12 Antagonist [EPC]","Interleukin-12 Antagonists [MoA]","Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":29874.448,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Stelara*|Ustekinumab","basis":"brand"},"part_b":null}, {"ndc":"57894006103","name":"STELARA 90 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-061-03","proprietary_name":"STELARA","nonproprietary_name":"ustekinumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"90 mg/mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-061-03) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-12 Antagonist [EPC]","Interleukin-12 Antagonists [MoA]","Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":29792.78667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Stelara*|Ustekinumab","basis":"brand"},"part_b":null}, {"ndc":"72606002801","name":"STEQEYMA 90 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72606-028-01","proprietary_name":"STEQEYMA","nonproprietary_name":"ustekinumab-stba","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"90 mg/mL","labeler":"CELLTRION USA, Inc.","package_description":"1 SYRINGE in 1 CARTON (72606-028-01) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-12 Antagonist [EPC]","Interleukin-12 Antagonists [MoA]","Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":3931.985,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5099","bill_units_per_package":{"value":90,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5099 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (90 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (72606-028-01) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00536124801","name":"STIMULANT LAXATIVE PLUS TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1248-01","proprietary_name":"Stimulant Laxative Plus Stool Softener","nonproprietary_name":"Docusate Sodium 50 mg and Sennosides 8.6 mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"RUGBY LABORATORIES","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0536-1248-01)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536124810","name":"STIMULANT LAXATIVE PLUS TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1248-10","proprietary_name":"Stimulant Laxative Plus Stool Softener","nonproprietary_name":"Docusate Sodium 50 mg and Sennosides 8.6 mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"RUGBY LABORATORIES","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0536-1248-10)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00597015561","name":"STIOLTO RESPIMAT INHALER (60)","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0155-61","proprietary_name":"Stiolto Respimat","nonproprietary_name":"tiotropium bromide and olodaterol","dosage_form":"SPRAY, METERED","route":"RESPIRATORY (INHALATION)","strength":"3.124 ug/1; 2.736 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 CARTRIDGE in 1 CARTON (0597-0155-61) / 60 SPRAY, METERED in 1 CARTRIDGE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":115.80015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Stiolto Respimat|Tiotropium Br/Olodaterol HCl","basis":"brand"},"part_b":null}, {"ndc":"72606003701","name":"STOBOCLO 60 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72606-037-01","proprietary_name":"Stoboclo","nonproprietary_name":"denosumab-bmwo","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"60 mg/mL","labeler":"CELLTRION USA, Inc.","package_description":"1 SYRINGE in 1 CARTON (72606-037-01) / 1 mL in 1 SYRINGE","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":1582.15435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5157","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5157 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (72606-037-01) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70000059401","name":"STOMACH RELIEF 262 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0594-1","proprietary_name":"Bismuth Subsalicylate","nonproprietary_name":"Bismuth Subsalicylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"262 mg/1","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE in 1 CARTON (70000-0594-1) / 24 TABLET, FILM COATED in 1 BOTTLE"},"nadac":{"value":0.09302,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000059102","name":"STOMACH RELIEF 262 MG CHEW TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0591-2","proprietary_name":"Stomach Relief","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"262 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"8 BLISTER PACK in 1 BOX (70000-0591-2) / 6 TABLET, CHEWABLE in 1 BLISTER PACK"},"nadac":{"value":0.08166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536128736","name":"STOMACH RELIEF 525 MG/15 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1287-36","proprietary_name":"Stomach Relief Ultra","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/15mL","labeler":"Rugby Laboratories, Inc.","package_description":"237 mL in 1 BOTTLE, PLASTIC (0536-1287-36)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000004501","name":"STOMACH RELIEF 525 MG/15 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0045-1","proprietary_name":"Stomach Relief Ultra","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/15mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"355 mL in 1 BOTTLE, PLASTIC (70000-0045-1)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.00964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000069801","name":"STOMACH RELIEF 525 MG/30 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0698-1","proprietary_name":"Stomach Relief Regular Strength","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"SUSPENSION","route":"ORAL","strength":"525 mg/30mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"236 mL in 1 BOTTLE (70000-0698-1)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00536128636","name":"STOMACH RLF 525 MG/30 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1286-36","proprietary_name":"Stomach Relief Regular Strength","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/30mL","labeler":"Rugby Laboratories","package_description":"237 mL in 1 BOTTLE, PLASTIC (0536-1286-36)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000004401","name":"STOMACH RLF 525 MG/30 ML SUSP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0044-1","proprietary_name":"Stomach Relief Original Strength","nonproprietary_name":"Bismuth subsalicylate","dosage_form":"LIQUID","route":"ORAL","strength":"525 mg/30mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"118 mL in 1 BOTTLE, PLASTIC (70000-0044-1)","pharm_classes":["Bismuth [CS]","Bismuth [EPC]"]},"nadac":{"value":0.01684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000009101","name":"STOOL SOFTENER 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0091-1","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70000-0091-1)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000009102","name":"STOOL SOFTENER 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0091-2","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"250 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70000-0091-2)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000009103","name":"STOOL SOFTENER 100 MG SOFTGEL","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0091-3","proprietary_name":"Stool Softener Laxative","nonproprietary_name":"DOCUSATE SODIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"100 mg/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"750 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (70000-0091-3)"},"nadac":{"value":0.02764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000052601","name":"STOOL SOFTENER-STIM LAX TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0526-1","proprietary_name":"Stool Softener plus Stimulant Laxative","nonproprietary_name":"Docusate Sodium 50 mg and Sennosides 8.6 mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"CARDINAL HEALTH, 110 DBA LEADER","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70000-0526-1)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000052602","name":"STOOL SOFTENER-STIM LAX TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0526-2","proprietary_name":"Stool Softener plus Stimulant Laxative","nonproprietary_name":"Docusate Sodium 50 mg and Sennosides 8.6 mg","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"8.6 mg/1; 50 mg/1","labeler":"CARDINAL HEALTH, 110 DBA LEADER","package_description":"200 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70000-0526-2)"},"nadac":{"value":0.02971,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61958120101","name":"STRIBILD TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-1201-1","proprietary_name":"Stribild","nonproprietary_name":"elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1; 150 mg/1; 200 mg/1; 300 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (61958-1201-1)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","HIV Integrase Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":150.14316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00597019261","name":"STRIVERDI RESPIMAT INHAL SPRAY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0192-61","proprietary_name":"Striverdi Respimat","nonproprietary_name":"olodaterol respimat inhalation spray","dosage_form":"SPRAY, METERED","route":"RESPIRATORY (INHALATION)","strength":"2.5 ug/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"1 CARTRIDGE in 1 CARTON (0597-0192-61) / 60 SPRAY, METERED in 1 CARTRIDGE","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":65.93603,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Striverdi Respimat|Olodaterol HCl","basis":"brand"},"part_b":null}, {"ndc":"00006003201","name":"STROMECTOL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0006-0032-01","proprietary_name":"STROMECTOL","nonproprietary_name":"ivermectin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"2 BLISTER PACK in 1 CARTON (0006-0032-01) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":4.4593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Stromectol|IVermectin","basis":"brand"},"part_b":null}, {"ndc":"00006003220","name":"STROMECTOL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0006-0032-20","proprietary_name":"STROMECTOL","nonproprietary_name":"ivermectin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"2 BLISTER PACK in 1 CARTON (0006-0032-20) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Antiparasitic [EPC]","Pediculicide [EPC]"]},"nadac":{"value":4.4593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Stromectol|IVermectin","basis":"brand"},"part_b":null}, {"ndc":"00006003299","name":"STROMECTOL 3 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":4.4593,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.99423,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Stromectol|IVermectin","basis":"brand"},"part_b":null}, {"ndc":"00642020790","name":"STROVITE ONE CAPLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0642-0207-90","proprietary_name":"Strovite One Caplets","nonproprietary_name":"Vitamin A, Calcium Pantothenate, Ascorbic Acid, Cholecalciferol, .Alpha.-Tocopherol Succinate, D-, Thiamine, Riboflavin, Niacinamide, Pyridoxine Hydrochloride, Folic Acid, Biotin, Cyanocobalamin, Selenium, Magnesium Oxide, Zinc Oxide, Cupric Sulfate, Manganese, Chromium, .Alpha.-Lipoic Acid, and Lutein","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1; 900 ug/1; 7.5 mg/1; 300 mg/1; 25 ug/1; 45 ug/1; 20 mg/1; 5 mg/1; 25 mg/1; 25 mg/1; 1700 ug/1; 100 ug/1; 50 ug/1; 100 ug/1; 50 mg/1; 25 mg/1; 1.5 mg/1; 50 ug/1; 15 mg/1; 5 mg/1","labeler":"Exeltis USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0642-0207-90)","pharm_classes":["Allergens [CS]","Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Calculi Dissolution Agent [EPC]","Cell-mediated Immunity [PE]","Increased Histamine Release [PE]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Standardized Chemical Allergen [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":2.62264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"12496121201","name":"SUBOXONE 12 MG-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":17.16317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496121203","name":"SUBOXONE 12 MG-3 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"12496-1212-3","proprietary_name":"Suboxone","nonproprietary_name":"buprenorphine hydrochloride, naloxone hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"12 mg/1; 3 mg/1","labeler":"INDIVIOR INC.","package_description":"30 POUCH in 1 CARTON (12496-1212-3) / 1 FILM, SOLUBLE in 1 POUCH (12496-1212-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":17.16317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.48557,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496120201","name":"SUBOXONE 2 MG-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496120203","name":"SUBOXONE 2 MG-0.5 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"12496-1202-3","proprietary_name":"Suboxone","nonproprietary_name":"buprenorphine hydrochloride, naloxone hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"2 mg/1; .5 mg/1","labeler":"INDIVIOR INC.","package_description":"30 POUCH in 1 CARTON (12496-1202-3) / 1 FILM, SOLUBLE in 1 POUCH (12496-1202-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":4.78523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.38554,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496120401","name":"SUBOXONE 4 MG-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.58442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496120403","name":"SUBOXONE 4 MG-1 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"12496-1204-3","proprietary_name":"Suboxone","nonproprietary_name":"buprenorphine hydrochloride, naloxone hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"4 mg/1; 1 mg/1","labeler":"INDIVIOR INC.","package_description":"30 POUCH in 1 CARTON (12496-1204-3) / 1 FILM, SOLUBLE in 1 POUCH (12496-1204-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":8.58442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.57624,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496120801","name":"SUBOXONE 8 MG-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.59221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"12496120803","name":"SUBOXONE 8 MG-2 MG SL FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"12496-1208-3","proprietary_name":"Suboxone","nonproprietary_name":"buprenorphine hydrochloride, naloxone hydrochloride","dosage_form":"FILM, SOLUBLE","route":"BUCCAL; SUBLINGUAL","strength":"8 mg/1; 2 mg/1","labeler":"INDIVIOR INC.","package_description":"30 POUCH in 1 CARTON (12496-1208-3) / 1 FILM, SOLUBLE in 1 POUCH (12496-1208-1)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":8.59221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.98226,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suboxone|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"69102041801","name":"SUBVENITE 10 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69102-418-01","proprietary_name":"SUBVENITE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"SUSPENSION","route":"ORAL","strength":"10 mg/mL","labeler":"OWP Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 PACKAGE (69102-418-01) / 240 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":2.86144,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69102031901","name":"SUBVENITE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69102-319-01","proprietary_name":"SUBVENITE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"OWP Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (69102-319-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.04873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69102015006","name":"SUBVENITE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69102-150-06","proprietary_name":"SUBVENITE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"OWP Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (69102-150-06)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.06947,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69102032001","name":"SUBVENITE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69102-320-01","proprietary_name":"SUBVENITE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"OWP Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (69102-320-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.08253,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69102030101","name":"SUBVENITE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69102-301-01","proprietary_name":"SUBVENITE","nonproprietary_name":"LAMOTRIGINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"OWP Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (69102-301-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Dihydrofolate Reductase Inhibitors [MoA]","Mood Stabilizer [EPC]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.02676,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093221001","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2210-01","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-2210-01)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093221005","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2210-05","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (0093-2210-05)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093221098","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2210-98","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 TABLET in 1 BOTTLE (0093-2210-98)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079075301","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079075320","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-753-20","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-753-20) / 1 TABLET in 1 BLISTER PACK (51079-753-01)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762040101","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0401-1","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Mylan Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-0401-1)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59762040105","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0401-5","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Mylan Pharmaceuticals, Inc.","package_description":"500 TABLET in 1 BOTTLE (59762-0401-5)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60219165601","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1656-1","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (60219-1656-1)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135043690","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-436-90","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-436-90)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238165601","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1656-1","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET in 1 BOTTLE (69238-1656-1)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578008101","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-081-01","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET in 1 BOTTLE (72578-081-01)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578008105","name":"SUCRALFATE 1 GM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-081-05","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 TABLET in 1 BOTTLE (72578-081-05)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.1727,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378920535","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.12412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713079175","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0791-75","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"420 mL in 1 BOTTLE (0713-0791-75)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.12412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"13668075442","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-754-42","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"Torrent Pharmaceuticals Limited","package_description":"420 mL in 1 BOTTLE (13668-754-42)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.12412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52817084016","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-840-16","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"TruPharma, LLC","package_description":"473 mL in 1 BOTTLE (52817-840-16)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.13714,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380014901","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-149-01","proprietary_name":"sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"Strides Pharma Science Limited","package_description":"420 mL in 1 BOTTLE, PLASTIC (64380-149-01)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.12412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162006205","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-062-05","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate Oral","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"420 mL in 1 BOTTLE (65162-062-05)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.12412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66689030516","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66689-305-16","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"VistaPharm, LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (66689-305-16) / 414 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.11631,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82182010614","name":"SUCRALFATE 1 GM/10 ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82182-106-14","proprietary_name":"Sucralfate","nonproprietary_name":"Sucralfate","dosage_form":"SUSPENSION","route":"ORAL","strength":"1 g/10mL","labeler":"Pacific Pharma, Inc.","package_description":"420 mL in 1 BOTTLE (82182-106-14)","pharm_classes":["Aluminum Complex [EPC]","Organometallic Compounds [CS]"]},"nadac":{"value":0.12412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00904675415","name":"SUDOGEST 12 HOUR 120 MG CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6754-15","proprietary_name":"SudoGest 12 Hour","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Major Pharmaceuticals","package_description":"10 BLISTER PACK in 1 CARTON (0904-6754-15) / 1 TABLET, FILM COATED, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.28111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904505359","name":"SUDOGEST 30 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5053-59","proprietary_name":"SudoGest","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0904-5053-59) / 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904633724","name":"SUDOGEST 30 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6337-24","proprietary_name":"SudoGest Nasal Decongestant","nonproprietary_name":"Pseudoephedrine HCl","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (0904-6337-24) / 12 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672760","name":"SUDOGEST 30 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6727-60","proprietary_name":"SudoGest","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 TABLET in 1 BOTTLE (0904-6727-60)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672846","name":"SUDOGEST 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6728-46","proprietary_name":"Pseudoephedrine Hydrochloride","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 TABLET in 1 BOTTLE (0904-6728-46)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904672852","name":"SUDOGEST 60 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6728-52","proprietary_name":"Pseudoephedrine Hydrochloride","nonproprietary_name":"Pseudoephedrine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (0904-6728-52) / 100 TABLET in 1 BOTTLE","pharm_classes":["Adrenergic alpha-Agonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904535124","name":"SUDOGEST COLD AND ALLERGY TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5351-24","proprietary_name":"SudoGest","nonproprietary_name":"Chlorpheniramine maleate, pseudoephedrine HCl","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1; 60 mg/1","labeler":"Major Pharmaceuticals","package_description":"1 BLISTER PACK in 1 CARTON (0904-5351-24) / 24 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.07873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24338055001","name":"SUFLAVE POWDER","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24338-550-01","proprietary_name":"SUFLAVE","nonproprietary_name":"polyethylene glycol 3350, sodium sulfate, potassium chloride, magnesium sulfate, and sodium chloride for oral solution","dosage_form":"KIT","route":null,"strength":null,"labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 KIT in 1 KIT (24338-550-01)"},"nadac":{"value":61.64625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suflave|PEG 3350/Sod Sulf,Chlr/Pot/Mag","basis":"brand"},"part_b":null}, {"ndc":"52268055001","name":"SUFLAVE POWDER","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52268-550-01","proprietary_name":"SUFLAVE","nonproprietary_name":"polyethylene glycol 3350, sodium sulfate, potassium chloride, magnesium sulfate, and sodium chloride for oral solution","dosage_form":"KIT","route":null,"strength":null,"labeler":"Braintree Laboratories, Inc.","package_description":"1 KIT in 1 KIT (52268-550-01)"},"nadac":{"value":61.64625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suflave|PEG 3350/Sod Sulf,Chlr/Pot/Mag","basis":"brand"},"part_b":null}, {"ndc":"52268055101","name":"SUFLAVE POWDER","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":null,"nadac":{"value":61.64625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Suflave|PEG 3350/Sod Sulf,Chlr/Pot/Mag","basis":"brand"},"part_b":null}, {"ndc":"24208031705","name":"SULF-PRED 10-0.23% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-317-05","proprietary_name":"Sulfacetamide Sodium and Prednisolone Sodium Phosphate","nonproprietary_name":"Sulfacetamide Sodium and Prednisolone Sodium Phosphate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL; 2.3 mg/mL","labeler":"Bausch & Lomb Incoporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-317-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":2.62002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208067004","name":"SULFACETAMIDE 10% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-670-04","proprietary_name":"Sulfacetamide Sodium","nonproprietary_name":"sulfacetamide sodium","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"100 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-670-04) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":1.96185,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802089626","name":"SULFACETAMIDE SOD 10% TOP SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-896-26","proprietary_name":"Sulfacetamide Sodium","nonproprietary_name":"Sulfacetamide Sodium","dosage_form":"LOTION","route":"TOPICAL","strength":"100 mg/mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"118 mL in 1 BOTTLE, PLASTIC (45802-896-26)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.51502,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192014902","name":"SULFACETAMIDE-SULFUR 10-5% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-149-02","proprietary_name":"SODIUM SULFACETAMIDE, SULFUR","nonproprietary_name":"Sodium Sulfacetamide and Sulfur","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Acella Pharmaceuticals, LLC","package_description":"57 g in 1 TUBE (42192-149-02)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.68719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657046801","name":"SULFACETAMIDE-SULFUR 10-5% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58657-468-01","proprietary_name":"SODIUM SULFACETAMIDE 10% AND SULFUR 5% Emollient Cream","nonproprietary_name":"SODIUM SULFACETAMIDE 10% AND SULFUR 5% Emollient Cream","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"28 g in 1 BOTTLE, PLASTIC (58657-468-01)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":1.55559,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"58657046802","name":"SULFACETAMIDE-SULFUR 10-5% CRM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-468-02","proprietary_name":"SODIUM SULFACETAMIDE 10% AND SULFUR 5% Emollient Cream","nonproprietary_name":"SODIUM SULFACETAMIDE 10% AND SULFUR 5% Emollient Cream","dosage_form":"CREAM","route":"TOPICAL","strength":"100 mg/g; 50 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"57 g in 1 BOTTLE, PLASTIC (58657-468-02)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.68719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"42192013316","name":"SULFACETAMIDE-SULFUR 8-4% SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-133-16","proprietary_name":"Sodium Sulfacetamide and Sulfur","nonproprietary_name":"Sodium Sulfacetamide and Sulfur","dosage_form":"SOLUTION","route":"TOPICAL","strength":"80 mg/mL; 40 mg/mL","labeler":"Acella Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (42192-133-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657046916","name":"SULFACETAMIDE-SULFUR 8-4% SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-469-16","proprietary_name":"Sodium Sulfacetamide 8% and Sulfur 4% Cleanser","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"80 mg/mL; 40 mg/mL","labeler":"Method Pharmaceuticals","package_description":"473 mL in 1 BOTTLE, PLASTIC (58657-469-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69367024516","name":"SULFACETAMIDE-SULFUR 8-4% SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-245-16","proprietary_name":"Sodium Sulfacetamide and Sulfur","nonproprietary_name":"Sodium Sulfacetamide and Sulfur","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"80 mg/mL; 40 mg/mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (69367-245-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.07097,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58657047316","name":"SULFACETAMIDE-SULFUR 9-4% CLSR","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-473-16","proprietary_name":"Sodium Sulfacetamide 9% and Sulfur 4% Cleanser","nonproprietary_name":"SULFACETAMIDE SODIUM, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"90 mg/mL; 40 mg/mL","labeler":"Method Pharmaceuticals","package_description":"473 mL in 1 BOTTLE, PLASTIC (58657-473-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.24781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42192012116","name":"SULFACETAMIDE-SULFUR 9-4% WASH","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42192-121-16","proprietary_name":"SODIUM SULFACETAMIDE - SULFUR WASH","nonproprietary_name":"SODIUM SULFACETAMIDE, SULFUR","dosage_form":"LIQUID","route":"TOPICAL","strength":"90 mg/473.2mL; 40 mg/473.2mL","labeler":"ACELLA PHARMACEUTICALS","package_description":"473.2 mL in 1 BOTTLE (42192-121-16)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.24781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42806075760","name":"SULFADIAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-757-60","proprietary_name":"SULFADIAZINE","nonproprietary_name":"sulfadiazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"EPIC PHARMA, LLC","package_description":"60 TABLET in 1 BOTTLE (42806-757-60)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":15.06467,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfadiazine|Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"62135084260","name":"SULFADIAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-842-60","proprietary_name":"sulfADIAZINE","nonproprietary_name":"sulfADIAZINE","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET in 1 BOTTLE (62135-842-60)","pharm_classes":["Sulfonamide Antibacterial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":15.06467,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfadiazine|Sulfadiazine","basis":"generic"},"part_b":null}, {"ndc":"00904272561","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-2725-61","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-2725-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746027205","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-272-05","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-272-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237023301","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-233-01","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-233-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237023305","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-233-05","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (57237-233-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687061401","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-614-01","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-614-01) / 1 TABLET in 1 BLISTER PACK (60687-614-11)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687061411","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089818","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-898-18","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-898-18)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089890","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-898-90","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-898-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162027210","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-272-10","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-272-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162027250","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-272-50","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-272-50)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862042001","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-420-01","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-420-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862042005","name":"SULFAMETHOXAZOLE-TMP DS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-420-05","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"800 mg/1; 160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-420-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.04481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268072811","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268072815","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-728-15","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-728-15) / 1 TABLET in 1 BLISTER PACK (50268-728-11)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"53746027105","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-271-05","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-271-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237023201","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-232-01","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-232-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237023205","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-232-05","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (57237-232-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089718","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-897-18","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Chartwell RX, LLC","package_description":"180 TABLET in 1 BOTTLE (62135-897-18)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135089790","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-897-90","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-897-90)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162027110","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-271-10","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-271-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65162027150","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-271-50","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET in 1 BOTTLE (65162-271-50)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862041901","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-419-01","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-419-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862041905","name":"SULFAMETHOXAZOLE-TMP SS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-419-05","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"400 mg/1; 80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET in 1 BOTTLE (65862-419-05)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.03948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135074947","name":"SULFAMETHOXAZOLE-TMP SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-749-47","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 40 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-749-47)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.05553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65862049647","name":"SULFAMETHOXAZOLE-TMP SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-496-47","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 40 mg/5mL","labeler":"Aurobindo Pharma Limited","package_description":"473 mL in 1 BOTTLE (65862-496-47)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.05553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"66993072757","name":"SULFAMETHOXAZOLE-TMP SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-727-57","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"sulfamethoxazole and trimethoprim","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 40 mg/5mL","labeler":"Prasco Laboratories","package_description":"473 mL in 1 BOTTLE, PLASTIC (66993-727-57)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.05553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70954025810","name":"SULFAMETHOXAZOLE-TMP SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-258-10","proprietary_name":"Sulfamethoxazole and Trimethoprim","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 40 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (70954-258-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.05553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16571072360","name":"SULFAMYLON 8.5% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"16571-723-60","proprietary_name":"SULFAMYLON","nonproprietary_name":"mafenide acetate","dosage_form":"CREAM","route":"TOPICAL","strength":"85 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 TUBE in 1 CARTON (16571-723-60) / 56.7 g in 1 TUBE","pharm_classes":["Methylated Sulfonamide Antibacterial [EPC]","Methylated Sulfonamides [EXT]"]},"nadac":{"value":1.23425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Sulfamylon|Mafenide Acetate","basis":"brand"},"part_b":null}, {"ndc":"00093323401","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3234-01","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0093-3234-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"00093323405","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3234-05","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0093-3234-05)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"00093323410","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3234-10","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0093-3234-10)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"11534020001","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-200-01","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Sunrise Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (11534-200-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"11534020004","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11534-200-04","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Sunrise Pharmaceutical, Inc.","package_description":"500 TABLET in 1 BOTTLE (11534-200-04)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"23155001901","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"59762500005","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5000-5","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-5000-5) / 100 TABLET in 1 BOTTLE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"59762500006","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-5000-6","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-5000-6) / 300 TABLET in 1 BOTTLE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"62135096001","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-960-01","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 TABLET in 1 BOTTLE (62135-960-01)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"62135096005","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-960-05","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"500 TABLET in 1 BOTTLE (62135-960-05)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"62135096010","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-960-10","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"1000 TABLET in 1 BOTTLE (62135-960-10)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"62135096031","name":"SULFASALAZINE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-960-31","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"300 TABLET in 1 BOTTLE (62135-960-31)","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.1991,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"59762010405","name":"SULFASALAZINE DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0104-5","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-0104-5) / 100 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.28592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine Dr|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"59762010406","name":"SULFASALAZINE DR 500 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-0104-6","proprietary_name":"Sulfasalazine","nonproprietary_name":"Sulfasalazine","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-0104-6) / 300 TABLET, DELAYED RELEASE in 1 BOTTLE","pharm_classes":["Aminosalicylate [EPC]","Aminosalicylic Acids [CS]"]},"nadac":{"value":0.28592,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulfasalazine Dr|Sulfasalazine","basis":"generic"},"part_b":null}, {"ndc":"00121085416","name":"SULFATRIM PEDIATRIC SUSPENSION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0854-16","proprietary_name":"SULFATRIM","nonproprietary_name":"Sulfamethoxazole and Trimethoprim","dosage_form":"SUSPENSION","route":"ORAL","strength":"200 mg/5mL; 40 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0854-16)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]","Sulfonamide Antimicrobial [EPC]","Sulfonamides [CS]"]},"nadac":{"value":0.05553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591566101","name":"SULINDAC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5661-01","proprietary_name":"Sulindac","nonproprietary_name":"Sulindac","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5661-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"00591566105","name":"SULINDAC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5661-05","proprietary_name":"Sulindac","nonproprietary_name":"Sulindac","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-5661-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"24658077005","name":"SULINDAC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-770-05","proprietary_name":"SULINDAC","nonproprietary_name":"SULINDAC","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"PuraCap Laboratories LLC dba Blu Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (24658-770-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"42806001801","name":"SULINDAC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-018-01","proprietary_name":"SULINDAC","nonproprietary_name":"SULINDAC","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-018-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"42806001805","name":"SULINDAC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-018-05","proprietary_name":"SULINDAC","nonproprietary_name":"SULINDAC","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (42806-018-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"53489047801","name":"SULINDAC 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-478-01","proprietary_name":"SULINDAC","nonproprietary_name":"sulindac","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-478-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.18906,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"00591566001","name":"SULINDAC 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5660-01","proprietary_name":"Sulindac","nonproprietary_name":"Sulindac","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5660-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"00591566005","name":"SULINDAC 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5660-05","proprietary_name":"Sulindac","nonproprietary_name":"Sulindac","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-5660-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"24658077105","name":"SULINDAC 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-771-05","proprietary_name":"SULINDAC","nonproprietary_name":"SULINDAC","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"PuraCap Laboratories LLC dba Blu Pharmaceuticals","package_description":"500 TABLET in 1 BOTTLE (24658-771-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"42806001101","name":"SULINDAC 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-011-01","proprietary_name":"SULINDAC","nonproprietary_name":"SULINDAC","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 TABLET in 1 BOTTLE (42806-011-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"42806001105","name":"SULINDAC 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-011-05","proprietary_name":"SULINDAC","nonproprietary_name":"SULINDAC","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 TABLET in 1 BOTTLE (42806-011-05)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"53489047901","name":"SULINDAC 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53489-479-01","proprietary_name":"SULINDAC","nonproprietary_name":"sulindac","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (53489-479-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]"]},"nadac":{"value":0.221,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sulindac|Sulindac","basis":"generic"},"part_b":null}, {"ndc":"00527185943","name":"SUMATRIPTAN 20 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1859-43","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"20 mg/.1mL","labeler":"Lannett Company, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0527-1859-43) / .1 mL in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.5061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"45802059806","name":"SUMATRIPTAN 20 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-598-06","proprietary_name":"SUMATRIPTAN","nonproprietary_name":"sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"20 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"6 CONTAINER in 1 CARTON (45802-598-06) / 1 SPRAY in 1 CONTAINER (45802-598-00)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.5061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"66993008269","name":"SUMATRIPTAN 20 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-082-69","proprietary_name":"SUMATRIPTAN","nonproprietary_name":"sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"20 mg/100uL","labeler":"Prasco Laboratories","package_description":"6 CONTAINER in 1 BOX (66993-082-69) / 100 uL in 1 CONTAINER","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.5061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"69097064448","name":"SUMATRIPTAN 20 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-644-48","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"6 CONTAINER in 1 BOX (69097-644-48) / 1 SPRAY in 1 CONTAINER","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":16.5061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"00527181843","name":"SUMATRIPTAN 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1818-43","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"5 mg/.1mL","labeler":"Lannett Company, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0527-1818-43) / .1 mL in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":17.03859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"45802061906","name":"SUMATRIPTAN 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-619-06","proprietary_name":"SUMATRIPTAN","nonproprietary_name":"sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"5 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"6 CONTAINER in 1 CARTON (45802-619-06) / 1 SPRAY in 1 CONTAINER (45802-619-00)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":17.03859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"66993008169","name":"SUMATRIPTAN 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-081-69","proprietary_name":"SUMATRIPTAN","nonproprietary_name":"sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"5 mg/100uL","labeler":"Prasco Laboratories","package_description":"6 CONTAINER in 1 BOX (66993-081-69) / 100 uL in 1 CONTAINER","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":17.03859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan|Sumatriptan","basis":"generic"},"part_b":null}, {"ndc":"43598076823","name":"SUMATRIPTAN 6 MG/0.5 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-768-23","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Dr. Reddy’s Laboratories Inc.,","package_description":"2 SYRINGE in 1 CARTON (43598-768-23) / .5 mL in 1 SYRINGE (43598-768-11)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":61.41234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"47335027641","name":"SUMATRIPTAN 6 MG/0.5 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-276-41","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"2 SYRINGE in 1 PACKAGE (47335-276-41) / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":61.41234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332065701","name":"SUMATRIPTAN 6 MG/0.5 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-657-01","proprietary_name":"SUMATRIPTAN SUCCINATE","nonproprietary_name":"sumatriptan succinate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"2 SYRINGE in 1 CARTON (62332-657-01) / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":61.41234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64380074002","name":"SUMATRIPTAN 6 MG/0.5 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-740-02","proprietary_name":"SUMATRIPTAN","nonproprietary_name":"sumatriptan","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Strides Pharma Science Limited","package_description":"2 SYRINGE in 1 CARTON (64380-740-02) / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":61.41234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603014102","name":"SUMATRIPTAN 6 MG/0.5 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-141-02","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"NorthStar Rx LLC","package_description":"2 SYRINGE in 1 CARTON (72603-141-02) / .5 mL in 1 SYRINGE (72603-141-01)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":61.41234,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143963801","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143963805","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9638-05","proprietary_name":"SUMATRIPTAN","nonproprietary_name":"sumatriptan","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"5 VIAL in 1 CARTON (0143-9638-05) / .5 mL in 1 VIAL (0143-9638-01)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":14.93447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150017301","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-173-01","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Eugia US LLC","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (55150-173-01) / .5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":14.93447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150017305","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-173-05","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Eugia US LLC","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (55150-173-05) / .5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":14.93447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63323027301","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"63323-273-01","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (63323-273-01) / .5 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145011801","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145011805","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-118-05","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Caplin Steriles Limited","package_description":"5 VIAL in 1 CARTON (65145-118-05) / .5 mL in 1 VIAL (65145-118-01)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":14.93447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70594006801","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70594006802","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70594-068-02","proprietary_name":"Sumatriptan","nonproprietary_name":"SUMATRIPTAN SUCCINATE","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"5 VIAL in 1 CARTON (70594-068-02) / .5 mL in 1 VIAL (70594-068-01)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":14.93447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485051801","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485051805","name":"SUMATRIPTAN 6 MG/0.5 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-518-05","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"6 mg/.5mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"5 VIAL, SINGLE-DOSE in 1 CARTON (72485-518-05) / .5 mL in 1 VIAL, SINGLE-DOSE (72485-518-01)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":14.93447,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378563259","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5632-59","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"sumatriptan succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"9 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5632-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079801","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-798-01","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-798-01) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029309","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-293-09","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"9 BLISTER PACK in 1 CARTON (55111-293-09) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029336","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-293-36","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"36 TABLET in 1 BOTTLE (55111-293-36)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029390","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-293-90","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-293-90)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029398","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-293-98","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-293-98) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066227","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-662-27","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (64980-662-27) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066236","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-662-36","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"36 TABLET, FILM COATED in 1 BOTTLE (64980-662-36)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066291","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-662-91","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (64980-662-91) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862014836","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-148-36","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-148-36) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862014859","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-148-59","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"36 TABLET in 1 BOTTLE (65862-148-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452034660","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452034672","name":"SUMATRIPTAN SUCC 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-346-72","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-346-72) / 9 TABLET, FILM COATED in 1 BLISTER PACK (69452-346-60)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.43878,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378563059","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5630-59","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"sumatriptan succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"9 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5630-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079601","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-796-01","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-796-01) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029109","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-291-09","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"9 BLISTER PACK in 1 CARTON (55111-291-09) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029136","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-291-36","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"36 TABLET in 1 BOTTLE (55111-291-36)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029190","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-291-90","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-291-90)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029198","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-291-98","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-291-98) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066027","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-660-27","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (64980-660-27) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066036","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-660-36","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"36 TABLET, FILM COATED in 1 BOTTLE (64980-660-36)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066091","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-660-91","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (64980-660-91) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862014636","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-146-36","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-146-36) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862014659","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-146-59","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"36 TABLET in 1 BOTTLE (65862-146-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452034460","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452034472","name":"SUMATRIPTAN SUCC 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-344-72","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-344-72) / 9 TABLET, FILM COATED in 1 BLISTER PACK (69452-344-60)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.23942,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378563159","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5631-59","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"sumatriptan succinate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"9 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5631-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714079701","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-797-01","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (16714-797-01) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029209","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-292-09","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"9 BLISTER PACK in 1 CARTON (55111-292-09) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029236","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-292-36","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"36 TABLET in 1 BOTTLE (55111-292-36)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029290","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-292-90","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET in 1 BOTTLE (55111-292-90)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111029298","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-292-98","proprietary_name":"Sumatriptan Succinate","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-292-98) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066127","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-661-27","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (64980-661-27) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066136","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-661-36","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"36 TABLET, FILM COATED in 1 BOTTLE (64980-661-36)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64980066191","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-661-91","proprietary_name":"sumatriptan","nonproprietary_name":"sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (64980-661-91) / 9 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862014736","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-147-36","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-147-36) / 9 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862014759","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-147-59","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"36 TABLET in 1 BOTTLE (65862-147-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452034560","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452034572","name":"SUMATRIPTAN SUCC 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-345-72","proprietary_name":"Sumatriptan","nonproprietary_name":"Sumatriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Bionpharma Inc.","package_description":"1 BLISTER PACK in 1 CARTON (69452-345-72) / 9 TABLET, FILM COATED in 1 BLISTER PACK (69452-345-60)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":0.30222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714089101","name":"SUMATRIPTAN-NAPROXEN 85-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-891-01","proprietary_name":"Sumatriptan and Naproxen Sodium","nonproprietary_name":"Sumatriptan and Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"85 mg/1; 500 mg/1","labeler":"NorthStar RxLLC","package_description":"9 TABLET, FILM COATED in 1 BOTTLE (16714-891-01)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":10.46339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan Succ-Naproxen Sod|Sumatriptan Succ/Naproxen Sod","basis":"generic"},"part_b":null}, {"ndc":"47335041022","name":"SUMATRIPTAN-NAPROXEN 85-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-410-22","proprietary_name":"Sumatriptan and Naproxen Sodium","nonproprietary_name":"Sumatriptan and Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"85 mg/1; 500 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"9 TABLET, FILM COATED in 1 BOTTLE (47335-410-22)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":10.46339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan Succ-Naproxen Sod|Sumatriptan Succ/Naproxen Sod","basis":"generic"},"part_b":null}, {"ndc":"65862092836","name":"SUMATRIPTAN-NAPROXEN 85-500 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-928-36","proprietary_name":"Sumatriptan and Naproxen Sodium","nonproprietary_name":"Sumatriptan and Naproxen Sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"85 mg/1; 500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"9 TABLET, FILM COATED in 1 BOTTLE (65862-928-36)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":10.46339,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sumatriptan Succ-Naproxen Sod|Sumatriptan Succ/Naproxen Sod","basis":"generic"},"part_b":null}, {"ndc":"81968035101","name":"SUNOSI 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81968-351-01","proprietary_name":"SUNOSI","nonproprietary_name":"solriamfetol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Axsome Therapeutics, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (81968-351-01)","pharm_classes":["Dopamine Uptake Inhibitors [MoA]","Dopamine and Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":31.34292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sunosi|Solriamfetol HCl","basis":"brand"},"part_b":null}, {"ndc":"81968035001","name":"SUNOSI 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81968-350-01","proprietary_name":"SUNOSI","nonproprietary_name":"solriamfetol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Axsome Therapeutics, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (81968-350-01)","pharm_classes":["Dopamine Uptake Inhibitors [MoA]","Dopamine and Norepinephrine Reuptake Inhibitor [EPC]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":31.36909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sunosi|Solriamfetol HCl","basis":"brand"},"part_b":null}, {"ndc":"52268001201","name":"SUPREP BOWEL PREP KIT","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52268-012-01","proprietary_name":"SUPREP Bowel Prep","nonproprietary_name":"sodium sulfate, potassium sulfate, magnesium sulfate","dosage_form":"SOLUTION, CONCENTRATE","route":"ORAL","strength":"17.5 g/mL; 3.13 g/mL; 1.6 g/mL","labeler":"Braintree Laboratories, Inc.","package_description":"2 BOTTLE, PLASTIC in 1 CARTON (52268-012-01) / 177.4 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.32462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24338020101","name":"SUTAB 1.479-0.225-0.188 GM TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24338-201-01","proprietary_name":"SUTAB","nonproprietary_name":"sodium sulfate, magnesium sulfate, and potassium chloride","dosage_form":"TABLET","route":"ORAL","strength":"17.75 g/1; 2.7 g/1; 2.25 g/1","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"2 BOTTLE, PLASTIC in 1 KIT (24338-201-01) / 12 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":6.73948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-05","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sutab|Sod Sulf/Pot Chloride/Mag Sulf","basis":"brand"},"part_b":null}, {"ndc":"52268020101","name":"SUTAB 1.479-0.225-0.188 GM TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52268-201-01","proprietary_name":"SUTAB","nonproprietary_name":"sodium sulfate, magnesium sulfate, and potassium chloride","dosage_form":"TABLET","route":"ORAL","strength":"17.75 g/1; 2.7 g/1; 2.25 g/1","labeler":"Braintree Laboratories, Inc.","package_description":"2 BOTTLE, PLASTIC in 1 KIT (52268-201-01) / 12 TABLET in 1 BOTTLE, PLASTIC","pharm_classes":["Calculi Dissolution Agent [EPC]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Potassium Compounds [CS]","Potassium Salt [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":6.73948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sutab|Sod Sulf/Pot Chloride/Mag Sulf","basis":"brand"},"part_b":null}, {"ndc":"00168012691","name":"SWIM EAR DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0126-91","proprietary_name":"Swim-EAR","nonproprietary_name":"Swim-EAR","dosage_form":"SOLUTION","route":"AURICULAR (OTIC)","strength":"950 mg/mL","labeler":"Fougera Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0168-0126-91) / 29.57 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.09098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700011584","name":"SYEDA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Syeda|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"70700011585","name":"SYEDA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-115-85","proprietary_name":"Syeda","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-115-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Syeda|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"00186037020","name":"SYMBICORT 160-4.5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0370-20","proprietary_name":"SYMBICORT","nonproprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 4.5 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 POUCH in 1 CARTON (0186-0370-20) / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":21.98404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":17.26446,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Symbicort|Budesonide/Formoterol Fumarate","basis":"brand"},"part_b":null}, {"ndc":"00186037028","name":"SYMBICORT 160-4.5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0370-28","proprietary_name":"SYMBICORT","nonproprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"160 ug/1; 4.5 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 POUCH in 1 CARTON (0186-0370-28) / 1 CANISTER in 1 POUCH / 60 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":25.45735,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Symbicort|Budesonide/Formoterol Fumarate","basis":"brand"},"part_b":null}, {"ndc":"00186037220","name":"SYMBICORT 80-4.5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0372-20","proprietary_name":"SYMBICORT","nonproprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1; 4.5 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 POUCH in 1 CARTON (0186-0372-20) / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":19.24533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":15.66845,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Symbicort|Budesonide/Formoterol Fumarate","basis":"brand"},"part_b":null}, {"ndc":"00186037228","name":"SYMBICORT 80-4.5 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0186-0372-28","proprietary_name":"SYMBICORT","nonproprietary_name":"Budesonide and Formoterol Fumarate Dihydrate","dosage_form":"AEROSOL","route":"RESPIRATORY (INHALATION)","strength":"80 ug/1; 4.5 ug/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"1 POUCH in 1 CARTON (0186-0372-28) / 1 CANISTER in 1 POUCH / 60 AEROSOL in 1 CANISTER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":19.28281,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Symbicort|Budesonide/Formoterol Fumarate","basis":"brand"},"part_b":null}, {"ndc":"81968002009","name":"SYMBRAVO 20-10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81968-020-09","proprietary_name":"SYMBRAVO","nonproprietary_name":"meloxicam, rizatriptan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1; 10 mg/1","labeler":"Axsome Therapeutics, Inc.","package_description":"9 TABLET in 1 BOTTLE (81968-020-09)","pharm_classes":["Anti-Inflammatory Agents, Non-Steroidal [CS]","Cyclooxygenase Inhibitors [MoA]","Nonsteroidal Anti-inflammatory Drug [EPC]","Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":122.64311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10094021001","name":"SYMPAZAN 10 MG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":32.75766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sympazan|Clobazam","basis":"brand"},"part_b":null}, {"ndc":"10094021060","name":"SYMPAZAN 10 MG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10094-210-60","proprietary_name":"SYMPAZAN","nonproprietary_name":"clobazam","dosage_form":"FILM","route":"ORAL","strength":"10 mg/1","labeler":"Aquestive Therapeutics","package_description":"60 POUCH in 1 PACKAGE (10094-210-60) / 1 FILM in 1 POUCH (10094-210-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":32.75766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sympazan|Clobazam","basis":"brand"},"part_b":null}, {"ndc":"10094022001","name":"SYMPAZAN 20 MG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":65.42818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sympazan|Clobazam","basis":"brand"},"part_b":null}, {"ndc":"10094022060","name":"SYMPAZAN 20 MG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10094-220-60","proprietary_name":"SYMPAZAN","nonproprietary_name":"clobazam","dosage_form":"FILM","route":"ORAL","strength":"20 mg/1","labeler":"Aquestive Therapeutics","package_description":"60 POUCH in 1 PACKAGE (10094-220-60) / 1 FILM in 1 POUCH (10094-220-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":65.42818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sympazan|Clobazam","basis":"brand"},"part_b":null}, {"ndc":"10094020501","name":"SYMPAZAN 5 MG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":16.40306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sympazan|Clobazam","basis":"brand"},"part_b":null}, {"ndc":"10094020560","name":"SYMPAZAN 5 MG FILM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"10094-205-60","proprietary_name":"SYMPAZAN","nonproprietary_name":"clobazam","dosage_form":"FILM","route":"ORAL","strength":"5 mg/1","labeler":"Aquestive Therapeutics","package_description":"60 POUCH in 1 PACKAGE (10094-205-60) / 1 FILM in 1 POUCH (10094-205-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]"]},"nadac":{"value":16.40306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Sympazan|Clobazam","basis":"brand"},"part_b":null}, {"ndc":"59385004130","name":"SYMPROIC 0.2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59385-041-30","proprietary_name":"SYMPROIC","nonproprietary_name":"naldemedine","dosage_form":"TABLET","route":"ORAL","strength":".2 mg/1","labeler":"BioDelivery Sciences International Inc","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (59385-041-30)","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]"]},"nadac":{"value":16.25585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Symproic|Naldemedine Tosylate","basis":"brand"},"part_b":null}, {"ndc":"59676080030","name":"SYMTUZA 800-150-200-10 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59676-800-30","proprietary_name":"Symtuza","nonproprietary_name":"Darunavir, Cobicistat, Emtricitabine, and Tenofovir alafenamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"800 mg/1; 150 mg/1; 200 mg/1; 10 mg/1","labeler":"Janssen Products LP","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59676-800-30)","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A Inhibitor [EPC]","Cytochrome P450 3A Inhibitors [MoA]","HIV Protease Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]","Organic Anion Transporting Polypeptide 1B1 Inhibitors [MoA]","Organic Anion Transporting Polypeptide 1B3 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]","Protease Inhibitor [EPC]"]},"nadac":{"value":152.86728,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Symtuza|Darunavir/Cob/Emtri/Tenof Alaf","basis":"brand"},"part_b":null}, {"ndc":"00597016818","name":"SYNJARDY 12.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0168-18","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET in 1 BOTTLE (0597-0168-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.60127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597016860","name":"SYNJARDY 12.5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0168-60","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (0597-0168-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.60127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597018018","name":"SYNJARDY 12.5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0180-18","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 500 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET in 1 BOTTLE (0597-0180-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.61305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597018060","name":"SYNJARDY 12.5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0180-60","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1; 500 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (0597-0180-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.61305,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597017518","name":"SYNJARDY 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0175-18","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET in 1 BOTTLE (0597-0175-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.59938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597017560","name":"SYNJARDY 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0175-60","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (0597-0175-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.59938,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597015918","name":"SYNJARDY 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0159-18","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET in 1 BOTTLE (0597-0159-18)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.62273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597015960","name":"SYNJARDY 5-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0159-60","proprietary_name":"Synjardy","nonproprietary_name":"empagliflozin and metformin hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (0597-0159-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.62273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597028073","name":"SYNJARDY XR 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0280-73","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0280-73)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.21863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597028090","name":"SYNJARDY XR 10-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0280-90","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0280-90)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.21863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597030045","name":"SYNJARDY XR 12.5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0300-45","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0300-45)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.59799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597030093","name":"SYNJARDY XR 12.5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0300-93","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0300-93)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.59799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597029578","name":"SYNJARDY XR 25-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0295-78","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0295-78)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.19287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597029588","name":"SYNJARDY XR 25-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0295-88","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0295-88)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.19287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597029059","name":"SYNJARDY XR 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0290-59","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0290-59)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.61111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00597029074","name":"SYNJARDY XR 5-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0290-74","proprietary_name":"Synjardy XR","nonproprietary_name":"empagliflozin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0290-74)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.61111,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synjardy XR|Empagliflozin/Metformin HCl","basis":"brand"},"part_b":null}, {"ndc":"00074662411","name":"SYNTHROID 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-6624-11","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"AbbVie Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0074-6624-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074662419","name":"SYNTHROID 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-6624-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-6624-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074662490","name":"SYNTHROID 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-6624-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-6624-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66193,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074929619","name":"SYNTHROID 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-9296-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-9296-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074929690","name":"SYNTHROID 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-9296-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-9296-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074706811","name":"SYNTHROID 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7068-11","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"AbbVie Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0074-7068-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66298,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074706819","name":"SYNTHROID 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7068-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-7068-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66298,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074706890","name":"SYNTHROID 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7068-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-7068-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66298,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074372719","name":"SYNTHROID 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-3727-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-3727-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074372790","name":"SYNTHROID 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-3727-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-3727-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074706911","name":"SYNTHROID 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7069-11","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"AbbVie Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0074-7069-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.6611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074706919","name":"SYNTHROID 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7069-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-7069-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.6611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074706990","name":"SYNTHROID 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7069-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-7069-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.6611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074707019","name":"SYNTHROID 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7070-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-7070-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074707090","name":"SYNTHROID 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7070-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-7070-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074714811","name":"SYNTHROID 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7148-11","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"AbbVie Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0074-7148-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074714819","name":"SYNTHROID 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7148-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-7148-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074714890","name":"SYNTHROID 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7148-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-7148-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65787,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074434119","name":"SYNTHROID 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-4341-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-4341-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074434190","name":"SYNTHROID 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-4341-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-4341-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074714919","name":"SYNTHROID 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7149-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-7149-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074714990","name":"SYNTHROID 300 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-7149-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"300 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-7149-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.65656,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10428,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074455211","name":"SYNTHROID 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-4552-11","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"AbbVie Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0074-4552-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074455219","name":"SYNTHROID 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-4552-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-4552-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074455290","name":"SYNTHROID 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-4552-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-4552-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074518211","name":"SYNTHROID 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-5182-11","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"AbbVie Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (0074-5182-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.6625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074518219","name":"SYNTHROID 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-5182-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-5182-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.6625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074518290","name":"SYNTHROID 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-5182-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-5182-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.6625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074659419","name":"SYNTHROID 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-6594-19","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"AbbVie Inc.","package_description":"1000 TABLET in 1 BOTTLE (0074-6594-19)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00074659490","name":"SYNTHROID 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0074-6594-90","proprietary_name":"Synthroid","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"AbbVie Inc.","package_description":"90 TABLET in 1 BOTTLE (0074-6594-90)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.66268,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Synthroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"00065047401","name":"SYSTANE 0.3% EYE GEL","unit":"GM","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0065-0474-01","proprietary_name":"Systane","nonproprietary_name":"hypromellose","dosage_form":"GEL","route":"OPHTHALMIC","strength":"3 mg/g","labeler":"Alcon Laboratories, Inc.","package_description":"1 TUBE in 1 CARTON (0065-0474-01) / 10 g in 1 TUBE"},"nadac":{"value":0.90372,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00065042915","name":"SYSTANE 0.4-0.3% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0429-15","proprietary_name":"Systane Lubricant","nonproprietary_name":"polyethylene glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0429-15) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.70184,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.36253,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065042930","name":"SYSTANE 0.4-0.3% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0429-30","proprietary_name":"Systane Lubricant","nonproprietary_name":"polyethylene glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0429-30) / 30 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.56795,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143302","name":"SYSTANE BALANCE 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1433-02","proprietary_name":"Systane Balance","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-1433-02) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.16753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143307","name":"SYSTANE BALANCE 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1433-07","proprietary_name":"Systane Balance","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0065-1433-07) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.00173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065048110","name":"SYSTANE COMPLETE 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0481-10","proprietary_name":"Systane COMPLETE","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0481-10) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.16753,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065048111","name":"SYSTANE COMPLETE 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0481-11","proprietary_name":"Systane COMPLETE","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0065-0481-11) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.00173,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065048155","name":"SYSTANE COMPLETE 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0481-55","proprietary_name":"Systane COMPLETE","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0481-55) / 5 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.36145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065150928","name":"SYSTANE COMPLETE PF 0.6% DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1509-28","proprietary_name":"Systane COMPLETE PF","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-1509-28) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.34681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065150977","name":"SYSTANE COMPLETE PF 0.6% DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1509-77","proprietary_name":"Systane COMPLETE PF","nonproprietary_name":"propylene glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":".06 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"3 BOTTLE, DROPPER in 1 CARTON (0065-1509-77) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.34681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065045407","name":"SYSTANE GEL EYE DROPS","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0454-07","proprietary_name":"Systane","nonproprietary_name":"polyethylene glycol 400 and propylene glycol","dosage_form":"GEL","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"10 mL in 1 BOTTLE, DROPPER (0065-0454-07)"},"nadac":{"value":1.13016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143704","name":"SYSTANE HYDRATION PF 0.4-0.3%","unit":"EA","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1437-04","proprietary_name":"SYSTANE HYDRATION PF PRESERVATIVE FREE","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"30 VIAL, SINGLE-DOSE in 1 CARTON (0065-1437-04) / .7 mL in 1 VIAL, SINGLE-DOSE"},"nadac":{"value":0.37625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.20368,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00065151006","name":"SYSTANE HYDRATION PF 0.4-0.3%","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1510-06","proprietary_name":"SYSTANE HYDRATION PF PRESERVATIVE FREE","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE in 1 CARTON (0065-1510-06) / 10 mL in 1 BOTTLE"},"nadac":{"value":1.15528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065329003","name":"SYSTANE PRO PF 0.6% EYE DROP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-3290-03","proprietary_name":"Systane Pro PF","nonproprietary_name":"Propylene Glycol","dosage_form":"EMULSION","route":"OPHTHALMIC","strength":"6 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-3290-03) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.34681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143105","name":"SYSTANE ULTRA 0.4-0.3% EYE DRP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1431-05","proprietary_name":"Systane Ultra","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-1431-05) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.02993,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143121","name":"SYSTANE ULTRA 0.4-0.3% EYE DRP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1431-21","proprietary_name":"Systane Ultra","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-1431-21) / 3 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.58867,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143128","name":"SYSTANE ULTRA 0.4-0.3% EYE DRP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1431-28","proprietary_name":"Systane Ultra","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0065-1431-28) / 4 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.09331,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065143141","name":"SYSTANE ULTRA 0.4-0.3% EYE DRP","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1431-41","proprietary_name":"Systane Ultra","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0065-1431-41) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.84667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065150782","name":"SYSTANE ULTRA PF 0.4-0.3% EYE","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-1507-82","proprietary_name":"Systane Ultra Preservative Free","nonproprietary_name":"Polyethylene Glycol 400 and Propylene Glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"4 mg/mL; 3 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-1507-82) / 10 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":1.15528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50222050106","name":"TACLONEX 0.005%-0.064% SUSPENSION","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"50222-501-06","proprietary_name":"TACLONEX","nonproprietary_name":"calcipotriene and betamethasone dipropionate","dosage_form":"SUSPENSION","route":"TOPICAL","strength":"50 ug/g; .5 mg/g","labeler":"LEO Pharma Inc.","package_description":"40 CARTON in 1 CASE (50222-501-06) / 1 BOTTLE in 1 CARTON / 60 g in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Vitamin D Analog [EPC]","Vitamin D [CS]"]},"nadac":{"value":20.69675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":1.42087,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Taclonex|Calcipotriene/Betamethasone","basis":"brand"},"part_b":null}, {"ndc":"00168041730","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0417-30","proprietary_name":"Tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0417-30) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.92703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168041760","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0417-60","proprietary_name":"Tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0417-60) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.99827,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168041799","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0417-99","proprietary_name":"Tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0417-99) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.88777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802039000","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-390-00","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-390-00) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.92703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802039001","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-390-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-390-01) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.99827,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802039002","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-390-02","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-390-02) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.88777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462088135","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-881-35","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-881-35) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.92703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462088165","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-881-65","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-881-65) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.99827,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462088194","name":"TACROLIMUS 0.03% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-881-94","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":".3 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-881-94) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.88777,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168041630","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0416-30","proprietary_name":"Tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0416-30) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.98159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168041660","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0416-60","proprietary_name":"Tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0416-60) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.94262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168041699","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0416-99","proprietary_name":"Tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0416-99) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.97006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001105","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-011-05","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus Ointment 0.1%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-011-05) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.98159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001107","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-011-07","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus Ointment 0.1%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-011-07) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.94262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001109","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-011-09","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus Ointment 0.1%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-011-09) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.97006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802070000","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-700-00","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-700-00) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.98159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802070001","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-700-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-700-01) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.94262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802070002","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-700-02","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-700-02) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.97006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308070360","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.94262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462053435","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-534-35","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-534-35) / 30 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.98159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462053465","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-534-65","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-534-65) / 60 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.94262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68462053494","name":"TACROLIMUS 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-534-94","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 TUBE in 1 CARTON (68462-534-94) / 100 g in 1 TUBE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.97006,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00378204501","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2045-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2045-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2045-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781210201","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2102-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Sandoz Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0781-2102-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0781-2102-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904662361","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6623-61","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6623-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714009801","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-098-01","proprietary_name":"tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-098-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (16714-098-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51079081701","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079081720","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-817-20","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"MylanInstitutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-817-20) / 1 CAPSULE in 1 BLISTER PACK (51079-817-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111052501","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-525-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-525-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (55111-525-01) / 100 CAPSULE in 1 BOTTLE) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59746079801","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-798-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":".5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (59746-798-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072006","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-720-06","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-720-06)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 CONTAINER (64380-720-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877027801","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-278-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-278-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (67877-278-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084044901","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-449-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-449-01) / 1 CAPSULE in 1 BLISTER PACK (68084-449-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-449-01) / 1 CAPSULE in 1 BLISTER PACK (68084-449-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084044911","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068501","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-685-01","proprietary_name":"tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-685-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (68462-685-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377001411","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-014-11","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-014-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (70377-014-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572076001","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"82009016401","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-164-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 CAPSULE in 1 BOTTLE (82009-164-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (82009-164-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"85972010101","name":"TACROLIMUS 0.5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85972-101-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":".5 mg/1","labeler":"Stellon Biotech Inc.","package_description":"100 CAPSULE in 1 BOTTLE (85972-101-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.12274,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378204601","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2046-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2046-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2046-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781210301","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2103-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0781-2103-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0781-2103-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904709761","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7097-61","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7097-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 CARTON (0904-7097-61) / 1 CAPSULE in 1 BLISTER PACK) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16714009901","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-099-01","proprietary_name":"tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-099-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (16714-099-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51079081801","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079081820","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-818-20","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"MylanInstitutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-818-20) / 1 CAPSULE in 1 BLISTER PACK (51079-818-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111052601","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-526-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-526-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (55111-526-01) / 100 CAPSULE in 1 BOTTLE) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59746079901","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-799-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"1 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (59746-799-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072106","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-721-06","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-721-06)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 CONTAINER (64380-721-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877027901","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-279-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-279-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (67877-279-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084045001","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-450-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-450-01) / 1 CAPSULE in 1 BLISTER PACK (68084-450-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-450-01) / 1 CAPSULE in 1 BLISTER PACK (68084-450-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084045011","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068601","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-686-01","proprietary_name":"tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-686-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (68462-686-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377001511","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-015-11","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-015-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (70377-015-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72572076101","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"82009005401","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-054-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 CAPSULE in 1 BOTTLE (82009-054-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (82009-054-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"85972010201","name":"TACROLIMUS 1 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85972-102-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Stellon Biotech Inc.","package_description":"100 CAPSULE in 1 BOTTLE (85972-102-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.1535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378204701","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2047-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2047-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2047-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00781210401","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2104-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0781-2104-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (0781-2104-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904662461","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6624-61","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6624-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714010001","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-100-01","proprietary_name":"tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"NORTHSTAR RX LLC","package_description":"100 CAPSULE in 1 BOTTLE (16714-100-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (16714-100-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51079002801","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079002820","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-028-20","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"MylanInstitutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-028-20) / 1 CAPSULE in 1 BLISTER PACK (51079-028-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111052701","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-527-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1 BOTTLE in 1 CARTON (55111-527-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (55111-527-01) / 100 CAPSULE in 1 BOTTLE) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"59746080001","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-800-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE, GELATIN COATED in 1 BOTTLE (59746-800-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072206","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-722-06","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 CONTAINER (64380-722-06)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 CONTAINER (64380-722-06)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877028001","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-280-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-280-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (67877-280-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084045101","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-451-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-451-01) / 1 CAPSULE in 1 BLISTER PACK (68084-451-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-451-01) / 1 CAPSULE in 1 BLISTER PACK (68084-451-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"68084045111","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462068701","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-687-01","proprietary_name":"tacrolimus","nonproprietary_name":"tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-687-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (68462-687-01)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70377001611","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-016-11","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-016-11)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J7507","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7507 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (500 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 CAPSULE in 1 BOTTLE (70377-016-11)) gives 100 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"82009016501","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-165-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"100 CAPSULE in 1 BOTTLE (82009-165-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"85972010301","name":"TACROLIMUS 5 MG CAPSULE (IMMEDIATE RELEASE)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"85972-103-01","proprietary_name":"Tacrolimus","nonproprietary_name":"Tacrolimus","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Stellon Biotech Inc.","package_description":"100 CAPSULE in 1 BOTTLE (85972-103-01)","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]"]},"nadac":{"value":0.68805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480231056","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2310-56","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2310-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"13668056730","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-567-30","proprietary_name":"TADALAFIL","nonproprietary_name":"TADALAFIL","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-567-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16714007601","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-076-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-076-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729037110","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-371-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-371-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729037116","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-371-16","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16729-371-16)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979072906","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-729-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24979-729-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979072969","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-729-69","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"250 TABLET, FILM COATED in 1 BOTTLE (24979-729-69)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011303","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-113-03","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-113-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011305","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-113-05","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-113-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028805","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-288-05","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-288-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028813","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-288-13","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-288-13)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"31722064530","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-645-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-645-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"33342026707","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-267-07","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-267-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"35573046230","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-462-30","proprietary_name":"tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (35573-462-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547003203","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-032-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-032-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547005003","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-050-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-050-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547005011","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-050-11","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-050-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547005050","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-050-50","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-050-50)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057430","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-574-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-574-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"60290002901","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-029-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-029-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"60290002902","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-029-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60290-029-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017930","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-179-30","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-179-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017991","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-179-91","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (62332-179-91)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089806","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-898-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-898-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089810","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-898-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-898-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"69238134803","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1348-3","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-1348-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"72303082401","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0824-1","proprietary_name":"TADALAFIL","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0824-1)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"75834024901","name":"TADALAFIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-249-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (75834-249-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.15341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"13668056530","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-565-30","proprietary_name":"TADALAFIL","nonproprietary_name":"TADALAFIL","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-565-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16714007401","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16714007402","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-074-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"NorthStar RxLLC","package_description":"2 BLISTER PACK in 1 CARTON (16714-074-02) / 15 TABLET, FILM COATED in 1 BLISTER PACK (16714-074-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729036910","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-369-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-369-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979072702","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-727-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (24979-727-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979072706","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-727-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24979-727-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011103","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-111-03","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-111-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011105","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-111-05","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-111-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028605","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-286-05","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-286-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028613","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-286-13","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-286-13)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"31722064330","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-643-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-643-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"33342026507","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-265-07","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-265-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"35573046038","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"35573046056","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-460-56","proprietary_name":"tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"15 CARTON in 1 BLISTER PACK (35573-460-56) / 30 TABLET, FILM COATED in 1 CARTON (35573-460-38)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547003003","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-030-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-030-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547004703","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-047-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-047-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547004711","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-047-11","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-047-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547004750","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-047-50","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-047-50)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057630","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-576-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-576-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017715","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-177-15","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 CARTON (62332-177-15)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017730","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-177-30","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-177-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089606","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-896-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-896-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089610","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-896-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-896-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"69238134603","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1346-3","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-1346-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"72303082201","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0822-1","proprietary_name":"TADALAFIL","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0822-1)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"75834024701","name":"TADALAFIL 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-247-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (75834-247-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.11265,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"13668056830","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-568-30","proprietary_name":"TADALAFIL","nonproprietary_name":"TADALAFIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-568-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"13668058130","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-581-30","proprietary_name":"TADALAFIL","nonproprietary_name":"TADALAFIL","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-581-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16714007701","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-077-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-077-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729037210","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-372-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-372-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729037216","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-372-16","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16729-372-16)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979073006","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-730-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24979-730-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979073044","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-730-44","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"120 TABLET, FILM COATED in 1 BOTTLE (24979-730-44)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011403","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-114-03","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-114-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011405","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-114-05","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-114-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241012302","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-123-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-123-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028905","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-289-05","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-289-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028913","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-289-13","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-289-13)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"31722064630","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-646-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-646-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"31722064730","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-647-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (31722-647-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"33342026807","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-268-07","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-268-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"33342027809","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-278-09","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-278-09)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"35573046330","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-463-30","proprietary_name":"tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (35573-463-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547003303","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-033-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-033-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547005103","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-051-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-051-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547005111","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-051-11","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-051-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547005150","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-051-50","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-051-50)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547099006","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-990-06","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"60 TABLET in 1 BOTTLE (43547-990-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057330","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-573-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-573-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057331","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-573-31","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"3 BLISTER PACK in 1 CARTON (43598-573-31) / 10 TABLET, FILM COATED in 1 BLISTER PACK (43598-573-79)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057379","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057860","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-578-60","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (43598-578-60)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"60290003001","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-030-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-030-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"60290003002","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-030-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60290-030-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332018030","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-180-30","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-180-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332018091","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-180-91","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (62332-180-91)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"65862088060","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-880-60","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-880-60)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089906","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-899-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-899-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089910","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-899-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-899-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"69097052603","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-526-03","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69097-526-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"69238134903","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1349-3","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-1349-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"72303082501","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0825-1","proprietary_name":"TADALAFIL","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0825-1)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"75834025001","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-250-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (75834-250-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"82009007905","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-079-05","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-079-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.16709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"82009008060","name":"TADALAFIL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-080-60","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"60 TABLET in 1 BOTTLE (82009-080-60)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.14633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"00480230956","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2309-56","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2309-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"13668056630","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-566-30","proprietary_name":"TADALAFIL","nonproprietary_name":"TADALAFIL","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (13668-566-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16714007501","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-075-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-075-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729037010","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-370-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16729-370-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"16729037016","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-370-16","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Accord Healthcare Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16729-370-16)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979072802","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-728-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (24979-728-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"24979072806","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-728-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (24979-728-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011203","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-112-03","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET in 1 BOTTLE (27241-112-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"27241011205","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-112-05","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"500 TABLET in 1 BOTTLE (27241-112-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028705","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-287-05","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-287-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"29300028713","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-287-13","proprietary_name":"tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-287-13)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"31722064430","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-644-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-644-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"33342026607","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-266-07","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-266-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"35573046130","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"35573-461-30","proprietary_name":"tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Burel Pharmaceuticals, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (35573-461-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547003103","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-031-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-031-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547004903","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-049-03","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-049-03)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547004911","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-049-11","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"1000 TABLET in 1 BOTTLE (43547-049-11)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43547004950","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-049-50","proprietary_name":"TADALAFIL","nonproprietary_name":"tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"500 TABLET in 1 BOTTLE (43547-049-50)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057530","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-575-30","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (43598-575-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057531","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-575-31","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"3 BLISTER PACK in 1 CARTON (43598-575-31) / 10 TABLET, FILM COATED in 1 BLISTER PACK (43598-575-79)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"43598057579","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"60290002801","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-028-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (60290-028-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"60290002802","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60290-028-02","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Umedica Laboratories USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (60290-028-02)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017815","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-178-15","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 CARTON (62332-178-15)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017830","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-178-30","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE (62332-178-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"62332017891","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-178-91","proprietary_name":"Tadalafil","nonproprietary_name":"tadalafil","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1000 TABLET, COATED in 1 BOTTLE (62332-178-91)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089706","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-897-06","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68382-897-06)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"68382089710","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-897-10","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68382-897-10)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"69238134703","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1347-3","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69238-1347-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"72303082301","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72303-0823-1","proprietary_name":"TADALAFIL","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"HEC Pharm USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72303-0823-1)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"75834024801","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-248-01","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NIVAGEN PHARMACEUTICALS, INC.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (75834-248-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"82009007705","name":"TADALAFIL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-077-05","proprietary_name":"Tadalafil","nonproprietary_name":"Tadalafil","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET in 1 BOTTLE (82009-077-05)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":0.10319,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tadalafil|Tadalafil","basis":"generic"},"part_b":null}, {"ndc":"46287004515","name":"TADLIQ 20 MG/5 ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["3","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46287-045-15","proprietary_name":"TADLIQ","nonproprietary_name":"Tadalafil","dosage_form":"SUSPENSION","route":"ORAL","strength":"20 mg/5mL","labeler":"CMP Pharma, Inc.","package_description":"150 mL in 1 BOTTLE (46287-045-15)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":13.59311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 3: the survey-based NADAC was adjusted for changes in published pricing, or after a help-desk inquiry; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tadliq|Tadalafil","basis":"brand"},"part_b":null}, {"ndc":"00781618487","name":"TAFLUPROST 0.0015% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-6184-87","proprietary_name":"Tafluprost","nonproprietary_name":"Tafluprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".0045 mg/.3mL","labeler":"Sandoz Inc","package_description":"6 POUCH in 1 CARTON (0781-6184-87) / 5 CONTAINER in 1 POUCH (0781-6184-14) / .3 mL in 1 CONTAINER","pharm_classes":["Increased Prostaglandin Activity [PE]","Prostaglandin Analog [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]"]},"nadac":{"value":2.4535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571026473","name":"TAFLUPROST 0.0015% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-264-73","proprietary_name":"tafluprost","nonproprietary_name":"tafluprost opthalmic","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".0045 mg/.3mL","labeler":"Micro Labs Limited","package_description":"2 POUCH in 1 CARTON (42571-264-73) / 15 VIAL in 1 POUCH / .3 mL in 1 VIAL","pharm_classes":["Increased Prostaglandin Activity [PE]","Prostaglandin Analog [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]"]},"nadac":{"value":2.4535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742033930","name":"TAFLUPROST 0.0015% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-339-30","proprietary_name":"Tafluprost","nonproprietary_name":"Tafluprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".015 mg/mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"6 POUCH in 1 CARTON (50742-339-30) / 5 VIAL, SINGLE-DOSE in 1 POUCH (50742-339-05) / .3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Increased Prostaglandin Activity [PE]","Prostaglandin Analog [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]"]},"nadac":{"value":2.4535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993042930","name":"TAFLUPROST 0.0015% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-429-30","proprietary_name":"Tafluprost Ophthalmic","nonproprietary_name":"tafluprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".0045 mg/.3mL","labeler":"Prasco Laboratories","package_description":"3 POUCH in 1 CARTON (66993-429-30) / 10 VIAL, SINGLE-USE in 1 POUCH (66993-429-81) / .3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Increased Prostaglandin Activity [PE]","Prostaglandin Analog [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]"]},"nadac":{"value":2.4535,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57841115001","name":"TALICIA DR 10-250-12.5 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.88245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57841115002","name":"TALICIA DR 10-250-12.5 MG CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57841-1150-2","proprietary_name":"Talicia","nonproprietary_name":"omeprazole magnesium, amoxicillin and rifabutin","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10 mg/1; 250 mg/1; 12.5 mg/1","labeler":"RedHill Biopharma Ltd","package_description":"2 BOTTLE in 1 CARTON (57841-1150-2) / 84 CAPSULE, DELAYED RELEASE in 1 BOTTLE (57841-1150-1)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Penicillin-class Antibacterial [EPC]","Penicillins [CS]","Proton Pump Inhibitor [EPC]","Proton Pump Inhibitors [MoA]","Rifamycin Antimycobacterial [EPC]","Rifamycins [CS]"]},"nadac":{"value":4.88245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00002144501","name":"TALTZ 80 MG/ML AUTOINJECTOR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7370.71514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Taltz Autoinjector|Ixekizumab","basis":"brand"},"part_b":null}, {"ndc":"00002144511","name":"TALTZ 80 MG/ML AUTOINJECTOR","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1445-11","proprietary_name":"TALTZ","nonproprietary_name":"ixekizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"80 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-1445-11) / 1 mL in 1 SYRINGE (0002-1445-01)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":7370.71514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Taltz Autoinjector|Ixekizumab","basis":"brand"},"part_b":null}, {"ndc":"00002144527","name":"TALTZ 80 MG/ML AUTOINJECTOR (2-PACK)","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0002-1445-27","proprietary_name":"TALTZ","nonproprietary_name":"ixekizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"80 mg/mL","labeler":"Eli Lilly and Company","package_description":"2 SYRINGE in 1 CARTON (0002-1445-27) / 1 mL in 1 SYRINGE (0002-1445-01)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":7435.87075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Taltz Autoinjector|Ixekizumab","basis":"brand"},"part_b":null}, {"ndc":"00002144509","name":"TALTZ 80 MG/ML AUTOINJECTOR (3-PACK)","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1445-09","proprietary_name":"TALTZ","nonproprietary_name":"ixekizumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"80 mg/mL","labeler":"Eli Lilly and Company","package_description":"3 SYRINGE in 1 CARTON (0002-1445-09) / 1 mL in 1 SYRINGE (0002-1445-01)","pharm_classes":["Interleukin-17A Antagonist [EPC]","Interleukin-17A Antagonists [MoA]"]},"nadac":{"value":7388.222,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Taltz Autoinjector|Ixekizumab","basis":"brand"},"part_b":null}, {"ndc":"00004082205","name":"TAMIFLU 6 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0004-0822-05","proprietary_name":"Tamiflu","nonproprietary_name":"Oseltamivir Phosphate","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"6 mg/mL","labeler":"Genentech, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (0004-0822-05) / 60 mL in 1 BOTTLE, GLASS","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":2.43293,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.14964,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00004080085","name":"TAMIFLU 75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0004-0800-85","proprietary_name":"Tamiflu","nonproprietary_name":"oseltamivir phosphate","dosage_form":"CAPSULE","route":"ORAL","strength":"75 mg/1","labeler":"Genentech, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (0004-0800-85) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Neuraminidase Inhibitor [EPC]","Neuraminidase Inhibitors [MoA]"]},"nadac":{"value":14.51856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.79621,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378014491","name":"TAMOXIFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0144-91","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET in 1 BOTTLE (0378-0144-91)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.12555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591247218","name":"TAMOXIFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2472-18","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"180 TABLET in 1 BOTTLE, PLASTIC (0591-2472-18)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.12555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591247260","name":"TAMOXIFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2472-60","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (0591-2472-60)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.12555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"59651029960","name":"TAMOXIFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-299-60","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59651-299-60)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.12555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"75907005810","name":"TAMOXIFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-058-10","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (75907-058-10)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.12555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"75907005860","name":"TAMOXIFEN 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-058-60","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (75907-058-60)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.12555,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"00378027493","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0274-93","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (0378-0274-93)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591247319","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2473-19","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0591-2473-19)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"00591247330","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2473-30","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0591-2473-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"59651030030","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-300-30","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (59651-300-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"59651030090","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-300-90","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (59651-300-90)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"75907005910","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-059-10","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (75907-059-10)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"75907005930","name":"TAMOXIFEN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-059-30","proprietary_name":"Tamoxifen Citrate","nonproprietary_name":"Tamoxifen Citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (75907-059-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":0.27682,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamoxifen Citrate|Tamoxifen Citrate","basis":"generic"},"part_b":null}, {"ndc":"00904738361","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7383-61","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7383-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"33342015911","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-159-11","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"100 CAPSULE in 1 BOTTLE (33342-159-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"33342015915","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-159-15","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 CAPSULE in 1 BOTTLE (33342-159-15)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"33342015944","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-159-44","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1000 CAPSULE in 1 BOTTLE (33342-159-44)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074011","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268074015","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-740-15","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-740-15) / 1 CAPSULE in 1 BLISTER PACK (50268-740-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237001401","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-014-01","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-014-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"57237001405","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-014-05","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (57237-014-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135077530","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-775-30","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 CAPSULE in 1 BOTTLE (62135-775-30)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135077590","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-775-90","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-775-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862059801","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-598-01","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-598-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"65862059805","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-598-05","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE in 1 BOTTLE (65862-598-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877045001","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-450-01","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-450-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877045005","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-450-05","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-450-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"67877045010","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-450-10","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1000 CAPSULE in 1 BOTTLE (67877-450-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084029901","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-299-01","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-299-01) / 1 CAPSULE in 1 BLISTER PACK (68084-299-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084029911","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68084029965","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-299-65","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-299-65) / 1 CAPSULE in 1 BLISTER PACK (68084-299-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382013201","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-132-01","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (68382-132-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382013210","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-132-10","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (68382-132-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"68382013216","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-132-16","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE in 1 BOTTLE (68382-132-16)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603011501","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-115-01","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-115-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72603011502","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-115-02","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 CAPSULE in 1 BOTTLE (72603-115-02)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282074405","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-744-05","proprietary_name":"Tamsulosin hydrochloride","nonproprietary_name":"Tamsulosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"500 CAPSULE in 1 BOTTLE (76282-744-05)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"76282074490","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-744-90","proprietary_name":"Tamsulosin hydrochloride","nonproprietary_name":"Tamsulosin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"EXELAN PHARMACEUTICALS, INC.","package_description":"90 CAPSULE in 1 BOTTLE (76282-744-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"82009002510","name":"TAMSULOSIN HCL 0.4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-025-10","proprietary_name":"Tamsulosin Hydrochloride","nonproprietary_name":"Tamsulosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":".4 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"1000 CAPSULE in 1 BOTTLE (82009-025-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.04997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tamsulosin HCl|Tamsulosin HCl","basis":"generic"},"part_b":null}, {"ndc":"72245087310","name":"TANLOR 1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72245-873-10","proprietary_name":"Tanlor","nonproprietary_name":"methocarbamol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1000 mg/1","labeler":"Forte Bio-Pharma","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (72245-873-10)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":8.348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tanlor|Methocarbamol","basis":"brand"},"part_b":null}, {"ndc":"00054093721","name":"TAPENTADOL ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0937-21","proprietary_name":"TAPENTADOL","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0054-0937-21)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":21.48667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054093921","name":"TAPENTADOL ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0939-21","proprietary_name":"TAPENTADOL","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0054-0939-21)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":35.31226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054093621","name":"TAPENTADOL ER 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0936-21","proprietary_name":"TAPENTADOL","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0054-0936-21)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":12.36583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054094525","name":"TAPENTADOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0945-25","proprietary_name":"TAPENTADOL","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0054-0945-25)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":14.47951,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806062801","name":"TAPENTADOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-628-01","proprietary_name":"Tapentadol Hydrochloride","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"EPIC PHARMA LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42806-628-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":14.47951,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054094225","name":"TAPENTADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0942-25","proprietary_name":"TAPENTADOL","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0054-0942-25)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":8.85429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806062601","name":"TAPENTADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-626-01","proprietary_name":"Tapentadol Hydrochloride","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"EPIC PHARMA LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42806-626-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":8.85429,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054094325","name":"TAPENTADOL HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0943-25","proprietary_name":"TAPENTADOL","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0054-0943-25)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":10.6496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806062701","name":"TAPENTADOL HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-627-01","proprietary_name":"Tapentadol Hydrochloride","nonproprietary_name":"Tapentadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"EPIC PHARMA LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (42806-627-01)","pharm_classes":["Opioid Agonist [EPC]","Opioid Agonists [MoA]"]},"nadac":{"value":10.6496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50102022401","name":"TARINA 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tarina 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"50102022421","name":"TARINA 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tarina 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"50102022423","name":"TARINA 24 FE 1 MG-20 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-224-23","proprietary_name":"TARINA 24 FE","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 POUCH in 1 CARTON (50102-224-23) / 1 BLISTER PACK in 1 POUCH (50102-224-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17478,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tarina 24 Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"50102022821","name":"TARINA FE 1-20 EQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tarina Fe 1-20 Eq|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"50102022823","name":"TARINA FE 1-20 EQ TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-228-23","proprietary_name":"Tarina Fe 1/20 EQ","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 POUCH in 1 CARTON (50102-228-23) / 1 BLISTER PACK in 1 POUCH (50102-228-21) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tarina Fe 1-20 Eq|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"13811053630","name":"TARON-C DHA CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Taron-C DHA|Mvn-Min75/Iron/Iron Ps/Om3/DHA","basis":"brand"},"part_b":null}, {"ndc":"00480449056","name":"TASIMELTEON 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-4490-56","proprietary_name":"Tasimelteon","nonproprietary_name":"Tasimelteon","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (0480-4490-56)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":228.24801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tasimelteon|Tasimelteon","basis":"generic"},"part_b":null}, {"ndc":"60505466503","name":"TASIMELTEON 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4665-3","proprietary_name":"Tasimelteon","nonproprietary_name":"Tasimelteon","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"30 CAPSULE in 1 BOTTLE (60505-4665-3)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":228.24801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tasimelteon|Tasimelteon","basis":"generic"},"part_b":null}, {"ndc":"69238254803","name":"TASIMELTEON 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2548-3","proprietary_name":"Tasimelteon","nonproprietary_name":"Tasimelteon","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"30 CAPSULE in 1 BOTTLE (69238-2548-3)","pharm_classes":["Melatonin Receptor Agonist [EPC]","Melatonin Receptor Agonists [MoA]"]},"nadac":{"value":228.24801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tasimelteon|Tasimelteon","basis":"generic"},"part_b":null}, {"ndc":"21922002012","name":"TAVABOROLE 5% TOPICAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-020-12","proprietary_name":"Tavaborole","nonproprietary_name":"TAVABOROLE topical solution, 5%","dosage_form":"SOLUTION","route":"TOPICAL","strength":"43.5 mg/mL","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (21922-020-12) / 10 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Boron Compounds [CS]","Oxaborole Antifungal [EPC]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":3.39012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tavaborole|Tavaborole","basis":"generic"},"part_b":null}, {"ndc":"62135066359","name":"TAVABOROLE 5% TOPICAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-663-59","proprietary_name":"Tavaborole","nonproprietary_name":"Tavaborole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"43.5 mg/mL","labeler":"Chartwell RX, LLC","package_description":"10 mL in 1 BOTTLE, DROPPER (62135-663-59)","pharm_classes":["Boron Compounds [CS]","Oxaborole Antifungal [EPC]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":3.39012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tavaborole|Tavaborole","basis":"generic"},"part_b":null}, {"ndc":"62332046710","name":"TAVABOROLE 5% TOPICAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-467-10","proprietary_name":"Tavaborole","nonproprietary_name":"Tavaborole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"43.5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (62332-467-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Boron Compounds [CS]","Oxaborole Antifungal [EPC]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":3.39012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tavaborole|Tavaborole","basis":"generic"},"part_b":null}, {"ndc":"72578010204","name":"TAVABOROLE 5% TOPICAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-102-04","proprietary_name":"Tavaborole","nonproprietary_name":"Tavaborole","dosage_form":"SOLUTION","route":"TOPICAL","strength":"43.5 mg/mL","labeler":"Viona Pharmaceuticals Inc","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (72578-102-04) / 10 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Boron Compounds [CS]","Oxaborole Antifungal [EPC]","Protein Synthesis Inhibitors [MoA]"]},"nadac":{"value":3.39012,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tavaborole|Tavaborole","basis":"generic"},"part_b":null}, {"ndc":"65162055858","name":"TAYSOFY 1 MG-20 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00023586228","name":"TAYTULLA 1 MG-20 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.97473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Taytulla|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"00023586230","name":"TAYTULLA 1 MG-20 MCG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-5862-30","proprietary_name":"Taytulla","nonproprietary_name":"norethindrone acetate and ethinyl estradiol, and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Allergan, Inc.","package_description":"5 CARTON in 1 TRAY (0023-5862-30) / 1 BLISTER PACK in 1 CARTON (0023-5862-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":8.97473,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.96176,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Taytulla|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"00713076531","name":"TAZAROTENE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0765-31","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0765-31) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.88896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00713076560","name":"TAZAROTENE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0765-60","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0765-60) / 60 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":8.06818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"45802070694","name":"TAZAROTENE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-706-94","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-706-94) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.88896,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"45802070696","name":"TAZAROTENE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-706-96","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-706-96) / 60 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":8.06818,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00713080531","name":"TAZAROTENE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0805-31","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0805-31) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":5.31381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"45802043694","name":"TAZAROTENE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-436-94","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-436-94) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":5.31381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"73473030930","name":"TAZAROTENE 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-309-30","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"GEL","route":"CUTANEOUS","strength":".5 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-309-30) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":5.31381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00713067031","name":"TAZAROTENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0670-31","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0670-31) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.92446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00713067060","name":"TAZAROTENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0670-60","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0670-60) / 60 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.84922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"51672137302","name":"TAZAROTENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1373-2","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1373-2) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.92446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"51672137303","name":"TAZAROTENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1373-3","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1373-3) / 60 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.84922,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"68308074530","name":"TAZAROTENE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-745-30","proprietary_name":"Tazarotene","nonproprietary_name":"TAZAROTENE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Mayne Pharma","package_description":"1 TUBE in 1 CARTON (68308-745-30) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.92446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00713080431","name":"TAZAROTENE 0.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0804-31","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0804-31) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.50389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00713080499","name":"TAZAROTENE 0.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0804-99","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0804-99) / 100 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":5.7146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"45802044201","name":"TAZAROTENE 0.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-442-01","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-442-01) / 100 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":5.7146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"45802044294","name":"TAZAROTENE 0.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-442-94","proprietary_name":"TAZAROTENE","nonproprietary_name":"tazarotene","dosage_form":"GEL","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-442-94) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.50389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"73473031010","name":"TAZAROTENE 0.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-310-10","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"GEL","route":"CUTANEOUS","strength":"1 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-310-10) / 100 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":5.7146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"73473031030","name":"TAZAROTENE 0.1% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73473-310-30","proprietary_name":"Tazarotene","nonproprietary_name":"Tazarotene","dosage_form":"GEL","route":"CUTANEOUS","strength":"1 mg/g","labeler":"Solaris Pharma Corporation","package_description":"1 TUBE in 1 CARTON (73473-310-30) / 30 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":6.50389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tazarotene|Tazarotene","basis":"generic"},"part_b":null}, {"ndc":"00065040872","name":"TEARS LUBRICANT 0.5% EYE DROP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-0408-72","proprietary_name":"Alcon Tears Lubricant Eye Drops","nonproprietary_name":"hypromellose 2910","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-0408-72) / 15 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":2.09955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078050883","name":"TEGRETOL 100 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0508-83","proprietary_name":"Tegretol","nonproprietary_name":"carbamazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"450 mL in 1 BOTTLE (0078-0508-83)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.43673,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.09255,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078050905","name":"TEGRETOL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0509-05","proprietary_name":"Tegretol","nonproprietary_name":"carbamazepine","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET in 1 BOTTLE (0078-0509-05)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":3.03973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11939,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00078051005","name":"TEGRETOL XR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0510-05","proprietary_name":"Tegretol XR","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0078-0510-05)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":1.62811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.20207,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tegretol XR|Carbamazepine","basis":"brand"},"part_b":null}, {"ndc":"00078051105","name":"TEGRETOL XR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0511-05","proprietary_name":"Tegretol XR","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0078-0511-05)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":3.24731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.39888,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tegretol XR|Carbamazepine","basis":"brand"},"part_b":null}, {"ndc":"00078051205","name":"TEGRETOL XR 400 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0512-05","proprietary_name":"Tegretol XR","nonproprietary_name":"carbamazepine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0078-0512-05)","pharm_classes":["Cytochrome P450 1A2 Inducers [MoA]","Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2C19 Inducers [MoA]","Cytochrome P450 2C9 Inducers [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":6.48996,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.65275,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tegretol XR|Carbamazepine","basis":"brand"},"part_b":null}, {"ndc":"70839030030","name":"TEKTURNA 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70839-300-30","proprietary_name":"Tekturna","nonproprietary_name":"aliskiren hemifumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"LXO US Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70839-300-30)","pharm_classes":["Renin Inhibitor [EPC]","Renin Inhibitors [MoA]"]},"nadac":{"value":15.09446,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-06","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.85836,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tekturna|Aliskiren Hemifumarate","basis":"brand"},"part_b":null}, {"ndc":"00378292077","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2920-77","proprietary_name":"Telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-2920-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"00378292093","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2920-93","proprietary_name":"Telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-2920-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"42571022630","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"43547028303","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-283-03","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-283-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"62135053530","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-535-30","proprietary_name":"TELMISARTAN","nonproprietary_name":"TELMISARTAN","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET in 1 BOTTLE (62135-535-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"62332008730","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-087-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-087-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086703","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-867-03","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-867-03) / 10 TABLET in 1 BLISTER PACK (65862-867-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086710","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086730","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-867-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-867-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048230","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-482-30","proprietary_name":"telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-482-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048233","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048284","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68382047130","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68382047178","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-471-78","proprietary_name":"telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 BLISTER PACK in 1 CARTON (68382-471-78) / 1 TABLET in 1 BLISTER PACK (68382-471-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462019911","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462019913","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-199-13","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-199-13) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462019930","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-199-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-199-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462019990","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-199-90","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-199-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"70756031230","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-312-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-312-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72241001504","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-015-04","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72241-015-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72241001522","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-015-22","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-015-22)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72603083101","name":"TELMISARTAN 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-831-01","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 CONTAINER (72603-831-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"00378292177","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2921-77","proprietary_name":"Telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-2921-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"00378292193","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2921-93","proprietary_name":"Telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-2921-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"42571022730","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"43547028403","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-284-03","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-284-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"62332008830","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-088-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-088-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086803","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-868-03","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-868-03) / 10 TABLET in 1 BLISTER PACK (65862-868-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086810","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086830","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-868-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-868-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048330","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-483-30","proprietary_name":"telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-483-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048333","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048384","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68382047230","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68382047278","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-472-78","proprietary_name":"telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 BLISTER PACK in 1 CARTON (68382-472-78) / 1 TABLET in 1 BLISTER PACK (68382-472-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020011","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020013","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-200-13","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-200-13) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020030","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-200-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-200-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020090","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-200-90","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-200-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"70756031330","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-313-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-313-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72241001604","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-016-04","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72241-016-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72241001622","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-016-22","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-016-22)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72603083201","name":"TELMISARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-832-01","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 CONTAINER (72603-832-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.15031,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"00378292277","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2922-77","proprietary_name":"Telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE, PLASTIC (0378-2922-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"00378292293","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2922-93","proprietary_name":"Telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-2922-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"42571022830","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"43547028503","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-285-03","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-285-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"62135053730","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-537-30","proprietary_name":"TELMISARTAN","nonproprietary_name":"TELMISARTAN","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET in 1 BOTTLE (62135-537-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"62332008930","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-089-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-089-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086903","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-869-03","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-869-03) / 10 TABLET in 1 BLISTER PACK (65862-869-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086910","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"65862086930","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-869-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-869-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048430","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-484-30","proprietary_name":"telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (67877-484-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048433","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"67877048484","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68382047330","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68382047378","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-473-78","proprietary_name":"telmisartan","nonproprietary_name":"telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 BLISTER PACK in 1 CARTON (68382-473-78) / 1 TABLET in 1 BLISTER PACK (68382-473-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020111","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020113","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-201-13","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-201-13) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020130","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-201-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET in 1 BOTTLE (68462-201-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"68462020190","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-201-90","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"90 TABLET in 1 BOTTLE (68462-201-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"70756031430","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-314-30","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Lifestar Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70756-314-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72241001704","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-017-04","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (72241-017-04)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72241001722","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-017-22","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72241-017-22)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"72603083301","name":"TELMISARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-833-01","proprietary_name":"Telmisartan","nonproprietary_name":"Telmisartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET in 1 CONTAINER (72603-833-01)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan|Telmisartan","basis":"generic"},"part_b":null}, {"ndc":"00378107693","name":"TELMISARTAN-AMLODIPINE 40-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1076-93","proprietary_name":"Telmisartan and Amlodipine","nonproprietary_name":"telmisartan and amlodipine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-1076-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":2.87974,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan-Amlodipine|Telmisartan/Amlodipine","basis":"generic"},"part_b":null}, {"ndc":"00378107593","name":"TELMISARTAN-AMLODIPINE 40-5 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1075-93","proprietary_name":"Telmisartan and Amlodipine","nonproprietary_name":"telmisartan and amlodipine","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-1075-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":3.19076,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan-Amlodipine|Telmisartan/Amlodipine","basis":"generic"},"part_b":null}, {"ndc":"00378107893","name":"TELMISARTAN-AMLODIPINE 80-10","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1078-93","proprietary_name":"Telmisartan and Amlodipine","nonproprietary_name":"telmisartan and amlodipine","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-1078-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":2.93583,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan-Amlodipine|Telmisartan/Amlodipine","basis":"generic"},"part_b":null}, {"ndc":"00378107793","name":"TELMISARTAN-AMLODIPINE 80-5 MG","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-1077-93","proprietary_name":"Telmisartan and Amlodipine","nonproprietary_name":"telmisartan and amlodipine","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0378-1077-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]"]},"nadac":{"value":2.87025,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Telmisartan-Amlodipine|Telmisartan/Amlodipine","basis":"generic"},"part_b":null}, {"ndc":"43547044103","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-441-03","proprietary_name":"TELMISARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"telmisartan and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"30 TABLET in 1 BOTTLE (43547-441-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332020930","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-209-30","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-209-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862097603","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-976-03","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-976-03) / 10 TABLET in 1 BLISTER PACK (65862-976-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862097610","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084011","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084013","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-840-13","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1; 12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-840-13) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547044203","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-442-03","proprietary_name":"TELMISARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"telmisartan and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Solco Healthcare LLC","package_description":"30 TABLET in 1 BOTTLE (43547-442-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332021030","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-210-30","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-210-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862097703","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-977-03","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-977-03) / 10 TABLET in 1 BLISTER PACK (65862-977-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862097710","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084111","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084113","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-841-13","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-841-13) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.31445,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547044303","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-443-03","proprietary_name":"TELMISARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"telmisartan and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 25 mg/1","labeler":"Solco Healthcare LLC","package_description":"30 TABLET in 1 BOTTLE (43547-443-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332021130","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-211-30","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-211-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862097803","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-978-03","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-978-03) / 10 TABLET in 1 BLISTER PACK (65862-978-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862097810","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084211","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462084213","name":"TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-842-13","proprietary_name":"Telmisartan and Hydrochlorothiazide","nonproprietary_name":"Telmisartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1; 25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-842-13) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.33828,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00228207610","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2076-10","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0228-2076-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00228207650","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2076-50","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0228-2076-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00406996101","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9961-01","proprietary_name":"TEMAZEPAM","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-9961-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"43547061210","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-612-10","proprietary_name":"Temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (43547-612-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"43547061250","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-612-50","proprietary_name":"Temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (43547-612-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"50268077911","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"50268077915","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-779-15","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-779-15) / 1 CAPSULE in 1 BLISTER PACK (50268-779-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"53746055601","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-556-01","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (53746-556-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"62332038031","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-380-31","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-380-31)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"62332038071","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-380-71","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (62332-380-71)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"67877014601","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-146-01","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-146-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"67877014605","name":"TEMAZEPAM 15 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-146-05","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-146-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.0767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00406995903","name":"TEMAZEPAM 22.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9959-03","proprietary_name":"TEMAZEPAM","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"22.5 mg/1","labeler":"SpecGx LLC","package_description":"30 CAPSULE in 1 BOTTLE (0406-9959-03)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.54918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"43547061303","name":"TEMAZEPAM 22.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-613-03","proprietary_name":"Temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"22.5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (43547-613-03)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.54918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"62332038130","name":"TEMAZEPAM 22.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-381-30","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"22.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE in 1 BOTTLE (62332-381-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.54918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"65162058403","name":"TEMAZEPAM 22.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-584-03","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"22.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 CAPSULE in 1 BOTTLE (65162-584-03)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.54918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"67877014930","name":"TEMAZEPAM 22.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-149-30","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"22.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE (67877-149-30)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":1.54918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00228207710","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2077-10","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0228-2077-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00228207750","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0228-2077-50","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 CAPSULE in 1 BOTTLE (0228-2077-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00406996201","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9962-01","proprietary_name":"TEMAZEPAM","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-9962-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"43547061410","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-614-10","proprietary_name":"Temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (43547-614-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"43547061450","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-614-50","proprietary_name":"Temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"500 CAPSULE in 1 BOTTLE, PLASTIC (43547-614-50)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"50268078011","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"50268078013","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-780-13","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-780-13) / 1 CAPSULE in 1 BLISTER PACK (50268-780-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"53746055701","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-557-01","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 CAPSULE in 1 BOTTLE (53746-557-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"62332038231","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-382-31","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-382-31)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"62332038271","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-382-71","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 CAPSULE in 1 BOTTLE (62332-382-71)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"67877014701","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-147-01","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-147-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"67877014705","name":"TEMAZEPAM 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-147-05","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 CAPSULE in 1 BOTTLE (67877-147-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.08929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00406996001","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0406-9960-01","proprietary_name":"TEMAZEPAM","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"SpecGx LLC","package_description":"100 CAPSULE in 1 BOTTLE (0406-9960-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"00904643604","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6436-04","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6436-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"43547061110","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-611-10","proprietary_name":"Temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (43547-611-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"62332037931","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-379-31","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (62332-379-31)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"65162058310","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-583-10","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 CAPSULE in 1 BOTTLE (65162-583-10)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"67877014801","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-148-01","proprietary_name":"temazepam","nonproprietary_name":"temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (67877-148-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"68084054911","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"68084054921","name":"TEMAZEPAM 7.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-549-21","proprietary_name":"Temazepam","nonproprietary_name":"Temazepam","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-549-21) / 1 CAPSULE in 1 BLISTER PACK (68084-549-11)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.83366,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temazepam|Temazepam","basis":"generic"},"part_b":null}, {"ndc":"16571081841","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-818-41","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"14 CAPSULE in 1 BOTTLE (16571-818-41)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16571081851","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-818-51","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (16571-818-51)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16729005053","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-050-53","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (16729-050-53) / 5 CAPSULE in 1 BOTTLE, GLASS","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (16729-050-53) / 5 CAPSULE in 1 BOTTLE, GLASS) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729005054","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-050-54","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (16729-050-54) / 14 CAPSULE in 1 BOTTLE, GLASS","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":280,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (280 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":14,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (16729-050-54) / 14 CAPSULE in 1 BOTTLE, GLASS) gives 14 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722041314","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-413-14","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"TEMOZOLOMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"14 CAPSULE in 1 BOTTLE (31722-413-14)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"31722041331","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-413-31","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"TEMOZOLOMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (31722-413-31)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"47335089260","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"47335089272","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-892-72","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"15 BLISTER PACK in 1 CARTON (47335-892-72) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":15,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (15 BLISTER PACK in 1 CARTON (47335-892-72) / 1 CAPSULE in 1 BLISTER PACK) gives 15 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"47335089274","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-892-74","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (47335-892-74) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (47335-892-74) / 1 CAPSULE in 1 BLISTER PACK) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65162080314","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-803-14","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-803-14) / 14 CAPSULE in 1 BOTTLE","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":280,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (280 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":14,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (65162-803-14) / 14 CAPSULE in 1 BOTTLE) gives 14 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65162080351","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-803-51","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-803-51) / 5 CAPSULE in 1 BOTTLE","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (65162-803-51) / 5 CAPSULE in 1 BOTTLE) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877053907","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-539-07","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"5 CAPSULE in 1 BOTTLE (67877-539-07)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"67877053914","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-539-14","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"14 CAPSULE in 1 BOTTLE (67877-539-14)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"73043001305","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-013-05","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Devatis, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (73043-013-05)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"73043001314","name":"TEMOZOLOMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-013-14","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Devatis, Inc.","package_description":"14 CAPSULE in 1 BOTTLE (73043-013-14)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":4.37549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16571081741","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-817-41","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"14 CAPSULE in 1 BOTTLE (16571-817-41)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16571081751","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-817-51","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (16571-817-51)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16729004953","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-049-53","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (16729-049-53) / 5 CAPSULE in 1 BOTTLE, GLASS","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (16729-049-53) / 5 CAPSULE in 1 BOTTLE, GLASS) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"16729004954","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16729-049-54","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (16729-049-54) / 14 CAPSULE in 1 BOTTLE, GLASS","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (56 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":14,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (16729-049-54) / 14 CAPSULE in 1 BOTTLE, GLASS) gives 14 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722041214","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-412-14","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"TEMOZOLOMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"14 CAPSULE in 1 BOTTLE (31722-412-14)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"31722041231","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-412-31","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"TEMOZOLOMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (31722-412-31)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"47335089160","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"47335089172","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-891-72","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"15 BLISTER PACK in 1 CARTON (47335-891-72) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":15,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (15 BLISTER PACK in 1 CARTON (47335-891-72) / 1 CAPSULE in 1 BLISTER PACK) gives 15 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"47335089174","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-891-74","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (47335-891-74) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (47335-891-74) / 1 CAPSULE in 1 BLISTER PACK) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65162080214","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-802-14","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-802-14) / 14 CAPSULE in 1 BOTTLE","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (56 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":14,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (65162-802-14) / 14 CAPSULE in 1 BOTTLE) gives 14 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65162080251","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-802-51","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-802-51) / 5 CAPSULE in 1 BOTTLE","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (65162-802-51) / 5 CAPSULE in 1 BOTTLE) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877053807","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-538-07","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"5 CAPSULE in 1 BOTTLE (67877-538-07)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"67877053814","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-538-14","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"14 CAPSULE in 1 BOTTLE (67877-538-14)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"73043001205","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-012-05","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Devatis, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (73043-012-05)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"73043001214","name":"TEMOZOLOMIDE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73043-012-14","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Devatis, Inc.","package_description":"14 CAPSULE in 1 BOTTLE (73043-012-14)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":0.87977,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16571082151","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"16571-821-51","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (16571-821-51)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"16729005153","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"16729-051-53","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Accord Healthcare Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (16729-051-53) / 5 CAPSULE in 1 BOTTLE, GLASS","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (16729-051-53) / 5 CAPSULE in 1 BOTTLE, GLASS) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722041631","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-416-31","proprietary_name":"TEMOZOLOMIDE","nonproprietary_name":"TEMOZOLOMIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (31722-416-31)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"47335089360","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"47335089374","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"47335-893-74","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (47335-893-74) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 BLISTER PACK in 1 CARTON (47335-893-74) / 1 CAPSULE in 1 BLISTER PACK) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"65162080651","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65162-806-51","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (65162-806-51) / 5 CAPSULE in 1 BOTTLE","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":{"hcpcs":"J8700","bill_units_per_package":{"value":250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8700 (5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (250 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE in 1 CARTON (65162-806-51) / 5 CAPSULE in 1 BOTTLE) gives 5 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"67877054207","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67877-542-07","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"5 CAPSULE in 1 BOTTLE (67877-542-07)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"73043001605","name":"TEMOZOLOMIDE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73043-016-05","proprietary_name":"Temozolomide","nonproprietary_name":"Temozolomide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Devatis, Inc.","package_description":"5 CAPSULE in 1 BOTTLE (73043-016-05)","pharm_classes":["Alkylating Activity [MoA]","Alkylating Drug [EPC]"]},"nadac":{"value":20.5332,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-10-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Temozolomide|Temozolomide","basis":"generic"},"part_b":null}, {"ndc":"00904682104","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6821-04","proprietary_name":"tenofovir disoproxil fumarate","nonproprietary_name":"tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6821-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"16714082001","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-820-01","proprietary_name":"Tenofovir Disoproxil Fumarate","nonproprietary_name":"Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar RxLLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-820-01)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"31722053530","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-535-30","proprietary_name":"Tenofovir Disoproxil Fumarate","nonproprietary_name":"Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-535-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"33342009607","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-096-07","proprietary_name":"tenofovir disoproxil fumarate","nonproprietary_name":"tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-096-07)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268075811","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"50268075812","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-758-12","proprietary_name":"TENOFOVIR DISOPROXIL FUMARATE","nonproprietary_name":"tenofovir disoproxil fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-758-12) / 1 TABLET in 1 BLISTER PACK (50268-758-11)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"62135046630","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-466-30","proprietary_name":"TENOFOVIR DISOPROXIL FUMARATE","nonproprietary_name":"TENOFOVIR DISOPROXIL FUMARATE Tablets","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62135-466-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"64380071404","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-714-04","proprietary_name":"TENOFOVIR DISOPROXIL FUMARATE","nonproprietary_name":"tenofovir disoproxil fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"30 TABLET in 1 BOTTLE (64380-714-04)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"65862042130","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-421-30","proprietary_name":"Tenofovir Disoproxil Fumarate","nonproprietary_name":"Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-421-30)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"69076010503","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69076-105-03","proprietary_name":"Tenofovir Disoproxil Fumarate","nonproprietary_name":"Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"300 mg/1","labeler":"Quinn Pharmaceuticals","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (69076-105-03)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"69097053302","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-533-02","proprietary_name":"Tenofovir disoproxil fumarate","nonproprietary_name":"Tenofovir disoproxil fumarate","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-533-02)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"71921010533","name":"TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-105-33","proprietary_name":"Tenofovir Disoproxil Fumarate","nonproprietary_name":"Tenofovir Disoproxil Fumarate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"300 mg/1","labeler":"Florida Pharmaceutical Products, LLC.","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (71921-105-33)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenofovir Disoproxil Fumarate|Tenofovir Disoproxil Fumarate","basis":"generic"},"part_b":null}, {"ndc":"24979024507","name":"TENORMIN 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-245-07","proprietary_name":"TENORMIN","nonproprietary_name":"Atenolol","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (24979-245-07)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":12.7821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0236,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tenormin|Atenolol","basis":"brand"},"part_b":null}, {"ndc":"70000015901","name":"TENSION HEADACHE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0159-1","proprietary_name":"Tension Headache","nonproprietary_name":"Acetaminophen, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 65 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0159-1) / 24 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000015902","name":"TENSION HEADACHE CAPLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0159-2","proprietary_name":"Tension Headache","nonproprietary_name":"Acetaminophen, Caffeine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1; 65 mg/1","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0159-2) / 100 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]","Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.06223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155073501","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-735-01","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-735-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073510","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-735-10","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-735-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689079201","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689079210","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241028801","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-288-01","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-288-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076411","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076415","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-764-15","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-764-15) / 1 CAPSULE in 1 BLISTER PACK (50268-764-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038306","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-383-06","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59746-383-06)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038310","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-383-10","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (59746-383-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135045890","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-458-90","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-458-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"69452033020","name":"TERAZOSIN 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-330-20","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-330-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073801","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-738-01","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-738-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073810","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-738-10","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-738-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689096101","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689096110","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241029101","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-291-01","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-291-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076711","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076715","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-767-15","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-767-15) / 1 CAPSULE in 1 BLISTER PACK (50268-767-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038606","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-386-06","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59746-386-06)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038610","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-386-10","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (59746-386-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135046190","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-461-90","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-461-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"69452033320","name":"TERAZOSIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-333-20","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-333-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.13049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073601","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-736-01","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-736-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073610","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-736-10","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-736-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689085501","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689085510","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241028901","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-289-01","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-289-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076511","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076515","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-765-15","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-765-15) / 1 CAPSULE in 1 BLISTER PACK (50268-765-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038406","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-384-06","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59746-384-06)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038410","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-384-10","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (59746-384-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135045990","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-459-90","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-459-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"69452033120","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-331-20","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-331-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"69452033132","name":"TERAZOSIN 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-331-32","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Bionpharma Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (69452-331-32)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10551,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073701","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-737-01","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-737-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"23155073710","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-737-10","proprietary_name":"terazosin","nonproprietary_name":"terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (23155-737-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689088201","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24689088210","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"27241029001","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-290-01","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (27241-290-01)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076611","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076615","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-766-15","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-766-15) / 1 CAPSULE in 1 BLISTER PACK (50268-766-11)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038506","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-385-06","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59746-385-06)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"59746038510","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-385-10","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (59746-385-10)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"62135046090","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-460-90","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-460-90)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"69452033220","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-332-20","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-332-20)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"69452033232","name":"TERAZOSIN 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-332-32","proprietary_name":"Terazosin","nonproprietary_name":"Terazosin","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"1000 CAPSULE in 1 BOTTLE (69452-332-32)","pharm_classes":["Adrenergic alpha-Antagonists [MoA]","alpha-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.10819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terazosin HCl|Terazosin HCl","basis":"generic"},"part_b":null}, {"ndc":"24385052403","name":"TERBINAFINE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-524-03","proprietary_name":"Good Neighbor Pharmacy","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-524-03) / 30 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.23063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385052405","name":"TERBINAFINE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-524-05","proprietary_name":"Good Neighbor Pharmacy","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (24385-524-05) / 15 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.39833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672208001","name":"TERBINAFINE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2080-1","proprietary_name":"Terbinafine Hydrochloride","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2080-1) / 15 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.39833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672208002","name":"TERBINAFINE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2080-2","proprietary_name":"Terbinafine Hydrochloride","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2080-2) / 30 g in 1 TUBE","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.30853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714079501","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-795-01","proprietary_name":"Terbinafine","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (16714-795-01)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714079502","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-795-02","proprietary_name":"Terbinafine","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET in 1 BOTTLE (16714-795-02)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"51991052601","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-526-01","proprietary_name":"Terbinafine Hydrochloride","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET in 1 BOTTLE (51991-526-01)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687090911","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"60687090921","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-909-21","proprietary_name":"Terbinafine","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-909-21) / 1 TABLET in 1 BLISTER PACK (60687-909-11)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057230","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-572-30","proprietary_name":"TERBINAFINE","nonproprietary_name":"Terbinafine","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-572-30)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135057290","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-572-90","proprietary_name":"TERBINAFINE","nonproprietary_name":"Terbinafine","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-572-90)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862007930","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-079-30","proprietary_name":"Terbinafine","nonproprietary_name":"Terbinafine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (65862-079-30)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"69097085902","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-859-02","proprietary_name":"Terbinafine","nonproprietary_name":"Terbinafine","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET in 1 BOTTLE (69097-859-02)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"69097085907","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-859-07","proprietary_name":"Terbinafine","nonproprietary_name":"Terbinafine","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Cipla USA Inc.","package_description":"100 TABLET in 1 BOTTLE (69097-859-07)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"69292022501","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-225-01","proprietary_name":"TERBINAFINE HYDROCHLORIDE","nonproprietary_name":"Terbinafine Tablets 250 mg","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amici Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE (69292-225-01)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"69292022530","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69292-225-30","proprietary_name":"TERBINAFINE HYDROCHLORIDE","nonproprietary_name":"Terbinafine Tablets 250 mg","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Amici Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (69292-225-30)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452035113","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-351-13","proprietary_name":"terbinafine hydrochloride","nonproprietary_name":"terbinafine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (69452-351-13)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"69452035120","name":"TERBINAFINE HCL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-351-20","proprietary_name":"terbinafine hydrochloride","nonproprietary_name":"terbinafine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (69452-351-20)","pharm_classes":["Allylamine Antifungal [EPC]","Allylamine [CS]"]},"nadac":{"value":0.1426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbinafine HCl|Terbinafine HCl","basis":"generic"},"part_b":null}, {"ndc":"00115261101","name":"TERBUTALINE SULFATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-2611-01","proprietary_name":"TERBUTALINE SULFATE","nonproprietary_name":"TERBUTALINE SULFATE","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-2611-01)"},"nadac":{"value":0.94675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00527131801","name":"TERBUTALINE SULFATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1318-01","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-1318-01)"},"nadac":{"value":0.94675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"24979013201","name":"TERBUTALINE SULFATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-132-01","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (24979-132-01)"},"nadac":{"value":0.94675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62135052490","name":"TERBUTALINE SULFATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-524-90","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET in 1 BOTTLE (62135-524-90)"},"nadac":{"value":0.94675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62559072101","name":"TERBUTALINE SULFATE 2.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-721-01","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-721-01)"},"nadac":{"value":0.94675,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00115262201","name":"TERBUTALINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0115-2622-01","proprietary_name":"TERBUTALINE SULFATE","nonproprietary_name":"TERBUTALINE SULFATE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (0115-2622-01)"},"nadac":{"value":0.63772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00527131101","name":"TERBUTALINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1311-01","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 TABLET in 1 BOTTLE (0527-1311-01)"},"nadac":{"value":0.63772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"24979013301","name":"TERBUTALINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-133-01","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 TABLET in 1 BOTTLE (24979-133-01)"},"nadac":{"value":0.63772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62135052590","name":"TERBUTALINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-525-90","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC.","package_description":"90 TABLET in 1 BOTTLE (62135-525-90)"},"nadac":{"value":0.63772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"62559072201","name":"TERBUTALINE SULFATE 5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-722-01","proprietary_name":"Terbutaline Sulfate","nonproprietary_name":"Terbutaline Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-722-01)"},"nadac":{"value":0.63772,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Terbutaline Sulfate*|Terbutaline Sulfate","basis":"generic"},"part_b":null}, {"ndc":"00168034646","name":"TERCONAZOLE 0.4% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0346-46","proprietary_name":"Terconazole","nonproprietary_name":"terconazole","dosage_form":"CREAM","route":"VAGINAL","strength":"4 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"45 g in 1 TUBE, WITH APPLICATOR (0168-0346-46)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.5523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672130406","name":"TERCONAZOLE 0.4% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1304-6","proprietary_name":"Terconazole","nonproprietary_name":"Terconazole","dosage_form":"CREAM","route":"VAGINAL","strength":"4 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (51672-1304-6) / 45 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.5523,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168034720","name":"TERCONAZOLE 0.8% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0347-20","proprietary_name":"Terconazole Vaginal Cream 0.8%","nonproprietary_name":"terconazole","dosage_form":"CREAM","route":"VAGINAL","strength":"8 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"20 g in 1 TUBE, WITH APPLICATOR (0168-0347-20)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.98654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672130200","name":"TERCONAZOLE 0.8% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1302-0","proprietary_name":"Terconazole","nonproprietary_name":"Terconazole","dosage_form":"CREAM","route":"VAGINAL","strength":"8 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (51672-1302-0) / 20 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":0.98654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713055273","name":"TERCONAZOLE 80 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0552-73","proprietary_name":"Terconazole","nonproprietary_name":"Terconazole","dosage_form":"SUPPOSITORY","route":"VAGINAL","strength":"80 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0713-0552-73) / 1 SUPPOSITORY in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":18.62247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802071700","name":"TERCONAZOLE 80 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.62247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802071708","name":"TERCONAZOLE 80 MG SUPPOSITORY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-717-08","proprietary_name":"Terconazole","nonproprietary_name":"Terconazole","dosage_form":"SUPPOSITORY","route":"VAGINAL","strength":"80 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"3 BLISTER PACK in 1 CARTON (45802-717-08) / 1 SUPPOSITORY in 1 BLISTER PACK (45802-717-00)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":18.62247,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480315656","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3156-56","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"14 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-3156-56)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"31722024730","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-247-30","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"14 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-247-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"59651005530","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-055-30","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET","route":"ORAL","strength":"14 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-055-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"62332031430","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-314-30","proprietary_name":"TERIFLUNOMIDE","nonproprietary_name":"TERIFLUNOMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"14 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-314-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"68462042430","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-424-30","proprietary_name":"teriflunomide","nonproprietary_name":"teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"14 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-424-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"70377001811","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-018-11","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"14 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-018-11)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"70512085128","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"70710111503","name":"TERIFLUNOMIDE 14 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1115-3","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"14 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1115-3)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.23335,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"00480315756","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3157-56","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-3157-56)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"31722024630","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-246-30","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-246-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"59651005430","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-054-30","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET","route":"ORAL","strength":"7 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-054-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"62332031330","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-313-30","proprietary_name":"TERIFLUNOMIDE","nonproprietary_name":"TERIFLUNOMIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-313-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"68462042330","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-423-30","proprietary_name":"teriflunomide","nonproprietary_name":"teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-423-30)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"70377001711","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-017-11","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7 mg/1","labeler":"Biocon Pharma Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70377-017-11)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"70512085028","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"70710111403","name":"TERIFLUNOMIDE 7 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1114-3","proprietary_name":"Teriflunomide","nonproprietary_name":"Teriflunomide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1114-3)","pharm_classes":["Dihydroorotate Dehydrogenase Inhibitors [MoA]","Pyrimidine Synthesis Inhibitor [EPC]"]},"nadac":{"value":0.29186,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Teriflunomide|Teriflunomide","basis":"generic"},"part_b":null}, {"ndc":"00093110616","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1106-16","proprietary_name":"Teriparatide","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE in 1 CARTON (0093-1106-16) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"00548231100","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0548-2311-00","proprietary_name":"Teriparatide","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Amphastar Pharmaceuticals, Inc.","package_description":"1 SYRINGE in 1 CARTON (0548-2311-00) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"47781065289","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-652-89","proprietary_name":"teriparatide","nonproprietary_name":"teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Alvogen, Inc.","package_description":"1 SYRINGE in 1 CARTON (47781-652-89) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"60505618800","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6188-0","proprietary_name":"Teriparatide","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Apotex Corp.","package_description":"1 SYRINGE in 1 CARTON (60505-6188-0) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"66993049528","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-495-28","proprietary_name":"Teriparatide","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Prasco Laboratories","package_description":"1 SYRINGE in 1 CARTON (66993-495-28) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"66993098928","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-989-28","proprietary_name":"Teriparatide","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"Prasco Laboratories","package_description":"1 SYRINGE in 1 CARTON (66993-989-28) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"68001069376","name":"TERIPARATIDE 560 MCG/2.24 ML PEN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-693-76","proprietary_name":"Teriparatide","nonproprietary_name":"Teriparatide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"250 ug/mL","labeler":"BluePoint Laboratories","package_description":"1 SYRINGE in 1 CARTON (68001-693-76) / 2.24 mL in 1 SYRINGE","pharm_classes":["Parathyroid Hormone Analog [EPC]","Parathyroid Hormone [CS]"]},"nadac":{"value":479.95105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Teriparatide|Teriparatide","basis":"generic"},"part_b":null}, {"ndc":"66887000105","name":"TESTIM 1% (50 MG) GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66887-001-05","proprietary_name":"Testim","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"50 mg/5g","labeler":"Endo USA, Inc.","package_description":"30 TUBE in 1 CARTON (66887-001-05) / 5 g in 1 TUBE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.78468,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":0.73654,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Testim|Testosterone","basis":"brand"},"part_b":null}, {"ndc":"00143975001","name":"TESTOSTERON ENAN 1,000 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9750-01","proprietary_name":"TESTOSTERONE ENANTHATE","nonproprietary_name":"TESTOSTERONE ENANTHATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"5 mL in 1 VIAL, MULTI-DOSE (0143-9750-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":14.4763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Enanthate|Testosterone Enanthate","basis":"generic"},"part_b":{"hcpcs":"J3121","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3121 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (5 mL in 1 VIAL, MULTI-DOSE (0143-9750-01)) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00591321630","name":"TESTOSTERONE 1% (25 MG/2.5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3216-30","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"30 PACKET in 1 CARTON (0591-3216-30) / 2.5 g in 1 PACKET (0591-3216-17)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.20385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001952","name":"TESTOSTERONE 1% (25 MG/2.5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-019-52","proprietary_name":"Testosterone Gel, 1%","nonproprietary_name":"Testosterone Gel, 1%","dosage_form":"GEL","route":"TRANSDERMAL","strength":"10 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-019-52) / 25 g in 1 PACKET","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.20385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"64380015102","name":"TESTOSTERONE 1% (25 MG/2.5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-151-02","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"25 mg/2.5g","labeler":"Strides Pharma Science Limited","package_description":"30 DOSE PACK in 1 CARTON (64380-151-02) / 2.5 g in 1 DOSE PACK (64380-151-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.20385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993095430","name":"TESTOSTERONE 1% (25 MG/2.5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-954-30","proprietary_name":"Testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"25 mg/2.5g","labeler":"Prasco Laboratories","package_description":"30 PACKET in 1 CARTON (66993-954-30) / 2.5 g in 1 PACKET","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.20385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591321730","name":"TESTOSTERONE 1% (50 MG/5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3217-30","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"30 PACKET in 1 CARTON (0591-3217-30) / 5 g in 1 PACKET (0591-3217-26)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.40611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001902","name":"TESTOSTERONE 1% (50 MG/5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-019-02","proprietary_name":"Testosterone Gel, 1%","nonproprietary_name":"Testosterone Gel, 1%","dosage_form":"GEL","route":"TRANSDERMAL","strength":"10 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"30 PACKET in 1 CARTON (21922-019-02) / 5 g in 1 PACKET","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.40611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"64380015202","name":"TESTOSTERONE 1% (50 MG/5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-152-02","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"50 mg/5g","labeler":"Strides Pharma Science Limited","package_description":"30 DOSE PACK in 1 CARTON (64380-152-02) / 5 g in 1 DOSE PACK (64380-152-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.40611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993095530","name":"TESTOSTERONE 1% (50 MG/5 G) PK","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-955-30","proprietary_name":"Testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"50 mg/5g","labeler":"Prasco Laboratories","package_description":"30 PACKET in 1 CARTON (66993-955-30) / 5 g in 1 PACKET","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.40611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591292630","name":"TESTOSTERONE 1.62% (2.5 G) PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2926-30","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"16.2 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"30 PACKET in 1 CARTON (0591-2926-30) / 2.5 g in 1 PACKET (0591-2926-25)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.81823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714096902","name":"TESTOSTERONE 1.62% (2.5 G) PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-969-02","proprietary_name":"testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"40.5 mg/2.5g","labeler":"Northstar Rx LLC","package_description":"30 PACKET in 1 CARTON (16714-969-02) / 2.5 g in 1 PACKET (16714-969-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.81823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802036665","name":"TESTOSTERONE 1.62% (2.5 G) PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-366-65","proprietary_name":"testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"40.5 mg/2.5g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-366-65) / 2.5 g in 1 PACKET (45802-366-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.81823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993095230","name":"TESTOSTERONE 1.62% (2.5 G) PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-952-30","proprietary_name":"Testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"16.2 mg/g","labeler":"Prasco Laboratories","package_description":"30 PACKET in 1 CARTON (66993-952-30) / 2.5 g in 1 PACKET (66993-952-86)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":1.81823,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591292418","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2924-18","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"16.2 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (0591-2924-18) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922003020","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-030-20","proprietary_name":"TESTOSTERONE","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"16.2 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (21922-030-20) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802075401","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-754-01","proprietary_name":"testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"16.2 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, PUMP in 1 CARTON (45802-754-01) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993095188","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-951-88","proprietary_name":"Testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"16.2 mg/g","labeler":"Prasco Laboratories","package_description":"1 BOTTLE, PUMP in 1 CARTON (66993-951-88) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180094111","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-941-11","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"16.2 mg/g","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (68180-941-11) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69238101302","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1013-2","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL, METERED","route":"TOPICAL","strength":"20.25 mg/1.25g","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (69238-1013-2) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70700011221","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-112-21","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL, METERED","route":"TRANSDERMAL","strength":"20.25 mg/1.25g","labeler":"Xiromed, LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (70700-112-21) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603026501","name":"TESTOSTERONE 1.62% GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-265-01","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL, METERED","route":"TRANSDERMAL","strength":"20.25 mg/1.25g","labeler":"Northstar Rx LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (72603-265-01) / 88 g in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.46695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714096802","name":"TESTOSTERONE 1.62%(1.25 G) PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-968-02","proprietary_name":"testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"20.25 mg/1.25g","labeler":"Northstar Rx LLC","package_description":"30 PACKET in 1 CARTON (16714-968-02) / 1.25 g in 1 PACKET (16714-968-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.64945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802028139","name":"TESTOSTERONE 1.62%(1.25 G) PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-281-39","proprietary_name":"testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"20.25 mg/1.25g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"30 PACKET in 1 CARTON (45802-281-39) / 1.25 g in 1 PACKET (45802-281-03)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.64945,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591236360","name":"TESTOSTERONE 10 MG GEL PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":4.5465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591292102","name":"TESTOSTERONE 12.5 MG/1.25 GRAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2921-02","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"10 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"2 BOTTLE, PUMP in 1 CARTON (0591-2921-02) / 75 g in 1 BOTTLE, PUMP (0591-2921-18)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.82642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00832112142","name":"TESTOSTERONE 12.5 MG/1.25 GRAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1121-42","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL, METERED","route":"TOPICAL","strength":"12.5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"2 BOTTLE, PUMP in 1 CARTON (0832-1121-42) / 60 GEL, METERED in 1 BOTTLE, PUMP (0832-1121-40)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.82642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922001947","name":"TESTOSTERONE 12.5 MG/1.25 GRAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-019-47","proprietary_name":"Testosterone Gel, 1%","nonproprietary_name":"Testosterone Gel, 1%","dosage_form":"GEL","route":"TRANSDERMAL","strength":"10 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"2 CONTAINER in 1 CARTON (21922-019-47) / 75 g in 1 CONTAINER","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.82642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"66993095344","name":"TESTOSTERONE 12.5 MG/1.25 GRAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-953-44","proprietary_name":"Testosterone","nonproprietary_name":"testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"12.5 mg/1.25g","labeler":"Prasco Laboratories","package_description":"2 BOTTLE, PUMP in 1 CARTON (66993-953-44) / 88 g in 1 BOTTLE, PUMP (66993-953-88)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.82642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00591211481","name":"TESTOSTERONE 30 MG/1.5 ML PUMP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2114-81","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"SOLUTION","route":"TOPICAL","strength":"30 mg/1.5mL","labeler":"Actavis Pharma, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (0591-2114-81) / 90 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.50763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"45802061001","name":"TESTOSTERONE 30 MG/1.5 ML PUMP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-610-01","proprietary_name":"testosterone","nonproprietary_name":"testosterone","dosage_form":"SOLUTION","route":"TOPICAL","strength":"30 mg/1.5mL","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE, PUMP in 1 CARTON (45802-610-01) / 110 mL in 1 BOTTLE, PUMP","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.50763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180094311","name":"TESTOSTERONE 30 MG/1.5 ML PUMP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-943-11","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"SOLUTION","route":"TOPICAL","strength":"30 mg/1.5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (68180-943-11) / 90 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.50763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69097036344","name":"TESTOSTERONE 30 MG/1.5 ML PUMP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-363-44","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"SOLUTION","route":"TOPICAL","strength":"30 mg/1.5mL","labeler":"Cipla USA Inc.","package_description":"1 BOTTLE in 1 CARTON (69097-363-44) / 90 mL in 1 BOTTLE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.50763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591352430","name":"TESTOSTERONE 50 MG/5 GRAM GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3524-30","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TRANSDERMAL","strength":"50 mg/5g","labeler":"Actavis Pharma, Inc.","package_description":"30 TUBE in 1 CARTON (0591-3524-30) / 5 g in 1 TUBE (0591-3524-26)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.73654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00832112005","name":"TESTOSTERONE 50 MG/5 GRAM GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1120-05","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/5g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TUBE in 1 CARTON (0832-1120-05) / 5 g in 1 TUBE (0832-1120-65)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.73654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00832112035","name":"TESTOSTERONE 50 MG/5 GRAM PKT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1120-35","proprietary_name":"Testosterone","nonproprietary_name":"Testosterone","dosage_form":"GEL","route":"TOPICAL","strength":"50 mg/5g","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 PACKET in 1 CARTON (0832-1120-35) / 5 g in 1 PACKET (0832-1120-89)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":0.40611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00409655701","name":"TESTOSTERONE CYP 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6557-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Hospira, Inc.","package_description":"1 VIAL in 1 CARTON (0409-6557-01) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":4.52814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0409-6557-01) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150027601","name":"TESTOSTERONE CYP 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-276-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"1000 mg/10mL","labeler":"Eugia US LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (55150-276-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":4.52814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (55150-276-01) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097053637","name":"TESTOSTERONE CYP 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-536-37","proprietary_name":"TESTOSTERONE CYPIONATE","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Cipla USA Inc.","package_description":"10 mL in 1 VIAL, GLASS (69097-536-37)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":4.52814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 mL in 1 VIAL, GLASS (69097-536-37)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700028822","name":"TESTOSTERONE CYP 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-288-22","proprietary_name":"testosterone cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"100 mg/mL","labeler":"Xiromed LLC","package_description":"1 VIAL in 1 CARTON (70700-288-22) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":4.52814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":1000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70700-288-22) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143900501","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9005-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 VIAL in 1 CARTON (0143-9005-01) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0143-9005-01) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143972601","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9726-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"10 mL in 1 VIAL (0143-9726-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 mL in 1 VIAL (0143-9726-01)) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409656220","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6562-20","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Hospira, Inc.","package_description":"1 VIAL in 1 CARTON (0409-6562-20) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0409-6562-20) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00574082010","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0820-10","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Padagis US LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0574-0820-10) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0574-0820-10) / 10 mL in 1 VIAL, GLASS) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00574082710","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0827-10","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Padagis US LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0574-0827-10) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0574-0827-10) / 10 mL in 1 VIAL, GLASS) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47781091022","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":null}, {"ndc":"47781091091","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-910-91","proprietary_name":"testosterone cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Alvogen Inc.","package_description":"10 VIAL, MULTI-DOSE in 1 CARTON (47781-910-91) / 10 mL in 1 VIAL, MULTI-DOSE (47781-910-22)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":2.31081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":20000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, MULTI-DOSE in 1 CARTON (47781-910-91) / 10 mL in 1 VIAL, MULTI-DOSE (47781-910-22)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"52536062510","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-625-10","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Wilshire Pharmaceuticals","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (52536-625-10) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":null}, {"ndc":"55150027801","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-278-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"2000 mg/10mL","labeler":"Eugia US LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (55150-278-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (55150-278-01) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700029022","name":"TESTOSTERONE CYP 2,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-290-22","proprietary_name":"testosterone cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Xiromed LLC","package_description":"1 VIAL in 1 CARTON (70700-290-22) / 10 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":3.58188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":2000,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2000 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70700-290-22) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143965901","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9659-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"1 mL in 1 VIAL (0143-9659-01)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 mL in 1 VIAL (0143-9659-01)) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409656201","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-6562-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Hospira, Inc.","package_description":"1 VIAL in 1 CARTON (0409-6562-01) / 1 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (0409-6562-01) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00574082001","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0820-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Padagis US LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0574-0820-01) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (0574-0820-01) / 1 mL in 1 VIAL, GLASS) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00574082701","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0827-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Padagis US LLC","package_description":"1 VIAL, GLASS in 1 CARTON (0574-0827-01) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":null}, {"ndc":"47781091193","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47781-911-93","proprietary_name":"testosterone cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Alvogen Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (47781-911-93) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (47781-911-93) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"52536062501","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-625-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Wilshire Pharmaceuticals","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (52536-625-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":null}, {"ndc":"55150027701","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-277-01","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Eugia US LLC","package_description":"1 VIAL, GLASS in 1 CARTON (55150-277-01) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (55150-277-01) / 1 mL in 1 VIAL, GLASS) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097053731","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-537-31","proprietary_name":"TESTOSTERONE CYPIONATE","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Cipla USA Inc.","package_description":"1 mL in 1 VIAL, GLASS (69097-537-31)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 mL in 1 VIAL, GLASS (69097-537-31)) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"69097080232","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-802-32","proprietary_name":"Testosterone Cypionate","nonproprietary_name":"Testosterone Cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Cipla USA Inc.","package_description":"1 VIAL, GLASS in 1 CARTON (69097-802-32) / 1 mL in 1 VIAL, GLASS","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (69097-802-32) / 1 mL in 1 VIAL, GLASS) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70700028922","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-289-22","proprietary_name":"testosterone cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"Xiromed LLC","package_description":"1 VIAL in 1 CARTON (70700-289-22) / 1 mL in 1 VIAL","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70700-289-22) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603028601","name":"TESTOSTERONE CYP 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-286-01","proprietary_name":"testosterone cypionate","nonproprietary_name":"testosterone cypionate","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR","strength":"200 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (72603-286-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":11.3924,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Testosterone Cypionate|Testosterone Cypionate","basis":"generic"},"part_b":{"hcpcs":"J1071","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1071 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (72603-286-01) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00591322126","name":"TESTOSTERONE ENAN 200 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":14.4763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155093863","name":"TETRABENAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-938-63","proprietary_name":"Tetrabenazine","nonproprietary_name":"Tetrabenazine","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"112 TABLET in 1 BOTTLE (23155-938-63)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"31722082111","name":"TETRABENAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-821-11","proprietary_name":"Tetrabenazine","nonproprietary_name":"Tetrabenazine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"12.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"112 TABLET, COATED in 1 BOTTLE (31722-821-11)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"43598039467","name":"TETRABENAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-394-67","proprietary_name":"Tetrabenazine","nonproprietary_name":"Tetrabenazine","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"112 TABLET in 1 BOTTLE (43598-394-67)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"60505388207","name":"TETRABENAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3882-7","proprietary_name":"Tetrabenazine","nonproprietary_name":"tetrabenazine","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Apotex Corp.","package_description":"112 TABLET in 1 BOTTLE (60505-3882-7)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"68094090510","name":"TETRABENAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-905-10","proprietary_name":"Tetrabenazine","nonproprietary_name":"TETRABENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Precision Dose Inc.","package_description":"112 TABLET in 1 BOTTLE, PLASTIC (68094-905-10)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"69452011721","name":"TETRABENAZINE 12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-117-21","proprietary_name":"TETRABENAZINE","nonproprietary_name":"TETRABENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"12.5 mg/1","labeler":"Bionpharma Inc.","package_description":"112 TABLET in 1 BOTTLE (69452-117-21)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":0.70194,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"23155093963","name":"TETRABENAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-939-63","proprietary_name":"Tetrabenazine","nonproprietary_name":"Tetrabenazine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"112 TABLET in 1 BOTTLE (23155-939-63)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.33628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"31722082211","name":"TETRABENAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-822-11","proprietary_name":"Tetrabenazine","nonproprietary_name":"Tetrabenazine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"112 TABLET, COATED in 1 BOTTLE (31722-822-11)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.33628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"43598039567","name":"TETRABENAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-395-67","proprietary_name":"Tetrabenazine","nonproprietary_name":"Tetrabenazine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"112 TABLET in 1 BOTTLE (43598-395-67)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.33628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"60505388307","name":"TETRABENAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3883-7","proprietary_name":"Tetrabenazine","nonproprietary_name":"tetrabenazine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Apotex Corp.","package_description":"112 TABLET in 1 BOTTLE (60505-3883-7)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.33628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"68094080510","name":"TETRABENAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68094-805-10","proprietary_name":"Tetrabenazine","nonproprietary_name":"TETRABENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Precision Dose Inc.","package_description":"112 TABLET in 1 BOTTLE, PLASTIC (68094-805-10)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.33628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"69452011821","name":"TETRABENAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-118-21","proprietary_name":"TETRABENAZINE","nonproprietary_name":"TETRABENAZINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Bionpharma Inc.","package_description":"112 TABLET in 1 BOTTLE (69452-118-21)","pharm_classes":["Vesicular Monoamine Transporter 2 Inhibitor [EPC]","Vesicular Monoamine Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.33628,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetrabenazine|Tetrabenazine","basis":"generic"},"part_b":null}, {"ndc":"70069059601","name":"TETRACAINE 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-596-01","proprietary_name":"Tetracaine Hydrochloride","nonproprietary_name":"Tetracaine Hydrochloride","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-596-01) / 5 mL in 1 BOTTLE","pharm_classes":["Ester Local Anesthetic [EPC]","Esters [CS]","Local Anesthesia [PE]"]},"nadac":{"value":4.32983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260092005","name":"TETRACAINE 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-920-05","proprietary_name":"Tetracaine Hydrochloride","nonproprietary_name":"Tetracaine Hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-920-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Ester Local Anesthetic [EPC]","Esters [CS]","Local Anesthesia [PE]"]},"nadac":{"value":4.32983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591247401","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2474-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-2474-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155076601","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-766-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-766-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"51991090601","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-906-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (51991-906-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60219152201","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1522-1","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE (60219-1522-1)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135022501","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-225-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"tetracycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 CAPSULE in 1 BOTTLE (62135-225-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135022560","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-225-60","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"tetracycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 CAPSULE in 1 BOTTLE (62135-225-60)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"69238152201","name":"TETRACYCLINE 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1522-1","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE (69238-1522-1)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.24722,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00591247501","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2475-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (0591-2475-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"23155076701","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-767-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 CAPSULE in 1 BOTTLE (23155-767-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"51991090701","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-907-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (51991-907-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"60219152301","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1523-1","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE (60219-1523-1)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135026601","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-266-01","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"tetracycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"100 CAPSULE in 1 BOTTLE (62135-266-01)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"62135026660","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-266-60","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"tetracycline hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC.","package_description":"60 CAPSULE in 1 BOTTLE (62135-266-60)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"69238152301","name":"TETRACYCLINE 500 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-1523-1","proprietary_name":"Tetracycline Hydrochloride","nonproprietary_name":"Tetracycline Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"500 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE (69238-1523-1)","pharm_classes":["Tetracycline-class Antimicrobial [EPC]","Tetracyclines [CS]"]},"nadac":{"value":0.62654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tetracycline HCl|Tetracycline HCl","basis":"generic"},"part_b":null}, {"ndc":"00178045501","name":"TEXACORT 2.5% SOLUTION","unit":"ML","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0178-0455-01","proprietary_name":"Texacort","nonproprietary_name":"Hydrocortisone","dosage_form":"SOLUTION","route":"TOPICAL","strength":"25 mg/mL","labeler":"Mission Pharmacal Company","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (0178-0455-01) / 30 mL in 1 BOTTLE, WITH APPLICATOR","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.22113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Texacort|Hydrocortisone","basis":"brand"},"part_b":null}, {"ndc":"70199001730","name":"THALITONE 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70199-017-30","proprietary_name":"Thalitone","nonproprietary_name":"Chlorthalidone","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Casper Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (70199-017-30)","pharm_classes":["Increased Diuresis [PE]","Thiazide-like Diuretic [EPC]"]},"nadac":{"value":3.54226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thalitone|Chlorthalidone","basis":"brand"},"part_b":null}, {"ndc":"52244010010","name":"THEO-24 ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52244-100-10","proprietary_name":"Theo-24","nonproprietary_name":"theophylline anhydrous","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"ENDO USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52244-100-10)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":3.81613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52244020010","name":"THEO-24 ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52244-200-10","proprietary_name":"Theo-24","nonproprietary_name":"theophylline anhydrous","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"ENDO USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52244-200-10)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":5.66778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52244030010","name":"THEO-24 ER 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52244-300-10","proprietary_name":"Theo-24","nonproprietary_name":"theophylline anhydrous","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"ENDO USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52244-300-10)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":6.95288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52244040010","name":"THEO-24 ER 400 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52244-400-10","proprietary_name":"Theo-24","nonproprietary_name":"theophylline anhydrous","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"ENDO USA, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52244-400-10)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":9.79324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27808003301","name":"THEOPHYLLINE 80 MG/15 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"27808-033-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"SOLUTION","route":"ORAL","strength":"80 mg/15mL","labeler":"Cranbury Pharmaceuticals, LLC","package_description":"473 mL in 1 BOTTLE (27808-033-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.11183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Theophylline|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"62135055647","name":"THEOPHYLLINE 80 MG/15 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62135-556-47","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"SOLUTION","route":"ORAL","strength":"80 mg/15mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-556-47)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.11183,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Theophylline|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"00480331001","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3310-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0480-3310-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"23155074101","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-741-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (23155-741-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"31722007701","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-077-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-077-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"60219204501","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2045-1","proprietary_name":"theophylline","nonproprietary_name":"theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (60219-2045-1)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"62135045790","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-457-90","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (62135-457-90)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"62332002531","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-025-31","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-025-31)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"64380024301","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-243-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64380-243-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"68462072101","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-721-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68462-721-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"69315022601","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-226-01","proprietary_name":"THEOPHYLLINE","nonproprietary_name":"THEOPHYLLINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69315-226-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"69452026720","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-267-20","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Bionpharma Inc.,","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69452-267-20)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"72578017301","name":"THEOPHYLLINE ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-173-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72578-173-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.32954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"42858070101","name":"THEOPHYLLINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.99526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"68462038001","name":"THEOPHYLLINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-380-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68462-380-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.99526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"69367041401","name":"THEOPHYLLINE ER 400 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-414-01","proprietary_name":"Theophylline (Anhydrous)","nonproprietary_name":"Theophylline Anhydrous","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"400 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-414-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":0.99526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"00480330901","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-3309-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (0480-3309-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"23155074201","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-742-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (23155-742-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"31722007801","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-078-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-078-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"60219204601","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2046-1","proprietary_name":"theophylline","nonproprietary_name":"theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (60219-2046-1)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"62332002631","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-026-31","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (62332-026-31)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"64380024401","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-244-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (64380-244-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"68462072201","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-722-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68462-722-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"69315022701","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-227-01","proprietary_name":"THEOPHYLLINE","nonproprietary_name":"THEOPHYLLINE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Leading Pharma, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69315-227-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"72578017401","name":"THEOPHYLLINE ER 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-174-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"450 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (72578-174-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.09918,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"68462035601","name":"THEOPHYLLINE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"68462-356-01","proprietary_name":"Theophylline","nonproprietary_name":"Theophylline","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68462-356-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.39516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"69367041501","name":"THEOPHYLLINE ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69367-415-01","proprietary_name":"Theophylline (Anhydrous)","nonproprietary_name":"Theophylline Anhydrous","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-415-01)","pharm_classes":["Methylxanthine [EPC]","Xanthines [CS]"]},"nadac":{"value":1.39516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-14","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Theophylline ER|Theophylline Anhydrous","basis":"generic"},"part_b":null}, {"ndc":"00904525944","name":"THERA-GEL 0.5% SHAMPOO","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-5259-44","proprietary_name":"Thera-Gel","nonproprietary_name":"Coal Tar","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"5 mg/mL","labeler":"Major Pharmaceuticals","package_description":"251 mL in 1 BOTTLE, PLASTIC (0904-5259-44)"},"nadac":{"value":0.00875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000055001","name":"THERAPEUTIC 3% DANDRUFF SHMP","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0550-1","proprietary_name":"Leader Therapeutic Dandruff Anti-Dandruff, anti-seborrheic dematitis and anti-psoriasis","nonproprietary_name":"Salicylic Acid","dosage_form":"SHAMPOO","route":"TOPICAL","strength":"30 mg/mL","labeler":"Cardinal Health, 110 dba LEADER","package_description":"133 mL in 1 BOTTLE, PLASTIC (70000-0550-1)"},"nadac":{"value":0.02188,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00641622825","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0641-6228-25","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0641-6228-25) / 2 mL in 1 VIAL (0641-6228-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0641-6228-25) / 2 mL in 1 VIAL (0641-6228-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"23155093341","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-933-41","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"25 VIAL in 1 CARTON (23155-933-41) / 2 mL in 1 VIAL (23155-933-31)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (23155-933-41) / 2 mL in 1 VIAL (23155-933-31)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021050002","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-500-02","proprietary_name":"thiamine hydrochloride","nonproprietary_name":"thiamine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-500-02) / 2 mL in 1 VIAL"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (25021-500-02) / 2 mL in 1 VIAL) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"31722036332","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-363-32","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (31722-363-32) / 2 mL in 1 VIAL, MULTI-DOSE (31722-363-31)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598005025","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-050-25","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"thiamine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (43598-050-25) / 2 mL in 1 VIAL, MULTI-DOSE (43598-050-11)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (43598-050-25) / 2 mL in 1 VIAL, MULTI-DOSE (43598-050-11)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"55150027325","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-273-25","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"200 mg/2mL","labeler":"Eugia US LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (55150-273-25) / 2 mL in 1 VIAL, MULTI-DOSE (55150-273-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (55150-273-25) / 2 mL in 1 VIAL, MULTI-DOSE (55150-273-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323001302","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-013-02","proprietary_name":"Thiamine","nonproprietary_name":"THIAMINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-013-02) / 2 mL in 1 VIAL, MULTI-DOSE (63323-013-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-013-02) / 2 mL in 1 VIAL, MULTI-DOSE (63323-013-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323001309","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-013-09","proprietary_name":"Thiamine","nonproprietary_name":"THIAMINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-013-09) / 2 mL in 1 VIAL, MULTI-DOSE (63323-013-21)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-013-09) / 2 mL in 1 VIAL, MULTI-DOSE (63323-013-21)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323001326","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-013-26","proprietary_name":"Thiamine","nonproprietary_name":"THIAMINE HYDROCHLORIDE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-013-26) / 2 mL in 1 VIAL, MULTI-DOSE (63323-013-41)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-013-26) / 2 mL in 1 VIAL, MULTI-DOSE (63323-013-41)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65145012925","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-129-25","proprietary_name":"Thiamine","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Caplin Steriles Limited","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (65145-129-25) / 2 mL in 1 VIAL, MULTI-DOSE (65145-129-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (65145-129-25) / 2 mL in 1 VIAL, MULTI-DOSE (65145-129-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457019602","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-196-02","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"thiamine hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (67457-196-02) / 2 mL in 1 VIAL, MULTI-DOSE (67457-196-00)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (67457-196-02) / 2 mL in 1 VIAL, MULTI-DOSE (67457-196-00)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72266026025","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-260-25","proprietary_name":"Thiamine Hydrochloride","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"25 VIAL in 1 CARTON (72266-260-25) / 2 mL in 1 VIAL (72266-260-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (72266-260-25) / 2 mL in 1 VIAL (72266-260-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72485050725","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-507-25","proprietary_name":"Thiamine","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72485-507-25) / 2 mL in 1 VIAL, MULTI-DOSE (72485-507-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (72485-507-25) / 2 mL in 1 VIAL, MULTI-DOSE (72485-507-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603013925","name":"THIAMINE 200 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-139-25","proprietary_name":"Thiamine","nonproprietary_name":"Thiamine Hydrochloride","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"100 mg/mL","labeler":"NorthStar Rx LLC","package_description":"25 VIAL, MULTI-DOSE in 1 CARTON (72603-139-25) / 2 mL in 1 VIAL, MULTI-DOSE (72603-139-01)"},"nadac":{"value":2.24683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3411","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3411 (100 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 CARTON (72603-139-25) / 2 mL in 1 VIAL, MULTI-DOSE (72603-139-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00378061201","name":"THIORIDAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0612-01","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0612-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.39394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079056501","name":"THIORIDAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.39394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079056520","name":"THIORIDAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-565-20","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-565-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-565-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.39394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135093490","name":"THIORIDAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-934-90","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"Thioridazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-934-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.39394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378061801","name":"THIORIDAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0618-01","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0618-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.83026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079058001","name":"THIORIDAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079058020","name":"THIORIDAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-580-20","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-580-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-580-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.83026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135093990","name":"THIORIDAZINE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-939-90","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"Thioridazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-939-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.83026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378061401","name":"THIORIDAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0614-01","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0614-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.57127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079056601","name":"THIORIDAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079056620","name":"THIORIDAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-566-20","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-566-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-566-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.57127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135093690","name":"THIORIDAZINE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-936-90","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"Thioridazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62135-936-90)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.57127,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-10-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378061601","name":"THIORIDAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-0616-01","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0616-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.72197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079056701","name":"THIORIDAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.72197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079056720","name":"THIORIDAZINE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-567-20","proprietary_name":"Thioridazine Hydrochloride","nonproprietary_name":"thioridazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-567-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-567-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.72197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thioridazine HCl|Thioridazine HCl","basis":"generic"},"part_b":null}, {"ndc":"60219167301","name":"THIOTHIXENE 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60219-1673-1","proprietary_name":"thiothixene","nonproprietary_name":"thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (60219-1673-1)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.65317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"70954001410","name":"THIOTHIXENE 1 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70954-014-10","proprietary_name":"Thiothixene","nonproprietary_name":"Thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"1 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-014-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.65317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"60219167601","name":"THIOTHIXENE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1676-1","proprietary_name":"thiothixene","nonproprietary_name":"thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (60219-1676-1)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.71654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"70954001710","name":"THIOTHIXENE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-017-10","proprietary_name":"Thiothixene","nonproprietary_name":"Thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-017-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.71654,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"60219167401","name":"THIOTHIXENE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1674-1","proprietary_name":"thiothixene","nonproprietary_name":"thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (60219-1674-1)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.76526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"70954001510","name":"THIOTHIXENE 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-015-10","proprietary_name":"Thiothixene","nonproprietary_name":"Thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-015-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":0.76526,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"60219167501","name":"THIOTHIXENE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-1675-1","proprietary_name":"thiothixene","nonproprietary_name":"thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (60219-1675-1)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.38958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"70954001610","name":"THIOTHIXENE 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-016-10","proprietary_name":"Thiothixene","nonproprietary_name":"Thiothixene","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70954-016-10)","pharm_classes":["Typical Antipsychotic [EPC]"]},"nadac":{"value":1.38958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thiothixene|Thiothixene","basis":"generic"},"part_b":null}, {"ndc":"58657013390","name":"THRIVITE RX TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Thrivite Rx|Prenatal Vit,Calc76/Iron/Folic","basis":"brand"},"part_b":null}, {"ndc":"52652195002","name":"THYQUIDITY 100 MCG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":1.38035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Thyquidity|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"82685036002","name":"THYQUIDITY 100 MCG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82685-360-02","proprietary_name":"THYQUIDITY","nonproprietary_name":"Levothyroxine Sodium","dosage_form":"SOLUTION","route":"ORAL","strength":"100 ug/5mL","labeler":"Oliva Therapeutics, LLC","package_description":"2 BOTTLE, GLASS in 1 CARTON (82685-360-02) / 100 mL in 1 BOTTLE, GLASS","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":1.38035,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Thyquidity|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"62559074401","name":"THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-744-01","proprietary_name":"Thyroid","nonproprietary_name":"Thyroid","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-744-01)"},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680016900","name":"THYROID 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-169-00","proprietary_name":"Thyroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Vitruvias Therapeutics","package_description":"100 TABLET in 1 BOTTLE (69680-169-00)"},"nadac":{"value":1.19755,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559074001","name":"THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-740-01","proprietary_name":"Thyroid","nonproprietary_name":"Thyroid","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-740-01)"},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680016500","name":"THYROID 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-165-00","proprietary_name":"Thyroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Vitruvias Therapeutics","package_description":"100 TABLET in 1 BOTTLE (69680-165-00)"},"nadac":{"value":0.52476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559074101","name":"THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-741-01","proprietary_name":"Thyroid","nonproprietary_name":"Thyroid","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-741-01)"},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680016600","name":"THYROID 30 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-166-00","proprietary_name":"Thyroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Vitruvias Therapeutics","package_description":"100 TABLET in 1 BOTTLE (69680-166-00)"},"nadac":{"value":0.59171,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559074201","name":"THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-742-01","proprietary_name":"Thyroid","nonproprietary_name":"Thyroid","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-742-01)"},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680016700","name":"THYROID 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-167-00","proprietary_name":"Thyroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Vitruvias Therapeutics","package_description":"100 TABLET in 1 BOTTLE (69680-167-00)"},"nadac":{"value":0.67098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559074301","name":"THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-743-01","proprietary_name":"Thyroid","nonproprietary_name":"Thyroid","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (62559-743-01)"},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69680016800","name":"THYROID 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-168-00","proprietary_name":"Thyroid","nonproprietary_name":"THYROID","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Vitruvias Therapeutics","package_description":"100 TABLET in 1 BOTTLE (69680-168-00)"},"nadac":{"value":1.0057,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382074516","name":"TIADYLT ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-745-16","proprietary_name":"TIADYLT ER","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-745-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.10539,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiadylt ER|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"68382074616","name":"TIADYLT ER 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-746-16","proprietary_name":"TIADYLT ER","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-746-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.15589,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiadylt ER|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"68382074716","name":"TIADYLT ER 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-747-16","proprietary_name":"TIADYLT ER","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-747-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.15394,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiadylt ER|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"68382074816","name":"TIADYLT ER 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-748-16","proprietary_name":"TIADYLT ER","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-748-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.26165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiadylt ER|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"68382074916","name":"TIADYLT ER 360 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-749-16","proprietary_name":"TIADYLT ER","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-749-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.34323,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiadylt ER|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"68382075016","name":"TIADYLT ER 420 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-750-16","proprietary_name":"TIADYLT ER","nonproprietary_name":"diltiazem hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"420 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-750-16)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.99395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiadylt ER|Diltiazem HCl","basis":"brand"},"part_b":null}, {"ndc":"00093807256","name":"TIAGABINE HCL 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-8072-56","proprietary_name":"Tiagabine Hydrochloride","nonproprietary_name":"Tiagabine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"12 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-8072-56)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.61904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiagabine HCl|Tiagabine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205008630","name":"TIAGABINE HCL 12 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-086-30","proprietary_name":"Tiagabine Hydrochloride","nonproprietary_name":"Tiagabine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"12 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-086-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.61904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiagabine HCl|Tiagabine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093503056","name":"TIAGABINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5030-56","proprietary_name":"Tiagabine Hydrochloride","nonproprietary_name":"Tiagabine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5030-56)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.62176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiagabine HCl|Tiagabine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205008430","name":"TIAGABINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-084-30","proprietary_name":"Tiagabine Hydrochloride","nonproprietary_name":"Tiagabine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-084-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.62176,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiagabine HCl|Tiagabine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093503156","name":"TIAGABINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-5031-56","proprietary_name":"Tiagabine Hydrochloride","nonproprietary_name":"Tiagabine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-5031-56)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.52464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiagabine HCl|Tiagabine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205008530","name":"TIAGABINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-085-30","proprietary_name":"Tiagabine Hydrochloride","nonproprietary_name":"Tiagabine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-085-30)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.52464,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiagabine HCl|Tiagabine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378221491","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2214-91","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2214-91)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480268806","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2688-06","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0480-2688-06)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788015760","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-157-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"60 TABLET in 1 BOTTLE (11788-157-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342043109","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-431-09","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-431-09)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598062960","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-629-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"60 TABLET in 1 BOTTLE (43598-629-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228052160","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-521-60","proprietary_name":"ticagrelor","nonproprietary_name":"ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"ScieGen Pharmaceuticals INC","package_description":"60 TABLET in 1 BOTTLE (50228-521-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505445306","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4453-6","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4453-6)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687093511","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687093521","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-935-21","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-935-21) / 1 TABLET in 1 BLISTER PACK (60687-935-11)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332050060","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-500-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-500-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877052260","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-522-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (67877-522-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452050817","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-508-17","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"BIONPHARMA INC.","package_description":"60 TABLET in 1 BOTTLE (69452-508-17)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205040601","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-406-01","proprietary_name":"TICAGRELOR","nonproprietary_name":"TICAGRELOR","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET in 1 BOTTLE (72205-406-01)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001706","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-017-06","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Oryza Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (72516-017-06)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282058460","name":"TICAGRELOR 60 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-584-60","proprietary_name":"TICAGRELOR","nonproprietary_name":"TICAGRELOR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"60 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-584-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.28214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00378221591","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2215-91","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2215-91)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00480269506","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2695-06","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0480-2695-06)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788015801","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-158-01","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"100 TABLET in 1 BOTTLE (11788-158-01)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"11788015860","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11788-158-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"AiPing Pharmaceutical, Inc","package_description":"60 TABLET in 1 BOTTLE (11788-158-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342043209","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-432-09","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-432-09)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42658011503","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42658-115-03","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Hisun Pharmaceuticals USA, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (42658-115-03)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43598048060","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-480-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Dr. Reddys Laboratories Inc","package_description":"60 TABLET in 1 BOTTLE (43598-480-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50228052260","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50228-522-60","proprietary_name":"ticagrelor","nonproprietary_name":"ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"ScieGen Pharmaceuticals INC","package_description":"60 TABLET in 1 BOTTLE (50228-522-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268082601","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-826-01","proprietary_name":"TICAGRELOR","nonproprietary_name":"TICAGRELOR","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"AvPAK","package_description":"100 BLISTER PACK in 1 BOX (50268-826-01) / 1 TABLET in 1 BLISTER PACK (50268-826-11)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268082611","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505445206","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4452-6","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET in 1 BOTTLE (60505-4452-6)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687092811","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687092857","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-928-57","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"American Health Packaging","package_description":"60 BLISTER PACK in 1 CARTON (60687-928-57) / 1 TABLET in 1 BLISTER PACK (60687-928-11)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332024160","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-241-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62332-241-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877049105","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-491-05","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"500 TABLET in 1 BOTTLE (67877-491-05)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67877049160","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-491-60","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 TABLET in 1 BOTTLE (67877-491-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452050917","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-509-17","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"BIONPHARMA INC.","package_description":"60 TABLET in 1 BOTTLE (69452-509-17)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205036860","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-368-60","proprietary_name":"TICAGRELOR","nonproprietary_name":"TICAGRELOR","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET in 1 BOTTLE (72205-368-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205036891","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-368-91","proprietary_name":"TICAGRELOR","nonproprietary_name":"TICAGRELOR","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (72205-368-91)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72516001806","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72516-018-06","proprietary_name":"Ticagrelor","nonproprietary_name":"Ticagrelor","dosage_form":"TABLET","route":"ORAL","strength":"90 mg/1","labeler":"Oryza Pharmaceuticals, Inc.","package_description":"60 TABLET in 1 BOTTLE (72516-018-06)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282055060","name":"TICAGRELOR 90 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-550-60","proprietary_name":"TICAGRELOR","nonproprietary_name":"TICAGRELOR","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"90 mg/1","labeler":"Exelan Pharmaceuticals, Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-550-60)","pharm_classes":["Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Platelet Aggregation [PE]","P-Glycoprotein Inhibitors [MoA]","P2Y12 Platelet Inhibitor [EPC]","P2Y12 Receptor Antagonists [MoA]"]},"nadac":{"value":0.25291,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907008628","name":"TILIA FE 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-086-28","proprietary_name":"Tilia Fe","nonproprietary_name":"NdAc and EE Tablets and Ferrous Fumarate Tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-086-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.7459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907008632","name":"TILIA FE 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-086-32","proprietary_name":"Tilia Fe","nonproprietary_name":"NdAc and EE Tablets and Ferrous Fumarate Tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"3 BLISTER PACK in 1 CARTON (75907-086-32) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.7459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24208081825","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021000805","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-008-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION, GEL FORMING / DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (25021-008-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598074711","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-747-11","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.25%","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.25%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-747-11) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"61314022405","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-224-05","proprietary_name":"Timolol GFS","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION, GEL FORMING / DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Sandoz Inc","package_description":"5 mL in 1 BOTTLE (61314-224-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332054505","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-545-05","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution, 0.25%","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution, 0.25%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-545-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"72266019901","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-199-01","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution","dosage_form":"SOLUTION, GEL FORMING / DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"FOSUN PHARMA USA INC","package_description":"1 BOTTLE in 1 CARTON (72266-199-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"72603016201","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-162-01","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.25%","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.25%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-162-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"82260081825","name":"TIMOLOL 0.25% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-818-25","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DISPENSING in 1 CARTON (82260-818-25) / 5 mL in 1 BOTTLE, DISPENSING","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.37609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069051601","name":"TIMOLOL 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-516-01","proprietary_name":"Timolol hemihydrate","nonproprietary_name":"Timolol hemihydrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-516-01) / 2.5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":21.80573,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069051701","name":"TIMOLOL 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-517-01","proprietary_name":"Timolol hemihydrate","nonproprietary_name":"Timolol hemihydrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-517-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":22.28973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260004505","name":"TIMOLOL 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-045-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-045-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":22.28973,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260004525","name":"TIMOLOL 0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-045-25","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-045-25) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":21.80573,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069069601","name":"TIMOLOL 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-696-01","proprietary_name":"Timolol Hemihydrate","nonproprietary_name":"Timolol Hemihydrate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-696-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":21.6742,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208081905","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":null,"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021000905","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-009-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION, GEL FORMING / DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (25021-009-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43598074811","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-748-11","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.5%","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.5%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Dr. Reddy's Laboratories, Inc.","package_description":"1 BOTTLE in 1 CARTON (43598-748-11) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"62332054605","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-546-05","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution, 0.5%","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution, 0.5%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-546-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"72266020001","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72266-200-01","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution","dosage_form":"SOLUTION, GEL FORMING / DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"FOSUN PHARMA USA INC","package_description":"1 BOTTLE in 1 CARTON (72266-200-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"72603016301","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-163-01","proprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.5%","nonproprietary_name":"Timolol Maleate Ophthalmic Gel Forming Solution 0.5%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE in 1 CARTON (72603-163-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"82260081905","name":"TIMOLOL 0.5% GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-819-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DISPENSING in 1 CARTON (82260-819-05) / 5 mL in 1 BOTTLE, DISPENSING","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022505","name":"TIMOLOL 0.5% GFS GEL-SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-225-05","proprietary_name":"Timolol GFS","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION, GEL FORMING / DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"5 mL in 1 BOTTLE (61314-225-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":8.30197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Timolol Maleate*|Timolol Maleate","basis":"generic"},"part_b":null}, {"ndc":"50742028760","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-287-60","proprietary_name":"Timolol Maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3.4 mg/mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"15 POUCH in 1 CARTON (50742-287-60) / 4 CONTAINER in 1 POUCH (50742-287-04) / .3 mL in 1 CONTAINER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":6.10159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60758080205","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-802-05","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-802-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60758080210","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-802-10","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-802-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022605","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-226-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-226-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022610","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-226-10","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-226-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022615","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-226-15","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-226-15) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.60023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980051301","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-513-01","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-513-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980051305","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-513-05","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-513-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980051315","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-513-15","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-513-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.60023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069070101","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-701-01","proprietary_name":"Timolol maleate","nonproprietary_name":"Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-701-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069070201","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-702-01","proprietary_name":"Timolol maleate","nonproprietary_name":"Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-702-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069070301","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-703-01","proprietary_name":"Timolol maleate","nonproprietary_name":"Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-703-01) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.60023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065415","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-654-15","proprietary_name":"timolol maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-654-15) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64351,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065530","name":"TIMOLOL MALEATE 0.25% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-655-30","proprietary_name":"timolol maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"2.5 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-655-30) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.64657,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571039871","name":"TIMOLOL MALEATE 0.5% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-398-71","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"6.8 mg/mL","labeler":"Micro Labs Limited","package_description":"6 POUCH in 1 CARTON (42571-398-71) / 10 VIAL in 1 POUCH / .3 mL in 1 VIAL","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.25546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50742028860","name":"TIMOLOL MALEATE 0.5% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-288-60","proprietary_name":"Timolol Maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"6.8 mg/mL","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"15 POUCH in 1 CARTON (50742-288-60) / 4 CONTAINER in 1 POUCH (50742-288-04) / .3 mL in 1 CONTAINER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.25546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69918060160","name":"TIMOLOL MALEATE 0.5% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-601-60","proprietary_name":"Timoptic in Ocudose","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Nordic Pharma, Inc.","package_description":"60 POUCH in 1 CARTON (69918-601-60) / 10 CONTAINER in 1 POUCH / .3 mL in 1 CONTAINER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.25546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"82260049605","name":"TIMOLOL MALEATE 0.5% EYE DROP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-496-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"6.8 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"6 POUCH in 1 CARTON (82260-496-05) / 10 CONTAINER in 1 POUCH / .3 mL in 1 CONTAINER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.25546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571040421","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-404-21","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate Ophthalmic","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Micro Labs Limited","package_description":"5 mL in 1 BOTTLE (42571-404-21)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571040488","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-404-88","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate Ophthalmic","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Micro Labs Limited","package_description":"10 mL in 1 BOTTLE (42571-404-88)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60758080105","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-801-05","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-801-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60758080110","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60758-801-10","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Pacific Pharma, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (60758-801-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022705","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-227-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-227-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022710","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-227-10","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-227-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314022715","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-227-15","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-227-15) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980051401","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-514-01","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-514-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980051405","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-514-05","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-514-05) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"64980051415","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-514-15","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BOTTLE in 1 CARTON (64980-514-15) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145015201","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-152-01","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE in 1 CARTON (65145-152-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145015301","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-153-01","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE in 1 CARTON (65145-153-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145015401","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-154-01","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Caplin Steriles Limited","package_description":"1 BOTTLE in 1 CARTON (65145-154-01) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032505","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-325-05","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"TIMOLOL MALEATE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"5 mL in 1 BOTTLE, PLASTIC (69315-325-05)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032510","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-325-10","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"TIMOLOL MALEATE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"10 mL in 1 BOTTLE, PLASTIC (69315-325-10)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69315032515","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69315-325-15","proprietary_name":"TIMOLOL MALEATE","nonproprietary_name":"TIMOLOL MALEATE","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Leading Pharma, LLC","package_description":"15 mL in 1 BOTTLE, PLASTIC (69315-325-15)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069070601","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-706-01","proprietary_name":"Timolol maleate","nonproprietary_name":"Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-706-01) / 5 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069070701","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-707-01","proprietary_name":"Timolol maleate","nonproprietary_name":"Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-707-01) / 10 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069070801","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-708-01","proprietary_name":"Timolol maleate","nonproprietary_name":"Timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-708-01) / 15 mL in 1 BOTTLE","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065615","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-656-15","proprietary_name":"timolol maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-656-15) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70756065730","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-657-30","proprietary_name":"timolol maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Lifestar Pharma LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (70756-657-30) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":0.71967,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603054001","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-540-01","proprietary_name":"timolol maleate","nonproprietary_name":"timolol maleate","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (72603-540-01) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260081305","name":"TIMOLOL MALEATE 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-813-05","proprietary_name":"Timolol Maleate","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DISPENSING in 1 CARTON (82260-813-05) / 5 mL in 1 BOTTLE, DISPENSING","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.046,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"24208049968","name":"TIMOPTIC 0.5% OCUDOSE DROP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-499-68","proprietary_name":"Timoptic in Ocudose","nonproprietary_name":"Timolol Maleate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"6.8 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"6 POUCH in 1 CARTON (24208-499-68) / 10 CONTAINER in 1 POUCH / .3 mL in 1 CONTAINER","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":10.32362,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.25546,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799020701","name":"TINIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-207-01","proprietary_name":"Tinidazole","nonproprietary_name":"Tinidazole","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"40 TABLET in 1 BOTTLE (42799-207-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":1.50324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"62135083420","name":"TINIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-834-20","proprietary_name":"Tinidazole","nonproprietary_name":"Tinidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (62135-834-20)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":1.50324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"64980042602","name":"TINIDAZOLE 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-426-02","proprietary_name":"Tindazole","nonproprietary_name":"Tinidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64980-426-02)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":1.50324,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"42799020801","name":"TINIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-208-01","proprietary_name":"Tinidazole","nonproprietary_name":"Tinidazole","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"20 TABLET in 1 BOTTLE (42799-208-01)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.35434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"44523045012","name":"TINIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44523-450-12","proprietary_name":"Tinidazole","nonproprietary_name":"tinidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BioComp Pharma, Inc.","package_description":"12 TABLET, FILM COATED in 1 BOTTLE (44523-450-12)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.35434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"44523045020","name":"TINIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"44523-450-20","proprietary_name":"Tinidazole","nonproprietary_name":"tinidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"BioComp Pharma, Inc.","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (44523-450-20)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.35434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"62135083520","name":"TINIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-835-20","proprietary_name":"Tinidazole","nonproprietary_name":"Tinidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"20 TABLET, FILM COATED in 1 BOTTLE (62135-835-20)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.35434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"64980042712","name":"TINIDAZOLE 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-427-12","proprietary_name":"Tindazole","nonproprietary_name":"Tinidazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"12 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64980-427-12)","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":2.35434,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tinidazole|Tinidazole","basis":"generic"},"part_b":null}, {"ndc":"00113042654","name":"TIOCONAZOLE 1 6.5% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0113-0426-54","proprietary_name":"good sense tioconazole 1","nonproprietary_name":"Tioconazole","dosage_form":"OINTMENT","route":"VAGINAL","strength":"6.5 g/100g","labeler":"L. Perrigo Company","package_description":"1 POUCH in 1 CARTON (0113-0426-54) / 1 APPLICATOR in 1 POUCH / 4.6 g in 1 APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.40894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000035701","name":"TIOCONAZOLE-1 6.5% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0357-1","proprietary_name":"Leader Tioconazole 1","nonproprietary_name":"Tioconazole","dosage_form":"OINTMENT","route":"VAGINAL","strength":"6.5 g/100g","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 APPLICATOR in 1 CARTON (70000-0357-1) / 4.6 g in 1 APPLICATOR","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]"]},"nadac":{"value":2.40894,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68180096412","name":"TIOTROPIUM 18 MCG CAP-INHALER","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-964-12","proprietary_name":"Tiotropium Bromide","nonproprietary_name":"Tiotropium Bromide","dosage_form":"CAPSULE","route":"ORAL; RESPIRATORY (INHALATION)","strength":"18 ug/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-964-12) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":11.81093,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tiotropium Bromide|Tiotropium Bromide","basis":"generic"},"part_b":null}, {"ndc":"49702022813","name":"TIVICAY 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49702-228-13","proprietary_name":"Tivicay","nonproprietary_name":"dolutegravir sodium","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"ViiV Healthcare Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49702-228-13)","pharm_classes":["HIV Integrase Inhibitors [MoA]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":77.63562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tivicay|Dolutegravir Sodium","basis":"brand"},"part_b":null}, {"ndc":"00591278886","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2788-86","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"150 CAPSULE, GELATIN COATED in 1 BOTTLE, PLASTIC (0591-2788-86)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742022415","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-224-15","proprietary_name":"TIZANIDINE HYDROCHLORIDE","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"150 CAPSULE in 1 BOTTLE, PLASTIC (50742-224-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651031477","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-314-77","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"150 CAPSULE in 1 BOTTLE (59651-314-77)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505264807","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2648-7","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"150 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-2648-7)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049141","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-491-41","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"150 CAPSULE in 1 BOTTLE (62332-491-41)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877061015","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-610-15","proprietary_name":"Tizanidne hydrochloride","nonproprietary_name":"Tizanidne hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"150 CAPSULE in 1 BOTTLE (67877-610-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710111108","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1111-8","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"150 CAPSULE in 1 BOTTLE (70710-1111-8)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888000115","name":"TIZANIDINE HCL 2 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-001-15","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"2 mg/1","labeler":"Advagen Pharma Limited","package_description":"150 CAPSULE in 1 BOTTLE (72888-001-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714017101","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-171-01","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"NorthStar Rx LLC","package_description":"150 TABLET in 1 BOTTLE (16714-171-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300016810","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-168-10","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-168-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300016815","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-168-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"150 TABLET in 1 BOTTLE, PLASTIC (29300-168-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268075911","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268075915","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-759-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-759-15) / 1 TABLET in 1 BLISTER PACK (50268-759-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111017910","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-179-10","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (55111-179-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111017915","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-179-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"150 TABLET in 1 BOTTLE (55111-179-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664050218","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-502-18","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (57664-502-18)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664050289","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-502-89","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"150 TABLET in 1 BOTTLE (57664-502-89)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505025102","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0251-2","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0251-2)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505025103","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0251-3","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Apotex Corp.","package_description":"150 TABLET in 1 BOTTLE (60505-0251-3)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065810","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-658-10","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-658-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065815","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-658-15","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"150 TABLET in 1 BOTTLE (64980-658-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877061315","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-613-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"150 TABLET in 1 BOTTLE (67877-613-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084077525","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-775-25","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-775-25) / 1 TABLET in 1 BLISTER PACK (68084-775-95)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084077595","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578009610","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-096-10","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (72578-096-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578009621","name":"TIZANIDINE HCL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-096-21","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"150 TABLET in 1 BOTTLE (72578-096-21)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591278986","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2789-86","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"4 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"150 CAPSULE, GELATIN COATED in 1 BOTTLE, PLASTIC (0591-2789-86)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742022515","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-225-15","proprietary_name":"TIZANIDINE HYDROCHLORIDE","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"150 CAPSULE in 1 BOTTLE, PLASTIC (50742-225-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651031577","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-315-77","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"150 CAPSULE in 1 BOTTLE (59651-315-77)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505264907","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2649-7","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"150 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-2649-7)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049241","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-492-41","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"150 CAPSULE in 1 BOTTLE (62332-492-41)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877061115","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-611-15","proprietary_name":"Tizanidne hydrochloride","nonproprietary_name":"Tizanidne hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"150 CAPSULE in 1 BOTTLE (67877-611-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710111208","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1112-8","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"150 CAPSULE in 1 BOTTLE (70710-1112-8)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888000215","name":"TIZANIDINE HCL 4 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-002-15","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"4 mg/1","labeler":"Advagen Pharma Limited","package_description":"150 CAPSULE in 1 BOTTLE (72888-002-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09672,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904641861","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6418-61","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6418-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714017201","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-172-01","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"NorthStar Rx LLC","package_description":"150 TABLET in 1 BOTTLE (16714-172-01)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"16714017202","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-172-02","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"NorthStar Rx LLC","package_description":"1000 TABLET in 1 BOTTLE (16714-172-02)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300016903","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-169-03","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"300 TABLET in 1 BOTTLE, PLASTIC (29300-169-03)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300016910","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-169-10","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (29300-169-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"29300016915","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-169-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"150 TABLET in 1 BOTTLE, PLASTIC (29300-169-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076011","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268076015","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-760-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-760-15) / 1 TABLET in 1 BLISTER PACK (50268-760-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111018010","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-180-10","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"1000 TABLET in 1 BOTTLE (55111-180-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"55111018015","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-180-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"150 TABLET in 1 BOTTLE (55111-180-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664050318","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-503-18","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (57664-503-18)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664050389","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-503-89","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"150 TABLET in 1 BOTTLE (57664-503-89)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505025202","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0252-2","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"1000 TABLET in 1 BOTTLE (60505-0252-2)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505025203","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0252-3","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Apotex Corp.","package_description":"150 TABLET in 1 BOTTLE (60505-0252-3)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065910","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-659-10","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-659-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980065915","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-659-15","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"150 TABLET in 1 BOTTLE (64980-659-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877061415","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-614-15","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"150 TABLET in 1 BOTTLE (67877-614-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084064501","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-645-01","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-645-01) / 1 TABLET in 1 BLISTER PACK (68084-645-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084064511","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084064565","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-645-65","proprietary_name":"Tizanidine","nonproprietary_name":"Tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"50 BLISTER PACK in 1 CARTON (68084-645-65) / 1 TABLET in 1 BLISTER PACK (68084-645-11)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578009710","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-097-10","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"1000 TABLET in 1 BOTTLE (72578-097-10)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578009721","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-097-21","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"150 TABLET in 1 BOTTLE (72578-097-21)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72578009776","name":"TIZANIDINE HCL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-097-76","proprietary_name":"tizanidine","nonproprietary_name":"tizanidine","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"300 TABLET in 1 BOTTLE (72578-097-76)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.03306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"00591279086","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2790-86","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"6 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"150 CAPSULE, GELATIN COATED in 1 BOTTLE, PLASTIC (0591-2790-86)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"50742022615","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-226-15","proprietary_name":"TIZANIDINE HYDROCHLORIDE","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"150 CAPSULE in 1 BOTTLE, PLASTIC (50742-226-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"59651031677","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-316-77","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"150 CAPSULE in 1 BOTTLE (59651-316-77)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"60505265007","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2650-7","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"6 mg/1","labeler":"Apotex Corp.","package_description":"150 CAPSULE, GELATIN COATED in 1 BOTTLE (60505-2650-7)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332049341","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-493-41","proprietary_name":"Tizanidine Hydrochloride","nonproprietary_name":"Tizanidine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"150 CAPSULE in 1 BOTTLE (62332-493-41)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877061215","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-612-15","proprietary_name":"Tizanidne hydrochloride","nonproprietary_name":"Tizanidne hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"150 CAPSULE in 1 BOTTLE (67877-612-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710111308","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1113-8","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"150 CAPSULE in 1 BOTTLE (70710-1113-8)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888000315","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-003-15","proprietary_name":"tizanidine hydrochloride","nonproprietary_name":"tizanidine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"6 mg/1","labeler":"Advagen Pharma Limited","package_description":"150 CAPSULE in 1 BOTTLE (72888-003-15)","pharm_classes":["Adrenergic alpha2-Agonists [MoA]","Central alpha-2 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834020915","name":"TIZANIDINE HCL 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.14053,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tizanidine HCl|Tizanidine HCl","basis":"generic"},"part_b":null}, {"ndc":"74676011202","name":"TLANDO 112.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"74676-0112-2","proprietary_name":"Tlando","nonproprietary_name":"testosterone undecanoate","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"112.5 mg/1","labeler":"Verity Pharmaceuticals Inc.","package_description":"120 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (74676-0112-2)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":7.16533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tlando|Testosterone Undecanoate","basis":"brand"},"part_b":null}, {"ndc":"00078087601","name":"TOBRADEX EYE OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0876-01","proprietary_name":"TobraDex","nonproprietary_name":"tobramycin and dexamethasone","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3 mg/g; 1 mg/g","labeler":"Novartis Pharmaceuticals Corporation","package_description":"3.5 g in 1 TUBE (0078-0876-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":89.7148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tobradex|Tobramycin/Dexamethasone","basis":"brand"},"part_b":null}, {"ndc":"71776003505","name":"TOBRADEX ST 0.3-0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71776-035-05","proprietary_name":"Tobradex ST","nonproprietary_name":"tobramycin / dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; .5 mg/mL","labeler":"Eyevance Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (71776-035-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":46.63243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobradex St|Tobramycin/Dexamethasone","basis":"brand"},"part_b":null}, {"ndc":"82667001105","name":"TOBRADEX ST 0.3-0.05% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82667-011-05","proprietary_name":"Tobradex ST","nonproprietary_name":"tobramycin / dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; .5 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82667-011-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":46.63243,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobradex St|Tobramycin/Dexamethasone","basis":"brand"},"part_b":null}, {"ndc":"24208029005","name":"TOBRAMYCIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-290-05","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-290-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.1081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61314064305","name":"TOBRAMYCIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-643-05","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Sandoz Inc","package_description":"5 mL in 1 BOTTLE, PLASTIC (61314-643-05)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.1081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62332051805","name":"TOBRAMYCIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-518-05","proprietary_name":"Tobramycin Ophthalmic Solution","nonproprietary_name":"Tobramycin Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-518-05) / 5 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.1081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069013101","name":"TOBRAMYCIN 0.3% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-131-01","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-131-01) / 5 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.1081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00093408563","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-4085-63","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"56 AMPULE in 1 CARTON (0093-4085-63) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (56 AMPULE in 1 CARTON (0093-4085-63) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"42571040892","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-408-92","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin solution","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Micro Labs Limited","package_description":"14 POUCH in 1 CARTON (42571-408-92) / 4 AMPULE in 1 POUCH (42571-408-19) / 5 mL in 1 AMPULE (42571-408-09)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (14 POUCH in 1 CARTON (42571-408-92) / 4 AMPULE in 1 POUCH (42571-408-19) / 5 mL in 1 AMPULE (42571-408-09)) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598060556","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-605-56","proprietary_name":"Tobramycin Inhalation Solution","nonproprietary_name":"Tobramycin Inhalation Solution","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"14 POUCH in 1 CARTON (43598-605-56) / 4 AMPULE in 1 POUCH (43598-605-04) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (14 POUCH in 1 CARTON (43598-605-56) / 4 AMPULE in 1 POUCH (43598-605-04) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598060558","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-605-58","proprietary_name":"Tobramycin Inhalation Solution","nonproprietary_name":"Tobramycin Inhalation Solution","dosage_form":"INHALANT","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"56 POUCH in 1 CARTON (43598-605-58) / 1 AMPULE in 1 POUCH (43598-605-11) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (56 POUCH in 1 CARTON (43598-605-58) / 1 AMPULE in 1 POUCH (43598-605-11) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"47335017149","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-171-49","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"14 POUCH in 1 CARTON (47335-171-49) / 4 AMPULE in 1 POUCH (47335-171-48) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (14 POUCH in 1 CARTON (47335-171-49) / 4 AMPULE in 1 POUCH (47335-171-48) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65162091446","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-914-46","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"56 AMPULE in 1 CARTON (65162-914-46) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (56 AMPULE in 1 CARTON (65162-914-46) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67877067870","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-678-70","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Ascend Laboratories, LLC","package_description":"56 POUCH in 1 CARTON (67877-678-70) / 7 AMPULE in 1 POUCH (67877-678-69) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68180096256","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-962-56","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"56 POUCH in 1 CARTON (68180-962-56) / 4 AMPULE in 1 POUCH / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"70756060456","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70756-604-56","proprietary_name":"TOBRAMYCIN","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Lifestar Pharma LLC","package_description":"14 POUCH in 1 CARTON (70756-604-56) / 4 AMPULE in 1 POUCH (70756-604-44) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (14 POUCH in 1 CARTON (70756-604-56) / 4 AMPULE in 1 POUCH (70756-604-44) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"72603043056","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-430-56","proprietary_name":"TOBRAMYCIN","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"NorthStar RxLLC","package_description":"14 POUCH in 1 CARTON (72603-430-56) / 4 AMPULE in 1 POUCH (72603-430-04) / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (14 POUCH in 1 CARTON (72603-430-56) / 4 AMPULE in 1 POUCH (72603-430-04) / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"76204002956","name":"TOBRAMYCIN 300 MG/5 ML AMPULE","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76204-029-56","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"300 mg/5mL","labeler":"Ritedose Pharmaceuticals, LLC","package_description":"14 POUCH in 1 CARTON (76204-029-56) / 4 AMPULE in 1 POUCH / 5 mL in 1 AMPULE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":1.084,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J7682","bill_units_per_package":{"value":56,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7682 (300 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (14 POUCH in 1 CARTON (76204-029-56) / 4 AMPULE in 1 POUCH / 5 mL in 1 AMPULE) gives 280 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":56,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00409357801","name":"TOBRAMYCIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-3578-01","proprietary_name":"TOBRAMYCIN","nonproprietary_name":"TOBRAMYCIN","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (0409-3578-01) / 2 mL in 1 VIAL, MULTI-DOSE (0409-3578-11)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3260","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3260 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (0409-3578-01) / 2 mL in 1 VIAL, MULTI-DOSE (0409-3578-11)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"36000024425","name":"TOBRAMYCIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"36000-244-25","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"25 VIAL, MULTI-DOSE in 1 BLISTER PACK (36000-244-25) / 2 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3260","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3260 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 BLISTER PACK (36000-244-25) / 2 mL in 1 VIAL, MULTI-DOSE) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323030602","name":"TOBRAMYCIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-306-02","proprietary_name":"Tobramycin","nonproprietary_name":"TOBRAMYCIN SULFATE","dosage_form":"INJECTION, SOLUTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL, MULTI-DOSE in 1 TRAY (63323-306-02) / 2 mL in 1 VIAL, MULTI-DOSE (63323-306-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3260","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3260 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, MULTI-DOSE in 1 TRAY (63323-306-02) / 2 mL in 1 VIAL, MULTI-DOSE (63323-306-01)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457047322","name":"TOBRAMYCIN 80 MG/2 ML VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-473-22","proprietary_name":"Tobramycin","nonproprietary_name":"Tobramycin","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS","strength":"40 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL in 1 CARTON (67457-473-22) / 2 mL in 1 VIAL (67457-473-00)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":0.83153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3260","bill_units_per_package":{"value":25,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3260 (80 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (1 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (67457-473-22) / 2 mL in 1 VIAL (67457-473-00)) gives 50 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00574403105","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4031-05","proprietary_name":"TOBRAMYCIN AND DEXAMETHASONE","nonproprietary_name":"tobramycin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0574-4031-05) / 5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00574403110","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4031-10","proprietary_name":"TOBRAMYCIN AND DEXAMETHASONE","nonproprietary_name":"tobramycin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0574-4031-10) / 10 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.1784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"00574403125","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-4031-25","proprietary_name":"TOBRAMYCIN AND DEXAMETHASONE","nonproprietary_name":"tobramycin and dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Padagis US LLC","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (0574-4031-25) / 2.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.56623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"24208029505","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-295-05","proprietary_name":"Tobramycin and Dexamethasone","nonproprietary_name":"Tobramycin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-295-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"24208029510","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-295-10","proprietary_name":"Tobramycin and Dexamethasone","nonproprietary_name":"Tobramycin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-295-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.1784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"24208029525","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-295-25","proprietary_name":"Tobramycin and Dexamethasone","nonproprietary_name":"Tobramycin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-295-25) / 2.5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.56623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"61314064705","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-647-05","proprietary_name":"Tobramycin and Dexamethasone","nonproprietary_name":"Tobramycin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-647-05) / 5 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.01206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"61314064710","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-647-10","proprietary_name":"Tobramycin and Dexamethasone","nonproprietary_name":"Tobramycin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-647-10) / 10 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.1784,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"61314064725","name":"TOBRAMYCIN-DEXAMETH OPHTH SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-647-25","proprietary_name":"Tobramycin and Dexamethasone","nonproprietary_name":"Tobramycin and Dexamethasone","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"3 mg/mL; 1 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (61314-647-25) / 2.5 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.56623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tobramycin-Dexamethasone|Tobramycin/Dexamethasone","basis":"generic"},"part_b":null}, {"ndc":"62332080105","name":"TOBRAMYCIN-LOTEPREDNOL 0.3%-0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-801-05","proprietary_name":"Loteprednol etabonate and Tobramycin","nonproprietary_name":"Loteprednol etabonate and Tobramycin","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 3 mg/mL","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (62332-801-05) / 5 mL in 1 BOTTLE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":39.26379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82260035805","name":"TOBRAMYCIN-LOTEPREDNOL 0.3%-0.5% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82260-358-05","proprietary_name":"Loteprednol etabonate and tobramycin","nonproprietary_name":"loteprednol etabonate and tobramycin","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 3 mg/mL","labeler":"Bausch & Lomb Americas Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82260-358-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":39.26379,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078081301","name":"TOBREX 0.3% EYE OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0813-01","proprietary_name":"TOBREX","nonproprietary_name":"tobramycin","dosage_form":"OINTMENT","route":"OPHTHALMIC","strength":"3 mg/g","labeler":"Novartis Pharmaceuticals Corporation","package_description":"3.5 g in 1 TUBE (0078-0813-01)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]"]},"nadac":{"value":84.41452,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tobrex|Tobramycin","basis":"brand"},"part_b":null}, {"ndc":"33342054109","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"33342-541-09","proprietary_name":"Tofacitinib","nonproprietary_name":"Tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-541-09)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42571026860","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42571-268-60","proprietary_name":"TOFACITINIB","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Micro Labs Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (42571-268-60)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51991032906","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51991-329-06","proprietary_name":"Tofacitinib","nonproprietary_name":"Tofacitinib Citrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"60 TABLET in 1 BOTTLE (51991-329-06)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651045960","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-459-60","proprietary_name":"TOFACITINIB","nonproprietary_name":"TOFACITINIB","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59651-459-60)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505626306","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-6263-6","proprietary_name":"Tofacitinib","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Apotex Corp.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (60505-6263-6)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70069084101","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70069-841-01","proprietary_name":"TOFACITINIB","nonproprietary_name":"TOFACITINIB","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Somerset Therapeutics, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70069-841-01)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710124306","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1243-6","proprietary_name":"tofacitinib","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1243-6)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72205013960","name":"TOFACITINIB 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72205-139-60","proprietary_name":"Tofacitinib","nonproprietary_name":"Tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (72205-139-60)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00574181130","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0574-1811-30","proprietary_name":"TOFACITINIB CITRATE","nonproprietary_name":"Tofacitinib Citrate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Padagis US LLC","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0574-1811-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241027030","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"27241-270-30","proprietary_name":"Tofacitinib","nonproprietary_name":"Tofacitinib","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-270-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42799097030","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"42799-970-30","proprietary_name":"Tofacitinib","nonproprietary_name":"Tofacitinib","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (42799-970-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651068530","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59651-685-30","proprietary_name":"TOFACITINIB","nonproprietary_name":"TOFACITINIB","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (59651-685-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505485803","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"60505-4858-3","proprietary_name":"Tofacitinib","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (60505-4858-3)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70377005711","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70377-057-11","proprietary_name":"Tofacitinib XR","nonproprietary_name":"Tofacitinib","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Biocon Pharma Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70377-057-11)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710135303","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1353-3","proprietary_name":"tofacitinib","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70710-1353-3)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"76282081630","name":"TOFACITINIB ER 11 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"76282-816-30","proprietary_name":"TOFACITINIB","nonproprietary_name":"TOFACITINIB","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Exelan pharmaceuticals,Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (76282-816-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00536131543","name":"TOLNAFTATE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1315-43","proprietary_name":"CR-371059 Tolnaftate 1% Cream","nonproprietary_name":"CR-371059 Tolnaftate 1% Cream","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Rugby Laboratories","package_description":"1 g in 1 BOX (0536-1315-43)"},"nadac":{"value":0.09038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"24385003203","name":"TOLNAFTATE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-032-03","proprietary_name":"Tolnaftate Antifungal","nonproprietary_name":"Tolnaftate","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (24385-032-03) / 30 g in 1 TUBE"},"nadac":{"value":0.11888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672202001","name":"TOLNAFTATE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2020-1","proprietary_name":"Tolnaftate Antifungal","nonproprietary_name":"Tolnaftate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2020-1) / 15 g in 1 TUBE"},"nadac":{"value":0.15,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672202002","name":"TOLNAFTATE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2020-2","proprietary_name":"Tolnaftate Antifungal","nonproprietary_name":"Tolnaftate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2020-2) / 30 g in 1 TUBE"},"nadac":{"value":0.11888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000008401","name":"TOLNAFTATE 1% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0084-1","proprietary_name":"Tolnaftate Cream 1% ANTIFUNGAL","nonproprietary_name":"Tolnaftate","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"CARDINAL HEALTH 110 dba LEADER","package_description":"1 TUBE in 1 BOX (70000-0084-1) / 30 g in 1 TUBE"},"nadac":{"value":0.11888,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536132926","name":"TOLNAFTATE 1% POWDER","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":0.04296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-11-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00093716305","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7163-05","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7163-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093716356","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7163-56","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7163-56)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093716398","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7163-98","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7163-98)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668018905","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-189-05","proprietary_name":"TOLTERODINE TARTRATE","nonproprietary_name":"TOLTERODINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (13668-189-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668018930","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-189-30","proprietary_name":"TOLTERODINE TARTRATE","nonproprietary_name":"TOLTERODINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (13668-189-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668018990","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-189-90","proprietary_name":"TOLTERODINE TARTRATE","nonproprietary_name":"TOLTERODINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (13668-189-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"27241019130","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-191-30","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (27241-191-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"29300030613","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-306-13","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (29300-306-13)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722060730","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-607-30","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-607-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43975032203","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-322-03","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-322-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43975032209","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-322-09","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-322-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43975032250","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-322-50","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-322-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59762004702","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687031911","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687031921","name":"TOLTERODINE TART ER 2 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-319-21","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-319-21) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-319-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.2678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093716405","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7164-05","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7164-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093716456","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7164-56","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7164-56)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093716498","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7164-98","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7164-98)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668019005","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-190-05","proprietary_name":"TOLTERODINE TARTRATE","nonproprietary_name":"TOLTERODINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (13668-190-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668019030","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-190-30","proprietary_name":"TOLTERODINE TARTRATE","nonproprietary_name":"TOLTERODINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (13668-190-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668019090","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-190-90","proprietary_name":"TOLTERODINE TARTRATE","nonproprietary_name":"TOLTERODINE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (13668-190-90)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"27241019230","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-192-30","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (27241-192-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"29300030713","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-307-13","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (29300-307-13)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722060830","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-608-30","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-608-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43975032303","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-323-03","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-323-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43975032309","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-323-09","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-323-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43975032350","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43975-323-50","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43975-323-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687033011","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687033021","name":"TOLTERODINE TART ER 4 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-330-21","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-330-21) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (60687-330-11)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.23116,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate ER|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093001006","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0010-06","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0093-0010-06)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16571012606","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-126-06","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (16571-126-06)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"29300023916","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-239-16","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-239-16)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722080560","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-805-60","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-805-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"33342009709","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-097-09","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-097-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"33342009715","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-097-15","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-097-15)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59762017006","name":"TOLTERODINE TARTRATE 1 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.20389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093001805","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0018-05","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-0018-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00093001806","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-0018-06","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0093-0018-06)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16571012706","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-127-06","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (16571-127-06)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16571012750","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-127-50","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-127-50)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"29300024016","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-240-16","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET in 1 BOTTLE, PLASTIC (29300-240-16)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722080605","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-806-05","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-806-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722080660","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-806-60","proprietary_name":"Tolterodine Tartrate","nonproprietary_name":"Tolterodine Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-806-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"33342009809","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-098-09","proprietary_name":"Tolterodine tartrate","nonproprietary_name":"Tolterodine tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (33342-098-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59762080006","name":"TOLTERODINE TARTRATE 2 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.26393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolterodine Tartrate|Tolterodine Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722086803","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-868-03","proprietary_name":"Tolvaptan","nonproprietary_name":"Tolvaptan","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (31722-868-03) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"49884076852","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"49884076854","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-768-54","proprietary_name":"Tolvaptan","nonproprietary_name":"Tolvaptan","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Par Health USA, LLC","package_description":"1 BLISTER PACK in 1 CARTON (49884-768-54) / 10 TABLET in 1 BLISTER PACK (49884-768-52)","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"60505431700","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4317-0","proprietary_name":"tolvaptan","nonproprietary_name":"tolvaptan","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Apotex Corp.","package_description":"1 BLISTER PACK in 1 CARTON (60505-4317-0) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"67877063502","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-635-02","proprietary_name":"Tolvaptan","nonproprietary_name":"Tolvaptan","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"10 TABLET in 1 BOTTLE (67877-635-02)","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"67877063533","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-635-33","proprietary_name":"Tolvaptan","nonproprietary_name":"Tolvaptan","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"1 BLISTER PACK in 1 CARTON (67877-635-33) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"72205013011","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-130-11","proprietary_name":"TOLVAPTAN","nonproprietary_name":"TOLVAPTAN","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BLISTER PACK in 1 CARTON (72205-130-11) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"72603093201","name":"TOLVAPTAN 15 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-932-01","proprietary_name":"TOLVAPTAN","nonproprietary_name":"TOLVAPTAN","dosage_form":"TABLET","route":"ORAL","strength":"15 mg/1","labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 CARTON (72603-932-01) / 10 TABLET in 1 BLISTER PACK","pharm_classes":["Vasopressin V2 Receptor Antagonist [EPC]","Vasopressin V2 Receptor Antagonists [MoA]"]},"nadac":{"value":14.57406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tolvaptan|Tolvaptan","basis":"generic"},"part_b":null}, {"ndc":"70792010230","name":"TONMYA 2.8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70792-102-30","proprietary_name":"TONMYA","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"2.8 mg/1","labeler":"Tonix Medicines, Inc.","package_description":"30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (70792-102-30)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":29.60952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70792010260","name":"TONMYA 2.8 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70792-102-60","proprietary_name":"TONMYA","nonproprietary_name":"Cyclobenzaprine Hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"2.8 mg/1","labeler":"Tonix Medicines, Inc.","package_description":"60 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (70792-102-60)","pharm_classes":["Centrally-mediated Muscle Relaxation [PE]","Muscle Relaxant [EPC]"]},"nadac":{"value":29.60952,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458064165","name":"TOPAMAX 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-641-65","proprietary_name":"Topamax","nonproprietary_name":"topiramate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (50458-641-65)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":17.91087,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topamax|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"50458064265","name":"TOPAMAX 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-642-65","proprietary_name":"Topamax","nonproprietary_name":"topiramate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (50458-642-65)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":21.07055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topamax|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"50458064565","name":"TOPAMAX 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-645-65","proprietary_name":"Topamax","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"25 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (50458-645-65)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.53998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topamax|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"50458063965","name":"TOPAMAX 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-639-65","proprietary_name":"Topamax","nonproprietary_name":"topiramate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (50458-639-65)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.57757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topamax|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"50458064065","name":"TOPAMAX 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-640-65","proprietary_name":"Topamax","nonproprietary_name":"topiramate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, COATED in 1 BOTTLE (50458-640-65)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":13.13389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topamax|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"00904692961","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6929-61","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6929-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011705","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-117-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-117-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011710","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-117-10","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-117-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011716","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-117-16","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-117-16)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"47335071186","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-711-86","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-711-86)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"65862017360","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-173-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-173-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034401","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-344-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-344-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-344-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034411","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382014005","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-140-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-140-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382014014","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-140-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-140-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462010905","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-109-05","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-109-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462010910","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-109-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-109-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462010960","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-109-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-109-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012403","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-124-03","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET in 1 BOTTLE (69097-124-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012412","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-124-12","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-124-12)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012415","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-124-15","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-124-15)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282028010","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-280-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"1000 TABLET in 1 BOTTLE (76282-280-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282028060","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-280-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"60 TABLET in 1 BOTTLE (76282-280-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"82009013705","name":"TOPIRAMATE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-137-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-137-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.05669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"23155089406","name":"TOPIRAMATE 15 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"24979021004","name":"TOPIRAMATE 15 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-210-04","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (24979-210-04)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"59651045260","name":"TOPIRAMATE 15 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-452-60","proprietary_name":"TOPIRAMATE","nonproprietary_name":"TOPIRAMATE","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-452-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"67877086860","name":"TOPIRAMATE 15 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-868-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE","route":"ORAL","strength":"15 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE (67877-868-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382000414","name":"TOPIRAMATE 15 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-004-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"15 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (68382-004-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462021860","name":"TOPIRAMATE 15 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-218-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"15 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (68462-218-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.22941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011805","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-118-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-118-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011810","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-118-10","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-118-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011816","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-118-16","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-118-16)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"65862017460","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-174-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-174-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034511","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034521","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-345-21","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-345-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-345-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382014105","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-141-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-141-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382014114","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-141-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-141-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462011010","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-110-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-110-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462011060","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-110-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-110-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012503","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-125-03","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET in 1 BOTTLE (69097-125-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012512","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-125-12","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-125-12)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012515","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-125-15","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-125-15)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282028110","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-281-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"1000 TABLET in 1 BOTTLE (76282-281-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282028160","name":"TOPIRAMATE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-281-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"200 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"60 TABLET in 1 BOTTLE (76282-281-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.11016,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"23155089506","name":"TOPIRAMATE 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"24979021104","name":"TOPIRAMATE 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24979-211-04","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE, PLASTIC (24979-211-04)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"59651045360","name":"TOPIRAMATE 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-453-60","proprietary_name":"TOPIRAMATE","nonproprietary_name":"TOPIRAMATE","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (59651-453-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"67877086960","name":"TOPIRAMATE 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-869-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"60 CAPSULE in 1 BOTTLE (67877-869-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382000514","name":"TOPIRAMATE 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-005-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (68382-005-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462021960","name":"TOPIRAMATE 25 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-219-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (68462-219-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.24588,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00904692861","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6928-61","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6928-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011505","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-115-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-115-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011510","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-115-10","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-115-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011516","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-115-16","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-115-16)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"47335070786","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-707-86","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-707-86)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"65862017160","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-171-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-171-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034201","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-342-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-342-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-342-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034211","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382013805","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-138-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-138-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382013814","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-138-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-138-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462010805","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-108-05","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-108-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462010810","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-108-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-108-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462010860","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-108-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-108-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012203","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-122-03","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET in 1 BOTTLE (69097-122-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012212","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-122-12","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-122-12)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012215","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-122-15","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-122-15)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282027810","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-278-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"1000 TABLET in 1 BOTTLE (76282-278-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282027860","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-278-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"60 TABLET in 1 BOTTLE (76282-278-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"82009013505","name":"TOPIRAMATE 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-135-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-135-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.02684,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"67877083347","name":"TOPIRAMATE 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-833-47","proprietary_name":"TOPIRAMATE","nonproprietary_name":"TOPIRAMATE","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"473 mL in 1 BOTTLE (67877-833-47)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.08239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877083361","name":"TOPIRAMATE 25 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-833-61","proprietary_name":"TOPIRAMATE","nonproprietary_name":"TOPIRAMATE","dosage_form":"SOLUTION","route":"ORAL","strength":"25 mg/mL","labeler":"Ascend Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (67877-833-61) / 120 mL in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.08667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"68382049814","name":"TOPIRAMATE 50 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-498-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, COATED PELLETS","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 CAPSULE, COATED PELLETS in 1 BOTTLE (68382-498-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.32398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"72888023030","name":"TOPIRAMATE 50 MG SPRINKLE CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-230-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"30 CAPSULE in 1 BOTTLE (72888-230-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.32398,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011605","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-116-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-116-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011610","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-116-10","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-116-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"29300011616","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-116-16","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-116-16)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"47335071013","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-710-13","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (47335-710-13)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"47335071086","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-710-86","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (47335-710-86)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"65862017260","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-172-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (65862-172-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034301","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-343-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-343-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-343-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68084034311","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382013905","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-139-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68382-139-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382013914","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-139-14","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68382-139-14)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462015305","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-153-05","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (68462-153-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462015310","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-153-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-153-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462015360","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-153-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-153-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012303","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-123-03","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"60 TABLET in 1 BOTTLE (69097-123-03)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012312","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-123-12","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"500 TABLET in 1 BOTTLE (69097-123-12)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69097012315","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-123-15","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Cipla USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (69097-123-15)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282027910","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-279-10","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"1000 TABLET in 1 BOTTLE (76282-279-10)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"76282027960","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-279-60","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"EXELAN PHARMACEUTICALS INC.","package_description":"60 TABLET in 1 BOTTLE (76282-279-60)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"82009013605","name":"TOPIRAMATE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-136-05","proprietary_name":"topiramate","nonproprietary_name":"topiramate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (82009-136-05)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":0.03705,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235801","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2358-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2358-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235856","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2358-56","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2358-56)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036701","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-367-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-367-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036711","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-367-11","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-367-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"43598094130","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-941-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-941-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382076906","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-769-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-769-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70748027706","name":"TOPIRAMATE ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-277-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70748-277-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00832107430","name":"TOPIRAMATE ER 100 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1074-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-1074-30) / 30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":5.49212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462037430","name":"TOPIRAMATE ER 100 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-374-30","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-374-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":5.49212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69680017930","name":"TOPIRAMATE ER 100 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-179-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-179-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":5.49212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70710104103","name":"TOPIRAMATE ER 100 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1041-3","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1041-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":5.49212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"72603012201","name":"TOPIRAMATE ER 100 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-122-01","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-122-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":5.49212,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00832107530","name":"TOPIRAMATE ER 150 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1075-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-1075-30) / 30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.35688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462037030","name":"TOPIRAMATE ER 150 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-370-30","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-370-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.35688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69680018030","name":"TOPIRAMATE ER 150 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-180-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-180-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.35688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70710104203","name":"TOPIRAMATE ER 150 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1042-3","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1042-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.35688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"72603012301","name":"TOPIRAMATE ER 150 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-123-01","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-123-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":7.35688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235901","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2359-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2359-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235956","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2359-56","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2359-56)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036801","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-368-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-368-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036811","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-368-11","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-368-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"43598094230","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-942-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-942-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382035806","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-358-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-358-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70748027806","name":"TOPIRAMATE ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-278-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70748-278-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00832107330","name":"TOPIRAMATE ER 200 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1073-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-1073-30) / 30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.54204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462037130","name":"TOPIRAMATE ER 200 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-371-30","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-371-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.54204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69680018130","name":"TOPIRAMATE ER 200 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-181-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 PACKAGE (69680-181-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.54204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70710104303","name":"TOPIRAMATE ER 200 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1043-3","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1043-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.54204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"72603012401","name":"TOPIRAMATE ER 200 MG SPRINK CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-124-01","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-124-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":9.54204,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235601","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2356-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2356-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235656","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2356-56","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2356-56)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036501","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-365-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-365-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036511","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-365-11","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-365-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"43598093930","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-939-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-939-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382086306","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-863-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-863-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70748027506","name":"TOPIRAMATE ER 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-275-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70748-275-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00832107130","name":"TOPIRAMATE ER 25 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1071-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-1071-30) / 30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.25428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462037230","name":"TOPIRAMATE ER 25 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-372-30","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-372-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.25428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69680017730","name":"TOPIRAMATE ER 25 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-177-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-177-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.25428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70710103903","name":"TOPIRAMATE ER 25 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1039-3","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1039-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.25428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"72603012001","name":"TOPIRAMATE ER 25 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-120-01","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-120-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.25428,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235701","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2357-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2357-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00480235756","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2357-56","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0480-2357-56)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036601","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-366-01","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-366-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"10370036611","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-366-11","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Par Health USA, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (10370-366-11)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"43598094030","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-940-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-940-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68382086406","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-864-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-864-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70748027606","name":"TOPIRAMATE ER 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-276-06","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70748-276-06)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"00832107230","name":"TOPIRAMATE ER 50 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-1072-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"1 BOTTLE in 1 CARTON (0832-1072-30) / 30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.14622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"68462037330","name":"TOPIRAMATE ER 50 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-373-30","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68462-373-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.14622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"69680017830","name":"TOPIRAMATE ER 50 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69680-178-30","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Vitruvias Therapeutics, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (69680-178-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.14622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70710104003","name":"TOPIRAMATE ER 50 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1040-3","proprietary_name":"Topiramate","nonproprietary_name":"Topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1040-3)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.14622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"72603012101","name":"TOPIRAMATE ER 50 MG SPRINKL CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-121-01","proprietary_name":"TOPIRAMATE","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar RxLLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-121-01)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":3.14622,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Topiramate ER|Topiramate","basis":"generic"},"part_b":null}, {"ndc":"70842011202","name":"TOPROL XL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70842-112-02","proprietary_name":"TOPROL XL","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Melinta Therapeutics, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70842-112-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":2.07883,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08496,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Toprol XL|Metoprolol Succinate","basis":"brand"},"part_b":null}, {"ndc":"70842011302","name":"TOPROL XL 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70842-113-02","proprietary_name":"TOPROL XL","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Melinta Therapeutics, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70842-113-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":3.3208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.188,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Toprol XL|Metoprolol Succinate","basis":"brand"},"part_b":null}, {"ndc":"70842011002","name":"TOPROL XL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70842-110-02","proprietary_name":"TOPROL XL","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Melinta Therapeutics, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70842-110-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.38564,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04762,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Toprol XL|Metoprolol Succinate","basis":"brand"},"part_b":null}, {"ndc":"70842011102","name":"TOPROL XL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70842-111-02","proprietary_name":"TOPROL XL","nonproprietary_name":"Metoprolol Succinate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Melinta Therapeutics, LLC","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (70842-111-02)","pharm_classes":["Adrenergic beta-Antagonists [MoA]","beta-Adrenergic Blocker [EPC]"]},"nadac":{"value":1.38525,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05152,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Toprol XL|Metoprolol Succinate","basis":"brand"},"part_b":null}, {"ndc":"64980040403","name":"TOREMIFENE CITRATE 60 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-404-03","proprietary_name":"toremifene citrate","nonproprietary_name":"toremifene citrate","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (64980-404-03)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":19.59893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Toremifene Citrate|Toremifene Citrate","basis":"generic"},"part_b":null}, {"ndc":"72205005030","name":"TOREMIFENE CITRATE 60 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-050-30","proprietary_name":"toremifene citrate","nonproprietary_name":"toremifene citrate","dosage_form":"TABLET","route":"ORAL","strength":"60 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-050-30)","pharm_classes":["Estrogen Agonist/Antagonist [EPC]","Selective Estrogen Receptor Modulators [MoA]"]},"nadac":{"value":19.59893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Toremifene Citrate|Toremifene Citrate","basis":"generic"},"part_b":null}, {"ndc":"00245082504","name":"TORPENZ 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0825-04","proprietary_name":"TORPENZ","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"28 BLISTER PACK in 1 CARTON (0245-0825-04) / 1 TABLET in 1 BLISTER PACK (0245-0825-89)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-13","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"00245082530","name":"TORPENZ 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0825-30","proprietary_name":"TORPENZ","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (0245-0825-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"00245082589","name":"TORPENZ 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-13","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"00245082304","name":"TORPENZ 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0823-04","proprietary_name":"TORPENZ","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"28 BLISTER PACK in 1 CARTON (0245-0823-04) / 1 TABLET in 1 BLISTER PACK (0245-0823-89)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-13","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"00245082330","name":"TORPENZ 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0245-0823-30","proprietary_name":"TORPENZ","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"30 TABLET in 1 BOTTLE (0245-0823-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"00245082389","name":"TORPENZ 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-13","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"23155087201","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-872-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-872-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"31722053001","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-530-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-530-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50111091601","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-916-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-916-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075511","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075515","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-755-15","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-755-15) / 1 TABLET in 1 BLISTER PACK (50268-755-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"62135081990","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-819-90","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-819-90)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"65862012601","name":"TORSEMIDE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-126-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-126-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06594,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"23155087401","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-874-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-874-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"31722053201","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-532-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-532-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50111091801","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-918-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-918-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075711","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075715","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-757-15","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-757-15) / 1 TABLET in 1 BLISTER PACK (50268-757-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"62135082190","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-821-90","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-821-90)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"65862012801","name":"TORSEMIDE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-128-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-128-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.17384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"00054007725","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0077-25","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0054-0077-25)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"00054007729","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0077-29","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0054-0077-29)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"00904728306","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7283-06","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-7283-06) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"00904728361","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7283-61","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7283-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"23155087301","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-873-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-873-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"31722053101","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-531-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-531-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50111091701","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-917-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-917-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50111091703","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-917-03","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-917-03)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075611","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075615","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-756-15","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-756-15) / 1 TABLET in 1 BLISTER PACK (50268-756-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"62135082090","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-820-90","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-820-90)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"65862012701","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-127-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-127-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"68084053901","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-539-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (68084-539-01) / 1 TABLET in 1 BLISTER PACK (68084-539-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"68084053911","name":"TORSEMIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.06361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"23155087101","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-871-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-871-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"31722052901","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-529-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (31722-529-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50111091501","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-915-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-915-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075411","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"50268075415","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-754-15","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-754-15) / 1 TABLET in 1 BLISTER PACK (50268-754-11)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"62135081890","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-818-90","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-818-90)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"65862012501","name":"TORSEMIDE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-125-01","proprietary_name":"Torsemide","nonproprietary_name":"Torsemide","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET in 1 BOTTLE (65862-125-01)","pharm_classes":["Increased Diuresis at Loop of Henle [PE]","Loop Diuretic [EPC]"]},"nadac":{"value":0.05726,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Torsemide|Torsemide","basis":"generic"},"part_b":null}, {"ndc":"00245081261","name":"TOSYMRA 10 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0812-61","proprietary_name":"TOSYMRA","nonproprietary_name":"sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"10 mg/.1mL","labeler":"Upsher-Smith Laboratories, LLC","package_description":"6 BLISTER PACK in 1 CARTON (0245-0812-61) / 1 BOTTLE, SPRAY in 1 BLISTER PACK (0245-0812-89) / .1 mL in 1 BOTTLE, SPRAY (0245-0812-59)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":108.22118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tosymra|Sumatriptan","basis":"brand"},"part_b":null}, {"ndc":"70792081261","name":"TOSYMRA 10 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70792-812-61","proprietary_name":"Tosymra","nonproprietary_name":"Sumatriptan","dosage_form":"SPRAY","route":"NASAL","strength":"10 mg/.1mL","labeler":"Tonix Medicines, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (70792-812-61) / 1 BOTTLE, SPRAY in 1 BLISTER PACK / .1 mL in 1 BOTTLE, SPRAY","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":108.22118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tosymra|Sumatriptan","basis":"brand"},"part_b":null}, {"ndc":"00024587102","name":"TOUJEO MAX SOLOSTR 300 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5871-02","proprietary_name":"TOUJEO Max","nonproprietary_name":"insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"300 U/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"2 SYRINGE in 1 CARTON (0024-5871-02) / 3 mL in 1 SYRINGE (0024-5871-00)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":91.30044,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00024586903","name":"TOUJEO SOLOSTAR 300 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0024-5869-03","proprietary_name":"TOUJEO","nonproprietary_name":"insulin glargine","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"300 U/mL","labeler":"Sanofi-Aventis U.S. LLC","package_description":"3 SYRINGE in 1 CARTON (0024-5869-03) / 1.5 mL in 1 SYRINGE (0024-5869-01)","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":91.3026,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Toujeo Solostar|Insulin Glargine,Hum.Rec.Anlog","basis":"brand"},"part_b":null}, {"ndc":"43538095210","name":"TOVET EMOLLIENT 0.05% FOAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43538-952-10","proprietary_name":"Tovet (emollient formulation)","nonproprietary_name":"CLOBETASOL PROPIONATE","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Medimetriks Pharmaceuticals, Inc.","package_description":"1 CANISTER in 1 CARTON (43538-952-10) / 100 g in 1 CANISTER","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.78921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tovet Emollient|Clobetasol Propionate/Emoll","basis":"brand"},"part_b":null}, {"ndc":"00069024230","name":"TOVIAZ ER 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0242-30","proprietary_name":"Toviaz","nonproprietary_name":"fesoterodine fumarate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"4 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0069-0242-30)"},"nadac":{"value":9.27825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.7938,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00069024430","name":"TOVIAZ ER 8 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0244-30","proprietary_name":"Toviaz","nonproprietary_name":"fesoterodine fumarate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"8 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0069-0244-30)"},"nadac":{"value":9.26235,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.8393,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00597014030","name":"TRADJENTA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0140-30","proprietary_name":"Tradjenta","nonproprietary_name":"linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0597-0140-30)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":16.79819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tradjenta|Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597014061","name":"TRADJENTA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0140-61","proprietary_name":"Tradjenta","nonproprietary_name":"linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"100 BLISTER PACK in 1 CARTON (0597-0140-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":16.79819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tradjenta|Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"00597014090","name":"TRADJENTA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0140-90","proprietary_name":"Tradjenta","nonproprietary_name":"linagliptin","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0597-0140-90)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":16.79819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tradjenta|Linagliptin","basis":"brand"},"part_b":null}, {"ndc":"64980066301","name":"TRAMADOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-663-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-663-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.08258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"72888000801","name":"TRAMADOL HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-008-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"100 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, COATED in 1 BOTTLE (72888-008-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.08258,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"72888016230","name":"TRAMADOL HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-162-30","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"25 mg/1","labeler":"Advagen Pharma Limited","package_description":"30 TABLET, COATED in 1 BOTTLE (72888-162-30)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":3.36652,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"00093330101","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3301-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0093-3301-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"00093330105","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-3301-05","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (0093-3301-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"00904749661","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7496-61","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7496-61) / 1 TABLET, COATED in 1 BLISTER PACK","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"16571071601","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-716-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16571-716-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"16571071610","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-716-10","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (16571-716-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"16571071650","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-716-50","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16571-716-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300035501","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-355-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-355-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300035505","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-355-05","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-355-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"29300035510","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-355-10","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (29300-355-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"60219234801","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2348-1","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (60219-2348-1)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"60219234805","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2348-5","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (60219-2348-5)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"60219234807","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60219-2348-7","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (60219-2348-7)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687079501","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-795-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-795-01) / 1 TABLET, COATED in 1 BLISTER PACK (60687-795-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"60687079511","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"64380079101","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-791-01","proprietary_name":"tramadol hydrochloride","nonproprietary_name":"tramadol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-791-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"64380079102","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-791-02","proprietary_name":"tramadol hydrochloride","nonproprietary_name":"tramadol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"500 TABLET in 1 BOTTLE (64380-791-02)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"64380079103","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-791-03","proprietary_name":"tramadol hydrochloride","nonproprietary_name":"tramadol hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Strides Pharma Science Limited","package_description":"1000 TABLET in 1 BOTTLE (64380-791-03)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"64980061401","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-614-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-614-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"64980061410","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-614-10","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-614-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"64980061450","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-614-50","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-614-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"65162062710","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-627-10","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET, COATED in 1 BOTTLE (65162-627-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"65162062711","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-627-11","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET, COATED in 1 BOTTLE (65162-627-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"65162062750","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-627-50","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"500 TABLET, COATED in 1 BOTTLE (65162-627-50)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"71093011904","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"71093011905","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"71093011906","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"72888008000","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-080-00","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"1000 TABLET, COATED in 1 BOTTLE (72888-080-00)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"72888008001","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-080-01","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"100 TABLET, COATED in 1 BOTTLE (72888-080-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"72888008005","name":"TRAMADOL HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-080-05","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Advagen Pharma Limited","package_description":"500 TABLET, COATED in 1 BOTTLE (72888-080-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.0248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"13811068930","name":"TRAMADOL HCL ER 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-689-30","proprietary_name":"Tramadol Hydrochloride Extended-Release","nonproprietary_name":"tramadol hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (13811-689-30)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":7.73637,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342026907","name":"TRAMADOL HCL ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-269-07","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (33342-269-07)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.89431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"68180069706","name":"TRAMADOL HCL ER 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-697-06","proprietary_name":"TRAMADOL HYDROCHLORIDE","nonproprietary_name":"TRAMADOL HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-697-06)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.89431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"13811069030","name":"TRAMADOL HCL ER 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-690-30","proprietary_name":"Tramadol Hydrochloride Extended-Release","nonproprietary_name":"tramadol hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"200 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"30 CAPSULE in 1 BOTTLE, PLASTIC (13811-690-30)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":9.35893,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342027007","name":"TRAMADOL HCL ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-270-07","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (33342-270-07)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.25071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"68180069806","name":"TRAMADOL HCL ER 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-698-06","proprietary_name":"TRAMADOL HYDROCHLORIDE","nonproprietary_name":"TRAMADOL HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-698-06)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":1.25071,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"33342027107","name":"TRAMADOL HCL ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-271-07","proprietary_name":"Tramadol Hydrochloride","nonproprietary_name":"Tramadol Hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (33342-271-07)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.16038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"68180069906","name":"TRAMADOL HCL ER 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-699-06","proprietary_name":"TRAMADOL HYDROCHLORIDE","nonproprietary_name":"TRAMADOL HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-699-06)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":2.16038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl ER|Tramadol HCl","basis":"generic"},"part_b":null}, {"ndc":"50268077411","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"50268077415","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-774-15","proprietary_name":"Tramadol Hydrochloride and Acetaminophen","nonproprietary_name":"Tramadol Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 325 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-774-15) / 1 TABLET in 1 BLISTER PACK (50268-774-11)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746061701","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-617-01","proprietary_name":"Tramadol Hydrochloride and Acetaminophen","nonproprietary_name":"Tramadol Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"100 TABLET in 1 BOTTLE (53746-617-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746061705","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-617-05","proprietary_name":"Tramadol Hydrochloride and Acetaminophen","nonproprietary_name":"Tramadol Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"500 TABLET in 1 BOTTLE (53746-617-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"53746061710","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53746-617-10","proprietary_name":"Tramadol Hydrochloride and Acetaminophen","nonproprietary_name":"Tramadol Hydrochloride and Acetaminophen","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 325 mg/1","labeler":"Amneal Pharmaceuticals of New York LLC","package_description":"1000 TABLET in 1 BOTTLE (53746-617-10)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65862092201","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-922-01","proprietary_name":"Tramadol Hydrochloride and Acetaminophen","nonproprietary_name":"Tramadol Hydrochloride and Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 325 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-922-01)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"65862092205","name":"TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-922-05","proprietary_name":"Tramadol Hydrochloride and Acetaminophen","nonproprietary_name":"Tramadol Hydrochloride and Acetaminophen","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"37.5 mg/1; 325 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-922-05)","pharm_classes":["Full Opioid Agonists [MoA]","Opioid Agonist [EPC]"]},"nadac":{"value":0.11595,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tramadol HCl-Acetaminophen|Tramadol HCl/Acetaminophen","basis":"generic"},"part_b":null}, {"ndc":"57237008901","name":"TRANDOLAPRIL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-089-01","proprietary_name":"Trandolapril","nonproprietary_name":"Trandolapril","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-089-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trandolapril|Trandolapril","basis":"generic"},"part_b":null}, {"ndc":"68180056601","name":"TRANDOLAPRIL 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-566-01","proprietary_name":"Trandolapril","nonproprietary_name":"Trandolapril","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-566-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trandolapril|Trandolapril","basis":"generic"},"part_b":null}, {"ndc":"57237009001","name":"TRANDOLAPRIL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-090-01","proprietary_name":"Trandolapril","nonproprietary_name":"Trandolapril","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-090-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.16218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trandolapril|Trandolapril","basis":"generic"},"part_b":null}, {"ndc":"68180056701","name":"TRANDOLAPRIL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-567-01","proprietary_name":"Trandolapril","nonproprietary_name":"Trandolapril","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-567-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.16218,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trandolapril|Trandolapril","basis":"generic"},"part_b":null}, {"ndc":"57237009101","name":"TRANDOLAPRIL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-091-01","proprietary_name":"Trandolapril","nonproprietary_name":"Trandolapril","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-091-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trandolapril|Trandolapril","basis":"generic"},"part_b":null}, {"ndc":"68180056801","name":"TRANDOLAPRIL 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-568-01","proprietary_name":"Trandolapril","nonproprietary_name":"Trandolapril","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET in 1 BOTTLE (68180-568-01)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":0.15608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trandolapril|Trandolapril","basis":"generic"},"part_b":null}, {"ndc":"23155016641","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-166-41","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"1 g/10mL","labeler":"Heritage Pharmaceuticals Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"10 VIAL, GLASS in 1 CARTON (23155-166-41) / 10 mL in 1 VIAL, GLASS (23155-166-31)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155052441","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-524-41","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"1 g/10mL","labeler":"Heritage Pharmaceuticals Labs Inc. d/b/a Avet Pharmaceuticals Labs Inc.","package_description":"10 VIAL, GLASS in 1 CARTON (23155-524-41) / 10 mL in 1 VIAL, GLASS (23155-524-31)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"23155091041","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-910-41","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (23155-910-41) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021041510","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-415-10","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-415-10) / 10 mL in 1 VIAL","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"25021041566","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-415-66","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-415-66) / 10 mL in 1 VIAL","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"39822100001","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39822-1000-1","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"XGen Pharmaceuticals DJB, Inc.","package_description":"10 VIAL in 1 CARTON (39822-1000-1) / 10 mL in 1 VIAL","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43066000810","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43066-008-10","proprietary_name":"TRANEXAMIC ACID","nonproprietary_name":"tranexamic acid","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Baxter Healthcare Corporation","package_description":"10 CARTON in 1 BOX (43066-008-10) / 1 VIAL, SINGLE-DOSE in 1 CARTON / 10 mL in 1 VIAL, SINGLE-DOSE (43066-008-01)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55150018810","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55150-188-10","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Eugia US LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (55150-188-10) / 10 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505616901","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6169-1","proprietary_name":"Tranexamic Acid","nonproprietary_name":"tranexamic acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Apotex Corp.","package_description":"10 VIAL in 1 CARTON (60505-6169-1) / 10 mL in 1 VIAL","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"61990061102","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65145010610","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65145-106-10","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Caplin Steriles Limited","package_description":"10 VIAL in 1 BOX (65145-106-10) / 10 mL in 1 VIAL (65145-106-01)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67457019710","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-197-10","proprietary_name":"Tranexamic Acid","nonproprietary_name":"tranexamic acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Mylan Institutional LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 PACKAGE (67457-197-10) / 10 mL in 1 VIAL, SINGLE-DOSE (67457-197-00)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72485051010","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72485-510-10","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Armas Pharmaceuticals Inc.","package_description":"10 VIAL in 1 CARTON (72485-510-10) / 10 mL in 1 VIAL (72485-510-01)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603038710","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-387-10","proprietary_name":"TRANEXAMIC ACID","nonproprietary_name":"Tranexamic acid","dosage_form":"INJECTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Northstar Rx LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72603-387-10) / 10 mL in 1 VIAL, SINGLE-DOSE (72603-387-01)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81284061110","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81284-611-10","proprietary_name":"tranexamic acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Provepharm Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (81284-611-10) / 10 mL in 1 VIAL, SINGLE-DOSE (81284-611-00)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81284061210","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81284-612-10","proprietary_name":"tranexamic acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Provepharm Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (81284-612-10) / 10 mL in 1 VIAL, SINGLE-DOSE (81284-612-00)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"83634040110","name":"TRANEXAMIC ACID 1,000 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83634-401-10","proprietary_name":"tranexamic acid","nonproprietary_name":"tranexamic acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"100 mg/mL","labeler":"Avenacy, Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (83634-401-10) / 10 mL in 1 VIAL, SINGLE-DOSE (83634-401-41)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.40354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591372030","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3720-30","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"650 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-3720-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268077211","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268077213","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-772-13","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-772-13) / 1 TABLET in 1 BLISTER PACK (50268-772-11)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"59651083930","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-839-30","proprietary_name":"TRANEXAMIC ACID","nonproprietary_name":"TRANEXAMIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET in 1 BOTTLE (59651-839-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687075011","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687075021","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-750-21","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-750-21) / 1 TABLET in 1 BLISTER PACK (60687-750-11)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559026530","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-265-30","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (62559-265-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69918030130","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69918-301-30","proprietary_name":"Tranexamic Acid","nonproprietary_name":"Tranexamic Acid","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Nordic Pharma, Inc.","package_description":"30 TABLET in 1 BOTTLE (69918-301-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888017830","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-178-30","proprietary_name":"TRANEXAMIC ACID","nonproprietary_name":"TRANEXAMIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"ADVAGEN PHARMA LIMITED","package_description":"30 TABLET in 1 BOTTLE (72888-178-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"75907030930","name":"TRANEXAMIC ACID 650 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-309-30","proprietary_name":"TRANEXAMIC ACID","nonproprietary_name":"TRANEXAMIC ACID","dosage_form":"TABLET","route":"ORAL","strength":"650 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET in 1 BOTTLE (75907-309-30)","pharm_classes":["Antifibrinolytic Agent [EPC]","Decreased Fibrinolysis [PE]"]},"nadac":{"value":0.83438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10019000810","name":"TRANSDERM-SCOP 1 MG/3 DAY PTCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10019-008-10","proprietary_name":"Transderm Scop","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Baxter Healthcare Corporation","package_description":"10 POUCH in 1 BOX (10019-008-10) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":11.02117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10019000824","name":"TRANSDERM-SCOP 1 MG/3 DAY PTCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10019-008-24","proprietary_name":"Transderm Scop","nonproprietary_name":"Scopolamine","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"1 mg/3d","labeler":"Baxter Healthcare Corporation","package_description":"24 POUCH in 1 BOX (10019-008-24) / 1 PATCH in 1 POUCH / 3 d in 1 PATCH","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":11.02117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.33565,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591559001","name":"TRANYLCYPROMINE SULF 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5590-01","proprietary_name":"Tranylcypromine Sulfate","nonproprietary_name":"tranylcypromine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0591-5590-01)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.5911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tranylcypromine Sulfate|Tranylcypromine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"43547065510","name":"TRANYLCYPROMINE SULF 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-655-10","proprietary_name":"Tranylcypromine","nonproprietary_name":"TRANYLCYPROMINE","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"100 TABLET in 1 BOTTLE (43547-655-10)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.5911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tranylcypromine Sulfate|Tranylcypromine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"64380017601","name":"TRANYLCYPROMINE SULF 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-176-01","proprietary_name":"TRANYLCYPROMINE SULFATE","nonproprietary_name":"tranylcypromine sulfate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (64380-176-01)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.5911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tranylcypromine Sulfate|Tranylcypromine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"70954053810","name":"TRANYLCYPROMINE SULF 10 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-538-10","proprietary_name":"Tranylcypromine","nonproprietary_name":"Tranylcypromine","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-538-10)","pharm_classes":["Monoamine Oxidase Inhibitor [EPC]","Monoamine Oxidase Inhibitors [MoA]"]},"nadac":{"value":0.5911,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tranylcypromine Sulfate|Tranylcypromine Sulfate","basis":"generic"},"part_b":null}, {"ndc":"66758009556","name":"TRAVATAN Z 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-095-56","proprietary_name":"Travatan Z","nonproprietary_name":"travoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (66758-095-56) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":94.2313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travatan Z|Travoprost","basis":"brand"},"part_b":null}, {"ndc":"66758009575","name":"TRAVATAN Z 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-095-75","proprietary_name":"Travatan Z","nonproprietary_name":"travoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE in 1 CARTON (66758-095-75) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":94.29844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travatan Z|Travoprost","basis":"brand"},"part_b":null}, {"ndc":"00378965132","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9651-32","proprietary_name":"Travoprost Ophthalmic Solution, 0.004%","nonproprietary_name":"Travoprost Ophthalmic Solution, 0.004%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (0378-9651-32) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"00378965150","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9651-50","proprietary_name":"Travoprost Ophthalmic Solution, 0.004%","nonproprietary_name":"Travoprost Ophthalmic Solution, 0.004%","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (0378-9651-50) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"25021000202","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-002-02","proprietary_name":"Travoprost Ophthalmic Soluton","nonproprietary_name":"Travoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (25021-002-02) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"25021000205","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-002-05","proprietary_name":"Travoprost Ophthalmic Soluton","nonproprietary_name":"Travoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"1 BOTTLE in 1 CARTON (25021-002-05) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"42571013021","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-130-21","proprietary_name":"Travoprost Ophthalmic","nonproprietary_name":"Travoprost Ophthalmic Solution","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Micro Labs Limited","package_description":"5 BOTTLE in 1 CARTON (42571-130-21) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"42571013027","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-130-27","proprietary_name":"Travoprost Ophthalmic","nonproprietary_name":"Travoprost Ophthalmic Solution","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Micro Labs Limited","package_description":"2.5 BOTTLE in 1 CARTON (42571-130-27) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"60505059301","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0593-1","proprietary_name":"Travoprost","nonproprietary_name":"travoprost","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-0593-1) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"60505059304","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-0593-4","proprietary_name":"Travoprost","nonproprietary_name":"travoprost","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Apotex Corp.","package_description":"1 BOTTLE in 1 CARTON (60505-0593-4) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"68462094303","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-943-03","proprietary_name":"Travoprost Ophthalmic Solution","nonproprietary_name":"Travoprost Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"GLENMARK PHARMACEUTICALS INC","package_description":"1 BOTTLE in 1 CARTON (68462-943-03) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"68462094305","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-943-05","proprietary_name":"Travoprost Ophthalmic Solution","nonproprietary_name":"Travoprost Ophthalmic Solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"GLENMARK PHARMACEUTICALS INC","package_description":"1 BOTTLE in 1 CARTON (68462-943-05) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"70069058601","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-586-01","proprietary_name":"Travoprost","nonproprietary_name":"Travoprost (Isomer Free)","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-586-01) / 2.5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":8.39412,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"70069058701","name":"TRAVOPROST 0.004% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-587-01","proprietary_name":"Travoprost","nonproprietary_name":"Travoprost (Isomer Free)","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".04 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-587-01) / 5 mL in 1 BOTTLE","pharm_classes":["Prostaglandin Analog [EPC]","Prostaglandins [CS]"]},"nadac":{"value":9.74746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Travoprost|Travoprost","basis":"generic"},"part_b":null}, {"ndc":"00904686961","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6869-61","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6869-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107008001","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-080-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-080-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107008005","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-080-05","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (13107-080-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033101","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-331-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-331-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033105","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-331-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-331-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111056101","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-561-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-561-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111056102","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-561-02","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (50111-561-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111056103","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-561-03","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-561-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664002672","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-026-72","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-026-72)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664002674","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-026-74","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-026-74)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664002675","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-026-75","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-026-75)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505265401","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2654-1","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-2654-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687045401","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-454-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-454-01) / 1 TABLET in 1 BLISTER PACK (60687-454-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687045411","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067301","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-673-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-673-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067310","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-673-10","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-673-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067350","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-673-50","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-673-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382061001","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-610-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-610-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382061005","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-610-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-610-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382061010","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-610-10","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-610-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080601","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-806-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-806-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080605","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-806-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-806-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080610","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-806-10","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-806-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023201","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-232-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-232-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023205","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-232-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-232-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023210","name":"TRAZODONE 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-232-10","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-232-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.05126,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904721261","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7212-61","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7212-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107008101","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-081-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-081-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107008105","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-081-05","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (13107-081-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033201","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-332-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-332-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033205","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-332-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-332-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111045001","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-450-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-450-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111045002","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-450-02","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (50111-450-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268077611","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268077615","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-776-15","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-776-15) / 1 TABLET in 1 BLISTER PACK (50268-776-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664005372","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-053-72","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (57664-053-72)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664005374","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-053-74","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (57664-053-74)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505265501","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2655-1","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-2655-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043201","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-432-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-432-01) / 1 TABLET in 1 BLISTER PACK (60687-432-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687043211","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067401","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-674-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-674-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067450","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-674-50","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-674-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080701","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-807-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-807-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080705","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-807-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-807-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023301","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-233-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-233-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023305","name":"TRAZODONE 150 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-233-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-233-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08645,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00555071102","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-0711-02","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0555-0711-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107008201","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-082-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-082-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033301","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-333-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-333-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505265901","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2659-1","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-2659-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067501","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-675-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-675-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080801","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-808-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-808-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023401","name":"TRAZODONE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-234-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-234-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.49767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904686861","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6868-61","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6868-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107007901","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-079-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurolife Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (13107-079-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13107007905","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13107-079-05","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"TRAZODONE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Aurolife Pharma LLC","package_description":"500 TABLET in 1 BOTTLE (13107-079-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033001","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-330-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-330-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"13668033005","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-330-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-330-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111056001","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-560-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (50111-560-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111056002","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-560-02","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 TABLET in 1 BOTTLE (50111-560-02)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"50111056003","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50111-560-03","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (50111-560-03)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664001472","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-014-72","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-014-72)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664001474","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-014-74","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-014-74)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"57664001475","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-014-75","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (57664-014-75)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505265301","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2653-1","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Apotex Corp","package_description":"100 TABLET in 1 BOTTLE (60505-2653-1)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044301","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-443-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-443-01) / 1 TABLET in 1 BLISTER PACK (60687-443-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687044311","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687095401","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-954-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-954-01) / 1 TABLET in 1 BLISTER PACK (60687-954-11)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60687095411","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067201","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-672-01","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (64980-672-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067210","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-672-10","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1000 TABLET in 1 BOTTLE (64980-672-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"64980067250","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-672-50","proprietary_name":"TRAZODONE HYDROCHLORIDE","nonproprietary_name":"trazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"500 TABLET in 1 BOTTLE (64980-672-50)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382060901","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-609-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-609-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382060905","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-609-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-609-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382060910","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-609-10","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-609-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080501","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-805-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-805-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080505","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-805-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-805-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"68382080510","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-805-10","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 TABLET in 1 BOTTLE (68382-805-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023101","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-231-01","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (70010-231-01)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023105","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-231-05","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (70010-231-05)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"70010023110","name":"TRAZODONE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-231-10","proprietary_name":"Trazodone Hydrochloride","nonproprietary_name":"Trazodone Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (70010-231-10)","pharm_classes":["Serotonin Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.03074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trazodone HCl|Trazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00173088710","name":"TRELEGY ELLIPTA 100-62.5-25","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0887-10","proprietary_name":"Trelegy Ellipta","nonproprietary_name":"fluticasone furoate, umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 62.5 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0887-10) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.15225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trelegy Ellipta|Fluticasone/Umeclidin/Vilanter","basis":"brand"},"part_b":null}, {"ndc":"00173088714","name":"TRELEGY ELLIPTA 100-62.5-25","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0887-14","proprietary_name":"Trelegy Ellipta","nonproprietary_name":"fluticasone furoate, umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 62.5 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0887-14) / 1 INHALER in 1 TRAY / 14 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.07954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trelegy Ellipta|Fluticasone/Umeclidin/Vilanter","basis":"brand"},"part_b":null}, {"ndc":"00173089310","name":"TRELEGY ELLIPTA 200-62.5-25","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0893-10","proprietary_name":"Trelegy Ellipta","nonproprietary_name":"fluticasone furoate, umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 62.5 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0893-10) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.15252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trelegy Ellipta|Fluticasone/Umeclidin/Vilanter","basis":"brand"},"part_b":null}, {"ndc":"00173089314","name":"TRELEGY ELLIPTA 200-62.5-25","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0893-14","proprietary_name":"Trelegy Ellipta","nonproprietary_name":"fluticasone furoate, umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"200 ug/1; 62.5 ug/1; 25 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 TRAY in 1 CARTON (0173-0893-14) / 1 INHALER in 1 TRAY / 14 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":11.1997,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trelegy Ellipta|Fluticasone/Umeclidin/Vilanter","basis":"brand"},"part_b":null}, {"ndc":"57894064011","name":"TREMFYA 100 MG/ML ONE-PRESS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-640-11","proprietary_name":"TREMFYA","nonproprietary_name":"Guselkumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-640-11) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":14743.71813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1628","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1628 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (57894-640-11) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"57894064003","name":"TREMFYA 100 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":14620.06917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57894064006","name":"TREMFYA 100 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-640-06","proprietary_name":"TREMFYA","nonproprietary_name":"Guselkumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-640-06) / 1 mL in 1 SYRINGE (57894-640-03)","pharm_classes":["Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":14620.06917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1628","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1628 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (57894-640-06) / 1 mL in 1 SYRINGE (57894-640-03)) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"57894064001","name":"TREMFYA 100 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-640-01","proprietary_name":"TREMFYA","nonproprietary_name":"Guselkumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-640-01) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":14728.90533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1628","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1628 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (57894-640-01) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"57894065101","name":"TREMFYA 200 MG/2 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7321.65571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"57894065102","name":"TREMFYA 200 MG/2 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57894-651-02","proprietary_name":"TREMFYA","nonproprietary_name":"guselkumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"200 mg/2mL","labeler":"Janssen Biotech, Inc.","package_description":"1 SYRINGE in 1 CARTON (57894-651-02) / 2 mL in 1 SYRINGE (57894-651-01)","pharm_classes":["Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":7321.65571,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J1628","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J1628 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":2,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (57894-651-02) / 2 mL in 1 SYRINGE (57894-651-01)) gives 2 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00169266211","name":"TRESIBA 100 UNIT/ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-2662-11","proprietary_name":"Tresiba","nonproprietary_name":"insulin degludec","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 U/mL","labeler":"Novo Nordisk","package_description":"1 VIAL, GLASS in 1 CARTON (0169-2662-11) / 10 mL in 1 VIAL, GLASS","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":9.02432,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tresiba|Insulin Degludec","basis":"brand"},"part_b":null}, {"ndc":"00169266015","name":"TRESIBA FLEXTOUCH 100 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-2660-15","proprietary_name":"Tresiba","nonproprietary_name":"insulin degludec","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 U/mL","labeler":"Novo Nordisk","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-2660-15) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":9.03577,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tresiba Flextouch U-100|Insulin Degludec","basis":"brand"},"part_b":null}, {"ndc":"00169255013","name":"TRESIBA FLEXTOUCH 200 UNIT/ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-2550-13","proprietary_name":"Tresiba","nonproprietary_name":"insulin degludec","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"200 U/mL","labeler":"Novo Nordisk","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (0169-2550-13) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":18.07027,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tresiba Flextouch U-200|Insulin Degludec","basis":"brand"},"part_b":null}, {"ndc":"00378808515","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8085-15","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8085-15) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.73988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808545","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8085-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8085-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.3019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574230115","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2301-15","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2301-15) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.73988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574230145","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2301-45","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2301-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.3019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922005604","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-056-04","proprietary_name":"TRETINOIN","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-056-04) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.73988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922005606","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-056-06","proprietary_name":"TRETINOIN","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-056-06) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.3019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651071214","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-712-14","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-712-14) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.73988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651071246","name":"TRETINOIN 0.01% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-712-46","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".1 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-712-46) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.3019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808220","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8082-20","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8082-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808245","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8082-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8082-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00472011720","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0117-20","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0117-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00472011745","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0472-0117-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Actavis Pharma, Inc.","package_description":"1 TUBE in 1 CARTON (0472-0117-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574222520","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2225-20","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2225-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574222545","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2225-45","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2225-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"16714027001","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-270-01","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-270-01) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"16714027002","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-270-02","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-270-02) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922007906","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-079-06","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-079-06) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922007925","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-079-25","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-079-25) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"51672140700","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1407-0","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1407-0) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"51672140709","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1407-9","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1407-9) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"62332080920","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-809-20","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-809-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.55294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"62332080945","name":"TRETINOIN 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-809-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-809-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.45929,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808615","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8086-15","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8086-15) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.54983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808645","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8086-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8086-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.50019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574232515","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2325-15","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2325-15) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.54983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574232545","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2325-45","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2325-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.50019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922005704","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-057-04","proprietary_name":"TRETINOIN","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-057-04) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.54983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922005706","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-057-06","proprietary_name":"TRETINOIN","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-057-06) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.50019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651071314","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-713-14","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-713-14) / 15 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.54983,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"59651071346","name":"TRETINOIN 0.025% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-713-46","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".25 mg/g","labeler":"Aurobindo Pharma Limited","package_description":"1 TUBE in 1 CARTON (59651-713-46) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.50019,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808320","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8083-20","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8083-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.61765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808345","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8083-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8083-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.05049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574220520","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2205-20","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2205-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.61765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574220545","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2205-45","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2205-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.05049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"16714024901","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-249-01","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-249-01) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.61765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"16714024902","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-249-02","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-249-02) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.05049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"51672139400","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1394-0","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1394-0) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.61765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"51672139409","name":"TRETINOIN 0.05% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1394-9","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1394-9) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.05049,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378809045","name":"TRETINOIN 0.05% GEL","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8090-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".5 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8090-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":3.93282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808420","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8084-20","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8084-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00378808445","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-8084-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (0378-8084-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574220120","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2201-20","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2201-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00574220145","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-2201-45","proprietary_name":"TRETINOIN","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis US LLC","package_description":"1 TUBE in 1 CARTON (0574-2201-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"16714025001","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-250-01","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-250-01) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"16714025002","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-250-02","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"NORTHSTAR RX LLC","package_description":"1 TUBE in 1 CARTON (16714-250-02) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922007706","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-077-06","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-077-06) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"21922007725","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-077-25","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-077-25) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"51672139500","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1395-0","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1395-0) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"51672139509","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1395-9","proprietary_name":"Tretinoin","nonproprietary_name":"tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1395-9) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"62332080720","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-807-20","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-807-20) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"62332080745","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-807-45","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 TUBE in 1 CARTON (62332-807-45) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"72578015308","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-153-08","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-153-08) / 45 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.77008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"72578015309","name":"TRETINOIN 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-153-09","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Viona Pharmaceuticals Inc","package_description":"1 TUBE in 1 CARTON (72578-153-09) / 20 g in 1 TUBE","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":0.91963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Tretinoin*|Tretinoin","basis":"generic"},"part_b":null}, {"ndc":"00904686704","name":"TRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6867-04","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6867-04) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":8.53098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"10370026801","name":"TRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10370-268-01","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (10370-268-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":8.53098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084007511","name":"TRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":8.53098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084007521","name":"TRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-075-21","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"American Health Packaging","package_description":"3 BLISTER PACK in 1 CARTON (68084-075-21) / 10 CAPSULE in 1 BLISTER PACK (68084-075-11)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":8.53098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462079201","name":"TRETINOIN 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-792-01","proprietary_name":"Tretinoin","nonproprietary_name":"Tretinoin","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-792-01)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":8.53098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"21922004340","name":"TRETINOIN GEL MICRO 0.08% PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-043-40","proprietary_name":"TRETINOIN","nonproprietary_name":"Tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".8 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 BOTTLE, PUMP in 1 CARTON (21922-043-40) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.46457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68308077750","name":"TRETINOIN GEL MICRO 0.08% PUMP","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68308-777-50","proprietary_name":"Tretinoin (Microsphere)","nonproprietary_name":"tretinoin","dosage_form":"GEL","route":"TOPICAL","strength":".8 mg/g","labeler":"Mayne Pharma","package_description":"1 BOTTLE, PUMP in 1 CARTON (68308-777-50) / 50 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":11.46457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51285036801","name":"TREXALL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51285-368-01","proprietary_name":"Trexall","nonproprietary_name":"Methotrexate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Women's Health LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51285-368-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":48.13525,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trexall|Methotrexate Sodium","basis":"brand"},"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (51285-368-01)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51285036601","name":"TREXALL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51285-366-01","proprietary_name":"Trexall","nonproprietary_name":"Methotrexate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Women's Health LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51285-366-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":24.08844,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trexall|Methotrexate Sodium","basis":"brand"},"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (51285-366-01)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"51285036701","name":"TREXALL 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51285-367-01","proprietary_name":"Trexall","nonproprietary_name":"Methotrexate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"7.5 mg/1","labeler":"Teva Women's Health LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51285-367-01)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":36.20914,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trexall|Methotrexate Sodium","basis":"brand"},"part_b":{"hcpcs":"J8610","bill_units_per_package":{"value":90,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8610 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (90 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":30,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 TABLET, FILM COATED in 1 BOTTLE (51285-367-01)) gives 30 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70700012184","name":"TRI-ESTARYLLA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Estarylla|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700012185","name":"TRI-ESTARYLLA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-121-85","proprietary_name":"Tri-Estarylla","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-121-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Estarylla|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555903270","name":"TRI-LEGEST FE-28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9032-70","proprietary_name":"Tri-Legest Fe 28 Day","nonproprietary_name":"Norethindrone Acetate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"5 BLISTER PACK in 1 CARTON (0555-9032-70) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.7459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Legest Fe|Norethindrone-E.Estradiol-Iron","basis":"brand"},"part_b":null}, {"ndc":"16714036301","name":"TRI-LINYAH TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-363-01","proprietary_name":"Tri-Linyah","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-363-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Linyah|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714036304","name":"TRI-LINYAH TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-363-04","proprietary_name":"Tri-Linyah","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Northstar Rx LLC","package_description":"6 BLISTER PACK in 1 CARTON (16714-363-04) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Linyah|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700012084","name":"TRI-LO-ESTARYLLA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Estarylla|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700012085","name":"TRI-LO-ESTARYLLA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-120-85","proprietary_name":"Tri-Lo- Estarylla","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-120-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Estarylla|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180083771","name":"TRI-LO-MARZIA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Marzia|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180083773","name":"TRI-LO-MARZIA TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-837-73","proprietary_name":"TRI-LO-MARZIA","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-837-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Marzia|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862077828","name":"TRI-LO-MILI TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-778-28","proprietary_name":"Tri-Lo-Mili","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-778-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Mili|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862077885","name":"TRI-LO-MILI TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-778-85","proprietary_name":"Tri-Lo-Mili","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-778-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Mili|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093214028","name":"TRI-LO-SPRINTEC TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Sprintec|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00093214062","name":"TRI-LO-SPRINTEC TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-2140-62","proprietary_name":"Tri-Lo-Sprintec","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0093-2140-62) / 1 BLISTER PACK in 1 POUCH (0093-2140-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Lo-Sprintec|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00299595030","name":"TRI-LUMA CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0299-5950-30","proprietary_name":"TRI-LUMA","nonproprietary_name":"fluocinolone acetonide, hydroquinone, and tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":".1 mg/g; 40 mg/g; .5 mg/g","labeler":"Galderma Laboratories, L.P.","package_description":"1 TUBE in 1 CARTON (0299-5950-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","Depigmenting Activity [PE]","Melanin Synthesis Inhibitor [EPC]","Melanin Synthesis Inhibitors [MoA]","Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":7.83363,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"65862077728","name":"TRI-MILI 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-777-28","proprietary_name":"Tri-Mili","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (65862-777-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Mili|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65862077785","name":"TRI-MILI 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-777-85","proprietary_name":"Tri-Mili","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (65862-777-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Mili|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555901858","name":"TRI-SPRINTEC TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9018-58","proprietary_name":"Tri-Sprintec","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"6 POUCH in 1 CARTON (0555-9018-58) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Sprintec|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"58657032350","name":"TRI-VITE-FLUORIDE 0.25 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-323-50","proprietary_name":"Tri-Vite Drops with Fluoride","nonproprietary_name":"ASCORBIC ACID, SODIUM FLUORIDE, VITAMIN A and VITAMIN D","dosage_form":"SOLUTION","route":"ORAL","strength":"1500 [iU]/mL; 35 mg/mL; 400 [iU]/mL; .25 mg/mL","labeler":"Method Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (58657-323-50) / 50 mL in 1 BOTTLE, DROPPER","pharm_classes":["Ascorbic Acid [CS]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin C [EPC]"]},"nadac":{"value":0.19608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50102023311","name":"TRI-VYLIBRA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-233-11","proprietary_name":"Tri-VyLibra","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"1 BLISTER PACK in 1 CARTON (50102-233-11) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Vylibra|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023313","name":"TRI-VYLIBRA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-233-13","proprietary_name":"Tri-VyLibra","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 BLISTER PACK in 1 CARTON (50102-233-13) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.12642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Vylibra|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023101","name":"TRI-VYLIBRA LO TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Vylibra Lo|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023111","name":"TRI-VYLIBRA LO TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Vylibra Lo|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023113","name":"TRI-VYLIBRA LO TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-231-13","proprietary_name":"Tri-VyLibra Lo","nonproprietary_name":"Norgestimate and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 PACKAGE in 1 CARTON (50102-231-13) / 1 BLISTER PACK in 1 PACKAGE (50102-231-11) / 1 KIT in 1 BLISTER PACK (50102-231-01)"},"nadac":{"value":0.10804,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tri-Vylibra Lo|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00168000315","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0003-15","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0003-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000380","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0003-80","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0003-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022615","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0226-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0226-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022680","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0226-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0226-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098501","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-985-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-985-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098502","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-985-02","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-985-02) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342032715","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-327-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-327-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342032780","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-327-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-327-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006305","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-063-05","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"454 g in 1 JAR (45802-063-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006335","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-063-35","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-063-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006336","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-063-36","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-063-36) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877031715","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-317-15","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"15 g in 1 TUBE (67877-317-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.1198,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877031745","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-317-45","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"454 g in 1 TUBE (67877-317-45)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03528,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877031780","name":"TRIAMCINOLONE 0.025% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-317-80","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":".25 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"80 g in 1 TUBE (67877-317-80)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.0532,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70752012905","name":"TRIAMCINOLONE 0.025% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-129-05","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"LOTION","route":"TOPICAL","strength":".25 mg/mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"60 mL in 1 BOTTLE, WITH APPLICATOR (70752-129-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.35034,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168000580","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0005-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"80 g in 1 TUBE (0168-0005-80)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022915","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0229-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0229-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022980","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0229-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0229-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714026701","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-267-01","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-267-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714026702","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-267-02","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-267-02) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714026703","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-267-03","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"NorthStar RxLLC","package_description":"454 g in 1 JAR (16714-267-03)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033115","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-331-15","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-331-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033154","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-331-54","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"454 g in 1 JAR (33342-331-54)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033180","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-331-80","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-331-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005405","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-054-05","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"454 g in 1 JAR (45802-054-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005435","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-054-35","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-054-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.23917,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005436","name":"TRIAMCINOLONE 0.025% OINT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-054-36","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".25 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-054-36) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.07404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922002411","name":"TRIAMCINOLONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-024-11","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide Ointment USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"430 g in 1 JAR (21922-024-11)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.18678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033413","name":"TRIAMCINOLONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-334-13","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"430 g in 1 JAR (33342-334-13)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.18678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802081701","name":"TRIAMCINOLONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-817-01","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"430 g in 1 JAR (45802-817-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.18678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"64380090190","name":"TRIAMCINOLONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-901-90","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Strides Pharma Science Limited","package_description":"430 g in 1 JAR (64380-901-90)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.18678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"72603031901","name":"TRIAMCINOLONE 0.05% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-319-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide Ointment USP, 0.05%","dosage_form":"OINTMENT","route":"TOPICAL","strength":".5 mg/g","labeler":"Northstar Rx LLC","package_description":"430 g in 1 JAR (72603-319-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.18678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000415","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0004-15","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0004-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000416","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0004-16","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"453.6 g in 1 JAR (0168-0004-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02496,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000480","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0004-80","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0004-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022515","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0225-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0225-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022531","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0225-31","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0225-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022580","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0225-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0225-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098601","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-986-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-986-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098602","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-986-02","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-986-02) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098603","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-986-03","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-986-03) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098604","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-986-04","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"454 g in 1 JAR (16714-986-04)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006204","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-062-04","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-062-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006205","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-062-05","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-062-05) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006215","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-062-15","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-062-15) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006230","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-062-30","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"454 g in 1 JAR (21922-062-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342032915","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-329-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-329-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342032954","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-329-54","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"454 g in 1 JAR (33342-329-54)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342032980","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-329-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-329-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006405","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-064-05","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"454 g in 1 JAR (45802-064-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006435","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-064-35","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-064-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006436","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-064-36","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-064-36) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128201","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1282-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1282-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128202","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1282-2","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1282-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128208","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1282-8","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1282-8) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"52817081154","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-811-54","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"TruPharma, LLC","package_description":"454 g in 1 JAR (52817-811-54)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877025115","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-251-15","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"15 g in 1 TUBE (67877-251-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877025130","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-251-30","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"30 g in 1 TUBE (67877-251-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877025145","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-251-45","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"454 g in 1 JAR (67877-251-45)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.02729,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877025180","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-251-80","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"80 g in 1 TUBE (67877-251-80)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"71656004215","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-042-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"1 TUBE in 1 CARTON (71656-042-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.10199,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"71656004230","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-042-30","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"1 TUBE in 1 CARTON (71656-042-30) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.08223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"71656004280","name":"TRIAMCINOLONE 0.1% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-042-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"1 TUBE in 1 CARTON (71656-042-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713067653","name":"TRIAMCINOLONE 0.1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0676-53","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (0713-0676-53) / 60 mL in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"42571038519","name":"TRIAMCINOLONE 0.1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-385-19","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"MICRO LABS LIMITED","package_description":"60 mL in 1 BOTTLE (42571-385-19)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752013005","name":"TRIAMCINOLONE 0.1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-130-05","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"60 mL in 1 BOTTLE, WITH APPLICATOR (70752-130-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71656004060","name":"TRIAMCINOLONE 0.1% LOTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71656-040-60","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"LOTION","route":"TOPICAL","strength":"1 mg/mL","labeler":"Saptalis Pharmaceuticals, LLC.","package_description":"60 mL in 1 BOTTLE (71656-040-60)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27095,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00168000615","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0006-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"15 g in 1 TUBE (0168-0006-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000616","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0168-0006-16","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"454 g in 1 JAR (0168-0006-16)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.04623,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000680","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0006-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"80 g in 1 TUBE (0168-0006-80)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022815","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0228-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0228-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022831","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0228-31","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0228-31) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713022880","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0228-80","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0228-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714027601","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-276-01","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-276-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714027602","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-276-02","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-276-02) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714027603","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-276-03","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"NorthStar RxLLC","package_description":"454 g in 1 JAR (16714-276-03)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006304","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-063-04","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-063-04) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006305","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-063-05","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-063-05) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006315","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-063-15","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-063-15) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922006330","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-063-30","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Encube Ethicals, Inc.","package_description":"454 g in 1 JAR (21922-063-30)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033315","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-333-15","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-333-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033354","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-333-54","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"454 g in 1 JAR (33342-333-54)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033380","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-333-80","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-333-80) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005505","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-055-05","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"454 g in 1 JAR (45802-055-05)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.03407,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005535","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-055-35","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-055-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802005536","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-055-36","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-055-36) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128401","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1284-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1284-1) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128402","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1284-2","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1284-2) / 30 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.11948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672128408","name":"TRIAMCINOLONE 0.1% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1284-8","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1284-8) / 80 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.06471,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713065540","name":"TRIAMCINOLONE 0.1% PASTE","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0655-40","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"PASTE","route":"DENTAL","strength":"1 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0655-40) / 5 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.58343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672126705","name":"TRIAMCINOLONE 0.1% PASTE","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-1267-5","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"PASTE","route":"DENTAL","strength":"1 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-1267-5) / 5 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.58343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"64980032005","name":"TRIAMCINOLONE 0.1% PASTE","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-320-05","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"PASTE","route":"TOPICAL","strength":"1 mg/g","labeler":"Rising Pharma Holdings, Inc.","package_description":"48 CARTON in 1 BOX (64980-320-05) / 1 TUBE in 1 CARTON / 5 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.58343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70752014017","name":"TRIAMCINOLONE 0.1% PASTE","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-140-17","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"PASTE","route":"DENTAL","strength":"1 mg/g","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"1 TUBE in 1 CARTON (70752-140-17) / 5 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.58343,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004501","name":"TRIAMCINOLONE 0.147 MG/G SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-045-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":".147 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"63 g in 1 CAN (45802-045-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":1.93075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004502","name":"TRIAMCINOLONE 0.147 MG/G SPRAY","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-045-02","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"AEROSOL, SPRAY","route":"TOPICAL","strength":".147 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"100 g in 1 CAN (45802-045-02)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":2.83003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00168000215","name":"TRIAMCINOLONE 0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0168-0002-15","proprietary_name":"triamcinolone acetonide","nonproprietary_name":"triamcinolone acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC","package_description":"1 TUBE in 1 CARTON (0168-0002-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714098701","name":"TRIAMCINOLONE 0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-987-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-987-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342032815","name":"TRIAMCINOLONE 0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-328-15","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-328-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802006535","name":"TRIAMCINOLONE 0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-065-35","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-065-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"67877031815","name":"TRIAMCINOLONE 0.5% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-318-15","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"CREAM","route":"TOPICAL","strength":"5 mg/g","labeler":"Ascend Laboratories, LLC","package_description":"15 g in 1 TUBE (67877-318-15)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.19028,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"16714026801","name":"TRIAMCINOLONE 0.5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-268-01","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"5 mg/g","labeler":"NorthStar RxLLC","package_description":"1 TUBE in 1 CARTON (16714-268-01) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"33342033215","name":"TRIAMCINOLONE 0.5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-332-15","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"5 mg/g","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 TUBE in 1 CARTON (33342-332-15) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802004935","name":"TRIAMCINOLONE 0.5% OINTMENT","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-049-35","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"5 mg/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-049-35) / 15 g in 1 TUBE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.27541,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802010901","name":"TRIAMCINOLONE 55 MCG NASAL SPR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-109-01","proprietary_name":"Triamcinolone Acetonide Nasal","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 BOTTLE in 1 CARTON (45802-109-01) / 120 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60505627507","name":"TRIAMCINOLONE 55 MCG NASAL SPR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-6275-7","proprietary_name":"Triamcinolone acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"Apotex Corp.","package_description":"1 BOTTLE, SPRAY in 1 CARTON (60505-6275-7) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000070201","name":"TRIAMCINOLONE 55 MCG NASAL SPR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000074201","name":"TRIAMCINOLONE 55 MCG NASAL SPR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0742-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone acetonide","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"55 ug/1","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER 70000","package_description":"1 BOTTLE, SPRAY in 1 CARTON (70000-0742-1) / 120 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":0.73884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00703024301","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0703-0243-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0703-0243-01) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0703-0243-01) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714014001","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-140-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"200 mg/5mL","labeler":"NorthStar Rx LLC","package_description":"1 VIAL in 1 CARTON (16714-140-01) / 5 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (16714-140-01) / 5 mL in 1 VIAL) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"43598069411","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-694-11","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"200 mg/5mL","labeler":"Dr. Reddy's Laboratories Inc","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (43598-694-11) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (43598-694-11) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457062205","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"70121116801","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1168-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"200 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1168-1) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1168-1) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165201","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1652-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"200 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1652-1) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1652-1) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165401","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1654-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"200 mg/5mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1654-1) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1654-1) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81298578503","name":"TRIAMCINOLONE ACET 200 MG/5 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81298-5785-3","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"SUSPENSION","route":"INTRA-ARTERIAL; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Long Grove Pharmaceuticals, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (81298-5785-3) / 5 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":6.38317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (20 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (81298-5785-3) / 5 mL in 1 VIAL, MULTI-DOSE) gives 5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00143938701","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00143938725","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0143-9387-25","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"25 VIAL in 1 CARTON (0143-9387-25) / 1 mL in 1 VIAL (0143-9387-01)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (0143-9387-25) / 1 mL in 1 VIAL (0143-9387-01)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00703024101","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0703-0241-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (0703-0241-01) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":4,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-DOSE in 1 CARTON (0703-0241-01) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714013001","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-130-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"NorthStar Rx LLC","package_description":"1 VIAL in 1 CARTON (16714-130-01) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"16714013025","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-130-25","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"NorthStar Rx LLC","package_description":"25 VIAL in 1 CARTON (16714-130-25) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (16714-130-25) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"25021005401","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"25021-054-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Sagent Pharmaceuticals","package_description":"25 VIAL in 1 CARTON (25021-054-01) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67457062102","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":4,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"67457062199","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-621-99","proprietary_name":"TRIAMCINOLONE ACETONIDE","nonproprietary_name":"TRIAMCINOLONE ACETONIDE","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Mylan Institutional LLC","package_description":"25 VIAL, SINGLE-DOSE in 1 CARTON (67457-621-99) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-DOSE in 1 CARTON (67457-621-99) / 1 mL in 1 VIAL, SINGLE-DOSE) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121104901","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70121104902","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1049-2","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL in 1 CARTON (70121-1049-2) / 1 mL in 1 VIAL (70121-1049-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":4,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70121-1049-2) / 1 mL in 1 VIAL (70121-1049-1)) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121104905","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1049-5","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"25 VIAL in 1 CARTON (70121-1049-5) / 1 mL in 1 VIAL (70121-1049-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70121-1049-5) / 1 mL in 1 VIAL (70121-1049-1)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165101","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1651-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL in 1 CARTON (70121-1651-1) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":4,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70121-1651-1) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165105","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1651-5","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"25 VIAL in 1 CARTON (70121-1651-5) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL in 1 CARTON (70121-1651-5) / 1 mL in 1 VIAL) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165701","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1657-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL in 1 CARTON (70121-1657-1) / 1 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":4,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (70121-1657-1) / 1 mL in 1 VIAL) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81298578101","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7.39146,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"81298578105","name":"TRIAMCINOLONE ACET 40 MG/ML VL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81298-5781-5","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"SUSPENSION","route":"INTRA-ARTERIAL; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Long Grove Pharmaceuticals, LLC","package_description":"25 VIAL, SINGLE-USE in 1 CARTON (81298-5781-5) / 1 mL in 1 VIAL, SINGLE-USE (81298-5781-1)","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.83043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (4 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (25 VIAL, SINGLE-USE in 1 CARTON (81298-5781-5) / 1 mL in 1 VIAL, SINGLE-USE (81298-5781-1)) gives 25 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":25,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00703024501","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0703-0245-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Teva Parenteral Medicines, Inc.","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (0703-0245-01) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (0703-0245-01) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"16714015001","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-150-01","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"400 mg/10mL","labeler":"NorthStar Rx LLC","package_description":"1 VIAL in 1 CARTON (16714-150-01) / 10 mL in 1 VIAL","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (16714-150-01) / 10 mL in 1 VIAL) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457062310","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"70121116901","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1169-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"400 mg/10mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1169-1) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1169-1) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165301","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1653-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"400 mg/10mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1653-1) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1653-1) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"70121165501","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70121-1655-1","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"INJECTION, SUSPENSION","route":"INTRA-ARTICULAR; INTRAMUSCULAR","strength":"400 mg/10mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (70121-1655-1) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (70121-1655-1) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"81298578303","name":"TRIAMCINOLONE ACET 400 MG/10 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81298-5783-3","proprietary_name":"Triamcinolone Acetonide","nonproprietary_name":"Triamcinolone Acetonide","dosage_form":"SUSPENSION","route":"INTRA-ARTERIAL; INTRAMUSCULAR","strength":"40 mg/mL","labeler":"Long Grove Pharmaceuticals, LLC","package_description":"1 VIAL, MULTI-DOSE in 1 CARTON (81298-5783-3) / 10 mL in 1 VIAL, MULTI-DOSE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":4.782,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3301","bill_units_per_package":{"value":40,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3301 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (40 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":10,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, MULTI-DOSE in 1 CARTON (81298-5783-3) / 10 mL in 1 VIAL, MULTI-DOSE) gives 10 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"52817036510","name":"TRIAMTERENE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-365-10","proprietary_name":"Triamterene","nonproprietary_name":"Triamterene Capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"TRUPHARMA LLC","package_description":"100 CAPSULE in 1 BOTTLE (52817-365-10)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":7.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triamterene|Triamterene","basis":"generic"},"part_b":null}, {"ndc":"66993083202","name":"TRIAMTERENE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-832-02","proprietary_name":"Triamterene","nonproprietary_name":"Triamterene","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (66993-832-02)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":7.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triamterene|Triamterene","basis":"generic"},"part_b":null}, {"ndc":"70377013912","name":"TRIAMTERENE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-139-12","proprietary_name":"Triamterene","nonproprietary_name":"Triamterene","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-139-12)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":7.04719,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triamterene|Triamterene","basis":"generic"},"part_b":null}, {"ndc":"52817036410","name":"TRIAMTERENE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52817-364-10","proprietary_name":"Triamterene","nonproprietary_name":"Triamterene Capsules","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"TRUPHARMA LLC","package_description":"100 CAPSULE in 1 BOTTLE (52817-364-10)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":5.97533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triamterene|Triamterene","basis":"generic"},"part_b":null}, {"ndc":"66993083102","name":"TRIAMTERENE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-831-02","proprietary_name":"triamterene","nonproprietary_name":"Triamterene","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Prasco Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (66993-831-02)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":5.97533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triamterene|Triamterene","basis":"generic"},"part_b":null}, {"ndc":"70377013812","name":"TRIAMTERENE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70377-138-12","proprietary_name":"Triamterene","nonproprietary_name":"Triamterene","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Biocon Pharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70377-138-12)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]"]},"nadac":{"value":5.97533,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triamterene|Triamterene","basis":"generic"},"part_b":null}, {"ndc":"00527163201","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00527163210","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781207401","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2074-01","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Sandoz Inc","package_description":"100 CAPSULE in 1 BOTTLE (0781-2074-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00781207410","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-2074-10","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Sandoz Inc","package_description":"1000 CAPSULE in 1 BOTTLE (0781-2074-10)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62135052990","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-529-90","proprietary_name":"TRIAMTERENE AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"TRIAMTERENE AND HYDROCHLOROTHIAZIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-529-90)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578009001","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-090-01","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-090-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578009010","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-090-10","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"CAPSULE","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"1000 CAPSULE in 1 BOTTLE (72578-090-10)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.11805,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591042401","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0424-01","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0424-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591042405","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0424-05","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0424-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505265601","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2656-1","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-2656-1)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505265605","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2656-5","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET in 1 BOTTLE (60505-2656-5)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001032700","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-327-00","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-327-00)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001032703","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-327-03","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-327-03)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084075025","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-750-25","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-750-25) / 1 TABLET in 1 BLISTER PACK (68084-750-95)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084075095","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382085601","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-856-01","proprietary_name":"triamterene and hydrochlorothiazide","nonproprietary_name":"triamterene and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-856-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382085605","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-856-05","proprietary_name":"triamterene and hydrochlorothiazide","nonproprietary_name":"triamterene and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-856-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888009401","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-094-01","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-094-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888009405","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-094-05","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1; 25 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-094-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591034801","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0348-01","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-0348-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591034805","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0348-05","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET in 1 BOTTLE, PLASTIC (0591-0348-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591034810","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0348-10","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-0348-10)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505265701","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2657-1","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Apotex Corp.","package_description":"100 TABLET in 1 BOTTLE (60505-2657-1)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60505265705","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2657-5","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Apotex Corp.","package_description":"500 TABLET in 1 BOTTLE (60505-2657-5)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001032800","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-328-00","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-328-00)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001032803","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-328-03","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"BluePoint Laboratories","package_description":"500 TABLET in 1 BOTTLE (68001-328-03)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382085701","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-857-01","proprietary_name":"triamterene and hydrochlorothiazide","nonproprietary_name":"triamterene and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-857-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68382085705","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-857-05","proprietary_name":"triamterene and hydrochlorothiazide","nonproprietary_name":"triamterene and hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-857-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888009501","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-095-01","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"100 TABLET in 1 BOTTLE (72888-095-01)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72888009505","name":"TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-095-05","proprietary_name":"Triamterene and Hydrochlorothiazide","nonproprietary_name":"Triamterene and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1; 50 mg/1","labeler":"Advagen Pharma Ltd","package_description":"500 TABLET in 1 BOTTLE (72888-095-05)","pharm_classes":["Decreased Renal K+ Excretion [PE]","Increased Diuresis [PE]","Potassium-sparing Diuretic [EPC]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00054485825","name":"TRIAZOLAM 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.26282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"50742064501","name":"TRIAZOLAM 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-645-01","proprietary_name":"Triazolam","nonproprietary_name":"Triazolam","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (50742-645-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.26282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"59762371709","name":"TRIAZOLAM 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3717-9","proprietary_name":"Triazolam","nonproprietary_name":"triazolam","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-3717-9)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.26282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"70710152101","name":"TRIAZOLAM 0.125 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1521-1","proprietary_name":"Triazolam","nonproprietary_name":"Triazolam","dosage_form":"TABLET","route":"ORAL","strength":".125 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1521-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.26282,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"00054485925","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"00054485929","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"50742064601","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50742-646-01","proprietary_name":"Triazolam","nonproprietary_name":"Triazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Ingenus Pharmaceuticals, LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (50742-646-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"59762371803","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3718-3","proprietary_name":"Triazolam","nonproprietary_name":"triazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (59762-3718-3)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"59762371809","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59762-3718-9","proprietary_name":"Triazolam","nonproprietary_name":"triazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (59762-3718-9)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"70710128901","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1289-1","proprietary_name":"Triazolam","nonproprietary_name":"Triazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1289-1)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"70710128905","name":"TRIAZOLAM 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1289-5","proprietary_name":"Triazolam","nonproprietary_name":"Triazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"500 TABLET in 1 BOTTLE (70710-1289-5)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":0.30835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triazolam|Triazolam","basis":"generic"},"part_b":null}, {"ndc":"00713087830","name":"TRIBENZOR 40-10-25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0878-30","proprietary_name":"Tribenzor","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 10 mg/1; 25 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0713-0878-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":19.41413,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.98947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tribenzor|Olmesartan/Amlodipin/HCThiazid","basis":"brand"},"part_b":null}, {"ndc":"00713087530","name":"TRIBENZOR 40-5-12.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0713-0875-30","proprietary_name":"Tribenzor","nonproprietary_name":"olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1; 5 mg/1; 12.5 mg/1","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0713-0875-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Dihydropyridine Calcium Channel Blocker [EPC]","Dihydropyridines [CS]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":19.53853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":1.01976,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tribenzor|Olmesartan/Amlodipin/HCThiazid","basis":"brand"},"part_b":null}, {"ndc":"67112010100","name":"TRICARE PRENATAL TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.9674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121067716","name":"TRICITRATES ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0677-16","proprietary_name":"TRICITRATES","nonproprietary_name":"POTASSIUM CITRATE, SODIUM CITRATE, and CITRIC ACID MONOHYDRATE","dosage_form":"SOLUTION","route":"ORAL","strength":"550 mg/5mL; 500 mg/5mL; 334 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0677-16)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.0314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tricitrates|Sod/Pot/K Cit/Sod Cit/Cit Acid","basis":"brand"},"part_b":null}, {"ndc":"62135043847","name":"TRICITRATES ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-438-47","proprietary_name":"Tricitrates","nonproprietary_name":"Tricitrates","dosage_form":"SOLUTION","route":"ORAL","strength":"550 mg/5mL; 500 mg/5mL; 334 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-438-47)","pharm_classes":["Acidifying Activity [MoA]","Anti-coagulant [EPC]","Calcium Chelating Activity [MoA]","Calculi Dissolution Agent [EPC]","Decreased Coagulation Factor Activity [PE]"]},"nadac":{"value":0.0314,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"73352083001","name":"TRIDACAINE II 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352083501","name":"TRIDACAINE III 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tridacaine III|Lidocaine","basis":"brand"},"part_b":null}, {"ndc":"73352084501","name":"TRIDACAINE XL 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73352084530","name":"TRIDACAINE XL 5% PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73352-845-30","proprietary_name":"Tridacaine XL","nonproprietary_name":"Lidocaine","dosage_form":"PATCH","route":"TOPICAL","strength":"50 mg/g","labeler":"Trifluent Pharma LLC","package_description":"30 PACKET in 1 BOX (73352-845-30) / 1 g in 1 PACKET (73352-845-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":1.99779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16571081001","name":"TRIENTINE HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"16571-810-01","proprietary_name":"Trientine Hydrochloride","nonproprietary_name":"Trientine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (16571-810-01)","pharm_classes":["Copper Chelating Activity [MoA]","Copper Chelator [EPC]","Metal Chelating Activity [MoA]"]},"nadac":{"value":2.30252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trientine HCl|Trientine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722068301","name":"TRIENTINE HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-683-01","proprietary_name":"TRIENTINE HYDROCHLORIDE","nonproprietary_name":"TRIENTINE HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-683-01) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Metal Chelating Activity [MoA]","Metal Chelator [EPC]"]},"nadac":{"value":2.30252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trientine HCl|Trientine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598045901","name":"TRIENTINE HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-459-01","proprietary_name":"Trientine Hydrochloride","nonproprietary_name":"Trientine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"100 CAPSULE in 1 BOTTLE (43598-459-01)","pharm_classes":["Copper Chelating Activity [MoA]","Copper Chelator [EPC]","Metal Chelating Activity [MoA]"]},"nadac":{"value":2.30252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trientine HCl|Trientine HCl","basis":"generic"},"part_b":null}, {"ndc":"49884006001","name":"TRIENTINE HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"49884-060-01","proprietary_name":"Trientine Hydrochloride","nonproprietary_name":"Trientine Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Par Health USA, LLC","package_description":"100 CAPSULE in 1 BOTTLE (49884-060-01)","pharm_classes":["Copper Chelating Activity [MoA]","Copper Chelator [EPC]","Metal Chelating Activity [MoA]"]},"nadac":{"value":2.30252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trientine HCl|Trientine HCl","basis":"generic"},"part_b":null}, {"ndc":"72205000891","name":"TRIENTINE HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72205-008-91","proprietary_name":"Trientine hydrochloride","nonproprietary_name":"Trientine hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-008-91) / 100 CAPSULE in 1 BOTTLE","pharm_classes":["Metal Chelating Activity [MoA]","Metal Chelator [EPC]"]},"nadac":{"value":2.30252,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trientine HCl|Trientine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378240101","name":"TRIFLUOPERAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2401-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2401-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.42513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00781802801","name":"TRIFLUOPERAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8028-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"Trifluoperazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8028-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.42513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057201","name":"TRIFLUOPERAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.42513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057220","name":"TRIFLUOPERAZINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-572-20","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-572-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-572-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.42513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378241001","name":"TRIFLUOPERAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2410-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2410-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.24317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00781803601","name":"TRIFLUOPERAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8036-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"Trifluoperazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8036-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.24317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057501","name":"TRIFLUOPERAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.24317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057520","name":"TRIFLUOPERAZINE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-575-20","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-575-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-575-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":1.24317,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378240201","name":"TRIFLUOPERAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2402-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2402-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.57869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00781803201","name":"TRIFLUOPERAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8032-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"Trifluoperazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8032-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.57869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057301","name":"TRIFLUOPERAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.57869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057320","name":"TRIFLUOPERAZINE 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-573-20","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-573-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-573-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.57869,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00378240501","name":"TRIFLUOPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-2405-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2405-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.86,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"00781803401","name":"TRIFLUOPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-8034-01","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"Trifluoperazine Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0781-8034-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.86,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057401","name":"TRIFLUOPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.86,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"51079057420","name":"TRIFLUOPERAZINE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-574-20","proprietary_name":"Trifluoperazine Hydrochloride","nonproprietary_name":"trifluoperazine hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-574-20) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-574-01)","pharm_classes":["Phenothiazine [EPC]","Phenothiazines [CS]"]},"nadac":{"value":0.86,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trifluoperazine HCl|Trifluoperazine HCl","basis":"generic"},"part_b":null}, {"ndc":"61314004475","name":"TRIFLURIDINE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-044-75","proprietary_name":"Trifluridine","nonproprietary_name":"trifluridine","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-044-75) / 7.5 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Nucleic Acid Synthesis Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]","Nucleoside Metabolic Inhibitor [EPC]"]},"nadac":{"value":23.02208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Trifluridine|Trifluridine","basis":"generic"},"part_b":null}, {"ndc":"13811051810","name":"TRIGELS-F FORTE SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.47151,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591533501","name":"TRIHEXYPHENIDYL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5335-01","proprietary_name":"Trihexyphenidyl Hydrochloride","nonproprietary_name":"Trihexyphenidyl Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5335-01)"},"nadac":{"value":0.08838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"00591533510","name":"TRIHEXYPHENIDYL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5335-10","proprietary_name":"Trihexyphenidyl Hydrochloride","nonproprietary_name":"Trihexyphenidyl Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-5335-10)"},"nadac":{"value":0.08838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"69452024120","name":"TRIHEXYPHENIDYL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"69452024132","name":"TRIHEXYPHENIDYL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"70954021210","name":"TRIHEXYPHENIDYL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-212-10","proprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","nonproprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-212-10)"},"nadac":{"value":0.08838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"70954021220","name":"TRIHEXYPHENIDYL 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-212-20","proprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","nonproprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Novitium Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70954-212-20)"},"nadac":{"value":0.08838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"00591533701","name":"TRIHEXYPHENIDYL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5337-01","proprietary_name":"Trihexyphenidyl Hydrochloride","nonproprietary_name":"Trihexyphenidyl Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (0591-5337-01)"},"nadac":{"value":0.1191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"00591533710","name":"TRIHEXYPHENIDYL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-5337-10","proprietary_name":"Trihexyphenidyl Hydrochloride","nonproprietary_name":"Trihexyphenidyl Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET in 1 BOTTLE, PLASTIC (0591-5337-10)"},"nadac":{"value":0.1191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"69452024220","name":"TRIHEXYPHENIDYL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"69452024232","name":"TRIHEXYPHENIDYL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"70954021110","name":"TRIHEXYPHENIDYL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-211-10","proprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","nonproprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE (70954-211-10)"},"nadac":{"value":0.1191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"70954021120","name":"TRIHEXYPHENIDYL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-211-20","proprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","nonproprietary_name":"TRIHEXYPHENIDYL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Novitium Pharma LLC","package_description":"1000 TABLET in 1 BOTTLE (70954-211-20)"},"nadac":{"value":0.1191,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trihexyphenidyl HCl|Trihexyphenidyl HCl","basis":"generic"},"part_b":null}, {"ndc":"00597038013","name":"TRIJARDY XR 10-5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0380-13","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0380-13)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.2774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597038068","name":"TRIJARDY XR 10-5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0380-68","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0380-68)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.2774,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597038577","name":"TRIJARDY XR 12.5-2.5-1,000 MG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0385-77","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0385-77)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.62766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597038586","name":"TRIJARDY XR 12.5-2.5-1,000 MG","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0385-86","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1; 2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0385-86)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.62766,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597039013","name":"TRIJARDY XR 25-5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0390-13","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0390-13)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.23864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597039071","name":"TRIJARDY XR 25-5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0390-71","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1; 5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0390-71)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":11.23864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597039523","name":"TRIJARDY XR 5-2.5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0395-23","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"180 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0395-23)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.66862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00597039582","name":"TRIJARDY XR 5-2.5-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0597-0395-82","proprietary_name":"Trijardy XR","nonproprietary_name":"empagliflozin, linagliptin, metformin hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 2.5 mg/1; 1000 mg/1","labeler":"Boehringer Ingelheim Pharmaceuticals, Inc.","package_description":"60 TABLET, EXTENDED RELEASE in 1 BOTTLE (0597-0395-82)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":5.66862,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trijardy XR|Empaglifloz/Linaglip/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00078045605","name":"TRILEPTAL 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0078-0456-05","proprietary_name":"Trileptal","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0078-0456-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":5.72156,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10623,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00078033705","name":"TRILEPTAL 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0337-05","proprietary_name":"Trileptal","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"300 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0078-0337-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":10.45435,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.16669,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00078035752","name":"TRILEPTAL 300 MG/5 ML SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0357-52","proprietary_name":"Trileptal","nonproprietary_name":"oxcarbazepine","dosage_form":"SUSPENSION","route":"ORAL","strength":"60 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"250 mL in 1 BOTTLE (0078-0357-52)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.93077,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.11023,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00078045705","name":"TRILEPTAL 600 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0457-05","proprietary_name":"Trileptal","nonproprietary_name":"oxcarbazepine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1","labeler":"Novartis Pharmaceuticals Corporation","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0078-0457-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":19.33273,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.31696,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70954054110","name":"TRIMETHOPRIM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70954-541-10","proprietary_name":"Trimethoprim","nonproprietary_name":"Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Novitium Pharma LLC","package_description":"100 TABLET in 1 BOTTLE, PLASTIC (70954-541-10)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trimethoprim|Trimethoprim","basis":"generic"},"part_b":null}, {"ndc":"75907004301","name":"TRIMETHOPRIM 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-043-01","proprietary_name":"Trimethoprim","nonproprietary_name":"Trimethoprim","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Dr. Reddy's Labratories Inc.","package_description":"100 TABLET in 1 BOTTLE (75907-043-01)","pharm_classes":["Cytochrome P450 2C8 Inhibitors [MoA]","Dihydrofolate Reductase Inhibitor Antibacterial [EPC]","Dihydrofolate Reductase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":1.30681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trimethoprim|Trimethoprim","basis":"generic"},"part_b":null}, {"ndc":"59365503000","name":"TRIMO-SAN JELLY","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59365-5030-0","proprietary_name":"TRIMO SAN","nonproprietary_name":"Oxyquinoline Sulfate and Sodium Lauryl Sulfate","dosage_form":"JELLY","route":"VAGINAL","strength":".25 mg/g; .1 mg/g","labeler":"CooperSurgical, Inc.","package_description":"113.4 g in 1 TUBE (59365-5030-0)"},"nadac":{"value":0.24306,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"13811000710","name":"TRINATAL RX 1 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.19426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trinatal Rx 1|Prenatal Vit27,Calcium/Iron/FA","basis":"brand"},"part_b":null}, {"ndc":"64764073030","name":"TRINTELLIX 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-730-30","proprietary_name":"Trintellix","nonproprietary_name":"vortioxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64764-730-30)"},"nadac":{"value":17.19738,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trintellix|Vortioxetine Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"64764075030","name":"TRINTELLIX 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-750-30","proprietary_name":"Trintellix","nonproprietary_name":"vortioxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64764-750-30)"},"nadac":{"value":17.19979,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trintellix|Vortioxetine Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"64764072030","name":"TRINTELLIX 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-720-30","proprietary_name":"Trintellix","nonproprietary_name":"vortioxetine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (64764-720-30)"},"nadac":{"value":17.19677,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trintellix|Vortioxetine Hydrobromide","basis":"brand"},"part_b":null}, {"ndc":"13811052501","name":"TRIPHROCAPS SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11308,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00713026831","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0268-31","proprietary_name":"Triple Antibiotic","nonproprietary_name":"Polymyxin B Sulfate, Bacitracin Zinc and Neomycin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"5000 [USP'U]/g; 3.5 mg/g; 400 [USP'U]/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (0713-0268-31) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.11088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904880531","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-8805-31","proprietary_name":"Major Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Neomycin, Polymyxin B Sulfat","dosage_form":"OINTMENT","route":"TOPICAL","strength":"3.5 mg/g; 400 [USP'U]/g; 5000 [USP'U]/g","labeler":"Major Pharmaceuticals","package_description":"1 TUBE in 1 BOX (0904-8805-31) / 28 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"11527016251","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-162-51","proprietary_name":"Sheffield Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Polymyxin B Sulfate, Neomycin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 5000 [USP'U]/g; 3.5 mg/g","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-162-51) / 14 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"11527016255","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"11527-162-55","proprietary_name":"Sheffield Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Polymyxin B Sulfate, Neomycin Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 5000 [USP'U]/g; 3.5 mg/g","labeler":"Sheffield Pharmaceuticals LLC","package_description":"1 TUBE in 1 CARTON (11527-162-55) / 28 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"21922009305","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"21922-093-05","proprietary_name":"TRIPLE ANTIBIOTIC","nonproprietary_name":"bacitracin zinc neomycin sulfate polymyxin b sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"Encube Ethicals, Inc.","package_description":"1 TUBE in 1 CARTON (21922-093-05) / 28 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802014301","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-143-01","proprietary_name":"triple antibiotic","nonproprietary_name":"bacitracin zinc, neomycin, polymyxin B","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-143-01) / 14 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"45802014303","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-143-03","proprietary_name":"triple antibiotic","nonproprietary_name":"bacitracin zinc, neomycin, polymyxin B","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"1 TUBE in 1 CARTON (45802-143-03) / 28 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.08877,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122041403","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-414-03","proprietary_name":"Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Neomycin Sulfate, and Polymyxin B Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [iU]/g; 3.5 mg/g; 5000 [iU]/g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (46122-414-03) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.11088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"46122041405","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-414-05","proprietary_name":"Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Neomycin Sulfate, and Polymyxin B Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [iU]/g; 3.5 mg/g; 5000 [iU]/g","labeler":"AmerisourceBergen","package_description":"1 TUBE in 1 CARTON (46122-414-05) / 14.2 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.13907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672212002","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2120-2","proprietary_name":"Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Neomycin Sulfate, and Polymyxin B Sulfate","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [iU]/g; 3.5 mg/g; 5000 [iU]/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2120-2) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.11088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001048345","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-483-45","proprietary_name":"Triple Antibiotic","nonproprietary_name":"First Aid Antibiotic","dosage_form":"OINTMENT","route":"TOPICAL","strength":"3.5 mg/g; 400 [iU]/g; 5000 [iU]/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-483-45) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.11088,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001048346","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-483-46","proprietary_name":"Triple Antibiotic","nonproprietary_name":"First Aid Antibiotic","dosage_form":"OINTMENT","route":"TOPICAL","strength":"3.5 mg/g; 400 [iU]/g; 5000 [iU]/g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-483-46) / 14.2 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.13907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000009401","name":"TRIPLE ANTIBIOTIC OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0094-1","proprietary_name":"Leader Triple Antibiotic","nonproprietary_name":"First Aid Triple Antibiotic","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"Cardinal Health 110,Inc.","package_description":"1 TUBE in 1 CARTON (70000-0094-1) / 14 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12482,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00904880567","name":"TRIPLE ANTIBIOTIC OINTMENT PKT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-8805-67","proprietary_name":"Major Triple Antibiotic","nonproprietary_name":"Bacitracin Zinc, Neomycin, Polymyxin B Sulfat","dosage_form":"OINTMENT","route":"TOPICAL","strength":"3.5 mg/g; 400 [USP'U]/g; 5000 [USP'U]/g","labeler":"Major Pharmaceuticals","package_description":"144 PACKET in 1 CARTON (0904-8805-67) / .9 g in 1 PACKET","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"45802014370","name":"TRIPLE ANTIBIOTIC OINTMENT PKT","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-143-70","proprietary_name":"triple antibiotic","nonproprietary_name":"bacitracin zinc, neomycin, polymyxin B","dosage_form":"OINTMENT","route":"TOPICAL","strength":"400 [USP'U]/g; 3.5 mg/g; 5000 [USP'U]/g","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"144 PACKET in 1 CARTON (45802-143-70) / .9 g in 1 PACKET (45802-143-00)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24385014303","name":"TRIPLE ANTIBIOTIC PLUS OINT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24385-143-03","proprietary_name":"Good Neighbor Pharmacy Triple Antibiotic Plus Pain Relief","nonproprietary_name":"Bacitracin zinc, Neomycin sulfate, Polymyxin B sulfate, and Pramoxine hydrochloride","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [iU]/g; 3.5 mg/g; 10000 [iU]/g; 10 mg/g","labeler":"Amerisource Bergen","package_description":"1 TUBE in 1 CARTON (24385-143-03) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00713062231","name":"TRIPLE ANTIBIOTIC PLUS OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0713-0622-31","proprietary_name":"Triple Antibiotic Plus","nonproprietary_name":"Polymyxin B Sulfate, Bacitracin Zinc, Neomycin Sulfate, Pramoxine HCl","dosage_form":"OINTMENT","route":"TOPICAL","strength":"10000 [USP'U]/g; 500 [USP'U]/g; 3.5 mg/g; 10 mg/g","labeler":"Cosette Pharmaceuticals, Inc.","package_description":"28.4 g in 1 TUBE (0713-0622-31)","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"51672202702","name":"TRIPLE ANTIBIOTIC PLUS OINTMNT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-2027-2","proprietary_name":"Triple Antibiotic Plus Pain Relief","nonproprietary_name":"Bacitracin Zinc, Neomycin Sulfate, Polymyxin B Sulfate, and Pramoxine Hydrochloride","dosage_form":"OINTMENT","route":"TOPICAL","strength":"500 [USP'U]/g; 3.5 mg/g; 10000 [USP'U]/g; 10 mg/g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (51672-2027-2) / 28.4 g in 1 TUBE","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Decreased Cell Wall Synthesis & Repair [PE]","Polymyxin-class Antibacterial [EPC]","Polymyxins [CS]"]},"nadac":{"value":0.12611,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367025330","name":"TRIPROLIDINE 0.938 MG/ML DROPS","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-253-30","proprietary_name":"TRIPROLIDINE HYDROCHLORIDE","nonproprietary_name":"TRIPROLIDINE HYDROCHLORIDE","dosage_form":"SYRUP","route":"ORAL","strength":".938 mg/mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (69367-253-30) / 30 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":0.40117,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"49702023113","name":"TRIUMEQ 600-50-300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49702-231-13","proprietary_name":"Triumeq","nonproprietary_name":"abacavir sulfate, dolutegravir sodium, lamivudine","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"600 mg/1; 50 mg/1; 300 mg/1","labeler":"ViiV Healthcare Company","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (49702-231-13)","pharm_classes":["Cytochrome P450 1A1 Inhibitors [MoA]","HIV Integrase Inhibitors [MoA]","Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Multidrug and Toxin Extrusion Transporter 1 Inhibitors [MoA]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Organic Cation Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":130.00625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Triumeq|Abacavir/Dolutegravir/Lamivudi","basis":"brand"},"part_b":null}, {"ndc":"17772010330","name":"TROKENDI XR 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"17772-103-30","proprietary_name":"Trokendi XR","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-103-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":34.43756,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":10.67522,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trokendi XR|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"17772010430","name":"TROKENDI XR 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"17772-104-30","proprietary_name":"Trokendi XR","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-104-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":47.1431,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":20.37363,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trokendi XR|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"17772010130","name":"TROKENDI XR 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"17772-101-30","proprietary_name":"Trokendi XR","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"25 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-101-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":13.29949,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.13989,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trokendi XR|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"17772010230","name":"TROKENDI XR 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["2"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"17772-102-30","proprietary_name":"Trokendi XR","nonproprietary_name":"topiramate","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1","labeler":"Supernus Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (17772-102-30)","pharm_classes":["Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":17.43323,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.17393,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trokendi XR|Topiramate","basis":"brand"},"part_b":null}, {"ndc":"24208058564","name":"TROPICAMIDE 1% EYE DROP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-585-64","proprietary_name":"Tropicamide","nonproprietary_name":"Tropicamide","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-585-64) / 15 mL in 1 BOTTLE, DROPPER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.55153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tropicamide|Tropicamide","basis":"generic"},"part_b":null}, {"ndc":"61314035501","name":"TROPICAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-355-01","proprietary_name":"Tropicamide","nonproprietary_name":"Tropicamide","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-355-01) / 3 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":2.63506,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tropicamide|Tropicamide","basis":"generic"},"part_b":null}, {"ndc":"61314035502","name":"TROPICAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-355-02","proprietary_name":"Tropicamide","nonproprietary_name":"Tropicamide","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Sandoz Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (61314-355-02) / 15 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.55153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tropicamide|Tropicamide","basis":"generic"},"part_b":null}, {"ndc":"70069012101","name":"TROPICAMIDE 1% EYE DROPS","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-121-01","proprietary_name":"Tropicamide","nonproprietary_name":"Tropicamide","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"10 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"1 BOTTLE in 1 CARTON (70069-121-01) / 15 mL in 1 BOTTLE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":0.55153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tropicamide|Tropicamide","basis":"generic"},"part_b":null}, {"ndc":"00574014560","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0145-60","proprietary_name":"TROSPIUM CHLORIDE","nonproprietary_name":"TROSPIUM CHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Padagis US LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0574-0145-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"00904705952","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7059-52","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0904-7059-52)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155053005","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-530-05","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (23155-530-05)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"23155053006","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-530-06","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (23155-530-06)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"33342055409","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-554-09","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 TABLET in 1 BOTTLE (33342-554-09)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"62135074260","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-742-60","proprietary_name":"TROSPIUM CHLORIDE","nonproprietary_name":"TROSPIUM CHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (62135-742-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"68462046110","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-461-10","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (68462-461-10)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"68462046160","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-461-60","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (68462-461-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"69097091203","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-912-03","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"CIPLA USA INC.,","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (69097-912-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"76282033660","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-336-60","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (76282-336-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"90096014160","name":"TROSPIUM CHLORIDE 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"90096-141-60","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zameer Pharmaceuticals LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (90096-141-60)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":0.21142,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"00574011830","name":"TROSPIUM CHLORIDE ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0574-0118-30","proprietary_name":"Trospium Chloride ER","nonproprietary_name":"Trospium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Padagis US LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0574-0118-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.64301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride ER|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"00591363630","name":"TROSPIUM CHLORIDE ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3636-30","proprietary_name":"Trospium Chloride","nonproprietary_name":"Trospium Chloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0591-3636-30)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.64301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride ER|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"68001042704","name":"TROSPIUM CHLORIDE ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-427-04","proprietary_name":"TROSPIUM CHLORIDE","nonproprietary_name":"TROSPIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Bluepoint Laboratories","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68001-427-04)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.64301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride ER|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"70010002703","name":"TROSPIUM CHLORIDE ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-027-03","proprietary_name":"TROSPIUM CHLORIDE","nonproprietary_name":"TROSPIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-027-03)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.64301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride ER|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"70436017404","name":"TROSPIUM CHLORIDE ER 60 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70436-174-04","proprietary_name":"TROSPIUM CHLORIDE","nonproprietary_name":"TROSPIUM CHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"60 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70436-174-04)","pharm_classes":["Cholinergic Muscarinic Antagonist [EPC]","Cholinergic Muscarinic Antagonists [MoA]"]},"nadac":{"value":1.64301,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Trospium Chloride ER|Trospium Chloride","basis":"generic"},"part_b":null}, {"ndc":"00002143380","name":"TRULICITY 0.75 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1433-80","proprietary_name":"Trulicity","nonproprietary_name":"Dulaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".75 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1433-80) / .5 mL in 1 SYRINGE (0002-1433-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":487.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Trulicity|Dulaglutide","basis":"brand"},"part_b":null}, {"ndc":"00002143480","name":"TRULICITY 1.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-1434-80","proprietary_name":"Trulicity","nonproprietary_name":"Dulaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-1434-80) / .5 mL in 1 SYRINGE (0002-1434-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":487.54289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Trulicity|Dulaglutide","basis":"brand"},"part_b":null}, {"ndc":"00002223680","name":"TRULICITY 3 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2236-80","proprietary_name":"Trulicity","nonproprietary_name":"Dulaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"3 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2236-80) / .5 mL in 1 SYRINGE (0002-2236-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":487.5022,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Trulicity|Dulaglutide","basis":"brand"},"part_b":null}, {"ndc":"00002318280","name":"TRULICITY 4.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3182-80","proprietary_name":"Trulicity","nonproprietary_name":"Dulaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"4.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-3182-80) / .5 mL in 1 SYRINGE (0002-3182-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":487.41808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Trulicity|Dulaglutide","basis":"brand"},"part_b":null}, {"ndc":"61958070101","name":"TRUVADA 200 MG-300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-0701-1","proprietary_name":"Truvada","nonproprietary_name":"emtricitabine and tenofovir disoproxil fumarate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1; 300 mg/1","labeler":"Gilead Sciences, Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (61958-0701-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":59.70975,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.52902,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Truvada|Emtricitabine/Tenofovir (Tdf)","basis":"brand"},"part_b":null}, {"ndc":"00065859502","name":"TRYPTYR 0.003% EYE DROP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-8595-02","proprietary_name":"TRYPTYR","nonproprietary_name":"Acoltremon","dosage_form":"SOLUTION","route":"OPHTHALMIC; TOPICAL","strength":".03 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"12 POUCH in 1 CARTON (0065-8595-02) / 5 VIAL in 1 POUCH / .4 mL in 1 VIAL"},"nadac":{"value":14.08638,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70515000201","name":"TUDORZA PRESSAIR 400 MCG INHAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-002-01","proprietary_name":"Tudorza Pressair","nonproprietary_name":"aclidinium bromide","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"400 ug/1","labeler":"Covis Pharma US, Inc","package_description":"1 POUCH in 1 CARTON (70515-002-01) / 1 INHALER in 1 POUCH / 60 POWDER, METERED in 1 INHALER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":431.5,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tudorza Pressair|Aclidinium Bromide","basis":"brand"},"part_b":null}, {"ndc":"70515000202","name":"TUDORZA PRESSAIR 400 MCG INHAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70515-002-02","proprietary_name":"Tudorza Pressair","nonproprietary_name":"aclidinium bromide","dosage_form":"POWDER, METERED","route":"RESPIRATORY (INHALATION)","strength":"400 ug/1","labeler":"Covis Pharma US, Inc","package_description":"1 POUCH in 1 CARTON (70515-002-02) / 1 INHALER in 1 POUCH / 30 POWDER, METERED in 1 INHALER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":257.59286,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tudorza Pressair|Aclidinium Bromide","basis":"brand"},"part_b":null}, {"ndc":"68180089511","name":"TURQOZ-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Turqoz|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180089513","name":"TURQOZ-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-895-13","proprietary_name":"Turqoz","nonproprietary_name":"norgestrel and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (68180-895-13) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.30211,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Turqoz|Norgestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"54859050504","name":"TUSNEL DIABETIC LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-505-04","proprietary_name":"Tusnel Diabetic","nonproprietary_name":"Dextromethorphan, Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"10 mg/5mL; 100 mg/5mL","labeler":"LLORENS PHARMACEUTICALS INTERNATIONAL DIVISION","package_description":"118 mL in 1 BOTTLE (54859-505-04)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54859054416","name":"TUSNEL PED 5-50-15 MG/5 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-544-16","proprietary_name":"Tusnel Pediatric","nonproprietary_name":"Dextromethorphan, Guiafenesin, Pseudoephedrine HCl","dosage_form":"LIQUID","route":"ORAL","strength":"5 mg/5mL; 50 mg/5mL; 15 mg/5mL","labeler":"Llorens Pharmaceutical International Division","package_description":"473 mL in 1 BOTTLE (54859-544-16)","pharm_classes":["Adrenergic alpha-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-Adrenergic Agonist [EPC]"]},"nadac":{"value":0.05507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54859060601","name":"TUSNEL-DM PED 2.5-25-1.25 MG/ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-606-01","proprietary_name":"Tusnel-DM Pediatric","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin, Phenylephrine HCl","dosage_form":"SOLUTION/ DROPS","route":"ORAL","strength":"2.5 mg/mL; 25 mg/mL; 1.25 mg/mL","labeler":"LLORENS PHARMACEUTICALS INTERNATIONAL DIVISION","package_description":"30 mL in 1 BOTTLE, DROPPER (54859-606-01)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.27516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"54859050704","name":"TUSNEL-EX 100 MG/5 ML LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54859-507-04","proprietary_name":"Tusnel EX","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"100 mg/5mL","labeler":"Llorens Pharmaceutical International Division, Inc.","package_description":"118 mL in 1 BOTTLE (54859-507-04)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000062301","name":"TUSSIN CF MAX SEVERE M-S COLD","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70000-0623-1","proprietary_name":"leader tussin cf","nonproprietary_name":"Acetaminophen, Dextromethorphan Hydrobromide, Guaifenesin, Phenylephrine Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/20mL; 20 mg/20mL; 400 mg/20mL; 10 mg/20mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0623-1) / 118 mL in 1 BOTTLE","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.0241,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000073901","name":"TUSSIN CF SEVERE MULTI-SYMPTOM","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0739-1","proprietary_name":"LEADER TUSSIN CF","nonproprietary_name":"acetaminophen, dextromethorphan hydrobromide, guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"650 mg/20mL; 20 mg/20mL; 400 mg/20mL","labeler":"Cardinal Health 110, LLC. dba Leader","package_description":"1 BOTTLE in 1 CARTON (70000-0739-1) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001404","name":"TUSSIN DM 20-200 MG/10 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0014-4","proprietary_name":"Tussin DM Regular","nonproprietary_name":"Dextromethorphan HBr and Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/10mL; 200 mg/10mL","labeler":"AARNA USA, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 PACKAGE (82568-0014-4) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001504","name":"TUSSIN DM 20-200 MG/10 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0015-4","proprietary_name":"Tussin DM Sugar free","nonproprietary_name":"Dextromethorphan HBr and Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"20 mg/10mL; 200 mg/10mL","labeler":"AARNA USA, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 PACKAGE (82568-0015-4) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000067001","name":"TUSSIN DM 200-20 MG/20 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0670-1","proprietary_name":"Tussin DM","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 200 mg/20mL","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0670-1) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000062801","name":"TUSSIN DM 400-20 MG/20 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0628-1","proprietary_name":"Tussin DM","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0628-1) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.02346,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000062802","name":"TUSSIN DM 400-20 MG/20 ML LIQ","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0628-2","proprietary_name":"Tussin DM","nonproprietary_name":"Dextromethorphan HBr, Guaifenesin","dosage_form":"SOLUTION","route":"ORAL","strength":"20 mg/20mL; 400 mg/20mL","labeler":"Cardinal Health 110, LLC. DBA Leader","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0628-2) / 237 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]"]},"nadac":{"value":0.01778,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000069601","name":"TUSSIN MUCUS-CONG 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0696-1","proprietary_name":"Leader Adult Tussin Mucus and Chest Congestion 541","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 BOTTLE in 1 CARTON (70000-0696-1) / 118 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70000069602","name":"TUSSIN MUCUS-CONG 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0696-2","proprietary_name":"Leader Adult Tussin Mucus and Chest Congestion 541","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"CARDINAL HEALTH 110, LLC. DBA LEADER","package_description":"1 BOTTLE in 1 CARTON (70000-0696-2) / 237 mL in 1 BOTTLE","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01819,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001204","name":"TUSSIN MUCUS-CONG 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0012-4","proprietary_name":"Tussin Mucus and Chest Congestion Sugar Free","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"AARNA USA, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 PACKAGE (82568-0012-4) / 118 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.02294,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001206","name":"TUSSIN MUCUS-CONG 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0012-6","proprietary_name":"Tussin Mucus and Chest Congestion Sugar Free","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"AARNA USA, Inc.","package_description":"473 mL in 1 BOTTLE, PLASTIC (82568-0012-6)","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.01103,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"82568001208","name":"TUSSIN MUCUS-CONG 200 MG/10 ML","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82568-0012-8","proprietary_name":"Tussin Mucus and Chest Congestion Sugar Free","nonproprietary_name":"Guaifenesin","dosage_form":"LIQUID","route":"ORAL","strength":"200 mg/10mL","labeler":"AARNA USA, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 PACKAGE (82568-0012-8) / 236 mL in 1 BOTTLE, PLASTIC","pharm_classes":["Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]"]},"nadac":{"value":0.0131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71671010003","name":"TWIRLA 120-30 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71671-100-03","proprietary_name":"Twirla","nonproprietary_name":"levonorgestrel/ethinyl estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"2.6 mg/1; 2.3 mg/1","labeler":"Agile Therapeutics, Inc.","package_description":"3 POUCH in 1 CARTON (71671-100-03) / 1 PATCH in 1 POUCH (71671-100-11)","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":66.95348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"71671010011","name":"TWIRLA 120-30 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":66.95348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00299594530","name":"TWYNEO 0.1%-3% CREAM PUMP","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0299-5945-30","proprietary_name":"TWYNEO","nonproprietary_name":"tretinoin and benzoyl peroxide","dosage_form":"CREAM","route":"TOPICAL","strength":"1 mg/g; 30 mg/g","labeler":"Galderma Laboratories, L.P.","package_description":"1 BOTTLE, PUMP in 1 BOX (0299-5945-30) / 30 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":31.6568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Twyneo|Tretinoin/Benzoyl Peroxide","basis":"brand"},"part_b":null}, {"ndc":"51862077130","name":"TWYNEO 0.1%-3% CREAM PUMP","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51862-771-30","proprietary_name":"Twyneo","nonproprietary_name":"Benzoyl Peroxide and Tretinoin","dosage_form":"CREAM","route":"TOPICAL","strength":"30 mg/g; 1 mg/g","labeler":"Mayne Pharma Commercial LLC","package_description":"1 BOTTLE, PUMP in 1 CARTON (51862-771-30) / 30 g in 1 BOTTLE, PUMP","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":31.6568,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Twyneo|Tretinoin/Benzoyl Peroxide","basis":"brand"},"part_b":null}, {"ndc":"00642747101","name":"TYBLUME 0.1-0.02 MG CHEW TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-7471-01","proprietary_name":"Tyblume","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Exeltis USA, Inc.","package_description":"1 BLISTER PACK in 1 BOX (0642-7471-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.82769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Tyblume|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180090471","name":"TYDEMY 3-0.03-0.451 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.95972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180090473","name":"TYDEMY 3-0.03-0.451 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-904-73","proprietary_name":"Tydemy","nonproprietary_name":"Drospirenone, Ethinyl Estradiol and Levomefolate Calcium and Levomefolate Calcium","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-904-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK * 21 TABLET, FILM COATED in 1 BLISTER PACK (68180-905-74) * 7 TABLET, FILM COATED in 1 BLISTER PACK (68180-910-74)"},"nadac":{"value":2.95972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65219058401","name":"TYENNE 162 MG/0.9 ML AUTOINJCT","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-584-01","proprietary_name":"TYENNE","nonproprietary_name":"Tocilizumab-aazg","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"162 mg/.9mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (65219-584-01) / .9 mL in 1 SYRINGE, GLASS","pharm_classes":["Interleukin 6 Receptor Antagonists [MoA]","Interleukin-6 Receptor Antagonist [EPC]"]},"nadac":{"value":820.99658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tyenne*|Tocilizumab-Aazg","basis":"brand"},"part_b":{"hcpcs":"Q5135","bill_units_per_package":{"value":162,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5135 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (162 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.9,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (65219-584-01) / .9 mL in 1 SYRINGE, GLASS) gives 0.9 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65219059601","name":"TYENNE 162 MG/0.9 ML AUTOINJCT","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65219-596-01","proprietary_name":"TYENNE","nonproprietary_name":"Tocilizumab-aazg","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"162 mg/.9mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 SYRINGE, GLASS in 1 CARTON (65219-596-01) / .9 mL in 1 SYRINGE, GLASS","pharm_classes":["Interleukin 6 Receptor Antagonists [MoA]","Interleukin-6 Receptor Antagonist [EPC]"]},"nadac":{"value":820.99658,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tyenne*|Tocilizumab-Aazg","basis":"brand"},"part_b":null}, {"ndc":"73521003002","name":"TYRVAYA 0.03 MG NASAL SPRAY","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73521-030-02","proprietary_name":"Tyrvaya","nonproprietary_name":"varenicline","dosage_form":"SPRAY","route":"NASAL","strength":".03 mg/.05mL","labeler":"Oyster Point Pharma, Inc.","package_description":"2 BOTTLE, PUMP in 1 CARTON (73521-030-02) / 4.2 mL in 1 BOTTLE, PUMP","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":79.62813,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Tyrvaya|Varenicline Tartrate","basis":"brand"},"part_b":null}, {"ndc":"00023650102","name":"UBRELVY 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":109.10704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ubrelvy|Ubrogepant","basis":"brand"},"part_b":null}, {"ndc":"00023650110","name":"UBRELVY 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6501-10","proprietary_name":"UBRELVY","nonproprietary_name":"ubrogepant","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Allergan, Inc.","package_description":"10 PACKET in 1 BOX (0023-6501-10) / 1 TABLET in 1 PACKET (0023-6501-02)","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":109.10704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ubrelvy|Ubrogepant","basis":"brand"},"part_b":null}, {"ndc":"00023650116","name":"UBRELVY 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6501-16","proprietary_name":"UBRELVY","nonproprietary_name":"ubrogepant","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Allergan, Inc.","package_description":"16 PACKET in 1 BOX (0023-6501-16) / 1 TABLET in 1 PACKET (0023-6501-02)","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":109.10704,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ubrelvy|Ubrogepant","basis":"brand"},"part_b":null}, {"ndc":"00023649802","name":"UBRELVY 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":108.89074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ubrelvy|Ubrogepant","basis":"brand"},"part_b":null}, {"ndc":"00023649810","name":"UBRELVY 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0023-6498-10","proprietary_name":"UBRELVY","nonproprietary_name":"ubrogepant","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Allergan, Inc.","package_description":"10 PACKET in 1 BOX (0023-6498-10) / 1 TABLET in 1 PACKET (0023-6498-02)","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":108.89074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ubrelvy|Ubrogepant","basis":"brand"},"part_b":null}, {"ndc":"64764091830","name":"ULORIC 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-918-30","proprietary_name":"ULORIC","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET in 1 BOTTLE (64764-918-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":10.54402,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.19115,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Uloric|Febuxostat","basis":"brand"},"part_b":null}, {"ndc":"64764067730","name":"ULORIC 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64764-677-30","proprietary_name":"ULORIC","nonproprietary_name":"febuxostat","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"30 TABLET in 1 BOTTLE (64764-677-30)","pharm_classes":["Xanthine Oxidase Inhibitor [EPC]","Xanthine Oxidase Inhibitors [MoA]"]},"nadac":{"value":10.53764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26104,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Uloric|Febuxostat","basis":"brand"},"part_b":null}, {"ndc":"70000050101","name":"ULTRA LUBRICANT 0.4-0.3% DROP","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0501-1","proprietary_name":"Leader Preservative-Free Ultra Lubricating Eye Drops","nonproprietary_name":"Polyethylene glycol 400, propylene glycol","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".4 g/100mL; .3 g/100mL","labeler":"Cardinal Health","package_description":"25 VIAL, SINGLE-USE in 1 BOX (70000-0501-1) / .4 mL in 1 VIAL, SINGLE-USE"},"nadac":{"value":0.21077,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993018997","name":"UMECLIDINIUM ELLIPTA 62.5 MCG INH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-189-97","proprietary_name":"Umeclidinium Ellipta","nonproprietary_name":"umeclidinium","dosage_form":"AEROSOL, POWDER","route":"ORAL","strength":"62.5 ug/1","labeler":"Prasco Laboratories","package_description":"1 TRAY in 1 CARTON (66993-189-97) / 1 INHALER in 1 TRAY / 30 AEROSOL, POWDER in 1 INHALER","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":7.35063,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"66993013497","name":"UMECLIDINIUM-VILANTEROL ELLIPTA 62.5-25 MCG INH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66993-134-97","proprietary_name":"Umeclidinium and Vilanterol Ellipta","nonproprietary_name":"umeclidinium bromide and vilanterol trifenatate","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"62.5 ug/1; 25 ug/1","labeler":"Prasco Laboratories","package_description":"1 TRAY in 1 CARTON (66993-134-97) / 1 INHALER in 1 TRAY / 30 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Anticholinergic [EPC]","Cholinergic Antagonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":4.95495,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60846080501","name":"UNITHROID 100 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-805-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"100 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-805-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.20785,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04972,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080601","name":"UNITHROID 112 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-806-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"112 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-806-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.2075,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05879,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080701","name":"UNITHROID 125 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-807-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"125 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-807-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.22691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05704,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080801","name":"UNITHROID 137 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-808-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"137 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-808-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.22764,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06388,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080901","name":"UNITHROID 150 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-809-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"150 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-809-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.22515,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05858,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846081001","name":"UNITHROID 175 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-810-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"175 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-810-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.2313,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07347,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846081101","name":"UNITHROID 200 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-811-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"200 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-811-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.24644,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08099,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080101","name":"UNITHROID 25 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-801-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"25 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-801-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.18263,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03506,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080201","name":"UNITHROID 50 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-802-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"50 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-802-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.18292,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04073,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080301","name":"UNITHROID 75 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-803-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"75 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-803-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.19621,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04612,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"60846080401","name":"UNITHROID 88 MCG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60846-804-01","proprietary_name":"Unithroid","nonproprietary_name":"levothyroxine sodium","dosage_form":"TABLET","route":"ORAL","strength":"88 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (60846-804-01)","pharm_classes":["Thyroxine [CS]","l-Thyroxine [EPC]"]},"nadac":{"value":4.19105,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04947,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Unithroid|Levothyroxine Sodium","basis":"brand"},"part_b":null}, {"ndc":"39328001901","name":"UREA 40% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-019-01","proprietary_name":"Urea 40%","nonproprietary_name":"Urea","dosage_form":"CREAM","route":"TOPICAL","strength":"400 mg/g","labeler":"Patrin Pharma, Inc","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (39328-019-01) / 28.35 g in 1 BOTTLE, PLASTIC"},"nadac":{"value":1.04865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Urea|Urea","basis":"generic"},"part_b":null}, {"ndc":"39328001903","name":"UREA 40% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"39328-019-03","proprietary_name":"Urea 40%","nonproprietary_name":"Urea","dosage_form":"CREAM","route":"TOPICAL","strength":"400 mg/g","labeler":"Patrin Pharma, Inc","package_description":"85 g in 1 BOTTLE, PLASTIC (39328-019-03)"},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Urea|Urea","basis":"generic"},"part_b":null}, {"ndc":"50268087228","name":"UREA 40% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-872-28","proprietary_name":"UREA","nonproprietary_name":"UREA","dosage_form":"CREAM","route":"TOPICAL","strength":"40 g/100g","labeler":"AvPAK","package_description":"28.35 g in 1 TUBE (50268-872-28)"},"nadac":{"value":1.04865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Urea|Urea","basis":"generic"},"part_b":null}, {"ndc":"50268087285","name":"UREA 40% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-872-85","proprietary_name":"UREA","nonproprietary_name":"UREA","dosage_form":"CREAM","route":"TOPICAL","strength":"40 g/100g","labeler":"AvPAK","package_description":"85 g in 1 TUBE (50268-872-85)"},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Urea|Urea","basis":"generic"},"part_b":null}, {"ndc":"58657048901","name":"UREA 40% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-489-01","proprietary_name":"Urea Cream 40 Percent","nonproprietary_name":"Urea","dosage_form":"CREAM","route":"TOPICAL","strength":"400 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"28.35 g in 1 BOTTLE (58657-489-01)"},"nadac":{"value":1.04865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Urea|Urea","basis":"generic"},"part_b":null}, {"ndc":"58657048903","name":"UREA 40% CREAM","unit":"GM","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-489-03","proprietary_name":"Urea Cream 40 Percent","nonproprietary_name":"Urea","dosage_form":"CREAM","route":"TOPICAL","strength":"400 mg/g","labeler":"Method Pharmaceuticals, LLC","package_description":"85 g in 1 BOTTLE (58657-489-03)"},"nadac":{"value":0.26873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Urea|Urea","basis":"generic"},"part_b":null}, {"ndc":"00037632190","name":"URELLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0037-6321-90","proprietary_name":"URELLE","nonproprietary_name":"hyoscyamine sulfate, methenamine, methylene blue, phenyl salicylate, and sodium phosphate, monobasic, monohydrate","dosage_form":"TABLET","route":"ORAL","strength":".12 mg/1; 81 mg/1; 10.8 mg/1; 32.4 mg/1; 40.8 mg/1","labeler":"Viatris Specialty LLC","package_description":"90 TABLET in 1 BOTTLE (0037-6321-90)","pharm_classes":["Oxidation-Reduction Activity [MoA]","Oxidation-Reduction Agent [EPC]"]},"nadac":{"value":9.4315,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"46122033765","name":"URINARY PAIN RELIEF 95 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-337-65","proprietary_name":"Good Neighbor Pharmacy Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"95 mg/1","labeler":"AmerisourceBergen Drug Corp","package_description":"1 BLISTER PACK in 1 CARTON (46122-337-65) / 30 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.13162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000024301","name":"URINARY PAIN RELIEF 95 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0243-1","proprietary_name":"Leader Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"95 mg/1","labeler":"Cardinal Health","package_description":"1 BLISTER PACK in 1 CARTON (70000-0243-1) / 30 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.13162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70000052301","name":"URINARY PAIN RELIEF 99.5 MG TB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0523-1","proprietary_name":"Leader Maximum Strength Urinary Pain Relief","nonproprietary_name":"PHENAZOPYRIDINE HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"99.5 mg/1","labeler":"Cardinal Health","package_description":"1 BLISTER PACK in 1 CARTON (70000-0523-1) / 12 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.18404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58657045601","name":"URO-MP CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58657-456-01","proprietary_name":"Uro-MP","nonproprietary_name":"Methenamine, Sodium Phosphate, Monobasic, Anhydrous, Phenyl Salicylate, Methylene Blue and Hyoscyamine Sulfate","dosage_form":"CAPSULE","route":"ORAL","strength":"118 mg/1; 40.8 mg/1; 36 mg/1; 10 mg/1; .12 mg/1","labeler":"Method Pharmaceuticals, LLC","package_description":"100 CAPSULE in 1 BOTTLE (58657-456-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Oxidation-Reduction Activity [MoA]","Oxidation-Reduction Agent [EPC]"]},"nadac":{"value":1.79462,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Uro-Mp|Meth/Meblue/Sod Phos/Psal/Hyos","basis":"brand"},"part_b":null}, {"ndc":"57237033103","name":"URO-PAIN 95 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-331-03","proprietary_name":"URO-PAIN","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"95 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (57237-331-03) / 30 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.13162,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033021","name":"URO-PAIN 99.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-330-21","proprietary_name":"URO-PAIN Maximum Strength","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"99.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (57237-330-21) / 12 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.18404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033042","name":"URO-PAIN 99.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-330-42","proprietary_name":"URO-PAIN Maximum Strength","nonproprietary_name":"Phenazopyridine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"99.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (57237-330-42) / 24 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.18404,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"57237033242","name":"URO-PAIN DUAL 162-162.5 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-332-42","proprietary_name":"URO-PAIN Dual Action Antibacterial Protection","nonproprietary_name":"Methenamine, Sodium salicylate","dosage_form":"TABLET","route":"ORAL","strength":"162 mg/1; 162.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 BOX (57237-332-42) / 24 TABLET in 1 BLISTER PACK"},"nadac":{"value":0.17591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00485015101","name":"UROGESIC-BLUE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0151-01","proprietary_name":"UROGESIC BLUE","nonproprietary_name":"METHENAMINE, SODIUM PHOSPHATE, MONOBASIC, METHYLENE BLUE, and HYOSCYAMINE SULFATE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81.6 mg/1; 40.8 mg/1; 10.8 mg/1; .12 mg/1","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"100 TABLET, COATED in 1 BOTTLE, PLASTIC (0485-0151-01)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Oxidation-Reduction Activity [MoA]","Oxidation-Reduction Agent [EPC]"]},"nadac":{"value":3.97609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Urogesic-Blue|Methenam/Sod Phos/Mblue/Hyoscy","basis":"brand"},"part_b":null}, {"ndc":"00485015130","name":"UROGESIC-BLUE TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0485-0151-30","proprietary_name":"UROGESIC BLUE","nonproprietary_name":"METHENAMINE, SODIUM PHOSPHATE, MONOBASIC, METHYLENE BLUE, and HYOSCYAMINE SULFATE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"81.6 mg/1; 40.8 mg/1; 10.8 mg/1; .12 mg/1","labeler":"EDWARDS PHARMACEUTICALS, INC.","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (0485-0151-30)","pharm_classes":["Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Oxidation-Reduction Activity [MoA]","Oxidation-Reduction Agent [EPC]"]},"nadac":{"value":3.97609,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Urogesic-Blue|Methenam/Sod Phos/Mblue/Hyoscy","basis":"brand"},"part_b":null}, {"ndc":"00904689004","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6890-04","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6890-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"49884041201","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-412-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"250 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49884-412-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"60687052711","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"60687052721","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-527-21","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-527-21) / 1 TABLET in 1 BLISTER PACK (60687-527-11)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"64380091806","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-918-06","proprietary_name":"URSODIOL","nonproprietary_name":"ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-918-06)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"68001037700","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-377-00","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-377-00)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"68462047301","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-473-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-473-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"70710112701","name":"URSODIOL 250 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1127-1","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"250 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1127-1)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.44954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"00527132601","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-1326-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Lannett Company, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0527-1326-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"00591315901","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-3159-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0591-3159-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"00904622106","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6221-06","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"50 BLISTER PACK in 1 CARTON (0904-6221-06) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"00904622161","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6221-61","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6221-61) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"10702023701","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"10702-237-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursosiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"KVK-Tech, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (10702-237-01)"},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24658078001","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24658-780-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"PuraCap Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (24658-780-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"42385094601","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42385-946-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Laurus Labs Limited","package_description":"100 CAPSULE in 1 BOTTLE (42385-946-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"42806050301","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-503-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Epic Pharma, LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-503-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"59651042101","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-421-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-421-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"60687010001","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-100-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-100-01) / 1 CAPSULE in 1 BLISTER PACK (60687-100-11)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"60687010011","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"62135043060","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-430-60","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-430-60)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"64380084406","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-844-06","proprietary_name":"URSODIOL","nonproprietary_name":"ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE (64380-844-06)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"70710148301","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1483-1","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 CAPSULE in 1 BOTTLE (70710-1483-1)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"72603061301","name":"URSODIOL 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-613-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"CAPSULE","route":"ORAL","strength":"300 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 CAPSULE in 1 BOTTLE (72603-613-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.42919,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"49884041301","name":"URSODIOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-413-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Par Health USA, LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (49884-413-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.64709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"64380091906","name":"URSODIOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-919-06","proprietary_name":"URSODIOL","nonproprietary_name":"ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 TABLET in 1 BOTTLE (64380-919-06)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.64709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"68001037800","name":"URSODIOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-378-00","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-378-00)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.64709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"68462047401","name":"URSODIOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-474-01","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET in 1 BOTTLE (68462-474-01)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.64709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"70710112801","name":"URSODIOL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1128-1","proprietary_name":"Ursodiol","nonproprietary_name":"Ursodiol","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (70710-1128-1)","pharm_classes":["Bile Acid [EPC]","Bile Acids and Salts [CS]"]},"nadac":{"value":0.64709,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ursodiol|Ursodiol","basis":"generic"},"part_b":null}, {"ndc":"51759052010","name":"UZEDY ER 100 MG/0.28 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-520-10","proprietary_name":"UZEDY","nonproprietary_name":"risperidone","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"SUBCUTANEOUS","strength":"100 mg/.28mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (51759-520-10) / .28 mL in 1 SYRINGE, GLASS","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":9389.08614,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2799","bill_units_per_package":{"value":100,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2799 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (100 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.28,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (51759-520-10) / .28 mL in 1 SYRINGE, GLASS) gives 0.28 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51759063010","name":"UZEDY ER 125 MG/0.35 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-630-10","proprietary_name":"UZEDY","nonproprietary_name":"risperidone","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"SUBCUTANEOUS","strength":"125 mg/.35mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (51759-630-10) / .35 mL in 1 SYRINGE, GLASS","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":9329.00476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2799","bill_units_per_package":{"value":125,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2799 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (125 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.35,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (51759-630-10) / .35 mL in 1 SYRINGE, GLASS) gives 0.35 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51759085010","name":"UZEDY ER 200 MG/0.56 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-850-10","proprietary_name":"UZEDY","nonproprietary_name":"risperidone","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"SUBCUTANEOUS","strength":"200 mg/.56mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (51759-850-10) / .56 mL in 1 SYRINGE, GLASS","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":9346.06786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2799","bill_units_per_package":{"value":200,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2799 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (200 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.56,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (51759-850-10) / .56 mL in 1 SYRINGE, GLASS) gives 0.56 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51759030510","name":"UZEDY ER 50 MG/0.14 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"51759-305-10","proprietary_name":"UZEDY","nonproprietary_name":"risperidone","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"SUBCUTANEOUS","strength":"50 mg/.14mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (51759-305-10) / .14 mL in 1 SYRINGE, GLASS","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":9451.01238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2799","bill_units_per_package":{"value":50,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2799 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.14,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (51759-305-10) / .14 mL in 1 SYRINGE, GLASS) gives 0.14 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51759041010","name":"UZEDY ER 75 MG/0.21 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51759-410-10","proprietary_name":"UZEDY","nonproprietary_name":"risperidone","dosage_form":"INJECTION, SUSPENSION, EXTENDED RELEASE","route":"SUBCUTANEOUS","strength":"75 mg/.21mL","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1 SYRINGE, GLASS in 1 CARTON (51759-410-10) / .21 mL in 1 SYRINGE, GLASS","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":9358.65986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J2799","bill_units_per_package":{"value":75,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2799 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (75 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.21,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE, GLASS in 1 CARTON (51759-410-10) / .21 mL in 1 SYRINGE, GLASS) gives 0.21 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"00169517603","name":"VAGIFEM 10 MCG VAGINAL TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-5176-03","proprietary_name":"Vagifem","nonproprietary_name":"estradiol","dosage_form":"INSERT","route":"VAGINAL","strength":"10 ug/1","labeler":"Novo Nordisk","package_description":"8 APPLICATOR in 1 CARTON (0169-5176-03) / 1 INSERT in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":20.32466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vagifem|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00169517604","name":"VAGIFEM 10 MCG VAGINAL TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-5176-04","proprietary_name":"Vagifem","nonproprietary_name":"estradiol","dosage_form":"INSERT","route":"VAGINAL","strength":"10 ug/1","labeler":"Novo Nordisk","package_description":"18 APPLICATOR in 1 CARTON (0169-5176-04) / 1 INSERT in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":20.32466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vagifem|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00378427677","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4276-77","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4276-77)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"00378427693","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4276-93","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4276-93)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"16714069703","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-697-03","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-697-03)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"31722070505","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-705-05","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (31722-705-05)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"31722070530","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-705-30","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-705-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"31722070590","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-705-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-705-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"50268078911","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"50268078915","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-789-15","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-789-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-789-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"57237004330","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-043-30","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-043-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"57237004390","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-043-90","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-043-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"62135061430","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-614-30","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-614-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"62135061490","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-614-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"1 g/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-614-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"63304090590","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-905-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (63304-905-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"65862044930","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-449-30","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-449-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"65862044990","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-449-90","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-449-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"68084030911","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"68084030921","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-309-21","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-309-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-309-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69097015402","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69097015405","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69097015412","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69367026309","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-263-09","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (69367-263-09)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69367026330","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-263-30","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"1000 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (69367-263-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"82009004190","name":"VALACYCLOVIR HCL 1 GRAM TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-041-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-041-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"00378427577","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4275-77","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4275-77)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"00378427593","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-4275-93","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-4275-93)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"00904656507","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6565-07","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6565-07) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"00904656561","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6565-61","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6565-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"16714069803","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-698-03","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"NorthStar Rx LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (16714-698-03)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"31722070430","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-704-30","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-704-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"31722070490","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-704-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-704-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"50268078811","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"50268078815","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-788-15","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-788-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-788-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"51079009301","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"51079009303","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-093-03","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"valacyclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Mylan Institutional Inc.","package_description":"30 BLISTER PACK in 1 CARTON (51079-093-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-093-01)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"57237004230","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-042-30","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (57237-042-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"57237004290","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-042-90","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (57237-042-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"62135061330","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-613-30","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-613-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"62135061390","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-613-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-613-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"63304090490","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63304-904-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"SUN PHARMACEUTICAL INDUSTRIES, INC.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (63304-904-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"65862044830","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-448-30","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-448-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"65862044890","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-448-90","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-448-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"68084021501","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-215-01","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-215-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-215-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"68084021511","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"68084021521","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-215-21","proprietary_name":"Valacyclovir Hydrochloride","nonproprietary_name":"Valacyclovir Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-215-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-215-11)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69367026209","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-262-09","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET in 1 BOTTLE (69367-262-09)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"69367026230","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-262-30","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET","route":"ORAL","strength":"500 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET in 1 BOTTLE (69367-262-30)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"82009004030","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"82009004090","name":"VALACYCLOVIR HCL 500 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-040-90","proprietary_name":"Valacyclovir","nonproprietary_name":"Valacyclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"Quallent Pharmaceuticals Health LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (82009-040-90)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valacyclovir|Valacyclovir HCl","basis":"generic"},"part_b":null}, {"ndc":"00904679604","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6796-04","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6796-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904679610","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6796-10","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Major Pharmaceuticals","package_description":"20 BLISTER PACK in 1 CARTON (0904-6796-10) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241015860","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-158-60","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET","route":"ORAL","strength":"450 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"60 TABLET in 1 BOTTLE (27241-158-60)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722083260","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-832-60","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-832-60)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268078711","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268078712","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-787-12","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-787-12) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-787-11)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"55111076260","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-762-60","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55111-762-60)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380015301","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-153-01","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-153-01)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380016101","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-161-01","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (64380-161-01)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862075360","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-753-60","proprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","nonproprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"450 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET in 1 BOTTLE (65862-753-60)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084096518","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084096519","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-965-19","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"American Health Packaging","package_description":"20 BLISTER PACK in 1 CARTON (68084-965-19) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-965-18)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084096525","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-965-25","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"450 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-965-25) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-965-95)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68084096595","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72603075001","name":"VALGANCICLOVIR 450 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-750-01","proprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","nonproprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"450 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 TABLET in 1 BOTTLE (72603-750-01)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.91499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00591257920","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-2579-20","proprietary_name":"Valganciclovir hydrochloride for Oral","nonproprietary_name":"Valganciclovir hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Actavis Pharma, Inc.","package_description":"100 mL in 1 BOTTLE, GLASS (0591-2579-20)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"27241015919","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-159-19","proprietary_name":"Valganciclovir hydrochloride","nonproprietary_name":"Valganciclovir hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Ajanta Pharma USA Inc.","package_description":"1 POUCH in 1 CARTON (27241-159-19) / 1 BOTTLE in 1 POUCH / 100 mL in 1 BOTTLE","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"31722083710","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-837-10","proprietary_name":"VALGANCICLOVIR","nonproprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (31722-837-10) / 100 mL in 1 BOTTLE, GLASS","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59651044401","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-444-01","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir hydrochloride powder,","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Aurobindo Pharma Limited","package_description":"1 BOTTLE, GLASS in 1 CARTON (59651-444-01) / 100 mL in 1 BOTTLE, GLASS","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"60687076513","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-765-13","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir Hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"American Health Packaging","package_description":"1 BOTTLE, GLASS in 1 CARTON (60687-765-13) / 100 mL in 1 BOTTLE, GLASS","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70010005140","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-051-40","proprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","nonproprietary_name":"VALGANCICLOVIR","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Granules Pharmaceuticals Inc.","package_description":"100 mL in 1 BOTTLE (70010-051-40)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70069081001","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70069-810-01","proprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","nonproprietary_name":"VALGANCICLOVIR","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Somerset Therapeutics, LLC","package_description":"100 mL in 1 BOTTLE (70069-810-01)","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"71921021012","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-210-12","proprietary_name":"Valganciclovir","nonproprietary_name":"Valganciclovir","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 BOTTLE in 1 CARTON (71921-210-12) / 100 mL in 1 BOTTLE","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72205001901","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-019-01","proprietary_name":"valganciclovir hydrochloride","nonproprietary_name":"valganciclovir hydrochloride","dosage_form":"FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"1 BOTTLE in 1 CARTON (72205-019-01) / 100 mL in 1 BOTTLE","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"72603017401","name":"VALGANCICLOVIR HCL 50 MG/ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-174-01","proprietary_name":"VALGANCICLOVIR","nonproprietary_name":"VALGANCICLOVIR HYDROCHLORIDE","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"50 mg/mL","labeler":"NorthStar RxLLC","package_description":"1 BOTTLE, GLASS in 1 CARTON (72603-174-01) / 100 mL in 1 BOTTLE, GLASS","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":1.00585,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00591401201","name":"VALPROIC ACID 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-4012-01","proprietary_name":"Valproic","nonproprietary_name":"Valproic Acid","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE (0591-4012-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00832031011","name":"VALPROIC ACID 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0832-0310-11","proprietary_name":"valproic acid","nonproprietary_name":"valproic acid","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"100 CAPSULE in 1 BOTTLE (0832-0310-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69452015020","name":"VALPROIC ACID 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-150-20","proprietary_name":"Valproic Acid","nonproprietary_name":"Valproic Acid","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"250 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69452-150-20)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.24262,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121067585","name":"VALPROIC ACID 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-0675-85","proprietary_name":"VALPROIC ACID","nonproprietary_name":"VALPROIC ACID","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"473 mL in 1 BOTTLE (0121-0675-85)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.03316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62135019647","name":"VALPROIC ACID 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-196-47","proprietary_name":"Valproic Acid","nonproprietary_name":"Valproic Acid","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Chartwell RX, LLC","package_description":"473 mL in 1 BOTTLE (62135-196-47)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.03316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559026616","name":"VALPROIC ACID 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-266-16","proprietary_name":"Valproic Acid","nonproprietary_name":"Valproic Acid","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"473 mL in 1 BOTTLE (62559-266-16)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.03316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70752020212","name":"VALPROIC ACID 250 MG/5 ML SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70752-202-12","proprietary_name":"VALPROIC ACID","nonproprietary_name":"VALPROIC ACID","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"QUAGEN PHARMACEUTICALS LLC","package_description":"12 BOTTLE in 1 CASE (70752-202-12) / 473 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","Mood Stabilizer [EPC]"]},"nadac":{"value":0.03316,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378581477","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5814-77","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5814-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"31722015390","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-153-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-153-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"31722074790","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-747-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-747-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342006410","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-064-10","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-064-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"43547036909","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-369-09","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-369-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074811","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074815","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-748-15","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-748-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-748-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"51660014290","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-142-90","proprietary_name":"VALSARTAN","nonproprietary_name":"VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (51660-142-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"55111073390","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-733-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55111-733-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"59746036290","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-362-90","proprietary_name":"valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59746-362-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"60687063401","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-634-01","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-634-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-634-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"60687063411","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004671","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-046-71","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-046-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004690","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-046-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-046-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65162083909","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-839-09","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-839-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862057290","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-572-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-572-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"67877041790","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-417-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-417-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"72578013316","name":"VALSARTAN 160 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-133-16","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72578-133-16)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.10604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378581577","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5815-77","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5815-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"31722015490","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-154-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-154-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342006510","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-065-10","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-065-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"43547037009","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-370-09","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"320 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-370-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074911","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074913","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-749-13","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"AvPAK","package_description":"30 BLISTER PACK in 1 BOX (50268-749-13) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-749-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"51660014390","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-143-90","proprietary_name":"VALSARTAN","nonproprietary_name":"VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (51660-143-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"55111073490","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-734-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55111-734-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004771","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-047-71","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"320 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-047-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004790","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-047-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"320 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-047-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65162084009","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-840-09","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"320 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-840-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862057390","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-573-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-573-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"67877041890","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-418-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-418-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"72578013416","name":"VALSARTAN 320 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-134-16","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72578-134-16)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.16341,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378580793","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5807-93","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5807-93)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"31722015130","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-151-30","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (31722-151-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342006207","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-062-07","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (33342-062-07)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"43547036703","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-367-03","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"30 TABLET in 1 BOTTLE (43547-367-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"43547036709","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-367-09","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-367-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074611","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074615","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-746-15","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-746-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-746-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"51660014030","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-140-30","proprietary_name":"VALSARTAN","nonproprietary_name":"VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (51660-140-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"55111073130","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-731-30","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (55111-731-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"59746036030","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-360-30","proprietary_name":"valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (59746-360-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"60687061211","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"60687061221","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-612-21","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-612-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-612-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004430","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-044-30","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE (62332-044-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004490","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-044-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-044-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65162083703","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-837-03","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (65162-837-03)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862057030","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-570-30","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-570-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"67877041530","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-415-30","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (67877-415-30)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"72578013106","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-131-06","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-131-06)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"72819018103","name":"VALSARTAN 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.0963,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378581377","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-5813-77","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5813-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"31722015290","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-152-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (31722-152-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"33342006310","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-063-10","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-063-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"43547036809","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-368-09","proprietary_name":"Valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET in 1 BOTTLE (43547-368-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074711","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"50268074715","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-747-15","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-747-15) / 1 TABLET, FILM COATED in 1 BLISTER PACK (50268-747-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"51660014190","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-141-90","proprietary_name":"VALSARTAN","nonproprietary_name":"VALSARTAN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (51660-141-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"55111073290","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-732-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (55111-732-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"59746036190","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-361-90","proprietary_name":"valsartan","nonproprietary_name":"valsartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Jubilant Cadista Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (59746-361-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"60687062301","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-623-01","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-623-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-623-11)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"60687062311","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004571","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-045-71","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET in 1 BOTTLE (62332-045-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"62332004590","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-045-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET in 1 BOTTLE (62332-045-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65162083809","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-838-09","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"90 TABLET in 1 BOTTLE (65162-838-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"65862057190","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-571-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-571-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"67877041690","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-416-90","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (67877-416-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"72578013216","name":"VALSARTAN 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-132-16","proprietary_name":"Valsartan","nonproprietary_name":"Valsartan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (72578-132-16)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]"]},"nadac":{"value":0.08197,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan|Valsartan","basis":"generic"},"part_b":null}, {"ndc":"00378632277","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6322-77","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6322-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007510","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-075-10","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-075-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007515","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-075-15","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-075-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547031209","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-312-09","proprietary_name":"VALSARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-312-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008071","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-080-71","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62332-080-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008090","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-080-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-080-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862054890","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-548-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-548-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862054899","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-548-99","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-548-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.10137,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378632377","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6323-77","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6323-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007610","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-076-10","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET in 1 BOTTLE (33342-076-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007615","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-076-15","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (33342-076-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547031309","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-313-09","proprietary_name":"VALSARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-313-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008171","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-081-71","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62332-081-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008190","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-081-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-081-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862054990","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-549-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-549-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862054999","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-549-99","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"160 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-549-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.12141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378632477","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6324-77","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6324-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007710","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-077-10","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-077-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007715","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-077-15","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-077-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547031409","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-314-09","proprietary_name":"VALSARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-314-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008271","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-082-71","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62332-082-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008290","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-082-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-082-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862055005","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-550-05","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-550-05)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862055090","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-550-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-550-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.18604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378632577","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6325-77","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6325-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007810","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-078-10","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-078-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007815","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-078-15","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (33342-078-15)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547031509","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-315-09","proprietary_name":"VALSARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-315-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008371","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-083-71","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62332-083-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332008390","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-083-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-083-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862055105","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-551-05","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (65862-551-05)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862055190","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-551-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"320 mg/1; 25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-551-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.1916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"00378632177","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6321-77","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-6321-77)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"33342007410","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-074-10","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (33342-074-10)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"43547031109","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-311-09","proprietary_name":"VALSARTAN AND HYDROCHLOROTHIAZIDE","nonproprietary_name":"valsartan and hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Solco Healthcare US, LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (43547-311-09)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332007971","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-079-71","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (62332-079-71)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"62332007990","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-079-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (62332-079-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862054790","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-547-90","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (65862-547-90)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"65862054799","name":"VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-547-99","proprietary_name":"Valsartan and Hydrochlorothiazide","nonproprietary_name":"Valsartan and Hydrochlorothiazide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1; 12.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-547-99)","pharm_classes":["Angiotensin 2 Receptor Antagonists [MoA]","Angiotensin 2 Receptor Blocker [EPC]","Increased Diuresis [PE]","Thiazide Diuretic [EPC]","Thiazides [CS]"]},"nadac":{"value":0.09732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valsartan-Hydrochlorothiazide|Valsartan/Hydrochlorothiazide","basis":"generic"},"part_b":null}, {"ndc":"72252051005","name":"VALTOCO 10 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72252-510-05","proprietary_name":"Valtoco","nonproprietary_name":"diazepam","dosage_form":"SPRAY","route":"NASAL","strength":"10 mg/.1mL","labeler":"Neurelis, Inc","package_description":"5 BLISTER PACK in 1 CARTON (72252-510-05) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":365.46786,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtoco|Diazepam","basis":"brand"},"part_b":null}, {"ndc":"72252051510","name":"VALTOCO 15 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72252-515-10","proprietary_name":"Valtoco","nonproprietary_name":"diazepam","dosage_form":"SPRAY","route":"NASAL","strength":"7.5 mg/.1mL","labeler":"Neurelis, Inc","package_description":"5 BLISTER PACK in 1 CARTON (72252-515-10) / 2 VIAL, SINGLE-DOSE in 1 BLISTER PACK / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":365.51001,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtoco|Diazepam","basis":"brand"},"part_b":null}, {"ndc":"72252052010","name":"VALTOCO 20 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72252-520-10","proprietary_name":"Valtoco","nonproprietary_name":"diazepam","dosage_form":"SPRAY","route":"NASAL","strength":"10 mg/.1mL","labeler":"Neurelis, Inc","package_description":"2 BLISTER PACK in 1 CARTON (72252-520-10) / 2 VIAL, SINGLE-DOSE in 1 BLISTER PACK / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":365.63626,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtoco|Diazepam","basis":"brand"},"part_b":null}, {"ndc":"72252050505","name":"VALTOCO 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72252-505-05","proprietary_name":"Valtoco","nonproprietary_name":"diazepam","dosage_form":"SPRAY","route":"NASAL","strength":"5 mg/.1mL","labeler":"Neurelis, Inc","package_description":"5 BLISTER PACK in 1 CARTON (72252-505-05) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":366.14353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtoco|Diazepam","basis":"brand"},"part_b":null}, {"ndc":"00173056504","name":"VALTREX 1 GRAM CAPLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0173-0565-04","proprietary_name":"VALTREX","nonproprietary_name":"valacyclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0173-0565-04)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":20.244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtrex|Valacyclovir HCl","basis":"brand"},"part_b":null}, {"ndc":"00173056510","name":"VALTREX 1 GRAM CAPLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0173-0565-10","proprietary_name":"VALTREX","nonproprietary_name":"valacyclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 g/1","labeler":"GlaxoSmithKline LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0173-0565-10)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":20.244,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.41001,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtrex|Valacyclovir HCl","basis":"brand"},"part_b":null}, {"ndc":"00173093308","name":"VALTREX 500 MG CAPLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0173-0933-08","proprietary_name":"VALTREX","nonproprietary_name":"valacyclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0173-0933-08)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":12.80513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtrex|Valacyclovir HCl","basis":"brand"},"part_b":null}, {"ndc":"00173093310","name":"VALTREX 500 MG CAPLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0173-0933-10","proprietary_name":"VALTREX","nonproprietary_name":"valacyclovir hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"500 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0173-0933-10)","pharm_classes":["DNA Polymerase Inhibitors [MoA]","Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":12.80513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22889,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Valtrex|Valacyclovir HCl","basis":"brand"},"part_b":null}, {"ndc":"70700030484","name":"VALTYA 1 MG-35 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.37904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030485","name":"VALTYA 1 MG-35 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-304-85","proprietary_name":"VALTYA 1/35","nonproprietary_name":"ethynodiol diacetate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-304-85) / 1 BLISTER PACK in 1 POUCH (70700-304-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.37904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030584","name":"VALTYA 1 MG-50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":0.73821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030585","name":"VALTYA 1 MG-50 MCG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70700-305-85","proprietary_name":"VALTYA 1/50","nonproprietary_name":"ethynodiol diacetate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-305-85) / 1 BLISTER PACK in 1 POUCH (70700-305-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.73821,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"58809055508","name":"VANACOF DM 18-200-10 MG/15 ML","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58809-555-08","proprietary_name":"VANACOF DM","nonproprietary_name":"DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, and PHENYLEPHRINE HYDROCHLORIDE","dosage_form":"LIQUID","route":"ORAL","strength":"18 mg/15mL; 200 mg/15mL; 10 mg/15mL","labeler":"GM Pharmaceuticals, INC","package_description":"240 mL in 1 BOTTLE (58809-555-08)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Decreased Respiratory Secretion Viscosity [PE]","Expectorant [EPC]","Increased Respiratory Secretions [PE]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.09749,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.072,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"58809065008","name":"VANALICE GEL","unit":"ML","otc":true,"rate_class":"B","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"58809-650-08","proprietary_name":"Vanalice","nonproprietary_name":"Piperonyl butoxide, Pyrethrum","dosage_form":"GEL","route":"TOPICAL","strength":"35 mg/mL; 3 mg/mL","labeler":"GM Pharmaceuticals, INC","package_description":"237 mL in 1 BOTTLE (58809-650-08)"},"nadac":{"value":0.16752,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536010405","name":"VANCOMYCIN 25 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-104-05","proprietary_name":"Vancomycin Hydrochloride for Oral Solution","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (52536-104-05) * 3.75 g in 1 BOTTLE (52536-094-05) * 147 mL in 1 BOTTLE (52536-084-05)"},"nadac":{"value":0.67288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536010710","name":"VANCOMYCIN 25 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-107-10","proprietary_name":"Vancomycin Hydrochloride for Oral Solution","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (52536-107-10) * 7.5 g in 1 BOTTLE (52536-095-10) * 295 mL in 1 BOTTLE (52536-085-10)"},"nadac":{"value":0.39002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877075058","name":"VANCOMYCIN 25 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-750-58","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ascend Laboratories, LLC","package_description":"1 KIT in 1 CARTON (67877-750-58) * 7.5 g in 1 BOTTLE * 295 mL in 1 BOTTLE * 147 mL in 1 BOTTLE * 3.75 g in 1 BOTTLE"},"nadac":{"value":0.39002,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877075081","name":"VANCOMYCIN 25 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-750-81","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ascend Laboratories, LLC","package_description":"1 KIT in 1 CARTON (67877-750-81) * 7.5 g in 1 BOTTLE * 295 mL in 1 BOTTLE * 147 mL in 1 BOTTLE * 3.75 g in 1 BOTTLE"},"nadac":{"value":0.67288,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559083003","name":"VANCOMYCIN 250 MG/5 ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62559-830-03","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"300 mL in 1 BOTTLE, PLASTIC (62559-830-03)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":0.8007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559083055","name":"VANCOMYCIN 250 MG/5 ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-830-55","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"150 mL in 1 BOTTLE, PLASTIC (62559-830-55)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":0.70181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62559083080","name":"VANCOMYCIN 250 MG/5 ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"62559-830-80","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"POWDER, FOR SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"ANI Pharmaceuticals, Inc.","package_description":"80 mL in 1 BOTTLE, PLASTIC (62559-830-80)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.90936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238226103","name":"VANCOMYCIN 250 MG/5 ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69238-2261-3","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"80 mL in 1 BOTTLE (69238-2261-3)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.90936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"69238226105","name":"VANCOMYCIN 250 MG/5 ML ORAL SOL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"69238-2261-5","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"SOLUTION","route":"ORAL","strength":"250 mg/5mL","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"300 mL in 1 BOTTLE (69238-2261-5)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":0.8007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536010605","name":"VANCOMYCIN 50 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-106-05","proprietary_name":"Vancomycin Hydrochloride for Oral Solution","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (52536-106-05) * 7.5 g in 1 BOTTLE (52536-096-05) * 145 mL in 1 BOTTLE (52536-086-05)"},"nadac":{"value":0.70181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"52536010810","name":"VANCOMYCIN 50 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"52536-108-10","proprietary_name":"Vancomycin Hydrochloride for Oral Solution","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"KIT","route":null,"strength":null,"labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (52536-108-10) * 15 g in 1 BOTTLE (52536-098-10) * 289 mL in 1 BOTTLE (52536-088-10)"},"nadac":{"value":0.8007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877075158","name":"VANCOMYCIN 50 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67877-751-58","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ascend Laboratories, LLC","package_description":"1 KIT in 1 CARTON (67877-751-58) * 145 mL in 1 BOTTLE * 15 g in 1 BOTTLE * 289 mL in 1 BOTTLE * 7.5 g in 1 BOTTLE"},"nadac":{"value":0.8007,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"67877075181","name":"VANCOMYCIN 50 MG/ML ORAL SOLN","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-751-81","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ascend Laboratories, LLC","package_description":"1 KIT in 1 CARTON (67877-751-81) * 145 mL in 1 BOTTLE * 15 g in 1 BOTTLE * 289 mL in 1 BOTTLE * 7.5 g in 1 BOTTLE"},"nadac":{"value":0.70181,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409433201","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0409-4332-01","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/1","labeler":"Hospira, Inc.","package_description":"10 VIAL in 1 TRAY (0409-4332-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL (0409-4332-11)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 TRAY (0409-4332-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL (0409-4332-11)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"25021015010","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"25021-150-10","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Sagent Pharmaceuticals","package_description":"10 VIAL in 1 CARTON (25021-150-10) / 10 mL in 1 VIAL","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (25021-150-10) / 10 mL in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"31722021010","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-210-10","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"10 VIAL in 1 CARTON (31722-210-10) / 10 mL in 1 VIAL (31722-210-33)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"67457033950","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"67457-339-50","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Mylan Institutional LLC","package_description":"10 VIAL in 1 CARTON (67457-339-50) / 10 mL in 1 VIAL (67457-339-00)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (67457-339-50) / 10 mL in 1 VIAL (67457-339-00)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70436002082","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70436-020-82","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/1","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"10 VIAL in 1 CARTON (70436-020-82) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL in 1 CARTON (70436-020-82) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70594004502","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"70594012202","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70594-122-02","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/1","labeler":"Xellia Pharmaceuticals USA LLC","package_description":"10 VIAL, GLASS in 1 CARTON (70594-122-02) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, GLASS (70594-122-01)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, GLASS in 1 CARTON (70594-122-02) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, GLASS (70594-122-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"71288002211","name":"VANCOMYCIN 500 MG VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"71288-022-11","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAVENOUS","strength":"500 mg/10mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (71288-022-11) / 10 mL in 1 VIAL, SINGLE-DOSE (71288-022-10)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.3054,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":{"hcpcs":"J3373","bill_units_per_package":{"value":500,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3373 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (50 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (71288-022-11) / 10 mL in 1 VIAL, SINGLE-DOSE (71288-022-10)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00121103220","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1032-20","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"2 BLISTER PACK in 1 CARTON (0121-1032-20) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121103250","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1032-50","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"50 CAPSULE in 1 BOTTLE (0121-1032-50)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085825","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-858-25","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"50 CAPSULE in 1 BOTTLE (23155-858-25)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085878","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-858-78","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"2 BLISTER PACK in 1 CARTON (23155-858-78) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42494045020","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-450-20","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Cameron Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (42494-450-20) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559039020","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-390-20","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (62559-390-20) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559039050","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-390-50","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (62559-390-50)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072901","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072902","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-729-02","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Strides Pharma Science Limited","package_description":"2 BLISTER PACK in 1 CARTON (64380-729-02) / 10 CAPSULE in 1 BLISTER PACK (64380-729-01)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380072903","name":"VANCOMYCIN HCL 125 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-729-03","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"125 mg/1","labeler":"Strides Pharma Science Limited","package_description":"50 CAPSULE in 1 BOTTLE (64380-729-03)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":1.32898,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121103320","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1033-20","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"2 BLISTER PACK in 1 CARTON (0121-1033-20) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00121103350","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0121-1033-50","proprietary_name":"VANCOMYCIN HYDROCHLORIDE","nonproprietary_name":"VANCOMYCIN HYDROCHLORIDE","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"PAI Holdings, LLC dba PAI Pharma","package_description":"50 CAPSULE in 1 BOTTLE (0121-1033-50)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085925","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-859-25","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"50 CAPSULE in 1 BOTTLE (23155-859-25)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"23155085978","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-859-78","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"2 BLISTER PACK in 1 CARTON (23155-859-78) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42494045120","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42494-451-20","proprietary_name":"Vancomycin Hydrochloride","nonproprietary_name":"Vancomycin Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Cameron Pharmaceuticals","package_description":"2 BLISTER PACK in 1 CARTON (42494-451-20) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42494045150","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559039120","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-391-20","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (62559-391-20) / 10 CAPSULE in 1 BLISTER PACK","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559039150","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-391-50","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"ANI Pharmaceuticals, Inc.","package_description":"50 CAPSULE in 1 BOTTLE (62559-391-50)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380073001","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380073002","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-730-02","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"2 BLISTER PACK in 1 CARTON (64380-730-02) / 10 CAPSULE in 1 BLISTER PACK (64380-730-01)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64380073003","name":"VANCOMYCIN HCL 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-730-03","proprietary_name":"vancomycin hydrochloride","nonproprietary_name":"vancomycin hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Strides Pharma Science Limited","package_description":"50 CAPSULE in 1 BOTTLE (64380-730-03)","pharm_classes":["Glycopeptide Antibacterial [EPC]","Glycopeptides [CS]"]},"nadac":{"value":2.59757,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00245086070","name":"VANDAZOLE VAGINAL 0.75% GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0245-0860-70","proprietary_name":"Vandazole","nonproprietary_name":"Metronidazole","dosage_form":"GEL","route":"VAGINAL","strength":"7.5 mg/g","labeler":"Upsher-smith Laboratories, LLC","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (0245-0860-70) / 70 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Nitroimidazole Antimicrobial [EPC]","Nitroimidazoles [CS]"]},"nadac":{"value":0.33416,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Vandazole|Metronidazole","basis":"brand"},"part_b":null}, {"ndc":"70000056301","name":"VAPOR STEAM LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0563-1","proprietary_name":"Leader Vapor Steam camphor (synthetic)","nonproprietary_name":"camphor (synthetic)","dosage_form":"LIQUID","route":"RESPIRATORY (INHALATION)","strength":".062 g/mL","labeler":"LEADER/Cardinal Health 110, Inc.","package_description":"1 BOTTLE, PLASTIC in 1 CARTON (70000-0563-1) / 237 mL in 1 BOTTLE, PLASTIC"},"nadac":{"value":0.01884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"33342020337","name":"VARDENAFIL HCL 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-203-37","proprietary_name":"Vardenafil","nonproprietary_name":"Vardenafil","dosage_form":"TABLET","route":"ORAL","strength":"11.85 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"1 BLISTER PACK in 1 CARTON (33342-203-37) / 4 TABLET in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":23.327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62332023504","name":"VARDENAFIL HCL 10 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-235-04","proprietary_name":"Vardenafil","nonproprietary_name":"Vardenafil","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"4 BLISTER PACK in 1 CARTON (62332-235-04) / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":23.327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093765456","name":"VARDENAFIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7654-56","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7654-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.86665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"00527280232","name":"VARDENAFIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2802-32","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (0527-2802-32)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.86665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342015307","name":"VARDENAFIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-153-07","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-153-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.86665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332023830","name":"VARDENAFIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-238-30","proprietary_name":"VARDENAFIL HYDROCHLORIDE","nonproprietary_name":"VARDENAFIL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-238-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.86665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"70710107003","name":"VARDENAFIL HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1070-3","proprietary_name":"VARDENAFIL","nonproprietary_name":"VARDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1070-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.86665,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"00093765556","name":"VARDENAFIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7655-56","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7655-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.7928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"00527280332","name":"VARDENAFIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0527-2803-32","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (0527-2803-32)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.7928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342015407","name":"VARDENAFIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-154-07","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-154-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.7928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"62332023930","name":"VARDENAFIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-239-30","proprietary_name":"VARDENAFIL HYDROCHLORIDE","nonproprietary_name":"VARDENAFIL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-239-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.7928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"70710107103","name":"VARDENAFIL HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1071-3","proprietary_name":"VARDENAFIL","nonproprietary_name":"VARDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1071-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":2.7928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"00093765356","name":"VARDENAFIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0093-7653-56","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0093-7653-56)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":7.0998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"00527280132","name":"VARDENAFIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0527-2801-32","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Lannett Company, Inc.","package_description":"30 TABLET in 1 BOTTLE (0527-2801-32)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":7.0998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"33342015207","name":"VARDENAFIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"33342-152-07","proprietary_name":"Vardenafil Hydrochloride","nonproprietary_name":"Vardenafil Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"30 TABLET in 1 BOTTLE (33342-152-07)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":7.0998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"70710106903","name":"VARDENAFIL HCL 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1069-3","proprietary_name":"VARDENAFIL","nonproprietary_name":"VARDENAFIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (70710-1069-3)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":7.0998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vardenafil HCl|Vardenafil HCl","basis":"generic"},"part_b":null}, {"ndc":"00904741335","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7413-35","proprietary_name":"varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Major Pharmaceuticals","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (0904-7413-35)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"27241017356","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-173-56","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (27241-173-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722067856","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-678-56","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (31722-678-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"33342048919","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-489-19","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (33342-489-19)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43598090756","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-907-56","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Dr. Reddys Laboratories Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (43598-907-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"49884015576","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-155-76","proprietary_name":"Varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Par Health USA, LLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (49884-155-76)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59651041756","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-417-56","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (59651-417-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505361305","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3613-5","proprietary_name":"VARENICLINE","nonproprietary_name":"VARENICLINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Apotex Corp","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (60505-3613-5)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"67877074395","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-743-95","proprietary_name":"varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (67877-743-95)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68462089356","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-893-56","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (68462-893-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70710161306","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1613-6","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (70710-1613-6)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70748012749","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-127-49","proprietary_name":"VARENICLINE","nonproprietary_name":"VARENICLINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (70748-127-49)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71921030856","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-308-56","proprietary_name":"Varenicline tartrate","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (71921-308-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72603047601","name":"VARENICLINE 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-476-01","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":".5 mg/1","labeler":"NorthStar RxLLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (72603-476-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.31158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00904741435","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7414-35","proprietary_name":"varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Major Pharmaceuticals","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (0904-7414-35)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"27241017456","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-174-56","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (27241-174-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722067956","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-679-56","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (31722-679-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"33342049019","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-490-19","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (33342-490-19)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"42571046082","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-460-82","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Micro Labs Limited","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (42571-460-82)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43598090856","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-908-56","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Dr. Reddys Laboratories Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (43598-908-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"49884015676","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-156-76","proprietary_name":"Varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Par Health USA, LLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (49884-156-76)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59651041856","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-418-56","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (59651-418-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505361405","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3614-5","proprietary_name":"VARENICLINE","nonproprietary_name":"VARENICLINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Apotex Corp","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (60505-3614-5)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687064811","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687064821","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-648-21","proprietary_name":"Varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-648-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-648-11)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687089311","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687089321","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-893-21","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-893-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-893-11)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"67877074495","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-744-95","proprietary_name":"varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (67877-744-95)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68462089456","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-894-56","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (68462-894-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70710161406","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1614-6","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (70710-1614-6)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70748012849","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-128-49","proprietary_name":"VARENICLINE","nonproprietary_name":"VARENICLINE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (70748-128-49)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71921030956","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-309-56","proprietary_name":"Varenicline tartrate","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"Florida Pharmaceutical Products, LLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (71921-309-56)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72603047701","name":"VARENICLINE 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-477-01","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"1 mg/1","labeler":"NorthStar RxLLC","package_description":"56 TABLET, FILM COATED in 1 BOTTLE (72603-477-01)","pharm_classes":["Cholinergic Agonists [MoA]","Cholinergic Receptor Agonist [EPC]","Partial Cholinergic Nicotinic Agonist [EPC]","Partial Cholinergic Nicotinic Agonists [MoA]"]},"nadac":{"value":0.3161,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00904741516","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7415-16","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Major Pharmaceuticals","package_description":"1 KIT in 1 CARTON (0904-7415-16) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"27241018757","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-187-57","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ajanta Pharma USA Inc.","package_description":"1 KIT in 1 CARTON (27241-187-57) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"31722069031","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-690-31","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (31722-690-31) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"33342057749","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-577-49","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"KIT","route":null,"strength":null,"labeler":"Macleods Pharmaceuticals Limited","package_description":"1 KIT in 1 CARTON (33342-577-49) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"42571047584","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42571-475-84","proprietary_name":"Varenicline tartrate","nonproprietary_name":"Varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Micro Labs Limited","package_description":"1 KIT in 1 CARTON (42571-475-84) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"43598002353","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-023-53","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Dr. Reddys Laboratories Inc.","package_description":"1 KIT in 1 CARTON (43598-023-53) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"49884094499","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-944-99","proprietary_name":"Varenicline","nonproprietary_name":"varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Par Health USA, LLC","package_description":"1 KIT in 1 BOX (49884-944-99) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"59651045153","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-451-53","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"1 KIT in 1 CARTON (59651-451-53) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60505361504","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-3615-4","proprietary_name":"VARENICLINE","nonproprietary_name":"VARENICLINE","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Apotex Corp","package_description":"1 KIT in 1 CARTON (60505-3615-4) * 42 TABLET, FILM COATED in 1 BLISTER PACK (60505-3607-1) * 11 TABLET, FILM COATED in 1 BLISTER PACK (60505-3606-1)"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"67877074554","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-745-54","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ascend Laboratories, LLC","package_description":"1 KIT in 1 CARTON (67877-745-54) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68462089504","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-895-04","proprietary_name":"varenicline tartrate","nonproprietary_name":"varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 KIT in 1 CARTON (68462-895-04) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70748012511","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"70748012513","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70748-125-13","proprietary_name":"VARENICLINE TARTRATE","nonproprietary_name":"VARENICLINE TARTRATE","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (70748-125-13) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71921030751","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71921-307-51","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline Tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Florida Pharmaceutical Products, LLC","package_description":"1 KIT in 1 CARTON (71921-307-51) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"72603047801","name":"VARENICLINE STARTING MONTH BOX","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-478-01","proprietary_name":"Varenicline","nonproprietary_name":"Varenicline tartrate","dosage_form":"KIT","route":null,"strength":null,"labeler":"NorthStar RxLLC","package_description":"1 KIT in 1 CARTON (72603-478-01) * 11 TABLET, FILM COATED in 1 BLISTER PACK * 42 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":0.3972,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Varenicline Tartrate|Varenicline Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00555905167","name":"VELIVET 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0555-9051-67","proprietary_name":"Velivet Triphasic Regimen","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"3 POUCH in 1 CARTON (0555-9051-67) / 1 BLISTER PACK in 1 POUCH (0555-9051-79) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.53646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Velivet|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00555905179","name":"VELIVET 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Velivet|Desogestrel-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"49230064551","name":"VELPHORO 500 MG CHEWABLE TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"49230-645-51","proprietary_name":"Velphoro","nonproprietary_name":"sucroferric oxyhydroxide","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"500 mg/1","labeler":"Fresenius Medical Care Renal Therapies Group, LLC","package_description":"1 BOTTLE in 1 CARTON (49230-645-51) / 90 TABLET, CHEWABLE in 1 BOTTLE","pharm_classes":["Phosphate Binder [EPC]","Phosphate Chelating Activity [MoA]"]},"nadac":{"value":17.10553,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Velphoro|Sucroferric Oxyhydroxide","basis":"brand"},"part_b":null}, {"ndc":"53436016801","name":"VELTASSA 16.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":33.96801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Veltassa|Patiromer Calcium Sorbitex","basis":"brand"},"part_b":null}, {"ndc":"53436016830","name":"VELTASSA 16.8 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53436-168-30","proprietary_name":"VELTASSA","nonproprietary_name":"patiromer","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"16.8 g/1","labeler":"Vifor Pharma, Inc.","package_description":"30 PACKET in 1 CARTON (53436-168-30) / 1 POWDER, FOR SUSPENSION in 1 PACKET (53436-168-01)","pharm_classes":["Potassium Binder [EPC]","Potassium Ion Binding Activity [MoA]"]},"nadac":{"value":33.96801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Veltassa|Patiromer Calcium Sorbitex","basis":"brand"},"part_b":null}, {"ndc":"53436008401","name":"VELTASSA 8.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":34.01781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Veltassa|Patiromer Calcium Sorbitex","basis":"brand"},"part_b":null}, {"ndc":"53436008404","name":"VELTASSA 8.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53436-084-04","proprietary_name":"VELTASSA","nonproprietary_name":"patiromer","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"8.4 g/1","labeler":"Vifor Pharma, Inc.","package_description":"4 PACKET in 1 CARTON (53436-084-04) / 1 POWDER, FOR SUSPENSION in 1 PACKET (53436-084-01)","pharm_classes":["Potassium Binder [EPC]","Potassium Ion Binding Activity [MoA]"]},"nadac":{"value":45.47695,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Veltassa|Patiromer Calcium Sorbitex","basis":"brand"},"part_b":null}, {"ndc":"53436008430","name":"VELTASSA 8.4 GM POWDER PACKET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"53436-084-30","proprietary_name":"VELTASSA","nonproprietary_name":"patiromer","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"8.4 g/1","labeler":"Vifor Pharma, Inc.","package_description":"30 PACKET in 1 CARTON (53436-084-30) / 1 POWDER, FOR SUSPENSION in 1 PACKET (53436-084-01)","pharm_classes":["Potassium Binder [EPC]","Potassium Ion Binding Activity [MoA]"]},"nadac":{"value":34.01781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Veltassa|Patiromer Calcium Sorbitex","basis":"brand"},"part_b":null}, {"ndc":"61958230101","name":"VEMLIDY 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-2301-1","proprietary_name":"VEMLIDY","nonproprietary_name":"tenofovir alafenamide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (61958-2301-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":51.98384,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vemlidy|Tenofovir Alafenamide","basis":"brand"},"part_b":null}, {"ndc":"52427063230","name":"VENLAFAXINE BES ER 112.5 MG TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-632-30","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"112.5 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (52427-632-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":6.22984,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00093916301","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9163-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9163-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155025001","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-250-01","proprietary_name":"VENLAFAXINE","nonproprietary_name":"VENLAFAXINE","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-250-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237017601","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-176-01","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-176-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664039688","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-396-88","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-396-88)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332001231","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-012-31","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-012-31)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001015600","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-156-00","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-156-00)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382010101","name":"VENLAFAXINE HCL 100 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-101-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-101-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.10992,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093914701","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9147-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9147-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155024601","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-246-01","proprietary_name":"VENLAFAXINE","nonproprietary_name":"VENLAFAXINE","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-246-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237017201","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-172-01","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-172-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664039288","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-392-88","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-392-88)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332000831","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-008-31","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-008-31)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001015700","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-157-00","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-157-00)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084089625","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-896-25","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-896-25) / 1 TABLET in 1 BLISTER PACK (68084-896-95)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084089695","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382001801","name":"VENLAFAXINE HCL 25 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-018-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-018-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093914801","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9148-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9148-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155024701","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-247-01","proprietary_name":"VENLAFAXINE","nonproprietary_name":"VENLAFAXINE","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-247-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237017301","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-173-01","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-173-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664039388","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-393-88","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-393-88)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332000931","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-009-31","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-009-31)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001015800","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-158-00","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-158-00)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084084401","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-844-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-844-01) / 1 TABLET in 1 BLISTER PACK (68084-844-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084084411","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382001901","name":"VENLAFAXINE HCL 37.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-019-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-019-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093914901","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9149-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9149-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155024801","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-248-01","proprietary_name":"VENLAFAXINE","nonproprietary_name":"VENLAFAXINE","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-248-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237017401","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-174-01","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-174-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664039488","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-394-88","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-394-88)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332001031","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-010-31","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-010-31)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001015900","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-159-00","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-159-00)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382002001","name":"VENLAFAXINE HCL 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-020-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-020-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08941,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093915701","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-9157-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-9157-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"23155024901","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-249-01","proprietary_name":"VENLAFAXINE","nonproprietary_name":"VENLAFAXINE","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-249-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57237017501","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-175-01","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 TABLET in 1 BOTTLE (57237-175-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"57664039588","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57664-395-88","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (57664-395-88)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332001131","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-011-31","proprietary_name":"venlafaxine","nonproprietary_name":"venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (62332-011-31)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001016000","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-160-00","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"100 TABLET in 1 BOTTLE (68001-160-00)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084085601","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-856-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-856-01) / 1 TABLET in 1 BLISTER PACK (68084-856-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084085611","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382002101","name":"VENLAFAXINE HCL 75 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-021-01","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-021-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.08507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738605","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7386-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7386-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738656","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7386-56","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7386-56)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738698","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7386-98","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7386-98)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904748961","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7489-61","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7489-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722000430","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-004-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-004-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722000490","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-004-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-004-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806060305","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-603-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42806-603-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806060309","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-603-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42806-603-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598000205","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-002-05","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-002-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598000230","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-002-30","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-002-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598000290","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-002-90","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-002-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268087511","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268087515","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-875-15","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-875-15) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-875-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332079490","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-794-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-794-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862069701","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-697-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-697-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862069705","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-697-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-697-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862069730","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-697-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-697-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862069790","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-697-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-697-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084071301","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-713-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-713-01) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (68084-713-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084071311","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382003610","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-036-10","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-036-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382003616","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-036-16","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-036-16)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018603","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-186-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-186-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018605","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-186-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-186-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018609","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-186-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-186-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710170000","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1700-0","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1700-0)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710170009","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1700-9","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1700-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603074901","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-749-01","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-749-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888018190","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-181-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72888-181-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009005805","name":"VENLAFAXINE HCL ER 150 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-058-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (82009-058-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.11901,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071430","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071490","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241022330","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-223-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-223-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012530","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-125-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-125-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012590","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-125-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-125-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42799096201","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-962-01","proprietary_name":"venlafaxine hydrochloride, extended release","nonproprietary_name":"venlafaxine hydrochloride, extended release","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET in 1 BOTTLE (42799-962-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42799096202","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-962-02","proprietary_name":"venlafaxine hydrochloride, extended release","nonproprietary_name":"venlafaxine hydrochloride, extended release","dosage_form":"TABLET","route":"ORAL","strength":"150 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"90 TABLET in 1 BOTTLE (42799-962-02)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598094330","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-943-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-943-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598094390","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-943-90","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-943-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980058003","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-580-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-580-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980058009","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-580-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-580-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072830","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-728-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-728-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072890","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-728-90","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-728-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001049804","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-498-04","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-498-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68025008190","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367041709","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-417-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-417-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367041730","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-417-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-417-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710135003","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1350-3","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1350-3)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710135009","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1350-9","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1350-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241007604","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-076-04","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"150 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-076-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241007622","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-076-22","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"150 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (72241-076-22)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834021830","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-218-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (75834-218-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834021890","name":"VENLAFAXINE HCL ER 150 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-218-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"150 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (75834-218-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.22771,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071530","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071590","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241022430","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-224-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-224-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012630","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-126-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-126-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012690","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-126-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-126-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42799096301","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-963-01","proprietary_name":"venlafaxine hydrochloride, extended release","nonproprietary_name":"venlafaxine hydrochloride, extended release","dosage_form":"TABLET","route":"ORAL","strength":"225 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"30 TABLET in 1 BOTTLE (42799-963-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42799096302","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42799-963-02","proprietary_name":"venlafaxine hydrochloride, extended release","nonproprietary_name":"venlafaxine hydrochloride, extended release","dosage_form":"TABLET","route":"ORAL","strength":"225 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"90 TABLET in 1 BOTTLE (42799-963-02)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598094430","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-944-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-944-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598094490","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-944-90","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Dr. Reddy's Laboratories Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (43598-944-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62135053130","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-531-30","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"225 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 TABLET in 1 BOTTLE (62135-531-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980058103","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-581-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-581-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980058109","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-581-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-581-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072930","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-729-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-729-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072990","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-729-90","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-729-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001049904","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-499-04","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-499-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68025008290","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367041809","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-418-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-418-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"69367041830","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-418-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Westminster Pharmaceuticals, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (69367-418-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710135203","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1352-3","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1352-3)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710135209","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1352-9","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1352-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241007704","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-077-04","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"225 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-077-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241007722","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-077-22","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"225 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (72241-077-22)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834021930","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-219-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (75834-219-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834021990","name":"VENLAFAXINE HCL ER 225 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-219-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"225 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (75834-219-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.47118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738405","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7384-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7384-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738456","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7384-56","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7384-56)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738498","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7384-98","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7384-98)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904748761","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7487-61","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7487-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722000230","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-002-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-002-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722000290","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-002-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-002-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806060109","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-601-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42806-601-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806060110","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-601-10","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42806-601-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598099910","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-999-10","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-999-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598099930","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-999-30","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-999-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598099990","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-999-90","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-999-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268087311","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268087315","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-873-15","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-873-15) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-873-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332079290","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-792-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-792-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052701","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-527-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-527-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052730","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-527-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-527-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052790","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-527-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-527-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052799","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-527-99","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-527-99)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084069801","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-698-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-698-01) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (68084-698-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084069811","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382003410","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-034-10","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-034-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382003416","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-034-16","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-034-16)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018403","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-184-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-184-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018405","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-184-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-184-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018409","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-184-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-184-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018410","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-184-10","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-184-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710169800","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1698-0","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1698-0)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710169809","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1698-9","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1698-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603074701","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-747-01","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-747-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888017990","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-179-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72888-179-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009005610","name":"VENLAFAXINE HCL ER 37.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-056-10","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (82009-056-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071230","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-712-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-712-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071290","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13811-712-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Trigen Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (13811-712-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241022130","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-221-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-221-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012330","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-123-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-123-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012390","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-123-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-123-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980057803","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-578-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-578-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980057809","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-578-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-578-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072630","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-726-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-726-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072690","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-726-90","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-726-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001049604","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-496-04","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-496-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68025007990","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710134803","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1348-3","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1348-3)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710134809","name":"VENLAFAXINE HCL ER 37.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1348-9","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"37.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1348-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.35811,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738505","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7385-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7385-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738556","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7385-56","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7385-56)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00093738598","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-7385-98","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0093-7385-98)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00904748861","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7488-61","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-7488-61) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722000330","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-003-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-003-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722000390","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-003-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (31722-003-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806060209","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-602-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Epic Pharma, LLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42806-602-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42806060210","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-602-10","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Epic Pharma, LLC","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (42806-602-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598000110","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-001-10","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-001-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598000130","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-001-30","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-001-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"43598000190","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43598-001-90","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Dr.Reddys Laboratories Inc","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (43598-001-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268087411","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"50268087415","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-874-15","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-874-15) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-874-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332079330","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-793-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-793-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"62332079390","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-793-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62332-793-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052801","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-528-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-528-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052830","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-528-30","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-528-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052890","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-528-90","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-528-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"65862052899","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-528-99","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (65862-528-99)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084070901","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-709-01","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-709-01) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (68084-709-11)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68084070911","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382003510","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-035-10","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-035-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68382003516","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-035-16","proprietary_name":"venlafaxine hydrochloride","nonproprietary_name":"venlafaxine hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (68382-035-16)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018503","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-185-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-185-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018505","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-185-05","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"500 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-185-05)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018509","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-185-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-185-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70010018510","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70010-185-10","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Granules Pharmaceuticals Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70010-185-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710169900","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1699-0","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1699-0)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710169909","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1699-9","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (70710-1699-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72603074801","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-748-01","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"NorthStar RxLLC","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72603-748-01)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72888018090","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72888-180-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Advagen Pharma Ltd.","package_description":"90 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (72888-180-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"82009005710","name":"VENLAFAXINE HCL ER 75 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82009-057-10","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"QUALLENT PHARMACEUTICALS HEALTH LLC","package_description":"1000 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (82009-057-10)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.07989,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071330","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"13811071390","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"27241022230","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-222-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (27241-222-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012430","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-124-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-124-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"31722012490","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-124-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-124-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42799096101","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"42799096102","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980057903","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-579-03","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-579-03)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"64980057909","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-579-09","proprietary_name":"Venlafaxine Hydrochloride","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-579-09)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072730","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-727-30","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-727-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"67877072790","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67877-727-90","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Ascend Laboratories, LLC","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (67877-727-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68001049704","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-497-04","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"BluePoint Laboratories","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68001-497-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"68025008090","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":null,"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710134903","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1349-3","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1349-3)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"70710134909","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1349-9","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (70710-1349-9)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241007504","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-075-04","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"75 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"90 TABLET, COATED in 1 BOTTLE (72241-075-04)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"72241007522","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72241-075-22","proprietary_name":"Venlafaxine","nonproprietary_name":"Venlafaxine","dosage_form":"TABLET, COATED","route":"ORAL","strength":"75 mg/1","labeler":"Modavar Pharmaceuticals LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (72241-075-22)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834021730","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-217-30","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"30 TABLET, EXTENDED RELEASE in 1 BOTTLE (75834-217-30)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"75834021790","name":"VENLAFAXINE HCL ER 75 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-217-90","proprietary_name":"VENLAFAXINE HYDROCHLORIDE","nonproprietary_name":"VENLAFAXINE HYDROCHLORIDE","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"75 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"90 TABLET, EXTENDED RELEASE in 1 BOTTLE (75834-217-90)","pharm_classes":["Norepinephrine Uptake Inhibitors [MoA]","Serotonin Uptake Inhibitors [MoA]","Serotonin and Norepinephrine Reuptake Inhibitor [EPC]"]},"nadac":{"value":0.28524,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Venlafaxine HCl ER|Venlafaxine HCl","basis":"generic"},"part_b":null}, {"ndc":"00173068220","name":"VENTOLIN HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0682-20","proprietary_name":"VENTOLIN HFA","nonproprietary_name":"albuterol sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0682-20) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":3.03483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":1.82548,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ventolin HFA|Albuterol Sulfate","basis":"brand"},"part_b":null}, {"ndc":"00173068224","name":"VENTOLIN HFA 90 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0682-24","proprietary_name":"VENTOLIN HFA","nonproprietary_name":"albuterol sulfate","dosage_form":"AEROSOL, METERED","route":"RESPIRATORY (INHALATION)","strength":"90 ug/1","labeler":"GlaxoSmithKline LLC","package_description":"1 INHALER in 1 CARTON (0173-0682-24) / 60 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":2.72021,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Ventolin HFA|Albuterol Sulfate","basis":"brand"},"part_b":null}, {"ndc":"00469266030","name":"VEOZAH 45 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0469-2660-30","proprietary_name":"VEOZAH","nonproprietary_name":"fezolinetant","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"45 mg/1","labeler":"Astellas Pharma US, Inc.","package_description":"1 BOTTLE in 1 CARTON (0469-2660-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Neurokinin 3 Receptor Antagonist [EPC]","Neurokinin 3 Receptor Antagonists [MoA]"]},"nadac":{"value":18.58225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Veozah|Fezolinetant","basis":"brand"},"part_b":null}, {"ndc":"00591034501","name":"VERAPAMIL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0345-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0345-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.08873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00591034505","name":"VERAPAMIL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0345-05","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0345-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.08873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00591034510","name":"VERAPAMIL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0345-10","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"120 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0345-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.08873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"23155048601","name":"VERAPAMIL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-486-01","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-486-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.08873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"62135074590","name":"VERAPAMIL 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-745-90","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-745-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.08873,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00591040401","name":"VERAPAMIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0404-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0404-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.11259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"23155005901","name":"VERAPAMIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-059-01","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-059-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.11259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"62135074390","name":"VERAPAMIL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-743-90","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-743-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.11259,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00591034301","name":"VERAPAMIL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0343-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0343-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00591034305","name":"VERAPAMIL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0343-05","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0343-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00591034310","name":"VERAPAMIL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0591-0343-10","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Actavis Pharma, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-0343-10)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"23155002601","name":"VERAPAMIL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"23155-026-01","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (23155-026-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"62135074490","name":"VERAPAMIL 80 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-744-90","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET","route":"ORAL","strength":"80 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-744-90)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.07325,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil HCl*|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00378632001","name":"VERAPAMIL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6320-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6320-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.74927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"51079091701","name":"VERAPAMIL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.74927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"51079091720","name":"VERAPAMIL ER 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-917-20","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Mylan Institutional Inc.","package_description":"100 BLISTER PACK in 1 CARTON (51079-917-20) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (51079-917-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.74927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68382056101","name":"VERAPAMIL ER 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-561-01","proprietary_name":"Verapamil hydrochloride","nonproprietary_name":"Verapamil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"120 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-561-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462029201","name":"VERAPAMIL ER 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-292-01","proprietary_name":"verapamil hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-292-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"75834032001","name":"VERAPAMIL ER 120 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-320-01","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75834-320-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00378638001","name":"VERAPAMIL ER 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6380-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6380-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.08661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68382056201","name":"VERAPAMIL ER 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-562-01","proprietary_name":"Verapamil hydrochloride","nonproprietary_name":"Verapamil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-562-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.19107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68382056205","name":"VERAPAMIL ER 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-562-05","proprietary_name":"Verapamil hydrochloride","nonproprietary_name":"Verapamil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"180 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-562-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.19107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462029301","name":"VERAPAMIL ER 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-293-01","proprietary_name":"verapamil hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-293-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.19107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462029305","name":"VERAPAMIL ER 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-293-05","proprietary_name":"verapamil hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-293-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.19107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"75834015801","name":"VERAPAMIL ER 180 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-158-01","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75834-158-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.19107,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"00378644001","name":"VERAPAMIL ER 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-6440-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0378-6440-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":3.1476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68382056301","name":"VERAPAMIL ER 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-563-01","proprietary_name":"Verapamil hydrochloride","nonproprietary_name":"Verapamil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"100 TABLET in 1 BOTTLE (68382-563-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68382056305","name":"VERAPAMIL ER 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-563-05","proprietary_name":"Verapamil hydrochloride","nonproprietary_name":"Verapamil hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"240 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"500 TABLET in 1 BOTTLE (68382-563-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026001","name":"VERAPAMIL ER 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-260-01","proprietary_name":"verapamil hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-260-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"68462026005","name":"VERAPAMIL ER 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-260-05","proprietary_name":"verapamil hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-260-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"75834015901","name":"VERAPAMIL ER 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-159-01","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75834-159-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"75834015905","name":"VERAPAMIL ER 240 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-159-05","proprietary_name":"VERAPAMIL HYDROCHLORIDE","nonproprietary_name":"VERAPAMIL HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (75834-159-05)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":0.17613,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"52536048537","name":"VERAPAMIL ER PM 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-485-37","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52536-485-37)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":4.08287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER PM|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"62135053230","name":"VERAPAMIL ER PM 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-532-30","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1","labeler":"Chartwell RX, LLC","package_description":"30 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (62135-532-30)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":4.08287,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER PM|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"52536048637","name":"VERAPAMIL ER PM 200 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-486-37","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"200 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52536-486-37)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":5.63549,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER PM|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"52536048737","name":"VERAPAMIL ER PM 300 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-487-37","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"Verapamil Hydrochloride","dosage_form":"CAPSULE, EXTENDED RELEASE","route":"ORAL","strength":"300 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (52536-487-37)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.92023,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verapamil ER PM|Verapamil HCl","basis":"generic"},"part_b":null}, {"ndc":"52536088001","name":"VERAPAMIL SR 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-880-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"120 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (52536-880-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.74927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536088201","name":"VERAPAMIL SR 180 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-882-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"180 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (52536-882-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":2.08661,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536088401","name":"VERAPAMIL SR 240 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-884-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"240 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (52536-884-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":3.1476,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52536088601","name":"VERAPAMIL SR 360 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52536-886-01","proprietary_name":"Verapamil Hydrochloride","nonproprietary_name":"verapamil hydrochloride","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"360 mg/1","labeler":"Wilshire Pharmaceuticals, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC (52536-886-01)","pharm_classes":["Calcium Channel Antagonists [MoA]","Calcium Channel Blocker [EPC]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":7.80238,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"62559038530","name":"VEREGEN 15% OINTMENT","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62559-385-30","proprietary_name":"Veregen","nonproprietary_name":"sinecatechins","dosage_form":"OINTMENT","route":"TOPICAL","strength":"150 mg/g","labeler":"ANI Pharmaceuticals, Inc.","package_description":"1 TUBE in 1 CARTON (62559-385-30) / 30 g in 1 TUBE"},"nadac":{"value":50.95767,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Veregen|Sinecatechins","basis":"brand"},"part_b":null}, {"ndc":"00006503001","name":"VERQUVO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5030-01","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5030-01)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.7248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006503002","name":"VERQUVO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5030-02","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (0006-5030-02)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.7248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006503003","name":"VERQUVO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.7248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006503004","name":"VERQUVO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5030-04","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"10 BLISTER PACK in 1 CARTON (0006-5030-04) / 10 TABLET, FILM COATED in 1 BLISTER PACK (0006-5030-03)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.7248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502801","name":"VERQUVO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5028-01","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"14 TABLET, FILM COATED in 1 BOTTLE (0006-5028-01)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.72691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502802","name":"VERQUVO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5028-02","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5028-02)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.72691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502803","name":"VERQUVO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.72691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502804","name":"VERQUVO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5028-04","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"10 BLISTER PACK in 1 CARTON (0006-5028-04) / 10 TABLET, FILM COATED in 1 BLISTER PACK (0006-5028-03)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.72691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502901","name":"VERQUVO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5029-01","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"14 TABLET, FILM COATED in 1 BOTTLE (0006-5029-01)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.72687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502902","name":"VERQUVO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5029-02","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0006-5029-02)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.72687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502903","name":"VERQUVO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":22.72687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00006502904","name":"VERQUVO 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0006-5029-04","proprietary_name":"VERQUVO","nonproprietary_name":"vericiguat","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Merck Sharp & Dohme LLC","package_description":"10 BLISTER PACK in 1 CARTON (0006-5029-04) / 10 TABLET, FILM COATED in 1 BLISTER PACK (0006-5029-03)","pharm_classes":["Guanylate Cyclase Stimulators [MoA]","Soluble Guanylate Cyclase Stimulator [EPC]"]},"nadac":{"value":22.72687,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Verquvo|Vericiguat","basis":"brand"},"part_b":null}, {"ndc":"00480400028","name":"VESTURA 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vestura|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"00480400062","name":"VESTURA 3 MG-0.02 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-4000-62","proprietary_name":"Vestura","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Teva Pharmaceuticals, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (0480-4000-62) / 1 KIT in 1 BLISTER PACK (0480-4000-28) * 24 TABLET in 1 BLISTER PACK (0480-3629-11) * 4 TABLET in 1 BLISTER PACK (0480-7892-22)"},"nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vestura|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"82667090002","name":"VEVYE 0.1% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["2","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82667-900-02","proprietary_name":"VEVYE","nonproprietary_name":"cyclosporine ophthalmic solution","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"1 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (82667-900-02) / 2 mL in 1 BOTTLE, DROPPER","pharm_classes":["Calcineurin Inhibitor Immunosuppressant [EPC]","Calcineurin Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","P-Glycoprotein Inhibitors [MoA]"]},"nadac":{"value":379.87295,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 2: the latest survey was within 2% of the current NADAC, so the NADAC was carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vevye|Cyclosporine","basis":"brand"},"part_b":null}, {"ndc":"00069422030","name":"VIAGRA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-4220-30","proprietary_name":"Viagra","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PFIZER LABORATORIES DIV PFIZER INC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0069-4220-30)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":83.71647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viagra|Sildenafil Citrate","basis":"brand"},"part_b":null}, {"ndc":"00069422066","name":"VIAGRA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-4220-66","proprietary_name":"Viagra","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"PFIZER LABORATORIES DIV PFIZER INC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (0069-4220-66)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":83.71647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viagra|Sildenafil Citrate","basis":"brand"},"part_b":null}, {"ndc":"58151042801","name":"VIAGRA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-428-01","proprietary_name":"Viagra","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (58151-428-01)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":83.71647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viagra|Sildenafil Citrate","basis":"brand"},"part_b":null}, {"ndc":"58151042893","name":"VIAGRA 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-428-93","proprietary_name":"Viagra","nonproprietary_name":"sildenafil citrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (58151-428-93)","pharm_classes":["Phosphodiesterase 5 Inhibitor [EPC]","Phosphodiesterase 5 Inhibitors [MoA]"]},"nadac":{"value":83.71647,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.13192,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viagra|Sildenafil Citrate","basis":"brand"},"part_b":null}, {"ndc":"61874010060","name":"VIBERZI 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-100-60","proprietary_name":"Viberzi","nonproprietary_name":"Eluxadoline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Allergan, Inc.","package_description":"1 BOTTLE in 1 CARTON (61874-100-60) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Opioid mu-Receptor Agonists [MoA]","mu-Opioid Receptor Agonist [EPC]"]},"nadac":{"value":28.09348,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viberzi|Eluxadoline","basis":"brand"},"part_b":null}, {"ndc":"61874007560","name":"VIBERZI 75 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-075-60","proprietary_name":"Viberzi","nonproprietary_name":"Eluxadoline","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"75 mg/1","labeler":"Allergan, Inc.","package_description":"1 BOTTLE in 1 CARTON (61874-075-60) / 60 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Opioid mu-Receptor Agonists [MoA]","mu-Opioid Receptor Agonist [EPC]"]},"nadac":{"value":28.10375,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viberzi|Eluxadoline","basis":"brand"},"part_b":null}, {"ndc":"00169406012","name":"VICTOZA 2-PAK 18 MG/3 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4060-12","proprietary_name":"Victoza","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Novo Nordisk","package_description":"2 SYRINGE, PLASTIC in 1 CARTON (0169-4060-12) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":87.748,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":31.40617,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169406013","name":"VICTOZA 3-PAK 18 MG/3 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4060-13","proprietary_name":"Victoza","nonproprietary_name":"liraglutide","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"6 mg/mL","labeler":"Novo Nordisk","package_description":"3 SYRINGE, PLASTIC in 1 CARTON (0169-4060-13) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":87.81962,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":30.63238,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70700011884","name":"VIENVA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vienva|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700011885","name":"VIENVA-28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-118-85","proprietary_name":"Vienva","nonproprietary_name":"Levonorgestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 BLISTER PACK in 1 CARTON (70700-118-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15354,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vienva|Levonorgestrel/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00078093926","name":"VIGAMOX 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":31.808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vigamox|Moxifloxacin HCl","basis":"brand"},"part_b":null}, {"ndc":"82667070003","name":"VIGAMOX 0.5% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82667-700-03","proprietary_name":"VIGAMOX","nonproprietary_name":"moxifloxacin hydrochloride","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 BOTTLE in 1 CARTON (82667-700-03) / 3 mL in 1 BOTTLE","pharm_classes":["Fluoroquinolone Antibacterial [EPC]","Fluoroquinolones [CS]"]},"nadac":{"value":31.808,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-06-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.59631,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vigamox|Moxifloxacin HCl","basis":"brand"},"part_b":null}, {"ndc":"00456111030","name":"VIIBRYD 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1110-30","proprietary_name":"VIIBRYD","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Allergan, Inc.","package_description":"30 TABLET in 1 BOTTLE (0456-1110-30)"},"nadac":{"value":12.17418,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viibryd|Vilazodone HCl","basis":"brand"},"part_b":null}, {"ndc":"00456112030","name":"VIIBRYD 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1120-30","proprietary_name":"VIIBRYD","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Allergan, Inc.","package_description":"30 TABLET in 1 BOTTLE (0456-1120-30)"},"nadac":{"value":12.18069,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viibryd|Vilazodone HCl","basis":"brand"},"part_b":null}, {"ndc":"00456114030","name":"VIIBRYD 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0456-1140-30","proprietary_name":"VIIBRYD","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Allergan, Inc.","package_description":"30 TABLET in 1 BOTTLE (0456-1140-30)"},"nadac":{"value":12.19239,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viibryd|Vilazodone HCl","basis":"brand"},"part_b":null}, {"ndc":"00480204556","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2045-56","proprietary_name":"Vilazodone Hydrochloride","nonproprietary_name":"Vilazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2045-56)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505437203","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4372-3","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4372-3)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332023230","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-232-30","proprietary_name":"VILAZODONE HYDROCHLORIDE","nonproprietary_name":"VILAZODONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-232-30)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"69097097902","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-979-02","proprietary_name":"Vilazodone Hydrochloride","nonproprietary_name":"Vilazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-979-02)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205026030","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-260-30","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-260-30)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603081301","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-813-01","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (72603-813-01)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282054430","name":"VILAZODONE HCL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-544-30","proprietary_name":"Vilazodone Hydrochloride","nonproprietary_name":"Vilazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-544-30)"},"nadac":{"value":0.73165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00480204456","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2044-56","proprietary_name":"Vilazodone Hydrochloride","nonproprietary_name":"Vilazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2044-56)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505437303","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4373-3","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4373-3)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332023330","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-233-30","proprietary_name":"VILAZODONE HYDROCHLORIDE","nonproprietary_name":"VILAZODONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-233-30)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"69097098102","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-981-02","proprietary_name":"Vilazodone hydrochloride","nonproprietary_name":"Vilazodone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-981-02)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205026130","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-261-30","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-261-30)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603081401","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-814-01","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (72603-814-01)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282054530","name":"VILAZODONE HCL 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-545-30","proprietary_name":"Vilazodone hydrochloride","nonproprietary_name":"Vilazodone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-545-30)"},"nadac":{"value":0.70558,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00480204356","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0480-2043-56","proprietary_name":"Vilazodone Hydrochloride","nonproprietary_name":"Vilazodone Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Teva Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0480-2043-56)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505437403","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-4374-3","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"30 TABLET in 1 BOTTLE (60505-4374-3)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"62332023430","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-234-30","proprietary_name":"VILAZODONE HYDROCHLORIDE","nonproprietary_name":"VILAZODONE HYDROCHLORIDE","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (62332-234-30)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"69097098202","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-982-02","proprietary_name":"Vilazodone hydrochloride","nonproprietary_name":"Vilazodone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Cipla USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (69097-982-02)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"72205026230","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72205-262-30","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Novadoz Pharmaceuticals LLC","package_description":"30 TABLET in 1 BOTTLE (72205-262-30)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"72603081501","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-815-01","proprietary_name":"vilazodone hydrochloride","nonproprietary_name":"vilazodone hydrochloride","dosage_form":"TABLET","route":"ORAL","strength":"40 mg/1","labeler":"Northstar Rx LLC","package_description":"30 TABLET in 1 BOTTLE (72603-815-01)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"76282054630","name":"VILAZODONE HCL 40 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-546-30","proprietary_name":"Vilazodone hydrochloride","nonproprietary_name":"Vilazodone hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (76282-546-30)"},"nadac":{"value":0.83998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vilazodone HCl|Vilazodone HCl","basis":"generic"},"part_b":null}, {"ndc":"00131541072","name":"VIMPAT 10 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-5410-72","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"SOLUTION","route":"ORAL","strength":"10 mg/mL","labeler":"UCB, Inc.","package_description":"200 mL in 1 BOTTLE, GLASS (0131-5410-72)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":2.29765,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":0.08288,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00131247835","name":"VIMPAT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2478-35","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0131-2478-35)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":18.53662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131247860","name":"VIMPAT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2478-60","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"UCB, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0131-2478-60) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":18.53662,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.17426,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131247935","name":"VIMPAT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2479-35","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0131-2479-35)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":19.64607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131247960","name":"VIMPAT 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2479-60","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"UCB, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0131-2479-60) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":19.64607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.22128,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131248035","name":"VIMPAT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2480-35","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0131-2480-35)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":19.62683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131248060","name":"VIMPAT 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2480-60","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"UCB, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0131-2480-60) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":19.62683,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24797,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131247735","name":"VIMPAT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2477-35","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"UCB, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0131-2477-35)","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":11.82165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00131247760","name":"VIMPAT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0131-2477-60","proprietary_name":"Vimpat","nonproprietary_name":"lacosamide","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"UCB, Inc.","package_description":"6 BLISTER PACK in 1 CARTON (0131-2477-60) / 10 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":11.82165,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.11859,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562010410","name":"VIOKACE 10,440-39,150 UNIT TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-104-10","proprietary_name":"Viokace","nonproprietary_name":"Pancrelipase","dosage_form":"TABLET","route":"ORAL","strength":"10440 [USP'U]/1; 39150 [USP'U]/1; 39150 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"1 BOTTLE in 1 CARTON (73562-104-10) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":4.15061,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562020810","name":"VIOKACE 20,880-78,300 UNITS TB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"73562-208-10","proprietary_name":"Viokace","nonproprietary_name":"Pancrelipase","dosage_form":"TABLET","route":"ORAL","strength":"20880 [USP'U]/1; 78300 [USP'U]/1; 78300 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"1 BOTTLE in 1 CARTON (73562-208-10) / 100 TABLET in 1 BOTTLE"},"nadac":{"value":8.21251,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-31","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462031829","name":"VIORELE 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-318-29","proprietary_name":"VIORELE","nonproprietary_name":"Desogestrel and Ethinyl Estradiol and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"3 BLISTER PACK in 1 CARTON (68462-318-29) / 1 KIT in 1 BLISTER PACK (68462-318-84)"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viorele|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68462031884","name":"VIORELE 28 DAY TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viorele|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"61958040101","name":"VIREAD 300 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61958-0401-1","proprietary_name":"Viread","nonproprietary_name":"TENOFOVIR DISOPROXIL FUMARATE","dosage_form":"TABLET, COATED","route":"ORAL","strength":"300 mg/1","labeler":"Gilead Sciences, Inc.","package_description":"30 TABLET, COATED in 1 BOTTLE, PLASTIC (61958-0401-1)","pharm_classes":["Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]","Nucleosides [CS]"]},"nadac":{"value":40.6865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.29381,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Viread|Tenofovir Disoproxil Fumarate","basis":"brand"},"part_b":null}, {"ndc":"00642747330","name":"VITAFOL FE PLUS SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-7473-30","proprietary_name":"Vitafol Fe Plus","nonproprietary_name":"DOCONEXENT, NIACINAMIDE, .ALPHA.-TOCOPHEROL ACETATE, DL-, CHOLECALCIFEROL, BETA CAROTENE, ASCORBIC ACID, THIAMINE MONONITRATE, Riboflavin, Pyridoxine Hydrochloride, CYANOCOBALAMIN, Iron, ZINC OXIDE, CUPRIC OXIDE, POTASSIUM IODIDE, MAGNESIUM OXIDE, Folic Acid, and LEVOMEFOLATE CALCIUM","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1; 15 mg/1; 9 mg/1; 25 mg/1; 330 ug/1; 60 mg/1; 1.6 mg/1; 1.8 mg/1; 2.5 mg/1; 25 ug/1; 90 mg/1; 25 mg/1; 2 mg/1; 150 ug/1; 20 mg/1; 680 mg/1; 1020 ug/1","labeler":"Exeltis USA, Inc.","package_description":"5 BLISTER PACK in 1 BOX, UNIT-DOSE (0642-7473-30) / 6 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Calculi Dissolution Agent [EPC]","Folate Analog [EPC]","Folic Acid [CS]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":4.548,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitafol Fe Plus|PNV 102/Iron/Folate/DHA","basis":"brand"},"part_b":null}, {"ndc":"00642012590","name":"VITAFOL GUMMIES","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":1.52425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitafol Gummies|PNV 112/Iron/Folic/Om3/DHA/EPA","basis":"brand"},"part_b":null}, {"ndc":"00642009330","name":"VITAFOL ULTRA SOFTGEL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-0093-30","proprietary_name":"Vitafol Ultra","nonproprietary_name":"Doconexent, Niacinamide, .Alpha.-Tocopherol Acetate, DL-, Cholecalciferol, .Beta.-Carotene, Ascorbic Acid, Thiamine Mononitrate, Riboflavin, Pyridoxine Hydrochloride, Cyanocobalamin, Iron, Zinc Oxide, Cupric Oxide, Potassium Iodide, Magnesium Oxide, Folic Acid, and Levomefolate Calcium","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"200 mg/1; 15 mg/1; 9 mg/1; 25 ug/1; 330 ug/1; 30 mg/1; 1.6 mg/1; 1.8 mg/1; 2.5 mg/1; 12 ug/1; 29 mg/1; 25 mg/1; 2 mg/1; 150 ug/1; 20 mg/1; 680 ug/1; 1020 ug/1","labeler":"Exeltis USA, Inc.","package_description":"5 BLISTER PACK in 1 BOX (0642-0093-30) / 6 CAPSULE, LIQUID FILLED in 1 BLISTER PACK","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Calculi Dissolution Agent [EPC]","Folate Analog [EPC]","Folic Acid [CS]","Increased Large Intestinal Motility [PE]","Inhibition Large Intestine Fluid/Electrolyte Absorption [PE]","Inhibition Small Intestine Fluid/Electrolyte Absorption [PE]","Magnesium Ion Exchange Activity [MoA]","Osmotic Activity [MoA]","Osmotic Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":4.52255,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitafol Ultra|PNV 67/Iron Ps/Folate No.1/DHA","basis":"brand"},"part_b":null}, {"ndc":"00642007912","name":"VITAFOL-OB CAPLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","6"],"carried_forward":true,"identity":null,"nadac":{"value":4.23422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitafol-Ob|Prenatal Vit 10/Iron Fum/Folic","basis":"brand"},"part_b":null}, {"ndc":"00642007630","name":"VITAFOL-OB+DHA COMBO PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-0076-30","proprietary_name":"Vitafol-OB Plus DHA Prenatal Supplement Plus DHA","nonproprietary_name":"Vitamin A, Ascorbic Acid, Vitamin D, .Alpha.-Tocopherol, Thiamine Mononitrate, Riboflavin, Niacin, Pyridoxine Hydrochloride, Folic Acid, Cyanocobalamin, Calcium, Iron, Magnesium, Zinc, Copper, and Doconexent","dosage_form":"KIT","route":null,"strength":null,"labeler":"Exeltis USA, Inc","package_description":"1 KIT in 1 CARTON (0642-0076-30) * 30 TABLET, COATED in 1 BOX * 30 CAPSULE in 1 BOX"},"nadac":{"value":2.39119,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00642007030","name":"VITAFOL-ONE CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0642-0070-30","proprietary_name":"Vitafol One","nonproprietary_name":"Prenatal Supplement with DHA","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"330 ug/1; 30 mg/1; 1.6 mg/1; 1.8 mg/1; 15 mg/1; 2.5 mg/1; .012 mg/1; 1700 ug/1; .15 mg/1; 20 mg/1; 25 mg/1; 2 mg/1; 25 ug/1; 200 mg/1; 9 mg/1; 29 mg/1","labeler":"Exeltis USA, Inc.","package_description":"5 BLISTER PACK in 1 BOX (0642-0070-30) / 6 CAPSULE, GELATIN COATED in 1 BLISTER PACK","pharm_classes":["Analogs/Derivatives [Chemical/Ingredient]","Ascorbic Acid [CS]","Copper [CS]","Copper-containing Intrauterine Device [EPC]","Decreased Embryonic Implantation [PE]","Decreased Sperm Motility [PE]","Fatty Acids, Omega-3 [CS]","Inhibit Ovum Fertilization [PE]","Nicotinic Acid [EPC]","Nicotinic Acids [CS]","Omega-3 Fatty Acid [EPC]","Vitamin A [CS]","Vitamin A [EPC]","Vitamin B 12 [CS]","Vitamin B 6 [Chemical/Ingredient]","Vitamin B12 [EPC]","Vitamin B6 Analog [EPC]","Vitamin C [EPC]","Vitamin D [CS]","Vitamin D [EPC]"]},"nadac":{"value":4.47298,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitafol-One|Prenatal 26/Iron Ps/Folic/DHA","basis":"brand"},"part_b":null}, {"ndc":"70000035801","name":"VITAMIN A AND D OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0358-1","proprietary_name":"LDR Vitamans A and D","nonproprietary_name":"Vitamins A and D Ointment","dosage_form":"OINTMENT","route":"TOPICAL","strength":"53.4 g/100g; 15.5 g/100g","labeler":"Cardinal Health","package_description":"425 g in 1 JAR (70000-0358-1)"},"nadac":{"value":0.01349,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"23155080901","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"42806054701","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-547-01","proprietary_name":"Ergocalciferol Capsules,","nonproprietary_name":"Ergocalciferol Capsules,","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Epic Pharma LLC","package_description":"100 CAPSULE in 1 BOTTLE (42806-547-01)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"42806054705","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"42806-547-05","proprietary_name":"Ergocalciferol Capsules,","nonproprietary_name":"Ergocalciferol Capsules,","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Epic Pharma LLC","package_description":"500 CAPSULE in 1 BOTTLE (42806-547-05)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"50268029711","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"50268029715","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-297-15","proprietary_name":"VITAMIN D","nonproprietary_name":"ergocalciferol","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-297-15) / 1 CAPSULE in 1 BLISTER PACK (50268-297-11)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"62135043990","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-439-90","proprietary_name":"Ergocalciferol","nonproprietary_name":"Ergocalciferol","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 CAPSULE in 1 BOTTLE (62135-439-90)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"64380073706","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-737-06","proprietary_name":"VITAMIN D","nonproprietary_name":"ergocalciferol","dosage_form":"CAPSULE","route":"ORAL","strength":"1.25 mg/1","labeler":"Strides Pharma Science Limited","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (64380-737-06)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"69452015120","name":"VITAMIN D2 1.25 MG(50,000 UNIT)","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-151-20","proprietary_name":"Ergocalciferol","nonproprietary_name":"Ergocalciferol","dosage_form":"CAPSULE, LIQUID FILLED","route":"ORAL","strength":"1.25 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (69452-151-20)","pharm_classes":["Ergocalciferols [CS]","Provitamin D2 Compound [EPC]"]},"nadac":{"value":0.11361,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vitamin D2|Ergocalciferol (Vitamin D2)","basis":"generic"},"part_b":null}, {"ndc":"66758014558","name":"VIVELLE-DOT 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.37872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014583","name":"VIVELLE-DOT 0.025 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-145-83","proprietary_name":"Vivelle-Dot","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".025 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 BOX (66758-145-83) / 1 PATCH in 1 POUCH (66758-145-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.37872,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":7.7577,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014658","name":"VIVELLE-DOT 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.37619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014683","name":"VIVELLE-DOT 0.0375 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-146-83","proprietary_name":"Vivelle-Dot","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".0375 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 BOX (66758-146-83) / 1 PATCH in 1 POUCH (66758-146-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.37619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.26227,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014758","name":"VIVELLE-DOT 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.4008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014783","name":"VIVELLE-DOT 0.05 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-147-83","proprietary_name":"Vivelle-Dot","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".05 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 BOX (66758-147-83) / 1 PATCH in 1 POUCH (66758-147-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.4008,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.50358,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014858","name":"VIVELLE-DOT 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.42998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014883","name":"VIVELLE-DOT 0.075 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-148-83","proprietary_name":"Vivelle-Dot","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".075 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 BOX (66758-148-83) / 1 PATCH in 1 POUCH (66758-148-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.42998,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.11285,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014958","name":"VIVELLE-DOT 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":18.39859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"66758014983","name":"VIVELLE-DOT 0.1 MG PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"66758-149-83","proprietary_name":"Vivelle-Dot","nonproprietary_name":"estradiol","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":".1 mg/d","labeler":"Sandoz Inc","package_description":"8 POUCH in 1 BOX (66758-149-83) / 1 PATCH in 1 POUCH (66758-149-58) / 3.5 d in 1 PATCH","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":18.39859,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":8.56811,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivelle-Dot|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65757030001","name":"VIVITROL 380 MG VIAL-DILUENT","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65757-300-01","proprietary_name":"VIVITROL","nonproprietary_name":"naltrexone","dosage_form":"KIT","route":null,"strength":null,"labeler":"Alkermes, Inc.","package_description":"1 KIT in 1 CARTON (65757-300-01) * 4 mL in 1 VIAL, GLASS (65757-302-02) * 4 mL in 1 VIAL, GLASS (65757-304-03)"},"nadac":{"value":1716.11389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vivitrol|Naltrexone Microspheres","basis":"brand"},"part_b":{"hcpcs":"J2315","bill_units_per_package":{"value":380,"kind":"count","state":"filed","reason":"Billable units of HCPCS J2315 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (380 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 KIT in 1 CARTON (65757-300-01) * 4 mL in 1 VIAL, GLASS (65757-302-02) * 4 mL in 1 VIAL, GLASS (65757-304-03)) lists 1 kit per NDC, and OpenBill reads NADAC's EA for a kit as the whole kit, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"70700012284","name":"VOLNEA 0.15-0.02-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Volnea|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"70700012285","name":"VOLNEA 0.15-0.02-0.01 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-122-85","proprietary_name":"Volnea","nonproprietary_name":"Desogestrel and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed, LLC.","package_description":"3 CARTON in 1 CARTON (70700-122-85) / 1 BLISTER PACK in 1 CARTON (70700-122-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.17245,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Volnea|Desog-E.Estradiol/E.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"81520010030","name":"VOQUEZNA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81520-100-30","proprietary_name":"VOQUEZNA","nonproprietary_name":"vonoprazan fumarate","dosage_form":"TABLET","route":"ORAL","strength":"13.36 mg/1","labeler":"Phathom Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (81520-100-30)"},"nadac":{"value":22.39663,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Voquezna|Vonoprazan Fumarate","basis":"brand"},"part_b":null}, {"ndc":"81520020030","name":"VOQUEZNA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81520-200-30","proprietary_name":"VOQUEZNA","nonproprietary_name":"vonoprazan fumarate","dosage_form":"TABLET","route":"ORAL","strength":"26.72 mg/1","labeler":"Phathom Pharmaceuticals Inc.","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (81520-200-30)"},"nadac":{"value":22.4121,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Voquezna|Vonoprazan Fumarate","basis":"brand"},"part_b":null}, {"ndc":"81520025001","name":"VOQUEZNA DUAL PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.49884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Voquezna Dual Pak|Vonoprazan/Amoxicillin","basis":"brand"},"part_b":null}, {"ndc":"81520025014","name":"VOQUEZNA DUAL PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81520-250-14","proprietary_name":"VOQUEZNA DUAL PAK","nonproprietary_name":"vonoprazan fumarate and amoxicillin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Phathom Pharmaceuticals Inc.","package_description":"14 BLISTER PACK in 1 CARTON (81520-250-14) / 1 KIT in 1 BLISTER PACK (81520-250-01)"},"nadac":{"value":7.49884,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Voquezna Dual Pak|Vonoprazan/Amoxicillin","basis":"brand"},"part_b":null}, {"ndc":"81520025501","name":"VOQUEZNA TRIPLE PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.5155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Voquezna Triple Pak|Vonoprazan/Amoxicillin/Clarith","basis":"brand"},"part_b":null}, {"ndc":"81520025514","name":"VOQUEZNA TRIPLE PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81520-255-14","proprietary_name":"VOQUEZNA TRIPLE PAK","nonproprietary_name":"vonoprazan fumarate, amoxicillin and clarithromycin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Phathom Pharmaceuticals Inc.","package_description":"14 BLISTER PACK in 1 CARTON (81520-255-14) / 1 KIT in 1 BLISTER PACK (81520-255-01)"},"nadac":{"value":7.5155,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Voquezna Triple Pak|Vonoprazan/Amoxicillin/Clarith","basis":"brand"},"part_b":null}, {"ndc":"00781566831","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5668-31","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-5668-31)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904702404","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-7024-04","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-7024-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714019901","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-199-01","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-199-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241006303","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-063-03","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (27241-063-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547037803","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-378-03","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (43547-378-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268080311","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50268080312","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-803-12","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"200 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-803-12) / 1 TABLET, COATED in 1 BLISTER PACK (50268-803-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079016501","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079016503","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-165-03","proprietary_name":"Voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Mylan Institutional Inc.","package_description":"30 BLISTER PACK in 1 CARTON (51079-165-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-165-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687027311","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687027321","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-273-21","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-273-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-273-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687097911","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687097921","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-979-21","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-979-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-979-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862089230","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-892-30","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-892-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462057330","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-573-30","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-573-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578006306","name":"VORICONAZOLE 200 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-063-06","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-063-06)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":1.88461,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"31722026631","name":"VORICONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"31722-266-31","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Camber Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (31722-266-31) / 75 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":5.49395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"43386003860","name":"VORICONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43386-038-60","proprietary_name":"VORICONAZOLE","nonproprietary_name":"voriconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Lupin Pharmaceuticals,Inc.","package_description":"1 BOTTLE in 1 CARTON (43386-038-60) / 75 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":5.49395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"59762093503","name":"VORICONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"59762-0935-3","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 BOTTLE in 1 CARTON (59762-0935-3) / 75 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":5.49395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162091322","name":"VORICONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"65162-913-22","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Amneal Pharmaceuticals LLC","package_description":"75 mL in 1 BOTTLE (65162-913-22)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":5.49395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"70436023039","name":"VORICONAZOLE 40 MG/ML SUSP","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70436-230-39","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"POWDER, FOR SUSPENSION","route":"ORAL","strength":"40 mg/mL","labeler":"Slate Run Pharmaceuticals, LLC","package_description":"1 BOTTLE in 1 CARTON (70436-230-39) / 75 mL in 1 BOTTLE","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":5.49395,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00781566731","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5667-31","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Sandoz Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (0781-5667-31)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00904659604","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6596-04","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Major Pharmaceuticals","package_description":"30 BLISTER PACK in 1 CARTON (0904-6596-04) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"16714019801","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-198-01","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"NorthStar Rx LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (16714-198-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"27241006203","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-062-03","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (27241-062-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"43547037703","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"43547-377-03","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, COATED","route":"ORAL","strength":"50 mg/1","labeler":"Solco Healthcare U.S., LLC","package_description":"30 TABLET, COATED in 1 BOTTLE (43547-377-03)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079016401","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"51079016403","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51079-164-03","proprietary_name":"Voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Mylan Institutional Inc.","package_description":"30 BLISTER PACK in 1 CARTON (51079-164-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-164-01)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687096811","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"60687096821","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-968-21","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 CARTON (60687-968-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-968-11)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-30","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"65862089130","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-891-30","proprietary_name":"Voriconazole","nonproprietary_name":"Voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (65862-891-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68462057230","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-572-30","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (68462-572-30)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72578006206","name":"VORICONAZOLE 50 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-062-06","proprietary_name":"voriconazole","nonproprietary_name":"voriconazole","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (72578-062-06)","pharm_classes":["Azole Antifungal [EPC]","Azoles [CS]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C9 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]"]},"nadac":{"value":0.82746,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"61874025030","name":"VRAYLAR 0.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-250-30","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":".5 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (61874-250-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.77868,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874027530","name":"VRAYLAR 0.75 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-275-30","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":".75 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (61874-275-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.83865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874011511","name":"VRAYLAR 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":50.84237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874011520","name":"VRAYLAR 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-115-20","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"1.5 mg/1","labeler":"Allergan, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (61874-115-20) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (61874-115-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.84237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874011530","name":"VRAYLAR 1.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-115-30","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"1.5 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (61874-115-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.84237,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874013011","name":"VRAYLAR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":50.88385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874013020","name":"VRAYLAR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-130-20","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"3 mg/1","labeler":"Allergan, Inc.","package_description":"2 BLISTER PACK in 1 CARTON (61874-130-20) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (61874-130-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.88385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874013030","name":"VRAYLAR 3 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-130-30","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"3 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (61874-130-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.88385,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874014530","name":"VRAYLAR 4.5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-145-30","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"4.5 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (61874-145-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.78615,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"61874016030","name":"VRAYLAR 6 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61874-160-30","proprietary_name":"Vraylar","nonproprietary_name":"cariprazine","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"6 mg/1","labeler":"Allergan, Inc.","package_description":"30 CAPSULE, GELATIN COATED in 1 BOTTLE (61874-160-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":50.77591,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vraylar|Cariprazine HCl","basis":"brand"},"part_b":null}, {"ndc":"81672505101","name":"VTAMA 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"81672-5051-1","proprietary_name":"VTAMA","nonproprietary_name":"tapinarof","dosage_form":"CREAM","route":"TOPICAL","strength":"10 mg/g","labeler":"Organon LLC","package_description":"1 TUBE in 1 PACKAGE (81672-5051-1) / 60 g in 1 TUBE","pharm_classes":["Aryl Hydrocarbon Receptor Agonist [EPC]","Aryl Hydrocarbon Receptor Agonists [MoA]"]},"nadac":{"value":25.23052,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Vtama|Tapinarof","basis":"brand"},"part_b":null}, {"ndc":"00074709802","name":"VUITY 1.25% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":31.3936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":24.74,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vuity|Pilocarpine HCl","basis":"brand"},"part_b":null}, {"ndc":"00074709804","name":"VUITY 1.25% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":31.3936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":24.74,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vuity|Pilocarpine HCl","basis":"brand"},"part_b":null}, {"ndc":"00074709806","name":"VUITY 1.25% EYE DROP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":23.39475,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":19.39133,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vuity|Pilocarpine HCl","basis":"brand"},"part_b":null}, {"ndc":"68180087571","name":"VYFEMLA 0.4 MG-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyfemla|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"68180087573","name":"VYFEMLA 0.4 MG-0.035 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-875-73","proprietary_name":"Vyfemla","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-875-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK * 21 TABLET in 1 BLISTER PACK (68180-495-74) * 7 TABLET in 1 BLISTER PACK (68180-500-74)"},"nadac":{"value":0.32955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyfemla|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023511","name":"VYLIBRA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-235-11","proprietary_name":"VyLibra","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"1 BLISTER PACK in 1 CARTON (50102-235-11) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vylibra|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"50102023513","name":"VYLIBRA 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50102-235-13","proprietary_name":"VyLibra","nonproprietary_name":"norgestimate and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Afaxys Pharma, LLC","package_description":"3 BLISTER PACK in 1 CARTON (50102-235-13) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.11481,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vylibra|Norgestimate-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"78206017501","name":"VYTORIN 10-20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-175-01","proprietary_name":"VYTORIN","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Organon LLC","package_description":"30 TABLET in 1 BOTTLE (78206-175-01)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":13.6206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vytorin|Ezetimibe/Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"78206017502","name":"VYTORIN 10-20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-175-02","proprietary_name":"VYTORIN","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 20 mg/1","labeler":"Organon LLC","package_description":"90 TABLET in 1 BOTTLE (78206-175-02)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":13.6206,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1985,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vytorin|Ezetimibe/Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"78206017601","name":"VYTORIN 10-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-176-01","proprietary_name":"VYTORIN","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Organon LLC","package_description":"30 TABLET in 1 BOTTLE (78206-176-01)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":13.79507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vytorin|Ezetimibe/Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"78206017602","name":"VYTORIN 10-40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-176-02","proprietary_name":"VYTORIN","nonproprietary_name":"ezetimibe and simvastatin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1; 40 mg/1","labeler":"Organon LLC","package_description":"90 TABLET in 1 BOTTLE (78206-176-02)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]","HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":13.79507,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.18305,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vytorin|Ezetimibe/Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"59417010110","name":"VYVANSE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-101-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-101-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.3494,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.624,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417011501","name":"VYVANSE 10 MG CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-115-01","proprietary_name":"Vyvanse","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"10 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (59417-115-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.35842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.73818,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417010210","name":"VYVANSE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-102-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-102-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.34801,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.43711,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417011601","name":"VYVANSE 20 MG CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-116-01","proprietary_name":"Vyvanse","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"20 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (59417-116-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.35039,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":4.33791,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417010310","name":"VYVANSE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-103-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"30 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-103-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.34562,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.70088,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417011701","name":"VYVANSE 30 MG CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-117-01","proprietary_name":"Vyvanse","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"30 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (59417-117-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.34907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.29147,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417010410","name":"VYVANSE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-104-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-104-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.34964,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.60126,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417011801","name":"VYVANSE 40 MG CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-118-01","proprietary_name":"Vyvanse","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"40 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (59417-118-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.3567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.98071,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417010510","name":"VYVANSE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-105-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-105-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.34718,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.63983,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417011901","name":"VYVANSE 50 MG CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-119-01","proprietary_name":"Vyvanse","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"50 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (59417-119-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.35835,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.64862,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417010610","name":"VYVANSE 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-106-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-106-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.36068,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.67291,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417012001","name":"VYVANSE 60 MG CHEWABLE TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-120-01","proprietary_name":"Vyvanse","nonproprietary_name":"LISDEXAMFETAMINE DIMESYLATE","dosage_form":"TABLET, CHEWABLE","route":"ORAL","strength":"60 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 TABLET, CHEWABLE in 1 BOTTLE (59417-120-01)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.36499,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":3.64601,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"59417010710","name":"VYVANSE 70 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59417-107-10","proprietary_name":"Vyvanse","nonproprietary_name":"lisdexamfetamine dimesylate","dosage_form":"CAPSULE","route":"ORAL","strength":"70 mg/1","labeler":"Takeda Pharmaceuticals America, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (59417-107-10)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":12.35254,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.67532,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Vyvanse|Lisdexamfetamine Dimesylate","basis":"brand"},"part_b":null}, {"ndc":"24208050402","name":"VYZULTA 0.024% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-504-02","proprietary_name":"Vyzulta","nonproprietary_name":"latanoprostene bunod","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".24 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-504-02) / 2.5 mL in 1 BOTTLE"},"nadac":{"value":102.28986,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vyzulta|Latanoprostene Bunod","basis":"brand"},"part_b":null}, {"ndc":"24208050405","name":"VYZULTA 0.024% OPHTH SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-504-05","proprietary_name":"Vyzulta","nonproprietary_name":"latanoprostene bunod","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".24 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE in 1 CARTON (24208-504-05) / 5 mL in 1 BOTTLE"},"nadac":{"value":102.25131,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Vyzulta|Latanoprostene Bunod","basis":"brand"},"part_b":null}, {"ndc":"00093171201","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1712-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1712-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171210","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1712-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1712-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402701","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4027-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4027-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402703","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4027-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4027-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402707","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4027-7","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5000 TABLET in 1 BOTTLE (51672-4027-7)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237011901","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237011999","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076110","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-761-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-761-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076111","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-761-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-761-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282032701","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-327-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-327-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282032710","name":"WARFARIN SODIUM 1 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-327-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-327-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093172001","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1720-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1720-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403501","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4035-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4035-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403503","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4035-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4035-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012701","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076910","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-769-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-769-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076911","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-769-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-769-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033501","name":"WARFARIN SODIUM 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-335-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-335-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.10627,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171301","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1713-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1713-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171310","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1713-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1713-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402801","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4028-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4028-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402803","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4028-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4028-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402807","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4028-7","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5000 TABLET in 1 BOTTLE (51672-4028-7)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012001","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012099","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"62584098401","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-984-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (62584-984-01) / 1 TABLET in 1 BLISTER PACK (62584-984-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"62584098411","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076210","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-762-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-762-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076211","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-762-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-762-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282032801","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-328-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-328-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282032810","name":"WARFARIN SODIUM 2 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-328-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-328-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09296,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171401","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1714-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1714-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171410","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1714-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1714-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402901","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4029-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4029-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402903","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4029-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4029-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672402907","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4029-7","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5000 TABLET in 1 BOTTLE (51672-4029-7)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012101","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012199","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076310","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-763-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-763-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076311","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-763-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-763-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084002701","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-027-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-027-01) / 1 TABLET in 1 BLISTER PACK (68084-027-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"68084002711","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282032901","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-329-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-329-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282032910","name":"WARFARIN SODIUM 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-329-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-329-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171501","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1715-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1715-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403001","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4030-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4030-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403003","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4030-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4030-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403007","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4030-7","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5000 TABLET in 1 BOTTLE (51672-4030-7)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012201","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012299","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076410","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-764-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-764-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076411","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-764-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-764-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033001","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-330-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-330-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033010","name":"WARFARIN SODIUM 3 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-330-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"3 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-330-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171601","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1716-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1716-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171610","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1716-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1716-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403101","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4031-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4031-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403103","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4031-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4031-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403107","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4031-7","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5000 TABLET in 1 BOTTLE (51672-4031-7)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012301","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012399","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076510","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-765-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-765-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076511","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-765-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-765-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033101","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-331-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-331-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033110","name":"WARFARIN SODIUM 4 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-331-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-331-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09565,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093172101","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1721-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1721-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093172110","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1721-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"1000 TABLET in 1 BOTTLE (0093-1721-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403201","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4032-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4032-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403203","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4032-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4032-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403207","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4032-7","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"5000 TABLET in 1 BOTTLE (51672-4032-7)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012401","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012499","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"62584099401","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62584-994-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (62584-994-01) / 1 TABLET in 1 BLISTER PACK (62584-994-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"62584099411","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076610","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-766-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-766-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076611","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-766-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-766-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033201","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-332-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-332-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033210","name":"WARFARIN SODIUM 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-332-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-332-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08882,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093171801","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1718-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1718-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403301","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4033-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4033-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403303","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4033-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4033-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012501","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076710","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-767-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-767-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076711","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-767-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-767-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033301","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-333-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-333-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033310","name":"WARFARIN SODIUM 6 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-333-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"6 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"1000 TABLET in 1 BOTTLE (76282-333-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.09814,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"00093172301","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0093-1723-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Teva Pharmaceuticals USA, Inc.","package_description":"100 TABLET in 1 BOTTLE (0093-1723-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403401","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4034-1","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET in 1 BOTTLE (51672-4034-1)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"51672403403","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51672-4034-3","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin Sodium","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1000 TABLET in 1 BOTTLE (51672-4034-3)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"57237012601","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076810","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-768-10","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"100 TABLET in 1 BOTTLE (65162-768-10)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"65162076811","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-768-11","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"1000 TABLET in 1 BOTTLE (65162-768-11)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"76282033401","name":"WARFARIN SODIUM 7.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-334-01","proprietary_name":"Warfarin Sodium","nonproprietary_name":"Warfarin","dosage_form":"TABLET","route":"ORAL","strength":"7.5 mg/1","labeler":"Exelan Pharmaceuticals Inc.","package_description":"100 TABLET in 1 BOTTLE (76282-334-01)","pharm_classes":["Vitamin K Antagonist [EPC]","Vitamin K Inhibitors [MoA]"]},"nadac":{"value":0.08912,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Warfarin Sodium|Warfarin Sodium","basis":"generic"},"part_b":null}, {"ndc":"70000032901","name":"WART REMOVER 17% LIQUID","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0329-1","proprietary_name":"Salicylic Acid","nonproprietary_name":"Liquid Wart Remover","dosage_form":"LIQUID","route":"TOPICAL","strength":"17 g/100mL","labeler":"LEADER/ Cardinal Health 110, Inc.","package_description":"1 BOTTLE, WITH APPLICATOR in 1 CARTON (70000-0329-1) / 9 mL in 1 BOTTLE, WITH APPLICATOR"},"nadac":{"value":0.36632,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409002410","name":"WATER FOR INJECTION VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-0024-10","proprietary_name":"Sterile Water","nonproprietary_name":"WATER","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mL/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0409-0024-10) / 10 mL in 1 VIAL, SINGLE-DOSE (0409-0024-01)"},"nadac":{"value":0.31501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00409488710","name":"WATER FOR INJECTION VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0409-4887-10","proprietary_name":"Sterile Water","nonproprietary_name":"WATER","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mL/mL","labeler":"Hospira, Inc.","package_description":"25 VIAL, PLASTIC in 1 TRAY (0409-4887-10) / 10 mL in 1 VIAL, PLASTIC (0409-4887-17)"},"nadac":{"value":0.31501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00517301025","name":"WATER FOR INJECTION VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0517-3010-25","proprietary_name":"Sterile Water","nonproprietary_name":"Water","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"1 mL/mL","labeler":"American Regent, Inc.","package_description":"25 VIAL, SINGLE-DOSE in 1 TRAY (0517-3010-25) / 10 mL in 1 VIAL, SINGLE-DOSE (0517-3010-01)"},"nadac":{"value":0.31501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"63323018510","name":"WATER FOR INJECTION VIAL","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-185-10","proprietary_name":"Sterile Water","nonproprietary_name":"WATER","dosage_form":"INJECTION","route":"INTRAMUSCULAR; INTRAVENOUS; SUBCUTANEOUS","strength":"1 mL/mL","labeler":"Fresenius Kabi USA, LLC","package_description":"25 VIAL in 1 TRAY (63323-185-10) / 10 mL in 1 VIAL (63323-185-07)"},"nadac":{"value":0.31501,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169452514","name":"WEGOVY 0.25 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4525-14","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".25 mg/.5mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"4 SYRINGE, PLASTIC in 1 CARTON (0169-4525-14) / .5 mL in 1 SYRINGE, PLASTIC (0169-4525-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":653.29422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169450514","name":"WEGOVY 0.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4505-14","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".5 mg/.5mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"4 SYRINGE, PLASTIC in 1 CARTON (0169-4505-14) / .5 mL in 1 SYRINGE, PLASTIC (0169-4505-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":653.27365,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169450114","name":"WEGOVY 1 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4501-14","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1 mg/.5mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"4 SYRINGE, PLASTIC in 1 CARTON (0169-4501-14) / .5 mL in 1 SYRINGE, PLASTIC (0169-4501-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":653.04458,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169441531","name":"WEGOVY 1.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4415-31","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4415-31)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":43.51871,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169451714","name":"WEGOVY 1.7 MG/0.75 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4517-14","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"1.7 mg/.75mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"4 SYRINGE, PLASTIC in 1 CARTON (0169-4517-14) / .5 mL in 1 SYRINGE, PLASTIC (0169-4517-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":435.55769,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169452414","name":"WEGOVY 2.4 MG/0.75 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4524-14","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"2.4 mg/.75mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"4 SYRINGE, PLASTIC in 1 CARTON (0169-4524-14) / .75 mL in 1 SYRINGE, PLASTIC (0169-4524-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":435.52629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00169442531","name":"WEGOVY 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4425-31","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4425-31)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":43.4289,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169440431","name":"WEGOVY 4 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4404-31","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"4 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4404-31)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":43.48634,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169440931","name":"WEGOVY 9 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4409-31","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"TABLET","route":"ORAL","strength":"9 mg/1","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"30 TABLET in 1 BOTTLE, PLASTIC (0169-4409-31)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":43.46516,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"00169457214","name":"WEGOVY HD 7.2 MG/0.75 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-4572-14","proprietary_name":"WEGOVY","nonproprietary_name":"semaglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"7.2 mg/.75mL","labeler":"Novo Nordisk Pharmaceutical Industries, LP","package_description":"4 SYRINGE, PLASTIC in 1 CARTON (0169-4572-14) / .75 mL in 1 SYRINGE, PLASTIC (0169-4572-01)","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]"]},"nadac":{"value":434.95017,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00713087981","name":"WELCHOL 625 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":null,"nadac":{"value":5.67166,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.26171,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Welchol|Colesevelam HCl","basis":"brand"},"part_b":null}, {"ndc":"00173094755","name":"WELLBUTRIN SR 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0947-55","proprietary_name":"WELLBUTRIN SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0173-0947-55)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":7.06228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.0679,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wellbutrin SR|Bupropion HCl","basis":"brand"},"part_b":null}, {"ndc":"00173013555","name":"WELLBUTRIN SR 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0135-55","proprietary_name":"WELLBUTRIN SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0173-0135-55)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":7.51608,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.07985,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wellbutrin SR|Bupropion HCl","basis":"brand"},"part_b":null}, {"ndc":"00173072200","name":"WELLBUTRIN SR 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0173-0722-00","proprietary_name":"WELLBUTRIN SR","nonproprietary_name":"bupropion hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"GlaxoSmithKline LLC","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0173-0722-00)","pharm_classes":["Aminoketone [EPC]","Dopamine Uptake Inhibitors [MoA]","Increased Dopamine Activity [PE]","Increased Norepinephrine Activity [PE]","Norepinephrine Uptake Inhibitors [MoA]"]},"nadac":{"value":13.97633,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.10362,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wellbutrin SR|Bupropion HCl","basis":"brand"},"part_b":null}, {"ndc":"16714037001","name":"WERA 0.5/0.035 MG 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-370-01","proprietary_name":"Wera","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"1 BLISTER PACK in 1 PACKET (16714-370-01) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.48747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wera|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"16714037003","name":"WERA 0.5/0.035 MG 28 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-370-03","proprietary_name":"Wera","nonproprietary_name":"norethindrone and ethinyl estradiol","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"Northstar Rx LLC","package_description":"3 BLISTER PACK in 1 CARTON (16714-370-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.48747,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wera|Norethindrone-Ethin. Estradiol","basis":"brand"},"part_b":null}, {"ndc":"69367031530","name":"WESCAP-C DHA SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.669,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367031630","name":"WESCAP-PN DHA CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.9857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wescap-Pn DHA|Multivit 47/Iron/Folate 1/DHA","basis":"brand"},"part_b":null}, {"ndc":"69367031401","name":"WESCAPS CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11308,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wescaps|B Complex W-C No.20/Folic Acid","basis":"brand"},"part_b":null}, {"ndc":"69367025130","name":"WESNATAL DHA COMPLETE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.34359,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367031730","name":"WESNATE DHA SOFTGEL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.5147,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69367026701","name":"WESTAB PLUS TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.11256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Westab Plus|PNV,Calcium 72/Iron/Folic Acid","basis":"brand"},"part_b":null}, {"ndc":"69367033416","name":"WESTUSSIN DM 1-5-10 MG/5 ML SYR","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-334-16","proprietary_name":"WesTussin DM","nonproprietary_name":"dexchlorpheniramine maleate, dextromethorphan hbr, phenylephrine hcl","dosage_form":"SYRUP","route":"ORAL","strength":"1 mg/5mL; 10 mg/5mL; 5 mg/5mL","labeler":"Westminster Pharmaceuticals, LLC","package_description":"480 mL in 1 BOTTLE, PLASTIC (69367-334-16)","pharm_classes":["Adrenergic alpha1-Agonists [MoA]","Sigma-1 Agonist [EPC]","Sigma-1 Receptor Agonists [MoA]","Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC]","Uncompetitive NMDA Receptor Antagonists [MoA]","alpha-1 Adrenergic Agonist [EPC]"]},"nadac":{"value":0.041,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"47335099436","name":"WINLEVI 1% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-994-36","proprietary_name":"Winlevi","nonproprietary_name":"Clascoterone","dosage_form":"CREAM","route":"TOPICAL","strength":"1 g/100g","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"1 TUBE in 1 CARTON (47335-994-36) / 60 g in 1 TUBE","pharm_classes":["Androgen Receptor Antagonists [MoA]","Androgen Receptor Inhibitor [EPC]"]},"nadac":{"value":10.00099,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Winlevi|Clascoterone","basis":"brand"},"part_b":null}, {"ndc":"70000061501","name":"WITCH HAZEL 86% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0615-1","proprietary_name":"Witch Hazel","nonproprietary_name":"Witch hazel","dosage_form":"LIQUID","route":"TOPICAL","strength":"842 mg/mL","labeler":"Cardinal Health (Leader) 70000","package_description":"473 mL in 1 BOTTLE, PLASTIC (70000-0615-1)"},"nadac":{"value":0.00761,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378932032","name":"WIXELA 100-50 INHUB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9320-32","proprietary_name":"Wixela Inhub","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"100 ug/1; 50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 INHALER in 1 CARTON (0378-9320-32) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.07358,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wixela Inhub|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00378932132","name":"WIXELA 250-50 INHUB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9321-32","proprietary_name":"Wixela Inhub","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"250 ug/1; 50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 INHALER in 1 CARTON (0378-9321-32) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.24514,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wixela Inhub|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"00378932232","name":"WIXELA 500-50 INHUB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-9322-32","proprietary_name":"Wixela Inhub","nonproprietary_name":"fluticasone propionate and salmeterol","dosage_form":"POWDER","route":"RESPIRATORY (INHALATION)","strength":"500 ug/1; 50 ug/1","labeler":"Mylan Pharmaceuticals Inc.","package_description":"1 INHALER in 1 CARTON (0378-9322-32) / 60 POWDER in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":1.63625,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wixela Inhub|Fluticasone Propion/Salmeterol","basis":"brand"},"part_b":null}, {"ndc":"46122042963","name":"WOMEN'S GENTLE LAX EC 5 MG TAB","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"46122-429-63","proprietary_name":"Womens Gentle Laxative","nonproprietary_name":"Bisacodyl","dosage_form":"TABLET, DELAYED RELEASE","route":"ORAL","strength":"5 mg/1","labeler":"Amerisource Bergen","package_description":"1 BLISTER PACK in 1 CARTON (46122-429-63) / 25 TABLET, DELAYED RELEASE in 1 BLISTER PACK","pharm_classes":["Increased Large Intestinal Motility [PE]","Stimulant Laxative [EPC]","Stimulation Large Intestine Fluid/Electrolyte Secretion [PE]"]},"nadac":{"value":0.04406,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68180087371","name":"WYMZYA FE 0.4-0.035 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wymzya Fe|Noreth-Ethinyl Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"68180087373","name":"WYMZYA FE 0.4-0.035 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-873-73","proprietary_name":"WYMZYA Fe","nonproprietary_name":"NORETHINDRONE AND ETHINYL ESTRADIOL","dosage_form":"KIT","route":null,"strength":null,"labeler":"Lupin Pharmaceuticals, Inc.","package_description":"3 POUCH in 1 CARTON (68180-873-73) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK * 21 TABLET, CHEWABLE in 1 BLISTER PACK (68180-832-74) * 7 TABLET in 1 BLISTER PACK (68180-856-74)"},"nadac":{"value":0.53158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Wymzya Fe|Noreth-Ethinyl Estradiol/Iron","basis":"brand"},"part_b":null}, {"ndc":"78206018901","name":"XACIATO 2% VAGINAL GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-189-01","proprietary_name":"XACIATO","nonproprietary_name":"clindamycin phosphate","dosage_form":"GEL","route":"VAGINAL","strength":"100 mg/5g","labeler":"Organon LLC","package_description":"1 TUBE in 1 CARTON (78206-189-01) / 8 g in 1 TUBE","pharm_classes":["Decreased Sebaceous Gland Activity [PE]","Lincosamide Antibacterial [EPC]","Lincosamides [CS]","Neuromuscular Blockade [PE]"]},"nadac":{"value":18.86864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Xaciato|Clindamycin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"78206018999","name":"XACIATO 2% VAGINAL GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":18.86864,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Xaciato|Clindamycin Phosphate","basis":"brand"},"part_b":null}, {"ndc":"27505011130","name":"XADAGO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27505-111-30","proprietary_name":"Xadago","nonproprietary_name":"safinamide mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"MDD US Operations LLC, a subsidiary of Supernus Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (27505-111-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":36.32581,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xadago|Safinamide Mesylate","basis":"brand"},"part_b":null}, {"ndc":"27505011030","name":"XADAGO 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"27505-110-30","proprietary_name":"Xadago","nonproprietary_name":"safinamide mesylate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"MDD US Operations LLC, a subsidiary of Supernus Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (27505-110-30) / 30 TABLET, FILM COATED in 1 BOTTLE","pharm_classes":["Breast Cancer Resistance Protein Inhibitors [MoA]","Monoamine Oxidase Type B Inhibitor [EPC]","Monoamine Oxidase-B Inhibitors [MoA]"]},"nadac":{"value":36.45907,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xadago|Safinamide Mesylate","basis":"brand"},"part_b":null}, {"ndc":"58151041935","name":"XALATAN 0.005% EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-419-35","proprietary_name":"XALATAN","nonproprietary_name":"Latanoprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 ug/mL","labeler":"Viatris Specialty LLC","package_description":"1 BOTTLE, DROPPER in 1 CARTON (58151-419-35) / 2.5 mL in 1 BOTTLE, DROPPER"},"nadac":{"value":108.34219,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.57513,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xalatan|Latanoprost","basis":"brand"},"part_b":null}, {"ndc":"00009002902","name":"XANAX 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0029-02","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"PHARMACIA & UPJOHN COMPANY LLC","package_description":"500 TABLET in 1 BOTTLE (0009-0029-02)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":5.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045201","name":"XANAX 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-452-01","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE (58151-452-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":5.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045205","name":"XANAX 0.25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-452-05","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".25 mg/1","labeler":"Viatris Specialty LLC","package_description":"500 TABLET in 1 BOTTLE (58151-452-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":5.62948,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02356,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"00009005503","name":"XANAX 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":7.03342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045301","name":"XANAX 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-453-01","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE (58151-453-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":7.03342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045305","name":"XANAX 0.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-453-05","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":".5 mg/1","labeler":"Viatris Specialty LLC","package_description":"500 TABLET in 1 BOTTLE (58151-453-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":7.03342,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02245,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"00009009001","name":"XANAX 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.35465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"00009009004","name":"XANAX 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0090-04","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"PHARMACIA & UPJOHN COMPANY LLC","package_description":"500 TABLET in 1 BOTTLE (0009-0090-04)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":9.35465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045401","name":"XANAX 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-454-01","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE (58151-454-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":9.35465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045405","name":"XANAX 1 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-454-05","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"1 mg/1","labeler":"Viatris Specialty LLC","package_description":"500 TABLET in 1 BOTTLE (58151-454-05)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":9.35465,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02433,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"00009009401","name":"XANAX 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0009-0094-01","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"PHARMACIA & UPJOHN COMPANY LLC","package_description":"100 TABLET in 1 BOTTLE (0009-0094-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":15.90988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"58151045501","name":"XANAX 2 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-455-01","proprietary_name":"Xanax","nonproprietary_name":"alprazolam","dosage_form":"TABLET","route":"ORAL","strength":"2 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 TABLET in 1 BOTTLE (58151-455-01)","pharm_classes":["Benzodiazepine [EPC]","Benzodiazepines [CS]"]},"nadac":{"value":15.90988,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.04877,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xanax|Alprazolam","basis":"brand"},"part_b":null}, {"ndc":"70700031084","name":"XARAH FE 1 MG/20-30-35 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.7459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700031085","name":"XARAH FE 1 MG/20-30-35 MCG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-310-85","proprietary_name":"XARAH FE","nonproprietary_name":"norethindrone acetate and ethinyl estradiol and ferrous fumarate tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-310-85) / 1 BLISTER PACK in 1 POUCH (70700-310-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.7459,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"50458057501","name":"XARELTO 1 MG/ML SUSPENSION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-575-01","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"GRANULE, FOR SUSPENSION","route":"ORAL","strength":"155 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (50458-575-01) / 1 GRANULE, FOR SUSPENSION in 1 BOTTLE","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":3.77426,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.78883,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"50458058001","name":"XARELTO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":19.52226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458058010","name":"XARELTO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-580-10","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (50458-580-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK (50458-580-01)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.52226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458058030","name":"XARELTO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-580-30","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50458-580-30)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.52226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458058090","name":"XARELTO 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-580-90","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50458-580-90)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.52226,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057801","name":"XARELTO 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":19.53519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057810","name":"XARELTO 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-578-10","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (50458-578-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK (50458-578-01)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.53519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057830","name":"XARELTO 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-578-30","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50458-578-30)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.53519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057890","name":"XARELTO 15 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-578-90","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"15 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50458-578-90)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.53519,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057701","name":"XARELTO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":9.77474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057710","name":"XARELTO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-577-10","proprietary_name":"XARELTO","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 BOX, UNIT-DOSE (50458-577-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK (50458-577-01)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":9.77474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057718","name":"XARELTO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-577-18","proprietary_name":"XARELTO","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"180 TABLET, FILM COATED in 1 BOTTLE (50458-577-18)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":9.77474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057760","name":"XARELTO 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-577-60","proprietary_name":"XARELTO","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (50458-577-60)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":9.77474,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.64963,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057901","name":"XARELTO 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":19.54187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057910","name":"XARELTO 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-579-10","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"10 BLISTER PACK in 1 CARTON (50458-579-10) / 10 TABLET, FILM COATED in 1 BLISTER PACK (50458-579-01)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.54187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057930","name":"XARELTO 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-579-30","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (50458-579-30)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.54187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057989","name":"XARELTO 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-579-89","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (50458-579-89)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.54187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458057990","name":"XARELTO 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-579-90","proprietary_name":"Xarelto","nonproprietary_name":"rivaroxaban","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Janssen Pharmaceuticals, Inc.","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (50458-579-90)","pharm_classes":["Factor Xa Inhibitor [EPC]","Factor Xa Inhibitors [MoA]"]},"nadac":{"value":19.54187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"50458058451","name":"XARELTO DVT-PE TREATMENT 30-DAY STARTER 15-20 MG PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50458-584-51","proprietary_name":"XARELTO","nonproprietary_name":"Rivaroxaban","dosage_form":"KIT","route":null,"strength":null,"labeler":"Janssen Pharmaceuticals, Inc.","package_description":"1 KIT in 1 CARTON (50458-584-51) * 42 TABLET, FILM COATED in 1 BLISTER PACK * 9 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":19.46651,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xarelto|Rivaroxaban","basis":"brand"},"part_b":null}, {"ndc":"52652200106","name":"XATMEP 2.5 MG/ML ORAL SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-2001-6","proprietary_name":"Xatmep","nonproprietary_name":"Methotrexate","dosage_form":"SOLUTION","route":"ORAL","strength":"2.5 mg/mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"60 mL in 1 BOTTLE (52652-2001-6)","pharm_classes":["Folate Analog Metabolic Inhibitor [EPC]","Folic Acid Metabolism Inhibitors [MoA]"]},"nadac":{"value":21.76353,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xatmep|Methotrexate","basis":"brand"},"part_b":{"hcpcs":"J8612","bill_units_per_package":{"value":60,"kind":"count","state":"filed","reason":"Billable units of HCPCS J8612 (2.5 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (60 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":60,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (60 mL in 1 BOTTLE (52652-2001-6)) gives 60 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71699010030","name":"XCOPRI 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-100-30","proprietary_name":"Xcopri","nonproprietary_name":"cenobamate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"SK Life Science, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (71699-100-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","GABA A Receptor Positive Modulators [MoA]","Sodium Channel Antagonists [MoA]"]},"nadac":{"value":39.87152,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699020128","name":"XCOPRI 12.5-25 MG TITRATION PK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-201-28","proprietary_name":"Xcopri Titration Pack","nonproprietary_name":"cenobamate","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"SK Life Science, Inc.","package_description":"1 KIT in 1 CARTON (71699-201-28) * 1 TABLET in 1 BLISTER PACK * 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":3.91043,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699015030","name":"XCOPRI 150 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-150-30","proprietary_name":"Xcopri","nonproprietary_name":"cenobamate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"150 mg/1","labeler":"SK Life Science, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (71699-150-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","GABA A Receptor Positive Modulators [MoA]","Sodium Channel Antagonists [MoA]"]},"nadac":{"value":39.8629,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699020328","name":"XCOPRI 150-200 MG TITRATION PK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-203-28","proprietary_name":"Xcopri Titration Pack","nonproprietary_name":"cenobamate","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"SK Life Science, Inc.","package_description":"1 KIT in 1 CARTON (71699-203-28) * 1 TABLET, FILM COATED in 1 BLISTER PACK * 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":42.9098,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699020030","name":"XCOPRI 200 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-200-30","proprietary_name":"Xcopri","nonproprietary_name":"cenobamate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"200 mg/1","labeler":"SK Life Science, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (71699-200-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","GABA A Receptor Positive Modulators [MoA]","Sodium Channel Antagonists [MoA]"]},"nadac":{"value":39.8775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699002530","name":"XCOPRI 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-025-30","proprietary_name":"Xcopri","nonproprietary_name":"cenobamate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"SK Life Science, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (71699-025-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","GABA A Receptor Positive Modulators [MoA]","Sodium Channel Antagonists [MoA]"]},"nadac":{"value":39.88192,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699010456","name":"XCOPRI 250 MG DAILY DOSE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-104-56","proprietary_name":"Xcopri Maintenance Pack","nonproprietary_name":"cenobamate","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"SK Life Science, Inc.","package_description":"1 KIT in 1 CARTON (71699-104-56) * 1 TABLET, FILM COATED in 1 BLISTER PACK * 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":21.36879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699010356","name":"XCOPRI 350 MG DAILY DOSE PACK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-103-56","proprietary_name":"Xcopri Maintenance Pack","nonproprietary_name":"cenobamate","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"SK Life Science, Inc.","package_description":"1 KIT in 1 CARTON (71699-103-56) * 1 TABLET, FILM COATED in 1 BLISTER PACK * 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":42.69935,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699005030","name":"XCOPRI 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-050-30","proprietary_name":"Xcopri","nonproprietary_name":"cenobamate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"SK Life Science, Inc.","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (71699-050-30)","pharm_classes":["Cytochrome P450 2B6 Inducers [MoA]","Cytochrome P450 2B6 Inhibitors [MoA]","Cytochrome P450 2C19 Inhibitors [MoA]","Cytochrome P450 2C8 Inducers [MoA]","Cytochrome P450 3A Inhibitors [MoA]","Cytochrome P450 3A4 Inducers [MoA]","GABA A Receptor Positive Modulators [MoA]","Sodium Channel Antagonists [MoA]"]},"nadac":{"value":39.85674,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"71699020228","name":"XCOPRI 50-100 MG TITRATION PAK","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71699-202-28","proprietary_name":"Xcopri Titration Pack","nonproprietary_name":"cenobamate","dosage_form":"KIT","route":"ORAL","strength":null,"labeler":"SK Life Science, Inc.","package_description":"1 KIT in 1 CARTON (71699-202-28) * 1 TABLET, FILM COATED in 1 BLISTER PACK * 1 TABLET, FILM COATED in 1 BLISTER PACK"},"nadac":{"value":42.71457,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xcopri|Cenobamate","basis":"brand"},"part_b":null}, {"ndc":"00069100201","name":"XELJANZ 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-1002-01","proprietary_name":"XELJANZ","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0069-1002-01)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":103.93842,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xeljanz|Tofacitinib Citrate","basis":"brand"},"part_b":null}, {"ndc":"00069100101","name":"XELJANZ 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-1001-01","proprietary_name":"XELJANZ","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (0069-1001-01)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":73.77164,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.57264,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xeljanz|Tofacitinib Citrate","basis":"brand"},"part_b":null}, {"ndc":"00069050130","name":"XELJANZ XR 11 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-0501-30","proprietary_name":"XELJANZ XR","nonproprietary_name":"tofacitinib","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"11 mg/1","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0069-0501-30)","pharm_classes":["Janus Kinase Inhibitor [EPC]","Janus Kinase Inhibitors [MoA]"]},"nadac":{"value":207.89619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.19263,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-02","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xeljanz XR|Tofacitinib Citrate","basis":"brand"},"part_b":null}, {"ndc":"70700030884","name":"XELRIA FE 0.4-0.035 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.53158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70700030885","name":"XELRIA FE 0.4-0.035 MG CHEW TB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70700-308-85","proprietary_name":"Xelria Fe","nonproprietary_name":"norethindrone and ethinyl estradiol and ferrous fumarate","dosage_form":"KIT","route":null,"strength":null,"labeler":"Xiromed LLC","package_description":"3 POUCH in 1 CARTON (70700-308-85) / 1 BLISTER PACK in 1 POUCH (70700-308-84) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.53158,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68968021501","name":"XELSTRYM 13.5 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.25846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968021503","name":"XELSTRYM 13.5 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0215-3","proprietary_name":"XELSTRYM","nonproprietary_name":"DEXTROAMPHETAMINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"13.5 mg/1","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0215-3) / 1 PATCH, EXTENDED RELEASE in 1 POUCH (68968-0215-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.25846,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968022001","name":"XELSTRYM 18 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.22681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968022003","name":"XELSTRYM 18 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0220-3","proprietary_name":"XELSTRYM","nonproprietary_name":"DEXTROAMPHETAMINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"18 mg/1","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0220-3) / 1 PATCH, EXTENDED RELEASE in 1 POUCH (68968-0220-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.22681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968020501","name":"XELSTRYM 4.5 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.22856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968020503","name":"XELSTRYM 4.5 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0205-3","proprietary_name":"XELSTRYM","nonproprietary_name":"DEXTROAMPHETAMINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"4.5 mg/1","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0205-3) / 1 PATCH, EXTENDED RELEASE in 1 POUCH (68968-0205-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.22856,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968021001","name":"XELSTRYM 9 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":16.2602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"68968021003","name":"XELSTRYM 9 MG/9 HR PATCH","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68968-0210-3","proprietary_name":"XELSTRYM","nonproprietary_name":"DEXTROAMPHETAMINE","dosage_form":"PATCH, EXTENDED RELEASE","route":"TRANSDERMAL","strength":"9 mg/1","labeler":"Noven Therapeutics, LLC","package_description":"30 POUCH in 1 CARTON (68968-0210-3) / 1 PATCH, EXTENDED RELEASE in 1 POUCH (68968-0210-1)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":16.2602,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xelstrym|Dextroamphetamine","basis":"brand"},"part_b":null}, {"ndc":"61269046090","name":"XENICAL 120 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-460-90","proprietary_name":"Xenical","nonproprietary_name":"orlistat","dosage_form":"CAPSULE","route":"ORAL","strength":"120 mg/1","labeler":"H2-Pharma LLC","package_description":"90 CAPSULE in 1 BOTTLE, PLASTIC (61269-460-90)","pharm_classes":["Intestinal Lipase Inhibitor [EPC]","Lipase Inhibitors [MoA]"]},"nadac":{"value":4.59792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":6.9989,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xenical|Orlistat","basis":"brand"},"part_b":null}, {"ndc":"00096070935","name":"XERAC AC 6.25% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0096-0709-35","proprietary_name":"Xerac AC","nonproprietary_name":"Xerac AC","dosage_form":"LIQUID","route":"TOPICAL","strength":".0625 g/g","labeler":"Person and Covey","package_description":"29.09 g in 1 PACKAGE (0096-0709-35)"},"nadac":{"value":0.21731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00096070960","name":"XERAC AC 6.25% SOLUTION","unit":"ML","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0096-0709-60","proprietary_name":"Xerac AC","nonproprietary_name":"Xerac AC","dosage_form":"LIQUID","route":"TOPICAL","strength":".0625 g/g","labeler":"Person and Covey","package_description":"49.86 g in 1 PACKAGE (0096-0709-60)"},"nadac":{"value":0.17196,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"55513073001","name":"XGEVA 120 MG/1.7 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-730-01","proprietary_name":"XGEVA","nonproprietary_name":"denosumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"120 mg/1.7mL","labeler":"Amgen, Inc","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (55513-730-01) / 1.7 mL in 1 VIAL, SINGLE-USE","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":2001.51678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xgeva|Denosumab","basis":"brand"},"part_b":{"hcpcs":"J0897","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0897 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit ML from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"55513073021","name":"XGEVA 120 MG/1.7 ML VIAL","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55513-730-21","proprietary_name":"XGEVA","nonproprietary_name":"denosumab","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"120 mg/1.7mL","labeler":"Amgen, Inc","package_description":"1 VIAL, SINGLE-USE in 1 CARTON (55513-730-21) / 1.7 mL in 1 VIAL, SINGLE-USE","pharm_classes":["RANK Ligand Blocking Activity [MoA]","RANK Ligand Inhibitor [EPC]"]},"nadac":{"value":2001.51678,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-07","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xgeva|Denosumab","basis":"brand"},"part_b":{"hcpcs":"J0897","bill_units_per_package":{"value":120,"kind":"count","state":"filed","reason":"Billable units of HCPCS J0897 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (120 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1.7,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, SINGLE-USE in 1 CARTON (55513-730-21) / 1.7 mL in 1 VIAL, SINGLE-USE) gives 1.7 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71143037501","name":"XHANCE 93 MCG EXHALATION DELIVERY NASAL SPRAY","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71143-375-01","proprietary_name":"XHANCE","nonproprietary_name":"fluticasone propionate","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"93 ug/1","labeler":"OptiNose US, Inc.","package_description":"1 BOTTLE in 1 CARTON (71143-375-01) / 120 SPRAY, METERED in 1 BOTTLE","pharm_classes":["Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":40.83706,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xhance|Fluticasone Propionate","basis":"brand"},"part_b":null}, {"ndc":"00310628030","name":"XIGDUO XR 10 MG-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6280-30","proprietary_name":"XIGDUO XR","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 1000 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0310-6280-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.20443,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.71952,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xigduo XR|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00310627030","name":"XIGDUO XR 10 MG-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6270-30","proprietary_name":"XIGDUO XR","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"10 mg/1; 500 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0310-6270-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.2391,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.80198,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xigduo XR|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00310622560","name":"XIGDUO XR 2.5 MG-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6225-60","proprietary_name":"XIGDUO XR","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"2.5 mg/1; 1000 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0310-6225-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.60825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xigduo XR|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00310626060","name":"XIGDUO XR 5 MG-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6260-60","proprietary_name":"XIGDUO XR","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 1000 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0310-6260-60)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":9.59236,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.46063,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xigduo XR|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00310625030","name":"XIGDUO XR 5 MG-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0310-6250-30","proprietary_name":"XIGDUO XR","nonproprietary_name":"dapagliflozin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"5 mg/1; 500 mg/1","labeler":"AstraZeneca Pharmaceuticals LP","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC (0310-6250-30)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Sodium-Glucose Cotransporter 2 Inhibitor [EPC]","Sodium-Glucose Transporter 2 Inhibitors [MoA]"]},"nadac":{"value":19.18159,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.70725,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xigduo XR|Dapaglifloz Propaned/Metformin","basis":"brand"},"part_b":null}, {"ndc":"00078091112","name":"XIIDRA 5% EYE DROPS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0078-0911-12","proprietary_name":"Xiidra","nonproprietary_name":"Lifitegrast","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 mg/mL","labeler":"Novartis Pharmaceuticals Corporation","package_description":"12 POUCH in 1 CARTON (0078-0911-12) / 5 AMPULE in 1 POUCH (0078-0911-05) / .2 mL in 1 AMPULE","pharm_classes":["Lymphocyte Function-Associated Antigen-1 Antagonist [EPC]","Lymphocyte Function-Associated Antigen-1 Antagonists [MoA]"]},"nadac":{"value":11.832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xiidra|Lifitegrast","basis":"brand"},"part_b":null}, {"ndc":"24208091112","name":"XIIDRA 5% EYE DROPS","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-911-12","proprietary_name":"Xiidra","nonproprietary_name":"Lifitegrast","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":"50 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"12 POUCH in 1 CARTON (24208-911-12) / 5 AMPULE in 1 POUCH (24208-911-05) / .2 mL in 1 AMPULE","pharm_classes":["Lymphocyte Function-Associated Antigen-1 Antagonist [EPC]","Lymphocyte Function-Associated Antigen-1 Antagonists [MoA]"]},"nadac":{"value":11.832,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xiidra|Lifitegrast","basis":"brand"},"part_b":null}, {"ndc":"50242086001","name":"XOFLUZA 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50242-860-01","proprietary_name":"Xofluza","nonproprietary_name":"BALOXAVIR MARBOXIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Genentech, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (50242-860-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Chelating Activity [MoA]","Polymerase Acidic Endonuclease Inhibitor [EPC]","Polymerase Acidic Endonuclease Inhibitors [MoA]"]},"nadac":{"value":161.93879,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xofluza|Baloxavir Marboxil","basis":"brand"},"part_b":null}, {"ndc":"50242087701","name":"XOFLUZA 80 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50242-877-01","proprietary_name":"Xofluza","nonproprietary_name":"BALOXAVIR MARBOXIL","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"80 mg/1","labeler":"Genentech, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (50242-877-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Chelating Activity [MoA]","Polymerase Acidic Endonuclease Inhibitor [EPC]","Polymerase Acidic Endonuclease Inhibitors [MoA]"]},"nadac":{"value":161.9469,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xofluza|Baloxavir Marboxil","basis":"brand"},"part_b":null}, {"ndc":"27437005601","name":"XOPENEX HFA 45 MCG INHALER","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27437-056-01","proprietary_name":"XOPENEX HFA","nonproprietary_name":"levalbuterol tartrate","dosage_form":"AEROSOL, METERED","route":"ORAL","strength":"45 ug/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"1 INHALER in 1 CARTON (27437-056-01) / 200 AEROSOL, METERED in 1 INHALER","pharm_classes":["Adrenergic beta2-Agonists [MoA]","beta2-Adrenergic Agonist [EPC]"]},"nadac":{"value":4.98775,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"generic_nadac":{"value":3.54974,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per GM.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Xopenex HFA|Levalbuterol Tartrate","basis":"brand"},"part_b":null}, {"ndc":"62484001504","name":"XROMI 100 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":4.96667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"62484001505","name":"XROMI 100 MG/ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62484-0015-5","proprietary_name":"XROMI","nonproprietary_name":"Hydroxyurea","dosage_form":"SOLUTION","route":"ORAL","strength":"100 mg/mL","labeler":"Nova Laboratories, Ltd.","package_description":"1 BOTTLE in 1 CARTON (62484-0015-5) / 148 mL in 1 BOTTLE (62484-0015-4)","pharm_classes":["Antimetabolite [EPC]","Urea [CS]"]},"nadac":{"value":4.96667,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00378334016","name":"XULANE 150-35 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":37.15513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xulane|Norelgestromin/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00378334053","name":"XULANE 150-35 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0378-3340-53","proprietary_name":"XULANE","nonproprietary_name":"norelgestromin and ethinyl estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"150 ug/d; 35 ug/d","labeler":"Mylan Pharmaceuticals Inc.","package_description":"3 POUCH in 1 CARTON (0378-3340-53) / 1 PATCH in 1 POUCH (0378-3340-16) / 7 d in 1 PATCH","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":37.15513,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Xulane|Norelgestromin/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"00169291115","name":"XULTOPHY 100 UNIT-3.6 MG/ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0169-2911-15","proprietary_name":"Xultophy 100/3.6","nonproprietary_name":"insulin degludec and liraglutide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"100 [iU]/mL; 3.6 mg/mL","labeler":"Novo Nordisk","package_description":"5 SYRINGE, PLASTIC in 1 CARTON (0169-2911-15) / 3 mL in 1 SYRINGE, PLASTIC","pharm_classes":["GLP-1 Receptor Agonist [EPC]","Glucagon-Like Peptide 1 [CS]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Insulin Analog [EPC]","Insulin [CS]"]},"nadac":{"value":85.88557,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xultophy 100-3.6|Insulin Degludec/Liraglutide","basis":"brand"},"part_b":null}, {"ndc":"54436020004","name":"XYOSTED 100 MG/0.5 ML AUTO-INJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54436-200-04","proprietary_name":"XYOSTED","nonproprietary_name":"testosterone enanthate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"100 mg/.5mL","labeler":"Antares Pharma, Inc.","package_description":"4 SYRINGE in 1 CARTON (54436-200-04) / .5 mL in 1 SYRINGE (54436-200-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":316.50058,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xyosted|Testosterone Enanthate","basis":"brand"},"part_b":null}, {"ndc":"54436025004","name":"XYOSTED 50 MG/0.5 ML AUTO-INJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54436-250-04","proprietary_name":"XYOSTED","nonproprietary_name":"testosterone enanthate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"50 mg/.5mL","labeler":"Antares Pharma, Inc.","package_description":"4 SYRINGE in 1 CARTON (54436-250-04) / .5 mL in 1 SYRINGE (54436-250-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":316.2082,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xyosted|Testosterone Enanthate","basis":"brand"},"part_b":null}, {"ndc":"54436027504","name":"XYOSTED 75 MG/0.5 ML AUTO-INJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54436-275-04","proprietary_name":"XYOSTED","nonproprietary_name":"testosterone enanthate","dosage_form":"INJECTION","route":"SUBCUTANEOUS","strength":"75 mg/.5mL","labeler":"Antares Pharma, Inc.","package_description":"4 SYRINGE in 1 CARTON (54436-275-04) / .5 mL in 1 SYRINGE (54436-275-02)","pharm_classes":["Androgen Receptor Agonists [MoA]","Androgen [EPC]","Androstanes [CS]"]},"nadac":{"value":316.38038,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Xyosted|Testosterone Enanthate","basis":"brand"},"part_b":null}, {"ndc":"50419040201","name":"YASMIN 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":4.39715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yasmin 28|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"50419040203","name":"YASMIN 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-402-03","proprietary_name":"Yasmin","nonproprietary_name":"drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 PACKAGE (50419-402-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":4.39715,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yasmin 28|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"50419040501","name":"YAZ 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.84382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yaz|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"50419040503","name":"YAZ 28 TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50419-405-03","proprietary_name":"Yaz","nonproprietary_name":"Drospirenone and ethinyl estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Bayer HealthCare Pharmaceuticals Inc.","package_description":"3 BLISTER PACK in 1 PACKAGE (50419-405-03) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":5.84382,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.1909,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yaz|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"83257002341","name":"YESINTEK 45 MG/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-023-41","proprietary_name":"YESINTEK","nonproprietary_name":"ustekinumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"45 mg/.5mL","labeler":"Biocon Biologics Inc.","package_description":"1 SYRINGE in 1 CARTON (83257-023-41) / .5 mL in 1 SYRINGE","pharm_classes":["Interleukin-12 Antagonist [EPC]","Interleukin-12 Antagonists [MoA]","Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":2855.572,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5100","bill_units_per_package":{"value":45,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (45 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (83257-023-41) / .5 mL in 1 SYRINGE) gives 0.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"83257002541","name":"YESINTEK 90 MG/ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83257-025-41","proprietary_name":"YESINTEK","nonproprietary_name":"ustekinumab","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"90 mg/mL","labeler":"Biocon Biologics Inc.","package_description":"1 SYRINGE in 1 CARTON (83257-025-41) / 1 mL in 1 SYRINGE","pharm_classes":["Interleukin-12 Antagonist [EPC]","Interleukin-12 Antagonists [MoA]","Interleukin-23 Antagonist [EPC]","Interleukin-23 Antagonists [MoA]"]},"nadac":{"value":2902.87833,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"Q5100","bill_units_per_package":{"value":90,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5100 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (90 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 SYRINGE in 1 CARTON (83257-025-41) / 1 mL in 1 SYRINGE) gives 1 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"51660099901","name":"YOUR CHOICE 1.5 MG TABLET","unit":"EA","otc":true,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51660-999-01","proprietary_name":"Levonorgestrel","nonproprietary_name":"Levonorgestrel","dosage_form":"TABLET","route":"ORAL","strength":"1.5 mg/1","labeler":"Ohm Laboratories Inc.","package_description":"1 BLISTER PACK in 1 CARTON (51660-999-01) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Inhibit Ovum Fertilization [PE]","Progesterone Congeners [CS]","Progestin [EPC]","Progestin-containing Intrauterine System [EPC]"]},"nadac":{"value":6.33055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"72606003009","name":"YUFLYMA(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"B-BIO","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72606-030-09","proprietary_name":"Yuflyma","nonproprietary_name":"adalimumab-aaty","dosage_form":"KIT","route":null,"strength":null,"labeler":"CELLTRION USA, Inc.","package_description":"1 KIT in 1 CARTON (72606-030-09) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":912.214,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yuflyma(Cf) Autoinjector|Adalimumab-Aaty","basis":"brand"},"part_b":null}, {"ndc":"72606003010","name":"YUFLYMA(CF) 40 MG/0.4 ML AUTOINJECTOR","unit":"EA","otc":false,"rate_class":"B-BIO","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72606-030-10","proprietary_name":"Yuflyma","nonproprietary_name":"adalimumab-aaty","dosage_form":"KIT","route":null,"strength":null,"labeler":"CELLTRION USA, Inc.","package_description":"2 KIT in 1 CARTON (72606-030-10) / 1 KIT in 1 KIT * 1 SYRINGE in 1 TRAY / .4 mL in 1 SYRINGE * 1 mL in 1 PACKET"},"nadac":{"value":896.83875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yuflyma(Cf) Autoinjector|Adalimumab-Aaty","basis":"brand"},"part_b":null}, {"ndc":"82249061330","name":"YULITHIRA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82249-613-30","proprietary_name":"Yulithira","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"CivicaScript, LLC","package_description":"30 TABLET in 1 BOTTLE (82249-613-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":26.32425,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-09","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"82249061130","name":"YULITHIRA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"82249-611-30","proprietary_name":"Yulithira","nonproprietary_name":"Everolimus","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"CivicaScript, LLC","package_description":"30 TABLET in 1 BOTTLE (82249-611-30)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Cytochrome P450 3A4 Inhibitors [MoA]","Decreased Immunologic Activity [PE]","Kinase Inhibitor [EPC]","Protein Kinase Inhibitors [MoA]","mTOR Inhibitor Immunosuppressant [EPC]","mTOR Inhibitors [MoA]"]},"nadac":{"value":14.77078,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-09","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Everolimus|Everolimus","basis":"generic"},"part_b":null}, {"ndc":"49502080693","name":"YUPELRI 175 MCG/3 ML SOLUTION","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49502-806-93","proprietary_name":"YUPELRI","nonproprietary_name":"revefenacin","dosage_form":"SOLUTION","route":"RESPIRATORY (INHALATION)","strength":"175 ug/3mL","labeler":"Viatris Specialty LLC","package_description":"30 POUCH in 1 CARTON (49502-806-93) / 1 VIAL, SINGLE-DOSE in 1 POUCH (49502-806-32) / 3 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Anticholinergic [EPC]","Cholinergic Antagonists [MoA]"]},"nadac":{"value":17.42713,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Yupelri|Revefenacin","basis":"brand"},"part_b":{"hcpcs":"J7677","bill_units_per_package":{"value":5250,"kind":"count","state":"filed","reason":"Billable units of HCPCS J7677 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (175 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":3,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (30 POUCH in 1 CARTON (49502-806-93) / 1 VIAL, SINGLE-DOSE in 1 POUCH (49502-806-32) / 3 mL in 1 VIAL, SINGLE-DOSE) gives 90 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":30,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"65162022621","name":"YUVAFEM 10 MCG VAGINAL INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-226-21","proprietary_name":"YUVAFEM","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"VAGINAL","strength":"10 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"8 APPLICATOR in 1 CARTON (65162-226-21) / 1 TABLET in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yuvafem|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162022623","name":"YUVAFEM 10 MCG VAGINAL INSERT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-226-23","proprietary_name":"YUVAFEM","nonproprietary_name":"Estradiol","dosage_form":"TABLET","route":"VAGINAL","strength":"10 ug/1","labeler":"Amneal Pharmaceuticals LLC","package_description":"18 APPLICATOR in 1 CARTON (65162-226-23) / 1 TABLET in 1 APPLICATOR","pharm_classes":["Estradiol Congeners [CS]","Estrogen Receptor Agonists [MoA]","Estrogen [EPC]"]},"nadac":{"value":5.51799,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Yuvafem|Estradiol","basis":"brand"},"part_b":null}, {"ndc":"58809037504","name":"Z-BUM 22% DIAPER RASH CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58809-375-04","proprietary_name":"Z-Bum","nonproprietary_name":"Diaper Rash Cream","dosage_form":"CREAM","route":"TOPICAL","strength":"22 g/100g","labeler":"GM Pharmaceuticals, Inc","package_description":"113 g in 1 TUBE (58809-375-04)"},"nadac":{"value":0.36763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00065401105","name":"ZADITOR 0.025% (0.035%) DROPS","unit":"ML","otc":true,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-4011-05","proprietary_name":"Zaditor","nonproprietary_name":"ketotifen fumarate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"1 BOTTLE, DROPPER in 1 CARTON (0065-4011-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":2.22853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":1.29403,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"00065401106","name":"ZADITOR 0.025% (0.035%) DROPS","unit":"ML","otc":true,"rate_class":"B-ANDA","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0065-4011-06","proprietary_name":"Zaditor","nonproprietary_name":"ketotifen fumarate","dosage_form":"SOLUTION","route":"OPHTHALMIC","strength":".25 mg/mL","labeler":"Alcon Laboratories, Inc.","package_description":"2 BOTTLE, DROPPER in 1 CARTON (0065-4011-06) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Inhibitor [EPC]"]},"nadac":{"value":1.87003,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":null}, {"ndc":"65162035801","name":"ZAFEMY 150-35 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":31.90792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafemy|Norelgestromin/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"65162035803","name":"ZAFEMY 150-35 MCG/DAY PATCH","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65162-358-03","proprietary_name":"ZAFEMY","nonproprietary_name":"Norelgestromin and Ethinyl Estradiol","dosage_form":"PATCH","route":"TRANSDERMAL","strength":"150 ug/d; 35 ug/d","labeler":"Amneal Pharmaceuticals LLC","package_description":"3 POUCH in 1 CARTON (65162-358-03) / 1 PATCH in 1 POUCH (65162-358-01) / 7 d in 1 PATCH","pharm_classes":["Estrogen Receptor Agonists [MoA]","Estrogen [EPC]","Progesterone Congeners [CS]","Progestin [EPC]"]},"nadac":{"value":31.90792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafemy|Norelgestromin/Ethin.Estradiol","basis":"brand"},"part_b":null}, {"ndc":"31722000760","name":"ZAFIRLUKAST 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-007-60","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-007-60)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.51691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"55111062560","name":"ZAFIRLUKAST 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-625-60","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55111-625-60)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.51691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"59651029160","name":"ZAFIRLUKAST 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-291-60","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59651-291-60)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.51691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"64380018701","name":"ZAFIRLUKAST 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-187-01","proprietary_name":"Zafirlukast","nonproprietary_name":"zafirlukast","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET, COATED in 1 BOTTLE (64380-187-01)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.51691,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"31722000860","name":"ZAFIRLUKAST 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-008-60","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (31722-008-60)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.62337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"55111062660","name":"ZAFIRLUKAST 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-626-60","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddys Laboratories Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (55111-626-60)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.62337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"59651029260","name":"ZAFIRLUKAST 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-292-60","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (59651-292-60)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.62337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"64380018801","name":"ZAFIRLUKAST 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-188-01","proprietary_name":"Zafirlukast","nonproprietary_name":"zafirlukast","dosage_form":"TABLET, COATED","route":"ORAL","strength":"20 mg/1","labeler":"Strides Pharma Science Limited","package_description":"60 TABLET, COATED in 1 BOTTLE (64380-188-01)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.62337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"68084005911","name":"ZAFIRLUKAST 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.62337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"68084005921","name":"ZAFIRLUKAST 20 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-059-21","proprietary_name":"Zafirlukast","nonproprietary_name":"Zafirlukast","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-059-21) / 1 TABLET, FILM COATED in 1 BLISTER PACK (68084-059-11)","pharm_classes":["Cytochrome P450 2C9 Inhibitors [MoA]","Leukotriene Receptor Antagonist [EPC]","Leukotriene Receptor Antagonists [MoA]"]},"nadac":{"value":0.62337,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zafirlukast|Zafirlukast","basis":"generic"},"part_b":null}, {"ndc":"00054008525","name":"ZALEPLON 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0085-25","proprietary_name":"Zaleplon","nonproprietary_name":"Zaleplon","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0085-25)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.1409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"29300013201","name":"ZALEPLON 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-132-01","proprietary_name":"zaleplon","nonproprietary_name":"zaleplon","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (29300-132-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.1409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"57237024001","name":"ZALEPLON 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-240-01","proprietary_name":"ZALEPLON","nonproprietary_name":"ZALEPLON","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-240-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.1409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"65862021501","name":"ZALEPLON 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-215-01","proprietary_name":"ZALEPLON","nonproprietary_name":"ZALEPLON","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-215-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.1409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"69452036520","name":"ZALEPLON 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-365-20","proprietary_name":"Zaleplon","nonproprietary_name":"Zaleplon","dosage_form":"CAPSULE","route":"ORAL","strength":"10 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-365-20)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.1409,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"00054008425","name":"ZALEPLON 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0054-0084-25","proprietary_name":"Zaleplon","nonproprietary_name":"Zaleplon","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Hikma Pharmaceuticals USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (0054-0084-25)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.15681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"29300013101","name":"ZALEPLON 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-131-01","proprietary_name":"zaleplon","nonproprietary_name":"zaleplon","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE, PLASTIC (29300-131-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.15681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"57237023901","name":"ZALEPLON 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"57237-239-01","proprietary_name":"ZALEPLON","nonproprietary_name":"ZALEPLON","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (57237-239-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.15681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"65862021401","name":"ZALEPLON 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-214-01","proprietary_name":"ZALEPLON","nonproprietary_name":"ZALEPLON","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (65862-214-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.15681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"69452036420","name":"ZALEPLON 5 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69452-364-20","proprietary_name":"Zaleplon","nonproprietary_name":"Zaleplon","dosage_form":"CAPSULE","route":"ORAL","strength":"5 mg/1","labeler":"Bionpharma Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69452-364-20)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","gamma-Aminobutyric Acid A Receptor Agonist [EPC]"]},"nadac":{"value":0.15681,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zaleplon|Zaleplon","basis":"generic"},"part_b":null}, {"ndc":"00071023724","name":"ZARONTIN 250 MG CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0071-0237-24","proprietary_name":"Zarontin","nonproprietary_name":"Ethosuximide","dosage_form":"CAPSULE","route":"ORAL","strength":"250 mg/1","labeler":"Parke-Davis Div of Pfizer Inc","package_description":"100 CAPSULE in 1 BOTTLE (0071-0237-24)","pharm_classes":["Anti-epileptic Agent [EPC]","Decreased Central Nervous System Disorganized Electrical Activity [PE]"]},"nadac":{"value":1.30857,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.24349,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zarontin|Ethosuximide","basis":"brand"},"part_b":null}, {"ndc":"61314031801","name":"ZARXIO 300 MCG/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61314-318-01","proprietary_name":"ZARXIO","nonproprietary_name":"filgrastim-sndz","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"300 ug/.5mL","labeler":"Sandoz Inc.","package_description":"1 BLISTER PACK in 1 CARTON (61314-318-01) / 1 SYRINGE in 1 BLISTER PACK / .5 mL in 1 SYRINGE","pharm_classes":["Granulocyte Colony-Stimulating Factor [CS]","Increased Myeloid Cell Production [PE]","Leukocyte Growth Factor [EPC]"]},"nadac":{"value":531.655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zarxio|Filgrastim-Sndz","basis":"brand"},"part_b":{"hcpcs":"Q5101","bill_units_per_package":{"value":300,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5101 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (300 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.5,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (61314-318-01) / 1 SYRINGE in 1 BLISTER PACK / .5 mL in 1 SYRINGE) gives 0.5 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"61314031805","name":"ZARXIO 300 MCG/0.5 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":531.655,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zarxio|Filgrastim-Sndz","basis":"brand"},"part_b":null}, {"ndc":"61314032601","name":"ZARXIO 480 MCG/0.8 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"61314-326-01","proprietary_name":"ZARXIO","nonproprietary_name":"filgrastim-sndz","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS; SUBCUTANEOUS","strength":"480 ug/.8mL","labeler":"Sandoz Inc.","package_description":"1 BLISTER PACK in 1 CARTON (61314-326-01) / 1 SYRINGE in 1 BLISTER PACK / .8 mL in 1 SYRINGE","pharm_classes":["Granulocyte Colony-Stimulating Factor [CS]","Increased Myeloid Cell Production [PE]","Leukocyte Growth Factor [EPC]"]},"nadac":{"value":533.4125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zarxio|Filgrastim-Sndz","basis":"brand"},"part_b":{"hcpcs":"Q5101","bill_units_per_package":{"value":480,"kind":"count","state":"filed","reason":"Billable units of HCPCS Q5101 (1 MCG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (480 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":0.8,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BLISTER PACK in 1 CARTON (61314-326-01) / 1 SYRINGE in 1 BLISTER PACK / .8 mL in 1 SYRINGE) gives 0.8 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"61314032605","name":"ZARXIO 480 MCG/0.8 ML SYRINGE","unit":"ML","otc":false,"rate_class":"B-BIO","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":533.4125,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2025-12-17","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zarxio|Filgrastim-Sndz","basis":"brand"},"part_b":null}, {"ndc":"00069350002","name":"ZAVZPRET 10 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0069-3500-02","proprietary_name":"ZAVZPRET","nonproprietary_name":"zavegepant","dosage_form":"SPRAY","route":"NASAL","strength":"10 mg/.1mL","labeler":"Pfizer Laboratories Div Pfizer Inc","package_description":"6 BLISTER PACK in 1 CARTON (0069-3500-02) / 1 VIAL, SINGLE-DOSE in 1 BLISTER PACK (0069-3500-01) / .1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Calcitonin Gene-related Peptide Receptor Antagonist [EPC]","Calcitonin Gene-related Peptide Receptor Antagonists [MoA]"]},"nadac":{"value":189.80062,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zavzpret|Zavegepant HCl","basis":"brand"},"part_b":null}, {"ndc":"00169191201","name":"ZEGALOGUE 0.6 MG/0.6 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0169-1912-01","proprietary_name":"Zegalogue","nonproprietary_name":"dasiglucagon","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".6 mg/.6mL","labeler":"Novo Nordisk","package_description":"1 CONTAINER in 1 PACKAGE (0169-1912-01) / 1 SYRINGE, GLASS in 1 CONTAINER / .6 mL in 1 SYRINGE, GLASS","pharm_classes":["Antihypoglycemic Agent [EPC]","Glucagon Receptor Agonists [MoA]","Increased Glycogenolysis [PE]"]},"nadac":{"value":493.89598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zegalogue Autoinjector|Dasiglucagon HCl","basis":"brand"},"part_b":null}, {"ndc":"00169191202","name":"ZEGALOGUE 0.6 MG/0.6 ML AUTOINJ","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0169-1912-02","proprietary_name":"Zegalogue","nonproprietary_name":"dasiglucagon","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".6 mg/.6mL","labeler":"Novo Nordisk","package_description":"2 PACKAGE in 1 CARTON (0169-1912-02) / 1 CONTAINER in 1 PACKAGE (0169-1912-12) / 1 SYRINGE, GLASS in 1 CONTAINER / .6 mL in 1 SYRINGE, GLASS","pharm_classes":["Antihypoglycemic Agent [EPC]","Glucagon Receptor Agonists [MoA]","Increased Glycogenolysis [PE]"]},"nadac":{"value":492.83148,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zegalogue Autoinjector|Dasiglucagon HCl","basis":"brand"},"part_b":null}, {"ndc":"00169191301","name":"ZEGALOGUE 0.6 MG/0.6 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0169-1913-01","proprietary_name":"Zegalogue","nonproprietary_name":"dasiglucagon","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".6 mg/.6mL","labeler":"Novo Nordisk","package_description":"1 CONTAINER in 1 PACKAGE (0169-1913-01) / 1 SYRINGE, GLASS in 1 CONTAINER / .6 mL in 1 SYRINGE, GLASS","pharm_classes":["Antihypoglycemic Agent [EPC]","Glucagon Receptor Agonists [MoA]","Increased Glycogenolysis [PE]"]},"nadac":{"value":494.05208,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zegalogue Syringe|Dasiglucagon HCl","basis":"brand"},"part_b":null}, {"ndc":"00169191302","name":"ZEGALOGUE 0.6 MG/0.6 ML SYRING","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"0169-1913-02","proprietary_name":"Zegalogue","nonproprietary_name":"dasiglucagon","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":".6 mg/.6mL","labeler":"Novo Nordisk","package_description":"2 PACKAGE in 1 CARTON (0169-1913-02) / 1 CONTAINER in 1 PACKAGE (0169-1913-12) / 1 SYRINGE, GLASS in 1 CONTAINER / .6 mL in 1 SYRINGE, GLASS","pharm_classes":["Antihypoglycemic Agent [EPC]","Glucagon Receptor Agonists [MoA]","Increased Glycogenolysis [PE]"]},"nadac":{"value":495.0225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-21","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zegalogue Syringe|Dasiglucagon HCl","basis":"brand"},"part_b":null}, {"ndc":"83787010331","name":"ZELSUVMI 10.3% GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"83787-103-31","proprietary_name":"ZELSUVMI","nonproprietary_name":"berdazimer","dosage_form":"KIT","route":null,"strength":null,"labeler":"LNHC, Inc.","package_description":"1 KIT in 1 KIT (83787-103-31) * 1 TUBE in 1 CARTON / 17 g in 1 TUBE * 1 TUBE in 1 CARTON / 14 g in 1 TUBE (83787-113-14)"},"nadac":{"value":61.89081,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00245080938","name":"ZEMBRACE SYMTOUCH 3 MG/0.5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":384.08921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zembrace Symtouch|Sumatriptan Succinate","basis":"brand"},"part_b":null}, {"ndc":"70792080938","name":"ZEMBRACE SYMTOUCH 3 MG/0.5 ML","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70792-809-38","proprietary_name":"Zembrace SymTouch","nonproprietary_name":"Sumatriptan Succinate","dosage_form":"SOLUTION","route":"SUBCUTANEOUS","strength":"3 mg/.5mL","labeler":"Tonix Medicines, Inc.","package_description":"4 BLISTER PACK in 1 CARTON (70792-809-38) / 1 SYRINGE in 1 BLISTER PACK / .5 mL in 1 SYRINGE","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":384.08921,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zembrace Symtouch|Sumatriptan Succinate","basis":"brand"},"part_b":null}, {"ndc":"55111013579","name":"ZENATANE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111013581","name":"ZENATANE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-135-81","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"10 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-135-81) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (55111-135-79)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065216","name":"ZENATANE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065217","name":"ZENATANE 10 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-652-17","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"10 mg/1","labeler":"BluePoint Laboratories","package_description":"3 BLISTER PACK in 1 CARTON (68001-652-17) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68001-652-16)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.96311,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111013679","name":"ZENATANE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111013681","name":"ZENATANE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-136-81","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-136-81) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (55111-136-79)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065316","name":"ZENATANE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065317","name":"ZENATANE 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-653-17","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"3 BLISTER PACK in 1 CARTON (68001-653-17) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68001-653-16)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":1.93248,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111011379","name":"ZENATANE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111011381","name":"ZENATANE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-113-81","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"30 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-113-81) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (55111-113-79)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065416","name":"ZENATANE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065417","name":"ZENATANE 30 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-654-17","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"30 mg/1","labeler":"BluePoint Laboratories","package_description":"3 BLISTER PACK in 1 CARTON (68001-654-17) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68001-654-16)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.12538,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111013779","name":"ZENATANE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"55111013781","name":"ZENATANE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-137-81","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"3 BLISTER PACK in 1 CARTON (55111-137-81) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (55111-137-79)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065516","name":"ZENATANE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"68001065517","name":"ZENATANE 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-655-17","proprietary_name":"ZENATANE","nonproprietary_name":"ISOTRETINOIN","dosage_form":"CAPSULE, GELATIN COATED","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"3 BLISTER PACK in 1 CARTON (68001-655-17) / 10 CAPSULE, GELATIN COATED in 1 BLISTER PACK (68001-655-16)","pharm_classes":["Retinoid [EPC]","Retinoids [CS]"]},"nadac":{"value":2.20779,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenatane|Isotretinoin","basis":"brand"},"part_b":null}, {"ndc":"73562011001","name":"ZENPEP DR 10,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-110-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"10000 [USP'U]/1; 32000 [USP'U]/1; 42000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-110-01)"},"nadac":{"value":4.18389,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011101","name":"ZENPEP DR 15,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-111-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"15000 [USP'U]/1; 47000 [USP'U]/1; 63000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-111-01)"},"nadac":{"value":6.0442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011201","name":"ZENPEP DR 20,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-112-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"20000 [USP'U]/1; 63000 [USP'U]/1; 84000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-112-01)"},"nadac":{"value":8.20033,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011601","name":"ZENPEP DR 25,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-116-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"25000 [USP'U]/1; 79000 [USP'U]/1; 105000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-116-01)"},"nadac":{"value":10.14619,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011301","name":"ZENPEP DR 3,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-113-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"3000 [USP'U]/1; 10000 [USP'U]/1; 14000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-113-01)"},"nadac":{"value":2.21453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011401","name":"ZENPEP DR 40,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-114-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"40000 [USP'U]/1; 126000 [USP'U]/1; 168000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-114-01)"},"nadac":{"value":16.20005,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011501","name":"ZENPEP DR 5,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-115-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"5000 [USP'U]/1; 17000 [USP'U]/1; 24000 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-115-01)"},"nadac":{"value":2.11642,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"73562011701","name":"ZENPEP DR 60,000 UNIT CAPSULE","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"73562-117-01","proprietary_name":"Zenpep","nonproprietary_name":"pancrelipase lipase, pancrelipase protease, pancrelipase amylase","dosage_form":"CAPSULE, DELAYED RELEASE","route":"ORAL","strength":"60000 [USP'U]/1; 189600 [USP'U]/1; 252600 [USP'U]/1","labeler":"Aimmune Therapeutics, Inc.","package_description":"100 CAPSULE, DELAYED RELEASE in 1 BOTTLE (73562-117-01)"},"nadac":{"value":24.31853,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"24338085603","name":"ZENZEDI 30 MG TABLET","unit":"EA","otc":false,"rate_class":"B-ANDA","explanation_codes":["4","6"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24338-856-03","proprietary_name":"Zenzedi","nonproprietary_name":"Dextroamphetamine Sulfate","dosage_form":"TABLET","route":"ORAL","strength":"30 mg/1","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"30 TABLET in 1 BOTTLE (24338-856-03)","pharm_classes":["Central Nervous System Stimulant [EPC]","Central Nervous System Stimulation [PE]"]},"nadac":{"value":10.40256,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-04-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":5.48996,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zenzedi|Dextroamphetamine Sulfate","basis":"brand"},"part_b":null}, {"ndc":"00002247180","name":"ZEPBOUND 10 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2471-80","proprietary_name":"ZEPBOUND","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"10 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2471-80) / .5 mL in 1 SYRINGE (0002-2471-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":526.04607,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002353301","name":"ZEPBOUND 10 MG/DOSE (40 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":281.62145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002353311","name":"ZEPBOUND 10 MG/DOSE (40 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3533-11","proprietary_name":"Zepbound KwikPen","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"16.7 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-3533-11) / 2.4 mL in 1 SYRINGE (0002-3533-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":281.62145,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002246080","name":"ZEPBOUND 12.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2460-80","proprietary_name":"ZEPBOUND","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"12.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2460-80) / .5 mL in 1 SYRINGE (0002-2460-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":525.84865,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002352201","name":"ZEPBOUND 12.5 MG/DOSE (50 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":281.98531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002352211","name":"ZEPBOUND 12.5 MG/DOSE (50 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3522-11","proprietary_name":"Zepbound KwikPen","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"20.8 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-3522-11) / 2.4 mL in 1 SYRINGE (0002-3522-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":281.98531,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002245780","name":"ZEPBOUND 15 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2457-80","proprietary_name":"ZEPBOUND","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"15 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2457-80) / .5 mL in 1 SYRINGE (0002-2457-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":525.92209,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002351101","name":"ZEPBOUND 15 MG/DOSE (60 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":281.42838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002351111","name":"ZEPBOUND 15 MG/DOSE (60 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3511-11","proprietary_name":"Zepbound KwikPen","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"25 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-3511-11) / 2.4 mL in 1 SYRINGE (0002-3511-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":281.42838,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002250680","name":"ZEPBOUND 2.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2506-80","proprietary_name":"ZEPBOUND","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"2.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2506-80) / .5 mL in 1 SYRINGE (0002-2506-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":526.20422,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002356601","name":"ZEPBOUND 2.5 MG/DOSE (10 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":201.2566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002356611","name":"ZEPBOUND 2.5 MG/DOSE (10 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3566-11","proprietary_name":"Zepbound KwikPen","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"4.17 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-3566-11) / 2.4 mL in 1 SYRINGE (0002-3566-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":201.2566,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002249580","name":"ZEPBOUND 5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2495-80","proprietary_name":"ZEPBOUND","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2495-80) / .5 mL in 1 SYRINGE (0002-2495-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":526.08276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002355501","name":"ZEPBOUND 5 MG/DOSE (20 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":201.03732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002355511","name":"ZEPBOUND 5 MG/DOSE (20 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3555-11","proprietary_name":"Zepbound KwikPen","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"8.33 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-3555-11) / 2.4 mL in 1 SYRINGE (0002-3555-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":201.03732,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002248480","name":"ZEPBOUND 7.5 MG/0.5 ML PEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-2484-80","proprietary_name":"ZEPBOUND","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"7.5 mg/.5mL","labeler":"Eli Lilly and Company","package_description":"4 SYRINGE in 1 CARTON (0002-2484-80) / .5 mL in 1 SYRINGE (0002-2484-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":526.00415,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002354401","name":"ZEPBOUND 7.5 MG/DOSE (30 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":200.9187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"00002354411","name":"ZEPBOUND 7.5 MG/DOSE (30 MG/2.4 ML) KWIKPEN","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0002-3544-11","proprietary_name":"Zepbound KwikPen","nonproprietary_name":"tirzepatide","dosage_form":"INJECTION, SOLUTION","route":"SUBCUTANEOUS","strength":"12.5 mg/mL","labeler":"Eli Lilly and Company","package_description":"1 SYRINGE in 1 CARTON (0002-3544-11) / 2.4 mL in 1 SYRINGE (0002-3544-01)","pharm_classes":["G-Protein-linked Receptor Interactions [MoA]","GLP-1 Receptor Agonist [EPC]","Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]","Glucose-dependent Insulinotropic Polypeptide Receptor Agonist [EPC]"]},"nadac":{"value":200.9187,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zepbound|Tirzepatide","basis":"brand"},"part_b":null}, {"ndc":"71776002430","name":"ZERVIATE 0.24% EYE DROP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":7.3536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zerviate|Cetirizine HCl","basis":"brand"},"part_b":null}, {"ndc":"82667001524","name":"ZERVIATE 0.24% EYE DROP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82667-015-24","proprietary_name":"ZERVIATE","nonproprietary_name":"cetirizine","dosage_form":"FOR SOLUTION","route":"OPHTHALMIC","strength":"2.4 mg/mL","labeler":"Harrow Eye, LLC","package_description":"1 POUCH in 1 CARTON (82667-015-24) / 30 VIAL, SINGLE-USE in 1 POUCH / 2.5 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Histamine H1 Receptor Antagonists [MoA]","Histamine-1 Receptor Antagonist [EPC]"]},"nadac":{"value":7.3536,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zerviate|Cetirizine HCl","basis":"brand"},"part_b":null}, {"ndc":"24979024007","name":"ZESTRIL 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"24979-240-07","proprietary_name":"Zestril","nonproprietary_name":"Lisinopril","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Upsher-Smith Laboratories, LLC","package_description":"90 TABLET in 1 BOTTLE (24979-240-07)","pharm_classes":["Angiotensin Converting Enzyme Inhibitor [EPC]","Angiotensin-converting Enzyme Inhibitors [MoA]"]},"nadac":{"value":12.52442,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-03-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.01815,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zestril|Lisinopril","basis":"brand"},"part_b":null}, {"ndc":"78206017801","name":"ZETIA 10 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"78206-178-01","proprietary_name":"Zetia","nonproprietary_name":"Ezetimibe","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Organon LLC","package_description":"30 TABLET in 1 BOTTLE (78206-178-01)","pharm_classes":["Decreased Cholesterol Absorption [PE]","Dietary Cholesterol Absorption Inhibitor [EPC]"]},"nadac":{"value":13.93688,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.06672,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zetia|Ezetimibe","basis":"brand"},"part_b":null}, {"ndc":"31722050960","name":"ZIDOVUDINE 300 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-509-60","proprietary_name":"Zidovudine","nonproprietary_name":"Zidovudine","dosage_form":"TABLET","route":"ORAL","strength":"300 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"12 BOTTLE in 1 CASE (31722-509-60) / 60 TABLET in 1 BOTTLE","pharm_classes":["Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]","Nucleoside Reverse Transcriptase Inhibitors [MoA]"]},"nadac":{"value":0.46377,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zidovudine|Zidovudine","basis":"generic"},"part_b":null}, {"ndc":"31722004412","name":"ZILEUTON ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"31722-044-12","proprietary_name":"Zileuton","nonproprietary_name":"Zileuton","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Camber Pharmaceuticals, Inc.","package_description":"120 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-044-12)","pharm_classes":["5-Lipoxygenase Inhibitor [EPC]","5-Lipoxygenase Inhibitors [MoA]","Decreased Leukotriene Production [PE]"]},"nadac":{"value":2.04927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zileuton ER|Zileuton","basis":"generic"},"part_b":null}, {"ndc":"64380018901","name":"ZILEUTON ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64380-189-01","proprietary_name":"Zileuton","nonproprietary_name":"zileuton","dosage_form":"TABLET, MULTILAYER, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Strides Pharma Science Limited","package_description":"120 TABLET, MULTILAYER, EXTENDED RELEASE in 1 BOTTLE (64380-189-01)","pharm_classes":["5-Lipoxygenase Inhibitor [EPC]","5-Lipoxygenase Inhibitors [MoA]","Decreased Leukotriene Production [PE]"]},"nadac":{"value":2.04927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zileuton ER|Zileuton","basis":"generic"},"part_b":null}, {"ndc":"64980020612","name":"ZILEUTON ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"64980-206-12","proprietary_name":"Zileuton","nonproprietary_name":"Zileuton","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"120 TABLET, EXTENDED RELEASE in 1 BOTTLE (64980-206-12)","pharm_classes":["5-Lipoxygenase Inhibitor [EPC]","5-Lipoxygenase Inhibitors [MoA]","Decreased Leukotriene Production [PE]"]},"nadac":{"value":2.04927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zileuton ER|Zileuton","basis":"generic"},"part_b":null}, {"ndc":"72603024601","name":"ZILEUTON ER 600 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72603-246-01","proprietary_name":"Zileuton","nonproprietary_name":"Zileuton","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"600 mg/1","labeler":"NorthStar RxLLC","package_description":"120 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (72603-246-01)","pharm_classes":["5-Lipoxygenase Inhibitor [EPC]","5-Lipoxygenase Inhibitors [MoA]","Decreased Leukotriene Production [PE]"]},"nadac":{"value":2.04927,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zileuton ER|Zileuton","basis":"generic"},"part_b":null}, {"ndc":"00536131625","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1316-25","proprietary_name":"Rugby Zinc Oxide 20%","nonproprietary_name":"Rugby Zinc Oxide 20%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 g/100g","labeler":"Rugby Laboratories","package_description":"72 TUBE in 1 CASE (0536-1316-25) / 60 g in 1 TUBE"},"nadac":{"value":0.06113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536131628","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1316-28","proprietary_name":"Rugby Zinc Oxide 20%","nonproprietary_name":"Rugby Zinc Oxide 20%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 g/100g","labeler":"Rugby Laboratories","package_description":"72 TUBE in 1 CASE (0536-1316-28) / 30 g in 1 TUBE"},"nadac":{"value":0.07716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"00536131698","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0536-1316-98","proprietary_name":"Rugby Zinc Oxide 20%","nonproprietary_name":"Rugby Zinc Oxide 20%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 g/100g","labeler":"Rugby Laboratories","package_description":"12 JAR in 1 CASE (0536-1316-98) / 454 g in 1 JAR"},"nadac":{"value":0.01542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001053245","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-532-45","proprietary_name":"Zinc Oxide","nonproprietary_name":"Skin Protectant","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-532-45) / 30 g in 1 TUBE"},"nadac":{"value":0.07716,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001053246","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-532-46","proprietary_name":"Zinc Oxide","nonproprietary_name":"Skin Protectant","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 g/100g","labeler":"BluePoint Laboratories","package_description":"1 TUBE in 1 CARTON (68001-532-46) / 60 g in 1 TUBE"},"nadac":{"value":0.06113,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"68001053350","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-533-50","proprietary_name":"Zinc Oxide","nonproprietary_name":"Skin Protectant","dosage_form":"OINTMENT","route":"TOPICAL","strength":"20 g/100g","labeler":"BluePoint Laboratories","package_description":"454 g in 1 JAR (68001-533-50)"},"nadac":{"value":0.01542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000033401","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0334-1","proprietary_name":"Leader Zinc Oxide","nonproprietary_name":"Zinc Oxide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"200 mg/g","labeler":"Cardinal Health 110,Inc.","package_description":"454 g in 1 JAR (70000-0334-1)"},"nadac":{"value":0.01542,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75834017001","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-170-01","proprietary_name":"NIVAGEN ZINC OXIDE","nonproprietary_name":"zinc oxide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"200 mg/g","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"28.4 g in 1 TUBE (75834-170-01)"},"nadac":{"value":0.10483,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"75834017002","name":"ZINC OXIDE 20% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75834-170-02","proprietary_name":"NIVAGEN ZINC OXIDE","nonproprietary_name":"zinc oxide","dosage_form":"OINTMENT","route":"TOPICAL","strength":"200 mg/g","labeler":"Nivagen Pharmaceuticals, Inc.","package_description":"56.7 g in 1 TUBE (75834-170-02)"},"nadac":{"value":0.08421,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"69367018804","name":"ZINC OXIDE 22% CREAM","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69367-188-04","proprietary_name":"Zinc Oxide","nonproprietary_name":"Zinc Oxide","dosage_form":"CREAM","route":"TOPICAL","strength":"22 g/100g","labeler":"Westminster Pharmaceuticals, LLC","package_description":"113 g in 1 TUBE (69367-188-04)"},"nadac":{"value":0.36763,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"70000048801","name":"ZINC OXIDE 25% OINTMENT","unit":"GM","otc":true,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70000-0488-1","proprietary_name":"Skin Protectant","nonproprietary_name":"Zinc Oxide 25%","dosage_form":"OINTMENT","route":"TOPICAL","strength":"25 mg/100mg","labeler":"Cardinal Health","package_description":"72 BOX in 1 CASE (70000-0488-1) / 1 TUBE in 1 BOX / 28400 mg in 1 TUBE"},"nadac":{"value":0.04453,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":null,"part_b":null}, {"ndc":"82584060930","name":"ZIOPTAN 0.0015% EYE DROP","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82584-609-30","proprietary_name":"ZIOPTAN","nonproprietary_name":"Tafluprost","dosage_form":"SOLUTION/ DROPS","route":"OPHTHALMIC","strength":".015 mg/mL","labeler":"Thea Pharma Inc.","package_description":"3 POUCH in 1 CARTON (82584-609-30) / 10 VIAL, SINGLE-USE in 1 POUCH (82584-609-01) / .3 mL in 1 VIAL, SINGLE-USE","pharm_classes":["Increased Prostaglandin Activity [PE]","Prostaglandin Analog [EPC]","Prostaglandin Receptor Agonists [MoA]","Prostaglandins [CS]"]},"nadac":{"value":8.48561,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":2.4535,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zioptan|Tafluprost/PF","basis":"brand"},"part_b":null}, {"ndc":"43598006158","name":"ZIPRASIDONE 20 MG/ML VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-061-58","proprietary_name":"ziprasidone mesylate","nonproprietary_name":"ziprasidone mesylate","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Dr.Reddy's Laboratories, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (43598-061-58) / 1 mL in 1 VIAL, SINGLE-DOSE (43598-061-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.8074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone Mesylate|Ziprasidone Mesylate","basis":"generic"},"part_b":{"hcpcs":"J3486","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3486 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"43598084858","name":"ZIPRASIDONE 20 MG/ML VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"43598-848-58","proprietary_name":"ziprasidone mesylate","nonproprietary_name":"ziprasidone mesylate","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Dr.Reddy's Laboratories, Inc.","package_description":"1 VIAL, SINGLE-DOSE in 1 CARTON (43598-848-58) / 1 mL in 1 VIAL, SINGLE-DOSE","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.8074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone Mesylate|Ziprasidone Mesylate","basis":"generic"},"part_b":{"hcpcs":"J3486","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3486 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. The crosswalk does not state the unit of package size; it could not be confirmed equal to NADAC's unit EA from FDA's package description, so package_unit is null.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":null}}, {"ndc":"72205020507","name":"ZIPRASIDONE 20 MG/ML VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72205-205-07","proprietary_name":"ziprasidone mesylate","nonproprietary_name":"ziprasidone mesylate","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Novadoz Pharmaceuticals LLC","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72205-205-07) / 1 mL in 1 VIAL, SINGLE-DOSE (72205-205-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.8074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone Mesylate|Ziprasidone Mesylate","basis":"generic"},"part_b":{"hcpcs":"J3486","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3486 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72205-205-07) / 1 mL in 1 VIAL, SINGLE-DOSE (72205-205-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72266016010","name":"ZIPRASIDONE 20 MG/ML VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72266-160-10","proprietary_name":"Ziprasidone Mesylate","nonproprietary_name":"Ziprasidone Mesylate","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72266-160-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72266-160-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.8074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone Mesylate|Ziprasidone Mesylate","basis":"generic"},"part_b":{"hcpcs":"J3486","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3486 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72266-160-10) / 1 mL in 1 VIAL, SINGLE-DOSE (72266-160-01)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"72266016042","name":"ZIPRASIDONE 20 MG/ML VIAL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"72266-160-42","proprietary_name":"Ziprasidone Mesylate","nonproprietary_name":"Ziprasidone Mesylate","dosage_form":"INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION","route":"INTRAMUSCULAR","strength":"20 mg/mL","labeler":"Fosun Pharma USA Inc.","package_description":"10 VIAL, SINGLE-DOSE in 1 CARTON (72266-160-42) / 1 mL in 1 VIAL, SINGLE-DOSE (72266-160-41)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":21.8074,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-07-22","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone Mesylate|Ziprasidone Mesylate","basis":"generic"},"part_b":{"hcpcs":"J3486","bill_units_per_package":{"value":20,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3486 (10 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (2 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":1,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (10 VIAL, SINGLE-DOSE in 1 CARTON (72266-160-42) / 1 mL in 1 VIAL, SINGLE-DOSE (72266-160-41)) gives 10 EA per NDC, equal to package size x quantity here, so the package is in NADAC's unit EA.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"EA","period":"2026-10-01/2026-12-31"},"package_qty":{"value":10,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"EA"}}, {"ndc":"00904626908","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6269-08","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-6269-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904626945","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6269-45","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6269-45) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714083501","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-835-01","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 CAPSULE in 1 BOTTLE (16714-835-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342014409","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-144-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-144-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081111","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081112","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-811-12","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-811-12) / 1 CAPSULE in 1 BLISTER PACK (50268-811-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"55111025660","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-256-60","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-256-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505252806","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2528-6","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-2528-6)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135099160","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-991-60","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-991-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862070260","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-702-60","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-702-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68001045006","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-450-06","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"BluePoint Laboratories","package_description":"60 CAPSULE in 1 BOTTLE (68001-450-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010309","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-103-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"20 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-103-09) / 1 CAPSULE in 1 BLISTER PACK (68084-103-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010311","name":"ZIPRASIDONE HCL 20 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.2694,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904627008","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6270-08","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-6270-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904627045","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6270-45","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6270-45) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714083601","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-836-01","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 CAPSULE in 1 BOTTLE (16714-836-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342014509","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-145-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-145-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081211","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081212","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-812-12","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-812-12) / 1 CAPSULE in 1 BLISTER PACK (50268-812-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"55111025760","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-257-60","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-257-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505252906","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2529-6","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-2529-6)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135099260","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-992-60","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-992-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862070360","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-703-60","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-703-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68001045106","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-451-06","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"BluePoint Laboratories","package_description":"60 CAPSULE in 1 BOTTLE (68001-451-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010409","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-104-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"40 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-104-09) / 1 CAPSULE in 1 BLISTER PACK (68084-104-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010411","name":"ZIPRASIDONE HCL 40 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.27223,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904627108","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6271-08","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-6271-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904627145","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6271-45","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6271-45) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714083701","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-837-01","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 CAPSULE in 1 BOTTLE (16714-837-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342014609","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-146-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-146-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081311","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081312","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-813-12","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-813-12) / 1 CAPSULE in 1 BLISTER PACK (50268-813-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"55111025860","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-258-60","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-258-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505253006","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2530-6","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-2530-6)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135099360","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-993-60","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-993-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862070460","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-704-60","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-704-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68001045206","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-452-06","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"BluePoint Laboratories","package_description":"60 CAPSULE in 1 BOTTLE (68001-452-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010509","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-105-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"60 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-105-09) / 1 CAPSULE in 1 BLISTER PACK (68084-105-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010511","name":"ZIPRASIDONE HCL 60 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31396,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904627208","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6272-08","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"40 BLISTER PACK in 1 CARTON (0904-6272-08) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"00904627245","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6272-45","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Major Pharmaceuticals","package_description":"80 BLISTER PACK in 1 CARTON (0904-6272-45) / 1 CAPSULE in 1 BLISTER PACK","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"16714083801","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-838-01","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"NorthStar Rx LLC","package_description":"60 CAPSULE in 1 BOTTLE (16714-838-01)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"33342014709","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"33342-147-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Macleods Pharmaceuticals Limited","package_description":"60 CAPSULE in 1 BOTTLE (33342-147-09)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081411","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"50268081412","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-814-12","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"AvPAK","package_description":"20 BLISTER PACK in 1 BOX (50268-814-12) / 1 CAPSULE in 1 BLISTER PACK (50268-814-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"55111025960","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-259-60","proprietary_name":"ziprasidone","nonproprietary_name":"ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Dr. Reddy's Laboratories Limited","package_description":"60 CAPSULE in 1 BOTTLE (55111-259-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"60505253106","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60505-2531-6","proprietary_name":"ziprasidone hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Apotex Corp.","package_description":"60 CAPSULE in 1 BOTTLE (60505-2531-6)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"62135099460","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-994-60","proprietary_name":"Ziprasidone","nonproprietary_name":"Ziprasidone","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Chartwell RX, LLC","package_description":"60 CAPSULE in 1 BOTTLE (62135-994-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"65862070560","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-705-60","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"60 CAPSULE in 1 BOTTLE (65862-705-60)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68001045306","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-453-06","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone Hydrochloride","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"BluePoint Laboratories","package_description":"60 CAPSULE in 1 BOTTLE (68001-453-06)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010609","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68084-106-09","proprietary_name":"Ziprasidone Hydrochloride","nonproprietary_name":"Ziprasidone HCl","dosage_form":"CAPSULE","route":"ORAL","strength":"80 mg/1","labeler":"American Health Packaging","package_description":"80 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-106-09) / 1 CAPSULE in 1 BLISTER PACK (68084-106-11)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"68084010611","name":"ZIPRASIDONE HCL 80 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.31567,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ziprasidone HCl|Ziprasidone HCl","basis":"generic"},"part_b":null}, {"ndc":"24208053535","name":"ZIRGAN 0.15% OPHTHALMIC GEL","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-535-35","proprietary_name":"ZIRGAN","nonproprietary_name":"ganciclovir","dosage_form":"GEL","route":"OPHTHALMIC","strength":"1.5 mg/g","labeler":"Bausch & Lomb Incorporated","package_description":"1 TUBE, WITH APPLICATOR in 1 CARTON (24208-535-35) / 5 g in 1 TUBE, WITH APPLICATOR","pharm_classes":["Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]","DNA Polymerase Inhibitors [MoA]","Nucleoside Analog Antiviral [EPC]","Nucleoside Analog [EXT]"]},"nadac":{"value":91.24108,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Zirgan|Ganciclovir","basis":"brand"},"part_b":null}, {"ndc":"70710178706","name":"ZITUVIMET 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1787-6","proprietary_name":"ZITUVIMET","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1787-6)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.03055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710178606","name":"ZITUVIMET 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1786-6","proprietary_name":"ZITUVIMET","nonproprietary_name":"Sitagliptin and Metformin Hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"60 TABLET, FILM COATED in 1 BOTTLE (70710-1786-6)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.05824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710180603","name":"ZITUVIMET XR 100-1,000 MG TAB","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1806-3","proprietary_name":"ZITUVIMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"100 mg/1; 1000 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70710-1806-3)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.07916,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710180506","name":"ZITUVIMET XR 50-1,000 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1805-6","proprietary_name":"ZITUVIMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 1000 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70710-1805-6)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.01928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710180406","name":"ZITUVIMET XR 50-500 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"70710-1804-6","proprietary_name":"ZITUVIMET XR","nonproprietary_name":"sitagliptin and metformin hydrochloride","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"50 mg/1; 500 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (70710-1804-6)","pharm_classes":["Biguanide [EPC]","Biguanides [CS]","Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":5.00957,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-05-20","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710124203","name":"ZITUVIO 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1242-3","proprietary_name":"ZITUVIO","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET","route":"ORAL","strength":"100 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1242-3)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.08225,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710124003","name":"ZITUVIO 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1240-3","proprietary_name":"ZITUVIO","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET","route":"ORAL","strength":"25 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1240-3)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.05424,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"70710124103","name":"ZITUVIO 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"70710-1241-3","proprietary_name":"ZITUVIO","nonproprietary_name":"Sitagliptin","dosage_form":"TABLET","route":"ORAL","strength":"50 mg/1","labeler":"Zydus Pharmaceuticals (USA) Inc.","package_description":"30 TABLET in 1 BOTTLE (70710-1241-3)","pharm_classes":["Dipeptidyl Peptidase 4 Inhibitor [EPC]","Dipeptidyl Peptidase 4 Inhibitors [MoA]"]},"nadac":{"value":10.04956,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"78206018101","name":"ZOCOR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-181-01","proprietary_name":"ZOCOR","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-181-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":9.7276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zocor|Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"78206018102","name":"ZOCOR 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-181-02","proprietary_name":"ZOCOR","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"20 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-181-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":9.7276,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03215,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zocor|Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"78206018201","name":"ZOCOR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-182-01","proprietary_name":"ZOCOR","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Organon LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (78206-182-01)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":9.72936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zocor|Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"78206018202","name":"ZOCOR 40 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"78206-182-02","proprietary_name":"ZOCOR","nonproprietary_name":"SIMVASTATIN","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"40 mg/1","labeler":"Organon LLC","package_description":"90 TABLET, FILM COATED in 1 BOTTLE (78206-182-02)","pharm_classes":["HMG-CoA Reductase Inhibitor [EPC]","Hydroxymethylglutaryl-CoA Reductase Inhibitors [MoA]"]},"nadac":{"value":9.72936,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-01-01","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05376,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zocor|Simvastatin","basis":"brand"},"part_b":null}, {"ndc":"55111068852","name":"ZOLEDRONIC ACID 5 MG/100 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55111-688-52","proprietary_name":"Zoledronic Acid","nonproprietary_name":"Zoledronic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/100mL","labeler":"Dr.Reddy's Laboratories Ltd","package_description":"100 mL in 1 BOTTLE, GLASS (55111-688-52)","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.47512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3489","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3489 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (100 mL in 1 BOTTLE, GLASS (55111-688-52)) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"63323096600","name":"ZOLEDRONIC ACID 5 MG/100 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"63323-966-00","proprietary_name":"Zoledronic Acid","nonproprietary_name":"Zoledronic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/100mL","labeler":"Fresenius Kabi USA, LLC","package_description":"1 VIAL, GLASS in 1 CARTON (63323-966-00) / 100 mL in 1 VIAL, GLASS","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.47512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3489","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3489 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL, GLASS in 1 CARTON (63323-966-00) / 100 mL in 1 VIAL, GLASS) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"67457061910","name":"ZOLEDRONIC ACID 5 MG/100 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"67457-619-10","proprietary_name":"Zoledronic Acid","nonproprietary_name":"Zoledronic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/100mL","labeler":"Mylan Institutional LLC","package_description":"1 VIAL in 1 CARTON (67457-619-10) / 100 mL in 1 VIAL","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.47512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3489","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3489 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 VIAL in 1 CARTON (67457-619-10) / 100 mL in 1 VIAL) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"71288080651","name":"ZOLEDRONIC ACID 5 MG/100 ML","unit":"ML","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71288-806-51","proprietary_name":"Zoledronic Acid","nonproprietary_name":"Zoledronic Acid","dosage_form":"INJECTION, SOLUTION","route":"INTRAVENOUS","strength":"5 mg/100mL","labeler":"Meitheal Pharmaceuticals Inc.","package_description":"1 BOTTLE, GLASS in 1 CARTON (71288-806-51) / 100 mL in 1 BOTTLE, GLASS","pharm_classes":["Bisphosphonate [EPC]","Diphosphonates [CS]"]},"nadac":{"value":0.47512,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":null,"part_b":{"hcpcs":"J3489","bill_units_per_package":{"value":5,"kind":"count","state":"filed","reason":"Billable units of HCPCS J3489 (1 MG) in the whole 11-digit NDC: crosswalk column BILLUNITSPKG ('Billable Units Per 11-Digit NDC'). Equals BILLUNITS (5 per item) x PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_size":{"value":100,"kind":"quantity","state":"filed","reason":"Amount in one item of this NDC, crosswalk column PKG SIZE. FDA's package description (1 BOTTLE, GLASS in 1 CARTON (71288-806-51) / 100 mL in 1 BOTTLE, GLASS) gives 100 ML per NDC, equal to package size x quantity here, so the package is in NADAC's unit ML.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","per":"ML","period":"2026-10-01/2026-12-31"},"package_qty":{"value":1,"kind":"count","state":"filed","reason":"Number of items in this NDC, crosswalk column PKG QTY.","source_name":"Medicare Part B crosswalk","source_url":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","source_file":"october-2026-ndc-hcpcs-crosswalk-final.zip","effective_date":"2026-10-01","retrieved_date":"2026-10-18","as_of_date":"2026-09-17","period":"2026-10-01/2026-12-31"},"package_unit":"ML"}}, {"ndc":"33342013974","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"62332018106","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-181-06","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (62332-181-06) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"64980025616","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68382071569","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68382071586","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-715-86","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2.5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68382-715-86) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68382-715-69)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68462049940","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68462049976","name":"ZOLMITRIPTAN 2.5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-499-76","proprietary_name":"zolmiptriptan","nonproprietary_name":"zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-499-76) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68462-499-40)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":2.06825,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"16571080316","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-803-16","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (16571-803-16) / 6 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"27241002168","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-021-68","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET","route":"ORAL","strength":"2.5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (27241-021-68) / 6 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"62332046206","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-462-06","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"6 TABLET, FILM COATED in 1 CARTON (62332-462-06)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"64980020316","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001024901","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-249-01","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (68001-249-01) / 6 TABLET, FILM COATED in 1 BLISTER PACK (68001-249-19)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68001024919","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68001-249","inner_of":["68001-249-01"]},"part_b":null}, {"ndc":"68462049776","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-497-76","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-497-76) / 6 TABLET, FILM COATED in 1 BLISTER PACK (68462-497-40)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"71626010106","name":"ZOLMITRIPTAN 2.5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71626-101-06","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"2.5 mg/1","labeler":"Medstone Pharma LLC","package_description":"6 BLISTER PACK in 1 CARTON (71626-101-06) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.0228,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"45802071191","name":"ZOLMITRIPTAN 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"45802-711-91","proprietary_name":"zolmitriptan","nonproprietary_name":"zolmitriptan","dosage_form":"SPRAY","route":"NASAL","strength":"5 mg/1","labeler":"Padagis Israel Pharmaceuticals Ltd","package_description":"6 BOTTLE, SPRAY in 1 CARTON (45802-711-91) / 1 SPRAY in 1 BOTTLE, SPRAY (45802-711-00)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":44.03928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"69238235206","name":"ZOLMITRIPTAN 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","5","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69238-2352-6","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"SPRAY, METERED","route":"NASAL","strength":"5 mg/1","labeler":"Amneal Pharmaceuticals NY LLC","package_description":"6 BOTTLE, SPRAY in 1 CARTON (69238-2352-6) / 1 SPRAY, METERED in 1 BOTTLE, SPRAY","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":44.03928,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"33342014052","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"59746046213","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59746-462-13","proprietary_name":"Zolmitriptan OD","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Jubilant Cadista Pharmacuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (59746-462-13) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"62332018203","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-182-03","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"1 BLISTER PACK in 1 CARTON (62332-182-03) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"64980025713","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68382071782","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68382-717-82","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Zydus Pharmaceuticals USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (68382-717-82) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68382-717-87)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68382071787","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68462050033","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-500-33","proprietary_name":"zolmiptriptan","nonproprietary_name":"zolmitriptan","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-500-33) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (68462-500-40)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68462050040","name":"ZOLMITRIPTAN 5 MG ODT","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":3.24791,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan ODT|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"16571080413","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16571-804-13","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Rising Pharma Holdings, Inc.","package_description":"1 BLISTER PACK in 1 CARTON (16571-804-13) / 3 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"27241002238","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"27241-022-38","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Ajanta Pharma USA Inc.","package_description":"1 BLISTER PACK in 1 CARTON (27241-022-38) / 3 TABLET in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"62332046303","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62332-463-03","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Alembic Pharmaceuticals Inc.","package_description":"3 TABLET, FILM COATED in 1 CARTON (62332-463-03)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"64980020413","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"68001025001","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-250-01","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"BluePoint Laboratories","package_description":"1 BLISTER PACK in 1 CARTON (68001-250-01) / 3 TABLET, FILM COATED in 1 BLISTER PACK (68001-250-18)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"68001025018","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"68001-250","inner_of":["68001-250-01"]},"part_b":null}, {"ndc":"68462049833","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-498-33","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Glenmark Pharmaceuticals Inc.,USA","package_description":"1 BLISTER PACK in 1 CARTON (68462-498-33) / 3 TABLET, FILM COATED in 1 BLISTER PACK (68462-498-40)","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"71626010203","name":"ZOLMITRIPTAN 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71626-102-03","proprietary_name":"Zolmitriptan","nonproprietary_name":"Zolmitriptan","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Medstone Pharma LLC","package_description":"3 BLISTER PACK in 1 CARTON (71626-102-03) / 1 TABLET, FILM COATED in 1 BLISTER PACK","pharm_classes":["Serotonin 1b Receptor Agonists [MoA]","Serotonin 1d Receptor Agonists [MoA]","Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]"]},"nadac":{"value":1.35334,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolmitriptan*|Zolmitriptan","basis":"generic"},"part_b":null}, {"ndc":"58151057632","name":"ZOLOFT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":14.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"58151057688","name":"ZOLOFT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-576-88","proprietary_name":"Zoloft","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-576-88) / 1 TABLET, FILM COATED in 1 BLISTER PACK (58151-576-32)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":14.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"58151057693","name":"ZOLOFT 100 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-576-93","proprietary_name":"Zoloft","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"100 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (58151-576-93)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":14.94336,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.05074,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"58151057493","name":"ZOLOFT 25 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-574-93","proprietary_name":"Zoloft","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"25 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (58151-574-93)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":15.17086,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.02884,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"58151057532","name":"ZOLOFT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":14.90731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"58151057588","name":"ZOLOFT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-575-88","proprietary_name":"Zoloft","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Viatris Specialty LLC","package_description":"100 BLISTER PACK in 1 CARTON (58151-575-88) / 1 TABLET, FILM COATED in 1 BLISTER PACK (58151-575-32)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":14.90731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"58151057593","name":"ZOLOFT 50 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"58151-575-93","proprietary_name":"Zoloft","nonproprietary_name":"sertraline hydrochloride","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"50 mg/1","labeler":"Viatris Specialty LLC","package_description":"30 TABLET, FILM COATED in 1 BOTTLE (58151-575-93)","pharm_classes":["Cytochrome P450 2D6 Inhibitors [MoA]","Serotonin Reuptake Inhibitor [EPC]","Serotonin Uptake Inhibitors [MoA]"]},"nadac":{"value":14.90731,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.03479,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zoloft|Sertraline HCl","basis":"brand"},"part_b":null}, {"ndc":"49884089811","name":"ZOLPIDEM TART 1.75 MG TAB SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-898-11","proprietary_name":"Zolpidem tartrate sublingual","nonproprietary_name":"Zolpidem tartrate sublingual","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"1.75 mg/1","labeler":"Par Health USA, LLC","package_description":"30 POUCH in 1 CARTON (49884-898-11) / 1 TABLET in 1 POUCH (49884-898-52)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":5.04569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884089852","name":"ZOLPIDEM TART 1.75 MG TAB SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.04569,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884089911","name":"ZOLPIDEM TART 3.5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"49884-899-11","proprietary_name":"Zolpidem tartrate sublingual","nonproprietary_name":"Zolpidem tartrate sublingual","dosage_form":"TABLET","route":"SUBLINGUAL","strength":"3.5 mg/1","labeler":"Par Health USA, LLC","package_description":"30 POUCH in 1 CARTON (49884-899-11) / 1 TABLET in 1 POUCH (49884-899-52)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":5.79015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"49884089952","name":"ZOLPIDEM TART 3.5 MG TABLET SL","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":5.79015,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"47335030888","name":"ZOLPIDEM TART ER 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-308-88","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-308-88)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.10925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"51991098201","name":"ZOLPIDEM TART ER 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-982-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-982-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.10925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68180078001","name":"ZOLPIDEM TART ER 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68180078004","name":"ZOLPIDEM TART ER 12.5 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-780-04","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"12.5 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-780-04)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.10925,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"47335030788","name":"ZOLPIDEM TART ER 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"47335-307-88","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1","labeler":"Sun Pharmaceutical Industries, Inc.","package_description":"100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (47335-307-88)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.10153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"51991098101","name":"ZOLPIDEM TART ER 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"51991-981-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1","labeler":"Breckenridge Pharmaceutical, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (51991-981-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.10153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68180077901","name":"ZOLPIDEM TART ER 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"68180077904","name":"ZOLPIDEM TART ER 6.25 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68180-779-04","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, EXTENDED RELEASE","route":"ORAL","strength":"6.25 mg/1","labeler":"Lupin Pharmaceuticals, Inc.","package_description":"100 TABLET, EXTENDED RELEASE in 1 BOTTLE (68180-779-04)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.10153,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate ER|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781531801","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5318-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, COATED in 1 BOTTLE (0781-5318-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781531810","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5318-10","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"10 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET, COATED in 1 BOTTLE (0781-5318-10)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000801","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-008-01","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-008-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000805","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-008-05","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-008-05)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000810","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-008-10","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (13668-008-10)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000815","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-008-15","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1500 TABLET in 1 BOTTLE (13668-008-15)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16714062201","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-622-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-622-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16714062202","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-622-02","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-622-02)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"62135077990","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-779-90","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-779-90)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862016001","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-160-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-160-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862016099","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-160-99","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"10 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-160-99)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71093015604","name":"ZOLPIDEM TARTRATE 10 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71093-156-04","proprietary_name":"Zolpidem","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"10 mg/1","labeler":"ACI Healthcare USA, Inc","package_description":"100 TABLET in 1 BOTTLE (71093-156-04)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03958,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781531701","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5317-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"100 TABLET, COATED in 1 BOTTLE (0781-5317-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00781531710","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0781-5317-10","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, COATED","route":"ORAL","strength":"5 mg/1","labeler":"Sandoz Inc","package_description":"1000 TABLET, COATED in 1 BOTTLE (0781-5317-10)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"00904608261","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"0904-6082-61","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Major Pharmaceuticals","package_description":"100 BLISTER PACK in 1 CARTON (0904-6082-61) / 1 TABLET in 1 BLISTER PACK","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000701","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-007-01","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"100 TABLET in 1 BOTTLE (13668-007-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000705","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-007-05","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"500 TABLET in 1 BOTTLE (13668-007-05)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000710","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-007-10","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1000 TABLET in 1 BOTTLE (13668-007-10)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"13668000715","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"13668-007-15","proprietary_name":"ZOLPIDEM TARTRATE","nonproprietary_name":"zolpidem tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Torrent Pharmaceuticals Limited","package_description":"1500 TABLET in 1 BOTTLE (13668-007-15)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16714062101","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-621-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (16714-621-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"16714062102","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"16714-621-02","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"NorthStar Rx LLC","package_description":"500 TABLET, FILM COATED in 1 BOTTLE (16714-621-02)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687083801","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-838-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 CARTON (60687-838-01) / 1 TABLET, FILM COATED in 1 BLISTER PACK (60687-838-11)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"60687083811","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic","route_from":"fda_product","route":"ORAL","product_ndc":"60687-838","inner_of":["60687-838-01"]},"part_b":null}, {"ndc":"62135077890","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"62135-778-90","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"Chartwell RX, LLC","package_description":"90 TABLET in 1 BOTTLE (62135-778-90)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862015901","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-159-01","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 TABLET, FILM COATED in 1 BOTTLE (65862-159-01)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"65862015999","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"65862-159-99","proprietary_name":"Zolpidem Tartrate","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET, FILM COATED","route":"ORAL","strength":"5 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"1000 TABLET, FILM COATED in 1 BOTTLE (65862-159-99)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"71093015504","name":"ZOLPIDEM TARTRATE 5 MG TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"71093-155-04","proprietary_name":"Zolpidem","nonproprietary_name":"Zolpidem Tartrate","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"ACI Healthcare USA, Inc","package_description":"100 TABLET in 1 BOTTLE (71093-155-04)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Agonists [MoA]","Pyridines [CS]","gamma-Aminobutyric Acid-ergic Agonist [EPC]"]},"nadac":{"value":0.03438,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"52427077530","name":"ZOLPIDEM TARTRATE 7.5 MG CAP","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1","6"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52427-775-30","proprietary_name":"zolpidem tartrate","nonproprietary_name":"zolpidem tartrate","dosage_form":"CAPSULE","route":"ORAL","strength":"7.5 mg/1","labeler":"Almatica Pharma LLC","package_description":"30 CAPSULE in 1 BOTTLE (52427-775-30)","pharm_classes":["Central Nervous System Depression [PE]","GABA A Receptor Positive Modulators [MoA]","gamma-Aminobutyric Acid A Receptor Positive Modulator [EPC]"]},"nadac":{"value":7.93327,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 6: the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zolpidem Tartrate*|Zolpidem Tartrate","basis":"generic"},"part_b":null}, {"ndc":"55566190101","name":"ZOMACTON 10 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":{"source":"fda_ndc","package_ndc":"55566-1901-1","proprietary_name":"ZOMACTON","nonproprietary_name":"somatropin","dosage_form":"KIT","route":"SUBCUTANEOUS","strength":null,"labeler":"Ferring Pharmaceuticals Inc.","package_description":"1 KIT in 1 CARTON (55566-1901-1) * 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL * 1 mL in 1 SYRINGE, PLASTIC"},"nadac":{"value":556.824,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-08-19","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zomacton|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"55566180101","name":"ZOMACTON 5 MG VIAL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"55566-1801-1","proprietary_name":"ZOMACTON","nonproprietary_name":"somatropin","dosage_form":"KIT","route":null,"strength":null,"labeler":"Ferring Pharmaceuticals Inc.","package_description":"1 KIT in 1 CARTON (55566-1801-1) * 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL * 5 mL in 1 VIAL (55566-2000-0)"},"nadac":{"value":278.604,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zomacton|Somatropin","basis":"brand"},"part_b":null}, {"ndc":"64896008312","name":"ZOMIG 2.5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["4","5"],"carried_forward":true,"identity":null,"nadac":{"value":108.56466,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 4: carried forward from the previous file; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-02-18","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"64896008412","name":"ZOMIG 5 MG NASAL SPRAY","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":null,"nadac":{"value":108.8863,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":44.03928,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":null,"part_b":null}, {"ndc":"52652800101","name":"ZONISADE 100 MG/5 ML ORAL SUSP","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"52652-8001-1","proprietary_name":"ZONISADE","nonproprietary_name":"ZONISAMIDE","dosage_form":"SUSPENSION","route":"ORAL","strength":"100 mg/5mL","labeler":"Azurity Pharmaceuticals, Inc.","package_description":"1 BOTTLE in 1 CARTON (52652-8001-1) / 150 mL in 1 BOTTLE","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":2.75055,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zonisade|Zonisamide","basis":"brand"},"part_b":null}, {"ndc":"29300043001","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-430-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE (29300-430-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"50268081611","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"50268081615","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"50268-816-15","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"AvPAK","package_description":"50 BLISTER PACK in 1 BOX (50268-816-15) / 1 CAPSULE in 1 BLISTER PACK (50268-816-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"59651038001","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-380-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-380-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"60687023001","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"60687-230-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"American Health Packaging","package_description":"100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-230-01) / 1 CAPSULE in 1 BLISTER PACK (60687-230-11)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"60687023011","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68001024400","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-244-00","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-244-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68001024403","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-244-03","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"BluePoint Laboratories","package_description":"500 CAPSULE in 1 BOTTLE (68001-244-03)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68462013001","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-130-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-130-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68462013005","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-130-05","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"500 CAPSULE in 1 BOTTLE (68462-130-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"69097086107","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69097-861-07","proprietary_name":"zonisamide","nonproprietary_name":"zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Cipla USA Inc.","package_description":"100 CAPSULE in 1 BOTTLE (69097-861-07)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"72578004201","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-042-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-042-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"72578004205","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-042-05","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"500 CAPSULE in 1 BOTTLE (72578-042-05)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"76282022801","name":"ZONISAMIDE 100 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-228-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"100 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-228-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.10618,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"29300042801","name":"ZONISAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-428-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE (29300-428-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.06546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"59651037801","name":"ZONISAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-378-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-378-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.06546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68001024200","name":"ZONISAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-242-00","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-242-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.06546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68462012801","name":"ZONISAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-128-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-128-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.06546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"72578004001","name":"ZONISAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-040-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-040-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.06546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"76282022601","name":"ZONISAMIDE 25 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-226-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"25 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-226-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.06546,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"29300042901","name":"ZONISAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"29300-429-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Unichem Pharmaceuticals (USA), Inc.","package_description":"100 CAPSULE in 1 BOTTLE (29300-429-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.0955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"59651037901","name":"ZONISAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-379-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Aurobindo Pharma Limited","package_description":"100 CAPSULE in 1 BOTTLE (59651-379-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.0955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68001024300","name":"ZONISAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68001-243-00","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"BluePoint Laboratories","package_description":"100 CAPSULE in 1 BOTTLE (68001-243-00)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.0955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"68462012901","name":"ZONISAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"68462-129-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Glenmark Pharmaceuticals Inc., USA","package_description":"100 CAPSULE in 1 BOTTLE (68462-129-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.0955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"72578004101","name":"ZONISAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"72578-041-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Viona Pharmaceuticals Inc","package_description":"100 CAPSULE in 1 BOTTLE (72578-041-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.0955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"76282022701","name":"ZONISAMIDE 50 MG CAPSULE","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"76282-227-01","proprietary_name":"Zonisamide","nonproprietary_name":"Zonisamide","dosage_form":"CAPSULE","route":"ORAL","strength":"50 mg/1","labeler":"Exelan Pharmaceuticals, Inc.","package_description":"100 CAPSULE in 1 BOTTLE (76282-227-01)","pharm_classes":["Anti-epileptic Agent [EPC]","Carbonic Anhydrase Inhibitors [MoA]","Decreased Central Nervous System Disorganized Electrical Activity [PE]","P-Glycoprotein Inhibitors [MoA]","Sulfonamides [CS]"]},"nadac":{"value":0.0955,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zonisamide|Zonisamide","basis":"generic"},"part_b":null}, {"ndc":"80610010560","name":"ZORYVE 0.05% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80610-105-60","proprietary_name":"ZORYVE","nonproprietary_name":"roflumilast","dosage_form":"CREAM","route":"TOPICAL","strength":".5 mg/g","labeler":"Arcutis Biotherapeutics, Inc.","package_description":"1 TUBE in 1 CARTON (80610-105-60) / 60 g in 1 TUBE","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":15.40606,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Zoryve|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"80610011560","name":"ZORYVE 0.15% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80610-115-60","proprietary_name":"ZORYVE","nonproprietary_name":"roflumilast","dosage_form":"CREAM","route":"TOPICAL","strength":"1.5 mg/g","labeler":"Arcutis Biotherapeutics, Inc.","package_description":"1 TUBE in 1 CARTON (80610-115-60) / 60 g in 1 TUBE","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":15.39875,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Zoryve|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"80610013060","name":"ZORYVE 0.3% CREAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80610-130-60","proprietary_name":"ZORYVE","nonproprietary_name":"roflumilast","dosage_form":"CREAM","route":"TOPICAL","strength":"3 mg/g","labeler":"Arcutis Biotherapeutics, Inc.","package_description":"1 TUBE in 1 CARTON (80610-130-60) / 60 g in 1 TUBE","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":15.38387,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Zoryve|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"80610043060","name":"ZORYVE 0.3% FOAM","unit":"GM","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"80610-430-60","proprietary_name":"ZORYVE","nonproprietary_name":"roflumilast","dosage_form":"AEROSOL, FOAM","route":"TOPICAL","strength":"3 mg/g","labeler":"Arcutis Biotherapeutics, Inc.","package_description":"1 CAN in 1 CARTON (80610-430-60) / 60 g in 1 CAN","pharm_classes":["Phosphodiesterase 4 Inhibitor [EPC]","Phosphodiesterase 4 Inhibitors [MoA]"]},"nadac":{"value":15.37781,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per GM. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"GM"},"part_d":{"key":"Zoryve|Roflumilast","basis":"brand"},"part_b":null}, {"ndc":"75907008728","name":"ZOVIA 1-35 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-087-28","proprietary_name":"Zovia 1/35","nonproprietary_name":"Ethynodiol Diacetate and Ethinyl Estradiol Tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"1 BLISTER PACK in 1 PACKET (75907-087-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.37904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zovia 1-35|Ethynodiol D-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"75907008762","name":"ZOVIA 1-35 TABLET","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"75907-087-62","proprietary_name":"Zovia 1/35","nonproprietary_name":"Ethynodiol Diacetate and Ethinyl Estradiol Tablets","dosage_form":"KIT","route":null,"strength":null,"labeler":"Dr. Reddy’s Laboratories Inc.","package_description":"6 BLISTER PACK in 1 CARTON (75907-087-62) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.37904,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zovia 1-35|Ethynodiol D-Ethinyl Estradiol","basis":"brand"},"part_b":null}, {"ndc":"69557011101","name":"ZTLIDO 1.8% TOPICAL SYSTEM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":null,"nadac":{"value":12.30598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ztlido|Lidocaine","basis":"brand"},"part_b":null}, {"ndc":"69557011130","name":"ZTLIDO 1.8% TOPICAL SYSTEM","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"69557-111-30","proprietary_name":"Ztlido","nonproprietary_name":"Lidocaine","dosage_form":"PATCH","route":"TOPICAL","strength":"36 mg/1","labeler":"Scilex Pharmaceuticals Inc.","package_description":"30 POUCH in 1 CARTON (69557-111-30) / 1 PATCH in 1 POUCH (69557-111-01)","pharm_classes":["Amide Local Anesthetic [EPC]","Amides [CS]","Antiarrhythmic [EPC]","Local Anesthesia [PE]"]},"nadac":{"value":12.30598,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Ztlido|Lidocaine","basis":"brand"},"part_b":null}, {"ndc":"54123090730","name":"ZUBSOLV 0.7-0.18 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54123-907-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":".7 mg/1; .18 mg/1","labeler":"Orexo US, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (54123-907-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":5.26141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"82111020130","name":"ZUBSOLV 0.7-0.18 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82111-201-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":".7 mg/1; .18 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"3 BLISTER PACK in 1 CARTON (82111-201-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":5.26141,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"54123091430","name":"ZUBSOLV 1.4-0.36 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54123-914-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"1.4 mg/1; .36 mg/1","labeler":"Orexo US, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (54123-914-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":5.2646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"82111020230","name":"ZUBSOLV 1.4-0.36 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82111-202-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"1.4 mg/1; .36 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"3 BLISTER PACK in 1 CARTON (82111-202-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":5.2646,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"54123011430","name":"ZUBSOLV 11.4-2.9 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54123-114-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"11.4 mg/1; 2.9 mg/1","labeler":"Orexo US, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (54123-114-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":21.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"82111020630","name":"ZUBSOLV 11.4-2.9 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82111-206-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"11.4 mg/1; 2.9 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"3 BLISTER PACK in 1 CARTON (82111-206-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":21.04792,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"54123092930","name":"ZUBSOLV 2.9-0.71 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54123-929-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"2.9 mg/1; .71 mg/1","labeler":"Orexo US, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (54123-929-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":10.51861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"82111020330","name":"ZUBSOLV 2.9-0.71 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82111-203-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"2.9 mg/1; .71 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"3 BLISTER PACK in 1 CARTON (82111-203-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":10.51861,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"54123095730","name":"ZUBSOLV 5.7-1.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54123-957-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"5.7 mg/1; 1.4 mg/1","labeler":"Orexo US, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (54123-957-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":10.54312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"82111020430","name":"ZUBSOLV 5.7-1.4 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82111-204-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"5.7 mg/1; 1.4 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"3 BLISTER PACK in 1 CARTON (82111-204-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":10.54312,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"54123098630","name":"ZUBSOLV 8.6-2.1 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"54123-986-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"8.6 mg/1; 2.1 mg/1","labeler":"Orexo US, Inc.","package_description":"3 BLISTER PACK in 1 CARTON (54123-986-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":15.80954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"82111020530","name":"ZUBSOLV 8.6-2.1 MG TABLET SL","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"82111-205-30","proprietary_name":"Zubsolv","nonproprietary_name":"buprenorphine hydrochloride and naloxone hydrochloride","dosage_form":"TABLET, ORALLY DISINTEGRATING","route":"SUBLINGUAL","strength":"8.6 mg/1; 2.1 mg/1","labeler":"Edenbridge Pharmaceuticals LLC.","package_description":"3 BLISTER PACK in 1 CARTON (82111-205-30) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK","pharm_classes":["Opioid Antagonist [EPC]","Opioid Antagonists [MoA]","Partial Opioid Agonist [EPC]","Partial Opioid Agonists [MoA]"]},"nadac":{"value":15.80954,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zubsolv|Buprenorphine HCl/Naloxone HCl","basis":"brand"},"part_b":null}, {"ndc":"59651003028","name":"ZUMANDIMINE 3 MG-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-030-28","proprietary_name":"Zumandimine","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"1 BLISTER PACK in 1 CARTON (59651-030-28) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zumandimine|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"59651003085","name":"ZUMANDIMINE 3 MG-0.03 MG TAB","unit":"EA","otc":false,"rate_class":"G","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"59651-030-85","proprietary_name":"Zumandimine","nonproprietary_name":"Drospirenone and Ethinyl Estradiol","dosage_form":"KIT","route":null,"strength":null,"labeler":"Aurobindo Pharma Limited","package_description":"3 BLISTER PACK in 1 CARTON (59651-030-85) / 1 KIT in 1 BLISTER PACK"},"nadac":{"value":0.15106,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zumandimine|Ethinyl Estradiol/Drospirenone","basis":"brand"},"part_b":null}, {"ndc":"24208035805","name":"ZYLET EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-358-05","proprietary_name":"Zylet","nonproprietary_name":"loteprednol etabonate and tobramycin","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-358-05) / 5 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":64.31703,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"generic_nadac":{"value":39.26379,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per ML.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zylet|Tobramycin/Lotepred Etab","basis":"brand"},"part_b":null}, {"ndc":"24208035810","name":"ZYLET EYE DROPS","unit":"ML","otc":false,"rate_class":"B","explanation_codes":["1","5"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"24208-358-10","proprietary_name":"Zylet","nonproprietary_name":"loteprednol etabonate and tobramycin","dosage_form":"SUSPENSION/ DROPS","route":"OPHTHALMIC","strength":"5 mg/mL; 3 mg/mL","labeler":"Bausch & Lomb Incorporated","package_description":"1 BOTTLE, DROPPER in 1 CARTON (24208-358-10) / 10 mL in 1 BOTTLE, DROPPER","pharm_classes":["Aminoglycoside Antibacterial [EPC]","Aminoglycosides [CS]","Corticosteroid Hormone Receptor Agonists [MoA]","Corticosteroid [EPC]"]},"nadac":{"value":64.5118,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per ML. Explanation code 1: calculated from the most recently completed pharmacy survey; 5: calculated based on package size.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"ML"},"part_d":{"key":"Zylet|Tobramycin/Lotepred Etab","basis":"brand"},"part_b":null}, {"ndc":"61269063530","name":"ZYPREXA 20 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-635-30","proprietary_name":"Zyprexa","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"20 mg/1","labeler":"H2-Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (61269-635-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":49.88179,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.14674,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zyprexa*|Olanzapine","basis":"brand"},"part_b":null}, {"ndc":"61269063130","name":"ZYPREXA 5 MG TABLET","unit":"EA","otc":false,"rate_class":"B","explanation_codes":["1"],"carried_forward":false,"identity":{"source":"fda_ndc","package_ndc":"61269-631-30","proprietary_name":"Zyprexa","nonproprietary_name":"Olanzapine","dosage_form":"TABLET","route":"ORAL","strength":"5 mg/1","labeler":"H2-Pharma LLC","package_description":"30 TABLET in 1 BOTTLE (61269-631-30)","pharm_classes":["Atypical Antipsychotic [EPC]"]},"nadac":{"value":16.61576,"kind":"usd","state":"filed","reason":"Read from the NADAC file, dollars per EA. Explanation code 1: calculated from the most recently completed pharmacy survey.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"generic_nadac":{"value":0.08709,"kind":"usd","state":"filed","reason":"Read from the NADAC file: the NADAC of the corresponding generic drug, listed on this brand NDC's row. Dollars per EA.","source_name":"CMS NADAC","source_url":"https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704","source_file":"nadac-national-average-drug-acquisition-cost-20261014.csv","effective_date":"2026-09-23","retrieved_date":"2026-10-17","as_of_date":"2026-10-14","per":"EA"},"part_d":{"key":"Zyprexa*|Olanzapine","basis":"brand"},"part_b":null} ] }